I am the third generation of my family to be diagnosed with cancer: my grandmother, mother, father, and even my stepmom all passed away because of it. Six years ago, I got the news of my Stage 3A Breast Cancer. Having health insurance, family support and higher education, and being bilingual, were not enough to protect me from cancer.
Cancer is the leading cause of death among Latinos in this country: according to the American Cancer Society, 1 in 3 Latino women living in the United States will be diagnosed with cancer. Today there are 59.8 million Latinos in the U.S.; 48% of them are women, which means at least 9 million Latinas’ are at risk because of cancer. My very own daughter is part of this statistic. What can we do to ensure that she, and young women like her, don’t inherit this part of my family’s legacy?
Research shows that between 90% to 95% of all cancer cases have roots in an unhealthy lifestyle like poor diet, obesity, and tobacco and alcohol use, making wellness education a vital part of preventing cancer. Cancer awareness organizations need to invest much more in wellness education, build social capital, and lobby for accessible medical attention and insurance options for the Latino community. We are getting sick not only because we don’t have enough economic resources, but because there is a lack of wellness education and social capital among us.
According to the American Cancer Society, “uninsured patients and those from minorities are more likely to be diagnosed with cancer at a later stage, when treatment can be more extensive, costlier and less successful.” The Office of Minority Health of the Department of Health and Human Services has declared that 19.5% of the Hispanic population in the country was not covered by health insurance, compared to 6.3% of the non-Hispanic white population. Once Latinas are diagnosed with cancer, they are not empowered enough to financially support the cost of treatments and their spillover effects: for every dollar a white person earns in Dallas, Latinos earn 58 cents and Latino women 44 cents .
This means that, in addition to investing in researching and cures, cancer awareness organizations and our social services institutions need to make it easier for Latinas and their families to get wellness education and medical attention, so that they can adopt healthier lifestyles, and afford regular checkups and screenings to spot cancer as early as possible.
Today, 48.6 million people in the country speak Spanish, and 11 million of them are undocumented Latin American immigrants who have come to pursue the American Dream. They understand enough basic English in order to be productive. However, when you are dealing with terms such as carcinoma in situ, disease-free survival, metastasis, mortality rate, neoadjuvant therapy, palliative care, remission, and targeted meds, you can be easily lost and overwhelmed.
Lesly, who is originally from Guatemala, received her breast cancer diagnosis in 2018. She had to rely on her teenage daughter to serve as her main interpreter at the hospital in Dallas. Lesly reports that she has been able to listen to the doctors and understand a few ideas, but without Ana’s help, she wouldn’t be able to understand her disease or the detailed instructions she needs for a successful recovery. When children are serving as their parents’ own translators, it’s a sign of a broken system, and Latinas in America deserve better.
Part of fixing that system will be rethinking how we approach wellness education for Latino communities. Most of the time, Latinos receive a plain translation of medical formats and classes related to cancer education. Language is important, yes, but culturally relevant content is key for changing behaviors and breaking the pathology of an unhealthy lifestyle.
Cancer awareness organizations and other nonprofits are struggling to serve us because there is a lack of wellness and cancer prevention programs that address our needs in a way that resonates for us. They need to include not just our language, but our idioms, traditional foods, way of expressing love and disgust, even jokes, myths, and music.
I personally lived through the efforts of my medical team at the hospital trying to convince me to eat more “green salads,” not knowing that I preferred to eat cucumbers or “jicama” with lime juice, a pinch of salt and chili flakes. I did not understand why, sometimes a doctor didn’t shake hands with me, when traditionally I wanted to thank him with a kiss on the cheek and a tight hug. I had a difficult time thinking about myself first, because when I was taught, by my heritage, to think about the others first. If we are going to be educated on how to achieve wellness, educators must not forget that a vast majority of us are huggers, a little bit “nosy” for the good of our communities, and often like to eat tortillas with cactus.
There’s a clear bottom line case for making these changes. In Texas, every dollar invested in cancer prevention leads to $25.75 in treatment cost savings. And healthy people, regardless of their ethnicity, are good for the economy, just as sick people are bad for it: in 2018 alone, Texas had 1,064,595 lost jobs due to cancer treatment, morbidity, and mortality, with a total cost to the economy of some $212.2 billion.
Women like Lesly, and their entire families, are at risk due to a lack of knowledge about wellness, resources and social capital. It is not easy for social services and institutions, such as hospitals, nonprofits, churches, and government agencies to serve the Latino community effectively. But for the sake of millions of us, they must do better.
The other day I was watching Lesly doing a Facebook Live from an Intensive Care Unit in a hospital in Dallas. She had had a surgery that took doctors more than 8 hours to complete. Lesly was in pain, but she was enthusiastic; she is close to finishing her treatment. Ana was by her side, holding the phone for her mom, “reporting” to us about how things went for her, sharing updates. Lesly could only say a few words, but her experience speaks volumes.
Aideé Granados, M.Ed., is the Founder and CEO of Rosa Es Rojo, Inc., a nonprofit making wellness and cancer prevention accessible for Latino women in North Texas.