With reference to the Communication-Persuasion model, we describe various research issues and challenges when considering the health of Latinos, and implications for designing and evaluating health communication and behavior change efforts in this population. Latinos, collectively the nation's largest minority group, vary substantially in terms of socioeconomic and legal status, their country of origin and the extent of ongoing contact with that country, their region of residence within the United States, their generation status and levels of acculturation, and psychosocial factors. Health communication efforts with Latinos need to focus on family, cultural traditions, and collectivism while attending to acculturation, language, generation and national origin. The most extensive intervention topic in Latino health promotion has been the application of the lay health advisor model. This and other fundamental communication approaches, as well as audience and population characteristics, need to be considered within the context of dynamic and complex societal changes.
PART I: LATINOS IN THE UNITED STATESMany national health and social science studies, including the National Health Interview Survey (NHIS) and other surveys, treat Latinos 1 as though they were a homogenous group. However, as Modiano and colleagues (75) stated,The aggregation of culturally distinct subgroups, which have resided in the United States for different periods of time, into a more inclusive Latino category assumes that all persons of Mexican, Cuban and Puerto Rican origin have similar needs and experience similar barriers in using health services.There is, however, no clear evidence for this assumption. On the contrary, there is evidence that each group has specific characteristics that make it different and independent from one another. . . . (p. 35) Clearly, extraordinary diversity exists among subgroups of Latinos. The immigration and acculturation experiences of Mexican or Central American-descended Americans, South Americans, Puerto Ricans, and Cuban Americans vary substantially from one another. The distinction among Latino subgroups can be traced back to highly varied experiences not only with respect to encounters with the dominant American culture but also extending back to Spanish colonization, which began to redefine the western hemisphere 500 years ago. Indigenous groups in the Caribbean Islands and coastal areas largely succumbed to Iberian diseases and aggression and were replaced by Europeans and African slaves. Although forced to adopt much of the culture and religion of the conquistadores, indigenous groups in central and highland areas of Mexico and further south survived 1 The field offers no consensus regarding the term to refer to persons of Latin American heritage who live in the United States. Both "Hispanic" and "Latino" are used extensively, although U.S. government documents, including the Census, use the term Hispanic. Given this mixed usage in the literature, we use the term Latino to indicate, where po...