Health needs of latina women in central Illinois: Promoting early detection of cervical and breast cancer

Latinos now constitute the largest ethnic minority group in the United States (U.S. Census Bureau 2008b). As such, they have contributed more than half of the population growth (50.5%) in the United States in the 21st century (Fry 2008). Although most of the growth has taken place in geographical areas that historically have been home to a large Latino population, fast growth has occurred in smaller urban and rural areas in which the Latino influx is a relatively new phenomenon (Cunningham et al. 2006). With increased geographic dispersion of the Latino community, attention has been drawn to health coverage and access of Latinos in "new growth" communities (Cunningham et al. 2006). In this chapter, we focus on central Illinois, an area that has seen significant growth in the last decade. Specifically, we present a needs assessment addressing issues of health coverage, access, and psychosocial factors influencing cervical and breast cancer screening in Latina women residing in two central Illinois counties. Seventy percent of the data (n = 85) was collected in Champaign County, one of the 148 counties in the United States that experienced slow Latino growth in the 1990s but above average growth in the 2000s (52% growth 2000-2007; Fry 2008). The remainder of the data (n = 35) was collected in Vermillion County, a county directly east of Champaign that is home to a population of Latinos clearly on the rise (19% growth 2000-2007), though growing at a slower rate than in Champaign (Pew Hispanic Center 2009b). Local institutions in these areas are just beginning to grapple with public health issues experienced by the growing Latino population. One such issue that requires attention is cancer prevention and control. Among Latinas, cancer disparities are evident in incidence, mortality, and survivorship (American Cancer Society 2006). Latina women have higher incidence and mortality rates from cervical cancer, and lower five-year survivorship rates from breast cancer, than non-Latina white women (Edwards et al. 2005; Jemal et al. 2008). For both of these cancers, early detection procedures are the best strategy to ensure cervical and breast health (U.S. Preventive Services Task Force 2002a; 2002b). Despite the existence of these procedures, data show that late detection contributes to health disparities in this population; Latinas are not screening according to the recommended guidelines (American Cancer Society 2006). For instance, data from 2003 show that prevalence of cervical cancer screening in the last three years is lower for Latinas (74.7%) than for non-Latina white women (80.2%), with women of Mexican descent and immigrant women having the lowest rates of screening (American Cancer Society 2006). Th erefore, it is critical to promote regular screening in this population. To increase rates of screening, scholars have proposed that in the design of interventions, we need to incorporate women's cultural, psychosocial, psychological, and geographical realities if we are to influence their screening behaviors (Buki, Salazar, and Pitton 2008; MacKinnon et al. 2007; Rajaram and Rashidi 1998). However, to date, there has not been an investigation of how these contextual factors may influence Latina women's screening rates in central Illinois. In this effort, we report on a needs assessment conducted with 120 women from four small urban and rural areas in central Illinois: Champaign, Danville, Hoopeston, and Rantoul. Because of the fast Latino growth experienced in the area and the fact that most newcomers are primarily Spanish speaking, the infrastructure is not available yet to serve the health needs of newcomers effectively (Champaign County 2003). Therefore, data from this needs assessment are needed to tailor educational interventions and prioritize efforts, thereby optimizing the use of resources while improving health outcomes.