‘Hispanic’ not defined by ‘skin of color’

The Hispanic population isn’t just skin of color; it’s skin of different colors. Dermatologists treating Hispanic patients need to understand the diversity and disparities that exist in this fast-growing U.S. population, according to Maritza Perez, M.D., a dermatologist who practices in New Canaan, Conn. 

Dr. Perez, an attending physician in dermatology at Mount Sinai Beth Israel and Mount Sinai St. Luke’s Roosevelt hospitals in New York, N.Y., discussed what dermatologists need to know about the Hispanic population at the May 2015 Skin of Color Seminar in New York City. 

READ: Melanoma rates rise in Hispanics

“Dermatologists are seeing Hispanic patients, but they don’t know about the population,” according to Dr. Perez. “Hispanics are [lumped] together in skin of color, but we’re different. We have been treated and evaluated as if we were African Americans, and we are not.”

The Hispanic population, according to Dr. Perez, is growing, complex and rapidly changing.

NEXT: A little history

A little history…

The Caribbean islands are the oldest areas for Hispanic population in the Americas because of the 1492 arrival of Christopher Columbus, who was sent by the Spanish throne to discover a western trade route to the Indies. His four excursions had profound effects on the areas he explored, one of which was the introduction of Spanish as a spoken language in those areas.

READ: Psoriasis in skin of color

Columbus’ excursions started a centuries-long process of exploration and colonization, as Spanish-speaking explorers moved into “Central and South America for the cultivation of sugar, coffee, tobacco and looking for gold and precious stones,” says Dr. Perez, all of which further spread the Spanish language to the indigenous populations.

Understanding the population: Who is Hispanic?

It’s not easy defining the Hispanic, or Latino, population. Dr. Perez says that Hispanics throughout history have had a multiplicity of origins, which helps to explain the spectrum of skin types. In Argentina, for example, most of the immigrants came from Italy and Germany, and they mixed with the local Indian population. In Mexico, they were primarily Spaniards and local Indians. In Peru, the population is mainly composed of Spaniards, local Indians and Japanese. In the Caribbean and Panama, African slaves and Chinese were introduced to cultivate sugar cane and tobacco, creating a melting pot of Spaniards, local Indians, African Americans and some Chinese.

NEXT: Population growth

Population growth

U.S. Census projections predicts that the Hispanic population in the U.S. will nearly triple in the 50 years from 2000 to 2050-from 35.3 million to 102.6 million.

“In the year 2008, 15% of the U.S. population was considered Hispanic; by 2050, 30% of the population is going to be considered Hispanic. So, the largest minority population is going to be Hispanic,” Dr. Perez says.

“The latest numbers come from the 2011 census, which says there are 64.1 million Hispanics [making] Hispanics 17% of the U.S. population,” Dr. Perez says. “According to the 2010 census, there has been a 78.1% growth in the Latino population from 2006 to 2010.”

READ: Psoriasis in skin of color

A growing number of Hispanics are not immigrating here; rather, they’re born in the U.S. Sixty-two percent of the Hispanics (of all ages) in this country are U.S. born, according to the Pew Research Center. And, while this population lives throughout the U.S., there are areas of high concentration. The Huffington Post reported in 2011 that these are the states where Hispanic population makes up a significant percentage of the population: New Mexico (46.7%), Texas (38.1%), California (38.1%), Arizona (30.1%), Nevada (27.1), Florida (22.8%), Colorado (20.9%), New Jersey (18.1%), New York (18%) and Illinois (16.1%). 

“In July 1, 2013, the state of New Mexico was composed of 47.3% Hispanic, which means the majority of people who live in New Mexico are Hispanic,” Dr. Perez says.

NEXT: An evolving population

An evolving population

More than 60% of today’s Latino U.S. population is of Mexican origin, according to Dr. Perez. Puerto Ricans comprise 9.2% (which does not include Puerto Ricans in Puerto Rico itself). Cubans, at 3.5%; Salvadorans at 3.3%; and Guatemalans, at 2.1%, help to round out the population, the dermatologist says.

Hispanics tend to be a younger demographic than Caucasians in the U.S., says Dr. Perez, noting that “45% of the Hispanic population is 24 years and under.”

READ: Psoriasis Guidelines

Education is one of the most rapidly evolving elements of the Latino population. “It has been demonstrated that the Hispanic population dropout rate has significantly decreased from 1994 to 2012. In 2002, only 3% of Hispanics had an advanced degree (college degree). In 2010, 9% of Hispanics had a bachelor’s degree and 13% had an associate’s degree,” Dr. Perez said. “It’s anticipated that, by the year 2040, 33% of the Hispanic population will have a college degree, according to the U.S. Census of 2004.” 

Dr. Perez said she presented statistics, history and the evolution of the U.S. Hispanic population to make a point to her dermatologist colleagues: “These statistics demonstrate that we are important,” she says.

In this and future issues, Dermatology Times will begin to explore the nuances and special considerations that dermatologists need to know in order to effectively diagnose and treat skin-of-color patients, including patients in the Hispanic population.

Disclosure: None