Robert García

National trends in smoking behaviors among Mexican, Puerto Rican, and Cuban men and women in the United States.

OBJECTIVES We examined trends in smoking behaviors across 2 periods among Mexicans, Puerto Ricans, and Cubans in the United States. METHODS We analyzed data from the 1992-2007 Tobacco Use Supplements to the Current Population Survey. We constructed 2 data sets (1990s vs 2000s) to compare smoking behaviors between the 2 periods. RESULTS Significant decreases in ever, current, and heavy smoking were accompanied by increases in light and intermittent smoking across periods for all Latino groups, although current smoking rates among Puerto Rican women did not decline. Adjusted logistic regression models revealed that in the 2000s, younger Mexicans and those interviewed in English were more likely to be light and intermittent smokers. Mexican and Cuban light and intermittent smokers were less likely to be advised by healthcare professionals to quit smoking. Mexicans and Puerto Ricans who were unemployed and Mexicans who worked outdoors were more likely to be heavy smokers. CONCLUSIONS Increases in light and intermittent smoking among Mexican, Puerto Rican, and Cuban Americans suggest that targeted efforts to further reduce smoking among Latinos may benefit by focusing on such smokers.

Social Science, Equal Justice, and Public Health Policy: Lessons from Los Angeles

This paper presents a case study on using research and law to change public health policy. The City Project (a legal and policy advocacy organization), working with teachers and school officials, is using social science and legal research to promote changes in public policy that hopefully will result in better and more equitably delivered physical education in public schools in Los Angeles, California. The major goals are, first, to help students learn the skills and knowledge to move more, eat well, stay healthy, and do their best in school and in life; second, to alleviate unfair disparities based on race, ethnicity, and income; and third, to engage, educate, and empower people to improve public education and health. This case study shows that academics can work with lawyers and other practitioners, including teachers and organizers, to maximize the impact of their research. The strategic, organized course of action has four major elements. First, the teachers’ union – United Teachers of Los Angeles – organized a public campaign to support physical education. Second, attorneys filed an administrative complaint on behalf of parents, youth groups, and health advocates under civil rights and education laws to require the school district to enforce physical education requirements. Third, in response to the campaign and complaint, the Board of Education of the Los Angeles Unified School District unanimously adopted a resolution to enforce physical education laws. Fourth, the teachers, attorneys, and school officials are now

Pushing physical activity, and justice

OBJECTIVE There has been an increasing realization of the need for environmental interventions to increase physical activity levels in the population. Although promising, the impact of these strategies in reducing obesity-related disparities will be limited by the presence of inequities in the distribution of activity-related resources in the community. Advocacy efforts are critically needed to ensure that all communities benefit from environmental strategies being implemented. METHOD AND RESULTS This paper describes two activist community-based organizations in Southern California, The City Project and Latino Health Access, and their successful efforts to mandate equitable access to public resources critical for reducing obesity-related disparities. CONCLUSION Principles for equitable development of public land are also presented as well as lessons learned that can inform future advocacy efforts.

First, Do No Harm: The US Sexually Transmitted Disease Experiments in Guatemala

Beginning in 1946, the United States government immorally and unethically-and, arguably, illegally-engaged in research experiments in which more than 5000 uninformed and unconsenting Guatemalan people were intentionally infected with bacteria that cause sexually transmitted diseases. Many have been left untreated to the present day. Although US President Barack Obama apologized in 2010, and although the US Presidential Commission for the Study of Bioethical Issues found the Guatemalan experiments morally wrong, little if anything has been done to compensate the victims and their families. We explore the backdrop for this unethical medical research and violation of human rights and call for steps the United States should take to provide relief and compensation to Guatemala and its people.

The George Butler Lecture Social Justice and Leisure The Usefulness and Uselessness of Research

Robert Garcia is Founding Director and Counsel at the City Project, a nonprofit legal and policy advocacy organization based in Los Angeles, California. Please send correspondence to Robert Garcia, The City Project, 1055 Wilshire Boulevard, Suite 1660, Los Angeles, CA 90017, rgarcia@cityprojectca.org The topic of this Butler Lecture is how to translate research through advocacy to seek equal access to parks and recreation and better health for all. The challenge in Los Angeles is this: Children of color living in poverty with limited access to a car have the worst access to parks and physical activity, to schools with five acres or more of playing fields, and to physical education in public schools. These children suffer disproportionately from obesity and diabetes and are the most at risk for gangs, crime, drugs, and violence (Garcia & Strongin, 2011; Garcia & Fenwick, 2009). Research has documented similar patterns in other regions in the state and nation (Maroko, Maantay, Sohler, Grady, & Arno, 2009; Snyder & Sickmund, 2006; Alleyne & LaPoint, 2004). Six strategies are relevant to address this challenge:

Social Science, Equal Justice and Public Health Policy: Translating Research into Action Through the Urban Greening Movement

In Los Angeles, California, United States of America, where one lives, the color of one’s skin, and how much money one has impacts one’s health and quality of life. One reason for this is that people of color and low-income people disproportionately lack access to safe places and programs for physical activity, including parks, school fields and green streets. People who lack access are deprived of the benefits of green space, including improved physical and mental health, the full development of the child including improved academic performance, positive alternatives to gangs, crime drugs and violence, social cohesion, economic vitality including green local jobs, and other values (Garcia and Strongin, 2011).