Dr. David Hayes-Bautista: The Prophet of Latino Health
Enthusiastic, inspiring, tireless, proactive, prolific and statistic-savvy, Dr. David Hayes-Bautista, has actively devoted his life to the practical study and application of Latino health and history. The Professor of Medicine and Director of the Center for the Study of Latino Health and Culture at the David Geffen School of Medicine, UCLA, Hayes-Bautista sees each of these qualities as being deeply intertwined. This satisfying quest has filled six books, with another three in the works. Delightfully divergent to many intellectuals, Dr. Hayes-Bautista is an optimist. Part compadre, part ‘man of the people’ and part avid scholar, he is ‘all in’ when it comes to Latino health as a future gateway to survival — and power.
“I studied basic sciences at the University California Medical Center in San Francisco,” said Hayes-Bautista, who left San Francisco to join the faculty at the School of Public Health in UC Berkeley.
“I received tenure and then was recruited to UCLA, where I am now Distinguished Professor at the David Geffen School of Medicine,” he said. “I run the Center for Latino Health and Culture, which celebrates its 25th anniversary this year. We study all different facets of Latino health and try to discover the linkage between daily behavior and health outcome.”
With a half century invested in the investigation and improvement of Latino health, no one challenges the credentials of the man; Hayes-Bautista is the preeminent expert. Accordingly, when asked to speak about himself, culture comes first.
“I’m eighth-generation American of Mexican origin,” he proudly points out. This is who Hayes-Bautista is above all, and it’s why he’s the best at what he does.
Born in Los Angeles and raised in California’s Central Valley, Hayes-Bautista is a BIG fan of California and vocal on the state’s importance as the Latino power seat in the U.S. He graduated from UC-Berkeley and completed his master’s and Ph.D. in Medical Sociology at the University of California Medical Center, San Francisco. Hayes-Bautista multi-tasked his way through graduate school.
“I graduated from Berkeley in 1970, and got involved in setting up La Clinica de la Raza in Oakland, which is celebrating its 50th anniversary soon,” said Hayes-Bautista, who does not come from a medical background.
“Other than the fact that I had an aunt in Mexico who was a curandera, and another who was a nurse in Los Angeles, there were no health professionals in the family,” he said.
In fact, Hayes-Bautista’s foray into medicine in 1970 at La Clinca de la Raza was an eye-opener.
“I got a quick introduction into health care research demography because we had to provide services in the Fruitvale District, and there were almost no medical services,” he said. “We decided that we were going to provide medical services and we were going to do them in Spanish, and we were going to do it for free and we had exactly $240 to start with!”
This coincided with Hayes-Bautista’s graduate studies at UCSF; his daily activities at the clinic and his basic health sciences studies matured harmoniously.
He’s a holistic thinker. “I have always defined health very, very broadly. So it’s not simply physical absence of disease; it’s actually also well-being of the family and the community in which they live.” Never silent or idle, Hayes-Bautista just published his sixth book, “La Nueva California: Latinos from Pioneers to Post-Millennials.” He believes passionately in the future of young Latinos, and the importance of leadership. He is very concerned, therefore, with the lack of Latino medical staff to carry forward the work, and writes fervently on the topic. “The Latino Physician Shortage,” published in 2000, lamented the lack of doctors. Incredibly, in the 17 years since, the gap has widened.
He’s very worried about the lack of Latino doctors, nurses, and especially dentists. Hayes- Bautista groans. “It’s gotten worse! Likewise the Latino nurse situation has gotten worse, and the dentist shortage is so bad it makes the physician shortage look good! The community lacks proper linguistic care; not enough doctors nurses, etc. In spite of all that, we have spectacular health, so I would say we need to see what drives this Latino epidemiological paradox and can we transfer that to non Latinos?” Always a ‘big picture’ man, Hayes-Bautista focused on where his findings led him, trusting the conclusions. “In 1978 I pulled the little information together that I had, and made my first presentation at the American Public Health Association conference in L.A. The 1980 census data came out; we were able to do demographic modeling and projections to the year 2030. It was clear to me that the Latino community was going to grow from being a very small segment into what it is now. We basically hit every census on the nose. California was going to have to adjust how it saw and dealt with the Latin population from being a small minority to being close to a majority.”
Many underestimated the Latino boom, but not Hayes-Bautista. “It was clear to me that Latinos had different demographics than non-Hispanic whites.” Hayes-Bautista got his information at the source. “Because I had to negotiate OB contracts with the hospital, I saw that while the non-Hispanic baby boom was over, and they were aging and there was no immigration, it was clear that the Latino population was growing. We were having high fertility and the non- Hispanic white baby boom was over, but ours was just beginning.”
Back to the “Latino” Future. “In 1988 my first book was published: ‘The Burden of Support – Young Latinos in an Aging Society.’ This was the first academic book that projected that by 2030 California would be 45% Latino and pretty much we hit it, we’re at 40% already, we’ll hit 45% by 2030.”
“We had this vision for the last 50 years. Our goal was to have healthy, empowered families and healthy, empowered communities that include not only physical but mental health, economic health, political health, spiritual health. Those are the directions my research is going in and cover the gamut from HIV to high-level wellness.”
Hayes-Bautista‘s prophetic books “Latinos in the Golden State,” “Cinco de Mayo an American Tradition,” and “Nueva California, Latino Pioneers to Post Millennials” carry the message in historic context. In his recent book, Hayes-Bautista had to add a bitter truth.
“I updated the last chapter and quoted Donald Trump because I saw him coming — and he did fit a ‘pattern’ of nativism that we have seen in California history. It fit the pattern perfectly.”
Diametrically opposed to Trump’s ‘ideas,’ Hayes-Bautista leads the positive resistance. “Latinos are one of the best things that happened to California, currently, historically and into the future! In my books I give Latinos ‘voice’ and ‘agency’ to discover how we are managing the state of California, how have we, and how will we? We Latinos seem to have some good ideas and have the best interest of the state at heart.”
Fascinated by the enduring strength of Latino health, Hayes-Bautista has been studying what he terms “Latino Epidemiological Paradox” for 35 years. The puzzling discovery that Latinos are healthier than the rest of the population despite having fewer resources both delights and haunts him.
“This paradox is not predicted by the models I was taught at UCSF; I do not predict Latino health outcomes, I report them and try to understand them. Latinos across the nation have less income, less education, less access to health care and yet we have nationally 30% lower mortality for heart disease, 35% lower cancer mortality, 25% stroke mortality 60% lower respiratory disease, a 30% lower cause of death rate compared to non Hispanic whites. The one exception is diabetes. We have a 3½- year-longer life expectancy, and at age 72, that’s looking good to me.”
Some things just don’t add up when it comes to Latinos and insurers. “Of course, we’re following health care reform closely. From an insurance standpoint, young, healthy Latinos are an ideal population to get into on an insurance pool. Yet, Latinos have the highest rate of uninsured of any population, highest among immigrants prior to Obamacare, and now it’s gone down to 30%, whereas the rest of population is down to 10% and yet the young healthy Latinos who generally don’t need health services were excluded from enrollment. The undocumented and recent immigrants were unable to participate in the insurance pool. Yet, from an actuarial perspective, those were exactly who you’d want in the pool because they would subsidize the elderly. So everybody got the worst of all possible worlds! We basically shot ourselves in both feet by excluding young, healthy Latinos who happen to be recent immigrants and/or undocumented!”
Sharing the secrets of Latino longevity and health with the world is his dream. “Now that would be real, true health reform! What makes Latinos live 3½ years longer, on average?” He has yet to crack that mystery. Hayes-Bautista puzzles delightedly over his paradox, looking for the singular X factor that has eluded him.
“It’s something that Latinos do every day! Is it diet? Family? Spirituality? Mind-body balance? There’s something that Latinos are doing that’s good for the health outcomes, but I don’t know what it is yet! My goal is to find out what Latinos are doing, so we can share it with our non- Latino neighbors. I want to understand the origins of Latino health patterns; we’re doing more clinical practice studies trying to figure out the future, and also are studying Latino post millennials.”
Heavy is the crown that David Hayes-Bautista places on the next generation of Latinos: “Latino postmillennials hold the future of this country in their hands. If everybody Latinizes and has the same edificial health as Latinos, we’d save 200,000 lives a year! I think that’s a wonderful gift that Latinos give the country.”
Bilinguals live longer. Latinos who speak Spanish and English fare better, according to Hayes-Bautista’s colleague, Xavier Cagigas, the Director of the Cultural Neuropsychology Initiative (CNI) and Health Sciences Assistant Clinical Professor, Department of Psychiatry and Biobehavioral Sciences at UCLA. Cagigas attests that bilingual brains function much better in face of Alzheimer’s because they have what he calls the “cognitive reserve”; the brain has greater plasticity.
Diabetes is the killer exception. “Diabetes is the major exception as a disease in any lifestyle. It is not just affecting Latinos in the U.S.; it’s also in Mexico. We are seeing higher rates of diabetes around the world; it is the No. 7 cause of Latino death. And women generally have lower death rate — except in diabetes cases.”
Who are, in fact, the Latinos at the highest risk? “Latinos with no college education, non-Spanish speaking who drink, smoke and do drugs. Not speaking Spanish is associated with poor health outcome.”
Is depression as big a factor in Latino communities as others? “Mental health is under diagnosed. We do not have a very clear picture here. Research has not caught up to where the population is. Mental health is not my area of expertise; it’s not quite as easy as heart, cancer and stroke. There is a lack of mental health providers.”
Dr Hayes-Bautista’s Latinos are “GOOD HOMBRES.” “In fifty years I’ve seen, studied and concluded Latinos have extraordinarily good social behavior. The rate of labor participation is higher. We work more hours than any other group, there are more Latinos working in the private sector, less in public sector, we use welfare less, have stronger families, set up businesses at 10 times the rate of others, and live 3½ years longer! If everybody could be like Latinos, it would be a much better country. Bottom line: if America adapted the good genebuilding habits of Latinos, 200,000 lives would be saved each year.”
Savoring life is inherently Latino, according to Dr. Hayes-Bautista. In his off-hours, Hayes-Bautista enjoys spending time with his wife, Teodocia Maria, who also works in the health sector, doing … guess what? “We love researching Latino health together. My wife and I enjoy the life of the mind.”
When the devoted couple isn’t poring over medical journals and health statistics for fun, they travel to Mexico, Latin America and Spain. “We’ll enjoy dinner in Mexico City, Lima or Valencia, experiencing the world together with food, drink or data, whatever form it may take.”