The US Latino population, at more than 31 million, is the largest minority group in this country, and their numbers are expected to reach more than 96 million in the next 50 years.1 This reality, along with the health disparities faced by Latinos,2 highlights the need to promote research involving this population. As stated by the Office on Minority Health: “Hispanics/Latinos are disproportionately underrepresented in research activities. Without adequate and targeted research, Hispanics/Latinos are disadvantaged in policy making, resource allocation, program planning, and program implementation activities.”3 A number of challenges must be addressed, however, when planning research involving Latinos.
First, much variability within the Latino population is based on country of origin and acculturation status. Two of 5 Latinos are foreign-born, and many born in the United States adhere to customs from their country of origin. The cultural variability among Latinos from different countries can affect health behaviors.4 Thus, we need to routinely assess Latinos’ country of origin and understand its importance. Acculturation, the process of assimilating to the majority culture, has also been shown to influence health-related behaviors,5–7 and is affected by individual factors, such as a person’s age upon arrival to the United States, level of education, number of years in the United States, and support systems. The environment into which one is assimilating can also affect acculturation. In the past, Latinos were likely to settle in metropolitan areas with already large Latino populations, such as New York and Miami. This strategy allowed Latinos to live in areas that already accommodated their culture and language. More recently Latinos have settled in smaller cities or more rural areas that do not have a large Latino community. Latinos in these areas may face difficulties in overcoming language and cultural barriers not encountered by those in more urbanized areas. Because of these differences, research from both urban and outlying communities is needed, and care must be taken during sample selection to make a project’s results meaningful to different Latino communities.
Recruiting Latinos for research projects involves unique issues. Standard recruitment practices, such as recruiting from clinics or through mainstream media, may not reach a desired population. It is essential to understand the influence of language barriers, immigration status, and distrust toward the mainstream culture on recruitment. Misperceptions, poor education, and distrust regarding research must also be addressed. Minority communities might not want to participate in research because of past experience in which they have felt used, rather than engaged as full partners. Involving knowledgeable community members early in the research process can help overcome this barrier. The principles for community-based research articulated by NAPCRG8 are particularly relevant for research with and for Latino communities.
A final key ingredient is including qualified bilingual/bicultural researchers on the team. NAPCRG and academic health science centers should focus on how such investigators can be developed and retained. Some examples of developing centers of excellence for Latino health research include the University of Texas Health Science Center, which includes sites in San Antonio and Houston, and the University of California, which includes sites in San Diego and Los Angeles. It is noteworthy that NAPCRG is planning its 2008 meeting for Puerto Rico in a specific effort to make the meeting more accessible to Spanish-speaking countries in the Western Hemisphere. Look for a growing visibility of research for and with Latinos at NAPCRG meetings.
- © 2005 Annals of Family Medicine, Inc.