The face of Iowa is rapidly evolving. And, as with any major change, our communities have both challenges and treasures strewn out before them.

Two-thirds of Iowa’s population growth between 1990 and 2005 was fueled by immigration. Latinos are the state’s fastest growing population segment, their numbers increasing by 234 percent in 15 years. It is estimated that 125,000 Latinos now live in the state, which makes them Iowa’s largest minority population, outnumbering African-Americans by more than 40,000.

Annie Vander Werff, director of Global Health Corps and instructor at the University of Northern Iowa’s School of Health, Physical Education and Leisure Services, came to Cedar Rapids on Tuesday afternoon to present a program on health disparities among minority populations in Iowa as a part of the monthly Brown Bag Lunch series through Diversity Focus.

“Health is about balance,” said Vander Werff. “Health is important as a lifestyle and it is a balancing act in your own personal lifestyle as well as the larger community.”

As a way of showing how communities play a part in health, she read a poem written in 1895 by Joseph Malins titled, “A Fence or an Ambulance.” In the poem a beautifully tempting, but very dangerous cliff is described. The people who lived around the cliff knew of both the temptation and danger and decided something should be done. Two ideas — one to place an ambulance in the valley below to aid the fallen and another to fence the cliff’s edge to prevent the falling — were discussed. Call it a play on the adage: “An ounce of prevention is worth a pound of cure.”

There are, unfortunately, barriers for people who seek to attain a healthy balance through preventive medicine or urgent care. This is true for average Americans and especially true for immigrants who may face additional stresses of cultural differences, language issues and a general lack of understanding the system.

“Our landscape is changing in Iowa and also in the United States,” she said. “We are becoming a more diverse population. White population continues to grow at a steady rate — roughly 12 percent. In the United States as whole, however, we see Asian/Pacific Islander populations growing at 200 percent and beyond. We see Hispanic populations growing at over 100 percent. The nation’s black population grew by roughly 30 percent. We are definitely changing.”

This change has come about for many different reasons, she says, but by and large people are moving to the midwest and Iowa for the same reasons existing residents did: good jobs, low cost of living, affordable housing, quality education and safe communities.

“The disparity or the difference between the health of minority populations and the majority population as a whole is very different and, in many cases, the health of the minority population is much worse,” she said.

Barriers such as cost, transportation, values and beliefs, child care, availability and geographic location can prevent immigrants, as well as people who’ve been in the community longer, from attaining health care.

“If you have four children, no car and you don’t feel well, chances are you are not going to go your health appointment if the trip includes taking all your children and locating transportation,” she said. “You may feel as if putting forth that type of effort when you are already weakened may be too much or leave you feeling even worse.”

Free clinics are wonderful, she says, but when all variables are considered treatment may not be without a price tag if the costs of transportation, child care and time from work and family are considered.

Finally, health care professionals have an added weight on their shoulders as they bridge communication and values gaps. Vander Werff presented the following Chinese fable to illustrate:

Once upon a time a monkey and a fish were caught up in a great flood. The monkey, agile and experienced, had the good fortune to scramble up a tree to safety.

As he looked down into the raging waters, he saw a fish struggling against the swift current. Filled with a humanitarian desire to help his less fortunate fellow, he reached down and scooped the fish from the water.

To the monkey’s surprise, the fish was not very grateful for this aid.

“That poor monkey was only trying to help,” she said. “Many times this is what happens when health care providers and members of communities or organizations try to help immigrants. They have the best of intentions, but they move forward with a plan that does not consider the needs, values and beliefs of the immigrant population.”

Readers interested in more information should visit the Iowa Center of Health Disparities.