Friday, April 10, 2009

About DAVID HAYES-BAUTISTA ~ Director, Center for the Study of Latino Health and Culture UCLA School of Medicine

Note: I am not sure how current all this information but it is still relevant. So much is out there that we are just not aware of and should make ourselves are of in this world where some suffer from information overload and others die for lack of knowledge. ~Peta-de-Aztlan

Monday, febraury 04, 2008. No. 91 

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Director, Center for the Study of Latino Health and Culture UCLA School of Medicine

David Hayes-Bautista
Director, Center for the Study of Latino Health and Culture UCLA School of Medicine

In an exclusive interview, Dr. David Hayes-Bautista talks about his passion for helping others and his phenomenal findings about the current situation of helthcare for Latinos.

Interviewed by Mariana Gutierrez at his offices in UCLA's school of Medicine in January, 2008. Photos for Latino Leaders by Ejen Chuang.

The days Dr. David Hayes-Bautista is not traveling, he wakes up at five a.m. Still at home, he immediately starts looking at new data and tries to figure out the patterns. 'What are this numbers trying to tell me?' he asks. In the quiet of an early morning, when the phones aren't ringing, statistics and percentages are transformed into the compelling story of the struggle of the Latino community in this country.

He then reads the papers, works out, and by eight is at a coffee house, were he spends two more hours thinking, writing and conceptualizing, trying to understand the information that his staff has presented. This, without a doubt, is his favorite part of the day. As Professor of Medicine and Director of the Center for the Study of Latino Health and Culture of the School of Medicine at UCLA, the rest of his hours are spent at the office answering phones and emails and in and out of meetings, but it is examining data that he is really passionate about. "I was in a plane once when the pattern of Latino Demographics during the gold rush in California became very clear to me, so I took out my lap top, started writing and didn't stop for three days", he explains excitedly. "At the end I had 30 pages and proof that our story in this country began much earlier than it is officially recognized."


A Legacy Begins

"A Passionate nerd" is how Hayes-Bautista describes his data-driven nature. His interest in numbers drove him to study engineering, but he soon found a fascination for the medical field and was about to make the transition to the Medical Center at Berkeley for his graduate studies when a definitive new chapter in his life began.

"In 1970, a group of parents from St. Elizabeth's Church decided to do something about the lack of healthcare in their community. They wanted to open a clinic, and because I had been doing some community work in east Oakland, they approached me and asked me to be the director. I was just beginning my studies, but when they explained that I was the only person they knew that had anything to do with medicine I had to accept."

It was a challenge, to say the least, but at 25 years of age, a budget of $240 and a group of volunteer doctors, community activists and students, Hayes-Bautista opened up the doors of La Clinica de la Raza in 1971. With the mission to provide free services in Spanish to low-income residents in the East Bay area "La Clinica" (the clinic) soon became a staple of the community.

"There were a million reasons why we should have failed, but because we didn't know them, we succeeded", he asserts. "At the time, there were programs that could have provided the funds we needed – this was during the days of the war on poverty – but we were very pure and idealistic and didn't want to become dependent on federal funds because they were too political.

"We had seen other programs fail and wanted something that the community could control, so we decided not to accept the money. People thought we were crazy, but we had big dreams and a lot of energy, so we made it work." County funding, the available insurance funds and a lot of creativity allowed for growth. Now in its 35th year of operations, "La Clinica" has expanded to 23 locations in three counties and serves over 100,000 patients a year.

"It was my experience with La Clinica that gave me a love for the policy end of the field," Hayes-Bautista continues. After graduating from Berkeley, he earned his Masters in 1971 and his Doctorate in Medical Sociology from the University of California, San Francisco in 1974..  It was at that time that he left La Clinica. "It was time for some one else to take over." He explains. "We had grown, but I realized that the need for information and data remained the same."

The perfect opportunity to continue his research came when in 1986 he was made an offer to head the UCLA Chicano Studies Research Center. "Getting involved in the Chicano movement really inspired me. I found what I really loved to do. I later established the Center for the Study of Latino Health and Culture, where our main goal is to provide data for policy makers, program planners and the general public so they can make better informed decisions about how to address these issues."  

Today, Hayes-Bautista is internationally recognized for his research on the culture and health of Latinos, focusing on the dynamics and processes of the health status of this segment of the population.


The Importance of Numbers

"Because of my initial training as an engineer, I am a very data driven person, so during the days of La Clinica, when deciding which services were needed my first instinct was to look at the data, but I found there wasn't any. At that point Latinos were not identified in the health census; prior to 1973 the category of Hispanic didn't even exist in public records, so Latinos would either categorize themselves as white, black or other minority.

"President Nixon mandated the use of the term Hispanic in Federal records in 1973, but it took years to actually implement this principle. The 1980 census was the first to identify Hispanics officially and it wasn't until the mid eighties that most states started to comply with their records, so we had very limited information."

Further research led to a discovery that would change his life. "At that time, we were developing the first Latino health statistics, and I was completely unprepared for what we were about to discover. It was the spring of 1989 when the first epidemiological data became available, and it contradicted every single model I had been taught.

"Normally, what we expect is a direct correlation between higher risk factors like lower income, education and less access to healthcare with a higher rate of adverse health outcomes such as premature death, heart attack, cancer, stroke and infant mortality. That was the expectation when we began to study Latino health, but until then we had no data.

"Once we got the information, we discovered the paradox that even though Latinos had fewer access to healthcare, they also had 35% fewer heart attacks, 43% fewer cancers, 45% fewer strokes, 5 years longer life expectancy and less infant mortality… At first I thought that there were problems with the data, but Dr. Martínez, a colleague of mine in Texas, had arrived to the same results. He named these findings "The Latino Epidemiological Paradox", and since then we have been looking at this pattern nationwide and found the same results year after year.

"For some reason, Latinos confound all the theoretical models on health, and it was important to find out why, so in 1992 I established the Center for Latino Health and Culture, because culture is the factor that seems to override income and education when it comes to Latino health. We need to understand what about this culture needs to be preserved, because if everyone in the U..S. had the same epidemiological profile as Latinos for heart disease, cancer and stroke, which are the top three causes of death, we would save a half a million lives every year, so it is worth understanding. It could be a tremendous contribution to our society in general to be able to determine what exactly it is that Latinos are doing differently that prevent them from acquiring these diseases."


A Complex Conundrum

Continuing with his research has been difficult. There is a lack of federal funding, but local, state and private support has allowed him to persevere.

It is the perceptual challenge, however, that has been the most difficult to overcome. "We are still largely considered as illegal immigrants, so it's very hard to get things done on a research basis, but even worse on a program or policy basis. When in 2006 California proposed to cover all children with health insurance, the issue of illegal children came up and the republicans killed the bill on the fear that more illegal immigrants would be attracted to cross over because of these benefits. 92% of Latino children in California are U.S. citizens, and of the other 8% maybe one or two percent are undocumented immigrants.

"But they barred the coverage for that 92% because of concern for the legal status of that one or two percent. Cleary, we have departed from rationality. I am not a politician or a debater, so the best that I can do is provide data, and hope it will be considered before other decisions are made, because I firmly believe in social justice and in health in the broadest sense: social, cultural and economical, and to be able to obtain it for our community we need to prove that America has Latino roots, that Latinos have never been strangers and that we have been contributing to American culture ever since July 4, 1776 during the American war for independence.

"We need to fight this perception that Latinos are strangers and foreigners and that we have no business being here, because we have helped create American history, and that is part of what we are trying to achieve with our Historic Epidemiological Demography, we are providing irrefutable facts. I am now working on a detailed demographic study from the early settlements in L.A. in 1781 until 2005. We are studying old mission records, information from the Mexican "patrones" out of the 1850 census, the first demographic data… and this will tell us a very compelling story about the very valuable ongoing Latino presence in this country."


Propelling Talent into the Future

The Latino physician shortage is another issue. In addition to his already busy schedule, Hayes-Bautista has other interests that he somehow finds the time to address. He is also the director of the UCLA/Drew Center of Excellence for Minority Medical Education, which is dedicated to increasing the number of minority physicians in clinical and academic careers.

"In 2000, we discovered that while Latinos represented about 33% of the total population, they were only 4% of them in the physician population. Since then, the Latino population has grown, but the number of Latino Physicians shrunk. I am trying to encourage more Latinos to enter this field through pipeline programs like Medicos Para el Pueblo. We have course work, summer workshops and experiential events among other programs to encourage students to go into the field of academic medicine, so that they will continue doing research.. Because we are studying very complicated issues and I feel like I'm just beginning to understand things, so it is clear that it will be up to the next generation to find the answers".

With a daughter who is now a legislative fellow in Sacramento, David is ensuring that his fight for Latino healthcare continues on. "It's what gets me out of bed every morning, to put my "granito de arena" (sand pebble). I always like to add another one every day."

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Education for Liberation!
Peter S. Lopez aka: Peta

Sacramento, California, Aztlan

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