Introduction
Fieldwork research was carried out in Little Havana, Miami –Dade County, Florida. The residents of the area are mainly immigrants from Cuba hence the name little Havana. The fieldwork research sought to establish several health concerns (Childhood obesity and Diabetes, lack of fresh fruits and vegetables, and lack of exercise) that may be affecting the population. The study further sought to establish the underlying causes, mitigation programs, and the challenges being faced.
Background
Community Description
Little Havana can be described as a neighborhood of Miami-Dade County in Florida that hosts many Cuban immigrants (Miami Government, 2011). Little Havana is sometimes referred to as the Latin Quarter but is more recognized by the name “little Havana”, named after the capital city of Cuba (Miami Government, 2011). Little Havana borders Miami River to the North, West 27th avenue to the West, 1-95 to the east, and SW 16th street to the South (Little Havana Activities and Nutrition Centers of Dade County, Inc, 2012).
Little Havana is recognized for its active role in social, cultural, and political activities. It’s boasts of some notable festivals such as Carnival Miami, which are televised for millions of viewers across the globe.
The available data indicates that little Havana had a population of 49,206 people as of the year 2000. This population was composed of 85% Hispanic or Latino mainly from Cuba. About 4% of the population was made of blacks or African Americans including Afro-Cubans, Afro-Nicaraguans, and others (American Diabetes Association, 2012). Ten percent of the population was made of non- Hispanic white.
Little Havana has a cultural event that often takes place on the last Friday of each month. The cultural event often takes place in the heart of Calle Ocho, a major venue for visual artists and other entertainers to showcase their talent (Buchman, 2002). This monthly event treats tourists and other visitors to unique cultural festivals of the Latino community.
Little Havana has up to nine parks within its boundaries including the Domino Park, Plaza de la
Cubanidad, Cuban Memorial Boulevard, Sewell park among others.
Health Concerns Studied
Childhood obesity
Research data collected over the years show that obesity is a health concern that keeps affecting more and more people in the United States. Data collected between 2006 and 2008 by the National Health and Nutrition Examination Survey (NHANES) indicates that more than 18% of children aged between 2-19 years are overweight (Ezzati, 2006). Childhood obesity can lead to other complications such as the reduction in the release of growth hormone, type II diabetes, hyperinsulinemia, and high blood pressure. There are also some psychosocial effects such as low self-esteem, negative towards self, and eating disorders.
Health programs have been rolled out to counter obesity in Miami-Dade County. Such programs “include the Health School Initiative that was established in 2001 to increase the awareness of students and their families about the risks of childhood obesity, nutrition improvement, and physical activity involvement” (Fiebelkorn, 2003,p. 5). The program includes a regular screening of height, weight, and body mass index (BMI) for children attending both Comprehensive and Full-service schools.
Obesity is a major problem in the United States affecting about 32% of men and 35% of women.
Diabetes
Diabetes, particularly type II diabetes has become a major health concern in the United States. It’s now estimated that one out of every three children born after 2000 in the United States will be directly affected by Diabetes (Kulkarmi, 2004). Statistics show that in Miami-Dade County close to 182,000 are currently suffering from diabetes.
Currently, approximately 25.8 million children and adults in the United States have diabetes according to the National Diabetes Fact Sheet released in 2011 (American Diabetes Association, 2012). Of this figure, 215,000 are below the age of 20 years. The national data indicate that Diabetes s highest among Hispanics affecting 11.8% of the Hispanic population in the United States. Among the Hispanic population, 7.6% of the affected are Cubans, 13.3% Mexican Americans, and 13.8% Puerto Ricans (American Diabetes Association, 2012).
Diabetes and its complications lead to a significant number of morbidity and mortality cases in the United States. In 2009, there were about 13’000 deaths associated with Diabetes and its complications in the State of Florida. The most common complications observed include heart disease and stroke, high blood pressure, blindness, kidney disease, and nervous system disease.
There are efforts to create public awareness of the disease and how it can be prevented. The American Diabetes Association’s Miami office is currently conducting activities that are aimed at educating the public on the different ways with which diabetes can be stopped.
The above information shows a higher prevalence of diabetes among the Hispanic population in the United States. The Hispanics make up to 80% of the little Havana residents. It’s, therefore, possible that there is a higher prevalence of the condition in little Havana.
Lack of fresh vegetables and the effects
For the human body to function optimally there has to be a constant supply of vitamins. These vitamins are commonly sourced from fresh fruits and vegetables. Vitamins are very essential for growth in children. Children and adults who do not eat fresh vegetables and fruits may develop vitamin and mineral deficiencies (Drapper, LoDou, & Tenner, 2011). The deficiencies are major causes of health problems during childhood and adult life. Health experts advise that the best diets for children should contain meats, grains, fresh fruits, and both cooked and raw vegetables (Miami-Dade County Health Department, 2012).
Generally, the United States has a vibrant supply of fresh produce which can be accessed via fresh produce markets or groceries. In Miami-Dade County, there are several groceries such as the Mom and Pop stores but they mostly offer canned fruits and vegetables.
Little Havana has the characteristics of many other immigrant settlements such as poor infrastructure and inadequate supply of essential commodities and other services. Children who live in this area are more likely to suffer from vitamin deficiency diseases compared to other areas of Miami-Dade County or even other parts of Florida.
Lack of exercise
Exercising is a very important way of keeping the body fit. Regular exercise keeps the body vibrant and maintains the working of many-body systems. Lack of exercise puts one at risk of developing many health problems such as obesity, diabetes due to an increase in insulin sensitivity, heart ailments, High Blood Pressure, and stroke among other ailments. Exercising can also help prevent diseases such as osteoporosis, depression weak immune systems.
There are several ways through which people do exercise. The best and most common way of exercising is through sporting activities. Many individuals who live in communities that do not indulge in sports or other active lifestyles for one reason or another are more likely to suffer from the health effects that are associated with lack of exercise (Home Remedies, 2009).
The United States has a lot of sporting facilities and health clubs that can be accessed by the majority of the population. However, there are other groups, such as the immigrant populations that may not access these facilities due to financial constraints or other reasons.
The population that was studied by this field research is a case in hand. There are very few facilities that can be accessed by very few individuals. The Little Havana residents do not indulge in active sports though have a vibrant cultural festival that takes place once a month. The cultural festival provides a platform for the talented members of the community to showcase their prowess. This is not sufficient for the majority of the residents to get sufficient exercise.
Plans are currently underway to establish sporting facilities and to encourage the community to be lead active lifestyles.
Problems Identified During the Fieldwork Research and the Remedies
The fieldwork research was carried out in phases to investigate the different aspects outlined above. On the first day of the study, a windshield survey of the neighborhood was carried out. This study established that there were no major shops for groceries. Even the Florida chain of Publix was not there. There were only a few small Mom and Pop Stores.
The neighborhood had very small parks for kids to play in. The only good sports amenities were in form of playgrounds at the local schools. Even so, the locals preferred their children to play near their homes with other kids for security concerns. Most of the residents expressed a love for soccer but said it was too expensive to have their kids join the kid leagues. This information was gained through a translator speaking to the Shatila, Karamanoglou, and Shira families.
On the second day, I visit was paid to the small Mom and Pop stores to identify the types of groceries that were being offered. These stored sold only canned fruits and vegetables and nonfresh.
On the third trip, an investigation was carried out to identify the type of food that was being offered in the fast-food restaurants located in Little Havana, Miami. There were no fast food establishments inside the little Havana. However, there were several just outside the settlement. The Little Havana had only street-side vendors who offered quick bites such as meat rolled on sticks.
Members of the community expressed hope because there were positive developments to be undertaken shortly. Plans were underway for the construction of an outdoor farmers market. These markets are established elsewhere in Florida and usually offer a variety of fresh produce, from seafood to fresh fruits and vegetables.
The information gained from the health department on the third and fourth visits showed that there are plans to establish screening booths inside the little Havana.
The city authorities are also cleaning and securing the parks to make them safer for kids to play. A new park (Maximo Gomez Park) is being developed from an old parking lot.
In one of the community meetings held by the Florida Marlins, it was established that a new stadium was being built in little Havana. It was also revealed that the community will be offered funds to develop sporting facilities and a parking lot in the new stadium will be reserved for selling fresh produce on weekly basis.
On the last trip, it was identified that the fresh market had already been opened at the Marlins stadium parking lot. There was also a health booth established at the market to diagnose the community for diabetes, obesity, and other disease conditions.
Data collected at local Health centers showed that cases of diabetes and obesity were particularly higher in littler Havana in comparison to other parts of Florida. This is particularly associated with the problems identified during the field study. The lack of physical activity and poor nutrition is particularly associated with high cases of obesity which in turn leads to diabetes. There were no recent study data to indicate the severance of the issue and measurements were only based on hospital visits by residents of Little Havana.
A major issue affecting the residents of Little Havana was their lack of trust in the existing health systems and this was the biggest reason leading to the failure of most health programs initiated to assist members of the community.
There was a program spearheaded by the Miami health department to promote healthy life-long behaviors, prevent disease through health education and improve academic outcomes by removing health and psycho-social barriers (Little Havana Activities and Nutrition Centers of Dade County, Inc, 2012). The program has established a wellness policy that all schools in Miami-Dade County are supposed to adhere to. The program includes measures to control diseases such as diabetes and obesity. Regarding little Havana, the program has largely failed due to a lack of follow-up mechanisms to ensure that the same is done at home.
Another program that is part of the nationwide campaign to control diabetes has also been rolled out in Miami- Dade County. The program dubbed “In My Community” aims at creating awareness and encouraging individuals to seek screening for diabetes (Iowa Intervention Project, 2000). Through this program, several community activities such as “WALK TO STOP DIABETES” have been initiated (American Diabetes Association, 2012, pp. 3). The program has had little impact on the residents of Little Havana. It remains to be seen if any future efforts will bear any fruit.
The Little Havana Activities and Nutrition Centers of the Dade County (LHANC) is an organization that mainly focuses on the needs of the elderly and frail in little Havana (Lucia, Otto, & Palmier, 2009). The organization’s mission is “to identify the need and procure the funding necessary to provide low-income, frail, isolated elderly persons and refugees with quality social, nutrition, and health services” (Little Havana Activities and Nutrition Centers of Dade County, Inc, 2012). The organization has offered these services since 1972 and remains relevant due to the constant flow of immigrants and cases of abandoned elderly poor residents. Over 90% of those who receive help are poor Hispanics (Buchman, 2002).
Many other programs implemented through public and private partnerships have been rolled out in recent times and it remains to be seen if they will offer any solution to the problems being faced by the residents of Little Havana.
Nursing Intervention
Nurses and other public health workers can effectively intervene collaboratively to mitigate the issues affecting residents of little Havana. An ecological approach can be established to respond to the health needs of the community in conjunction with proactive programs and policy mechanisms to ensure that healthy lifestyles are adopted in little Havana. The Minnesota nursing intervention wheel can be used effectively to address most of the problems being faced by members of little Havana. To identify whether the program is impacting the community, the prevalence rates of diabetes in the community will be established regularly (Lucia, Otto, & Palmier, 2009).
References
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