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Hispanics are almost twice as likely as non-Hispanic whites to have type 2 diabetes, and more than a third of working adult Hispanics do not have health insurance. For this audience, Jane Delgado, PhD, has written The Buena Salud Guide to Diabetes and Your Life. Available in both Spanish and English, it's a culturally sensitive and reassuring book that dispels myths and presents detailed science while gently guiding readers toward the right path in caring for their diabetes. The tone is conversational, as Dr. Delgado speaks to her readers like a family member who knows them well and has their best interests at heart.
Dr. Delgado says, "Since I'm a clinical psychologist, my whole training is on behavior change, helping people do something different. It's not just giving them information. You have to give them the information in a way in which they're more likely to accept it. Even if they don't make the change right away, they'll retain some of it and use it later. I think that's the key to how I write my books. You know, everyone has facts--the facts are out there: It's good to exercise, not to smoke, do all these things. You need to do more than just say it again. You really have to help each individual create the environment which nurtures those healthy behaviors."
The core of Dr. Delgado's book is the "Ten-Point Program for Health," which contains four "must-do's": Eat and drink for a healthy body; Exercise for life; Take your medicines; and Have a regular source of healthcare. Dr. Delgado says, "The other six points are what I call the magnifiers, things that take those four things and really just magnify them, make them even better. You have to do the four, but of the magnifiers, just pick one. Is it that you're going to work to get enough sleep? Or are you going to work to really have healthy relationships? Are you going to keep a journal? Are you going to nurture some sort of faith and spiritual life? Are you really going to work to listen to your body? Those are the kinds of things that people need to do, but they can pick one. You tell people to do too much, and it's just not going to help them be successful. It's small steps--pick the step that you think that you can do. Once you're successful, then pick another one. If you say, ‘I'm going to change my life,' well, you know, that doesn't happen."
The same calm "start slow" philosophy applies to Dr. Delgado's advice about eating healthfully and exercising. She says, "I don't use the words ‘on a diet' in my book because I think that it's really a lifestyle change. You have to eat in a different way, and you have to maintain it. I'll tell you, the easiest part is to lose some weight, but to maintain a healthy weight is very hard."
"You also have to be thoughtful about what you eat, and why you're eating. Some people just eat when they're stressed. I remember one woman who told me that she was sitting alone and she was very upset, and then, when she looked over, there was an empty box of bonbons. That was her coping skill, but long-term it doesn't help her."
"It's also particularly difficult for people to change their activity habits. What we always say is start slow. Even though you may have done something like this years ago, that's not where you're at now. You're in a different place, so you have to start little. Start walking five minutes a day. You have to start where you can and then slowly move it up to get more and more activity into your life. It's really looking at behavior changes, with the goal of being healthier."
With regard to her last must-do point, "Have a regular source of healthcare," Dr. Delgado says, "The greatest health risks for Hispanics are a lack of information and the belief that you don't go see a healthcare provider until you're practically dead. Now, I have to say that Hispanics are very good about going for wellness visits for their children, but when it comes to themselves, it's another story. We really have to start thinking of ourselves as machines that are connected to feelings and need to be maintained, not just when they're broken."
"A lot of Hispanics wait until it's too late with regard to diabetes instead of preventing it. In the 1990s and early 2000s, people were very good about getting the information out that Hispanics have a high rate of diabetes. Well, all that did is make people think that it was inevitable, and many of them thought, ‘Oh well, it's going to happen, so I might as well do what I want to now.' But I'm saying, ‘Hey, there are things you can do to delay the onset and to reduce the complications.' You can be the master of your destiny. Of course, things can still happen, but you want to start out with the healthiest body that you can."
Dr. Delgado hopes that her book will provide readers with "hope, and the belief that they can make the change, and little tips that can help them. Basically, it's a book of encouragement and science, presenting the science so that people understand it: This is what's going on in your body, you need to understand it." She concludes, "Most health books are so solemn--who the heck wants to read that? You need somebody who's going to motivate you to get up and go, and know that health is good. You can do as much as you can to be as healthy as you can be."
Dr. Delgado is also the president and CEO of the National Alliance for Hispanic Health, whose mission is to improve the health of Hispanic communities and to work with others to secure health for all. She says, "At the Alliance, we operate national information programs. We have a help line at (866) 783-2645, or (866) Su Familia, where people can call Monday through Friday 9:00 to 6:00 Eastern Standard time. We can direct them to local clinics and resources, all sorts of things to help them get care. We also have community programs that we run on diabetes and education and physical activity, and we have a yearly event that is the largest health/wellness and fitness event for Hispanic families in the country. We also have a science and policy center that focuses on what is the best science available, and we have a foundation. Those are just some of the things that we do at the Alliance."
There's a vignette in Dr. Delgado's book about Sarah, who could not afford all her medicines and therefore stopped taking her diabetes medicines in favor of her heart medicines. Dr. Delgado says, "The idea is that people make choices, but they shouldn't make those choices without talking to their healthcare provider. If they're having problems paying for something, they don't need to be embarrassed. But more importantly, they can call us on our help line and we can connect them with services that will be more in keeping with their budget. In some instances we can even refer them to places where they can drugs at lower or reduced cost."