Issues in Latina Health
Teen Pregnancy
Introduction Latinos are the fastest growing minority population in the U.S., and also the youngest. It is estimated that 40.9% of Latinos are under the age of 21, [3] which also suggests that the Latino population will grow at an incredibly fast rate as this young population reaches adulthood and starts families of their own. This is part of the reason why Latina teen pregnancy is becoming such a pressing issue. National rates of teen pregnancy have decreased dramatically over the past 20 years, yet the teen pregnancy for Latinas has decreased the least. Today, Latinas have the highest teen birthrate of any minority population, with an estimated 51% of Latinas getting pregnant at least once before age 20. [4] To add to this issue, 20% of Latinos live below the poverty line, and they are drastically underrepresented in medicine. However, other racial groups that also have high rates of poverty and low rates of medical coverage similar to Latinos but have much lower rates of teen pregnancy. This suggests that there is a cultural factor that is affecting the issue [5].
Traditional Beliefs There are many stereotypes surrounding Latino sexuality. While, like all stereotypes, these ideas do not apply to everyone, many stem from traditional Latino beliefs about sexuality that continue to influence the population. First off, Latinos are predominately Catholic, a religion with stringent guidelines about sexual practice. Sex outside of marriage and birth control of any kind, including condoms, are strictly forbidden. For young women who subscribe to these beliefs, religion has a strong effect on their sexual practices. Most will abstain from vaginal-penile intercourse until marriage, but, because the definition of “sex” varies so much, some will engage in other sexual activities, such as oral sex. Because this group is also generally opposed to birth control, this could put them at a higher risk for STDs. [6] However, other studies suggest that no link exists between Latino Catholic affiliation and low rates of condom use. [7] In any case, Catholicism is a contributing factor to the overall idea of sex as a “taboo” topic in Latino culture. Machismo and marianismo, while considered outdated ideas by many, still seem to have a strong influence on Latino ideas about sexuality. Marianismo is traditional feminine values, including the importance of virginity before marriage and an overall passivity in matters of sex. Women who discuss sex openly are often labeled as promiscuous, so Latinas can be hesitant to discuss sexual issues including birth control. [8] Marianismo also places a strong importance on maternity. In comparison with other racial groups, studies show that Latinas desire to start families earlier and have more children. Machismo, the traditional masculine values, and emphasizes strength and control over women, including in regard to sexual decision-making. For this reason, some Latina adolescents do not feel in control of their contraception decisions because they do not feel comfortable asking their male partners to use a condom. However, an alternative, more modern, view of machismo focuses on a man’s desire to protect women. This would lead to a higher likelihood to use a condom, as the man would wish to protect his partner from both STDs and unwanted pregnancies. [9] As with most traditional beliefs, these ideas are held more strongly by the older generation than by younger Latinos, especially when the younger generation is more assimilated into American culture (see below). This means that sex is more of a taboo topic for parents than for their adolescent children. Studies have shown that Latino families are less likely to engage in discussions about sex than non-Hispanic whites. [10] Adolescents often feel uncomfortable or afraid of discussing their sexual habits with their parents for fear of their disapproval.
Acculturation Acculturation is the process by which a group integrates the cultural practices of another group into their own. In this case, it refers to the process through which Latino immigrants adopt American culture into their own, similar to assimilation. Acculturation can be measured through variables such as generational status (eg: 1st generation immigrant, 2nd generation, etc), time in the U.S., and language preference. Many studies have attempted to research the link between acculturation and sexual behavior of Latinos. However, many of these studies use samples that are not representative of the Latino population as a whole, for example, patients at a free health care clinic that caters to low-income families. This should be carefully considered when trying to interpret their results. [11] Most studies find a correlation between acculturation and sexual activity in adolescents, that is, adolescents that identify more with American culture are more likely to engage in sexual activity. In addition, studies have suggested that higher levels of acculturation are related to earlier first intercourse. Studies linking acculturation to birth control use have less clear results. Some have found no link between use of birth control and acculturation. Others have found that more assimilated adolescents are more likely to use condoms and have a more positive view on birth control in general. A few studies have found evidence that higher levels of acculturation are correlated with higher rates of teen pregnancy, but that acculturated teens expect to have fewer children in their lifetime. [12] In contrast, other evidence has shown that less acculturated teens, especially newer immigrants to the U.S., have a less negative view of teen pregnancy, and plan to start families earlier. In many of these communities, marriage and childbirth at early ages is the norm, and often supported by the teen's family. It is clear that not all Latina teen pregnancy are unwanted or unplanned, though reports of teen pregnancy do not take into this into account. [13] Despite some flawed study designs and conflicting evidence, it seems clear that there is some link between acculturation and sexual activity of Latino adolescents. Perhaps this is because acculturated teens are less likely to hold the conservative beliefs about sex of the traditional Latino community. It seems plausible that acculturated teens would be more likely to engage in sexual activity and more likely to use birth control than their less assimilated peers, but more rigorous studies must be done to come to a definitive conclusion.
Birth Control Utilization Evidence has shown that the Latina community as a whole is using birth control at rates far lower than non-Hispanic whites, a fact that is likely responsible for the high rates of teen pregnancy in this community. Of all racial groups, Latinos report the lowest rate of birth control use during their first sexual encounters. “Worse, when asked whether they used any birth control method the last time they had sex, only 36 percent of Latinas said yes, while 72 percent of non-Hispanic whites reported that they used birth control.” [14] In fact, one study that focused on low-income, Spanish-speaking Latinas found that many women were misinformed about hormonal birth control, which is considered one of the most effective methods by health care workers. Many Latinas in this study did not know of the benefits of using hormonal birth control, and many actually feared harmful side effects. Some believed that hormonal birth control could make them permanently sterile, others feared the possibility of birth defects, and some believed that hormonal birth control could damage their own health. [15] These fears could be caused by a lack of quality sex education, or could possibly stem from a history of medical racism that includes sterilization campaigns targeting Latinas, which has led to mistrust of the medical community by many Latinos. Reports indicate that condom use by Latino adolescents is sporadic at best, even if it is the only method of birth control being employed. Common reasons cited by Latinas for not using a condom include trusting one’s partner, not being able to convince one’s partner to use a condom, or just general dislike of condoms. Another idea is that many Latino adolescents view sex as less “bad” when it is spontaneous, so partners are not prepared and do not have condoms on hand when sex occurs. [16] In addition, Latinos report higher rates of contraception failure than do other races, suggesting that they may be using them incorrectly due to lack of proper sexual education or misinformation. [17] In conclusion, it seems clear that Latina teen pregnancy is not caused solely by poverty or low health care coverage; instead, there is a cultural factor that adds to the issue. However, it is not clear if Latina teen pregnancy is actually considered a problem by the Latino community. Further action in this area must take into account cultural values that may actually favor early childbearing. Still, young mothers are far less likely to finish high school than those who wait to have children, and children with more educated parents are far less likely to live in poverty. [18] In addition, it is important that Latinos receive better sexual education so that they may be properly informed about protecting themselves from unwanted pregnancies as well as STDs.
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