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Originally Processed With FOIA(s): FOIA Number: S S FOIA MARKER This is not a textual record. This is used as an administrative marker by the George Bush Presidential Library Staff. Record Group/Collection: George H.W. Bush Presidential Records Collection/Office of Origin: Speechwriting, White House Office of Series: Speech File Draft Files Subseries: Chron File, 1989-1993 OA/ID Number: 13566 Folder ID Number: 13566-006 Folder Title: Hispanic Business Leaders 5/9/91 [OA 6032] Stack: Row: Section: Shelf: Position: G 26 17 1 2 NAME OF SPEECH & DATE OF SPEECH Hispanic Business Leaders /Tree Trade 5/9/91 NAME OF WRITER : Grant NAME OF RESEARCHER: Cawley SPEECH SYNOPSIS: The President begins by auscussing the basic theory of "fast flack" which is that it allows us to negative in good faith The President track" in talks such as outlines the need for "fast Matt ; NaFla The Resident then states that he finds the ads put out by the offensive The pusident then apponents of last Hack Phsonally Ouscusses the mud for The President ends by asking uncleased free hade policies. for Support for "fast Hack" NAME OF SPEECH & DATE OF SPEECH NAME OF WRITER : NAME OF RESEARCHER: SPEECH SYNOPSIS: HISPANIC BUSINESS LEADERS - FREE TRADE INDIAN TREATY ROOM \ THURSDAY, MAY 9, 1991 \ 10:10 A.M. WELCOME TO THE WHITE HOUSE. WE'VE ALL BEEN VERY CONCERNED LATELY WITH TWO VITAL ISSUES: AMERICA'S ABILITY TO COMPETE IN THE GLOBAL MARKETPLACE AND OUR ABILITY TO NEGOTIATE WITH OUR TRADING PARTNERS. THE TWO CONCERNS MEET IN AN ISSUE THAT WE ALL CARE ABOUT DEEPLY: THE "FAST TRACK" PROCEDURES THAT I'VE ASKED CONGRESS TO EXTEND. - 2 - FAST TRACK PROCEDURES LET US NEGOTIATE IN GOOD FAITH WITH OUR TRADING PARTNERS AND WORK IN CONCERT WITH CONGRESS. THEY SIMPLY ENSURE THAT WE WILL NOT ALTER AGREEMENTS THAT OUR NEGOTIATORS HAVE REACHED WITH THEIR COUNTERPARTS. FAST TRACK DOESN'T TAKE AWAY CONGRESS' POWER TO ACCEPT OR REJECT TRADE AGREEMENTS. CONGRESS WILL STILL HAVE ITS SAY -- IN A YES-OR-NO VOTE -- BECAUSE FAST TRACK DOES NOT GUARANTEE APPROVAL OF ANY AGREEMENT. - 3 - AND I WILL CONSULT CONGRESS CLOSELY DURING THE COURSE OF TRADE TALKS, AS CALLED FOR BY FAST TRACK. WE HAVE PURSUED FAST-TRACK IN A BIPARTISAN MANNER -- AND WE SHALL DO THE SAME IN WORKING THROUGH TRADE AGREEMENTS. FAST TRACK'S MAIN VIRTUE IS THIS: IT PREVENTS 11TH-HOUR CHANGES TO AGREEMENTS WE HAVE REACHED, CHANGES THAT FORCE EVERYONE INVOLVED TO START FROM SCRATCH. - 4 - CONGRESS FIRST ESTABLISHED FAST TRACK PROCEDURES IN 1974, AND WE HAVE USED IT IN NEGOTIATING THREE MAJOR TRADE AGREEMENTS SINCE. As MANY OF YOU KNOW, FAST TRACK ALSO PLAYS AN ESSENTIAL ROLE IN HELPING US ADVANCE THREE OTHER IMPORTANT TRADE INITIATIVES: THE URUGUAY ROUND OF GATT TALKS; THE NORTH AMERICAN FREE TRADE AGREEMENT AND THE ENTERPRISE FOR THE AMERICAS INITIATIVE. - 5 - [[UNFORTUNATELY, SOME OPPONENTS OF FREE TRADE HAVE RESORTED TO SCARE TACTICS IN TRYING To DERAIL FAST TRACK. I'VE BROUGHT ALONG A COUPLE OF EXAMPLES OF THIS STUFF. HERE'S ONE AD THAT IMPLIES FAST TRACK WILL LEAD TO RAW SEWAGE, DISEASE, AND CONTAMINATED FOOD SUPPLIES TO OUR COUNTRY -- CHOLD UP TWO ADS -- SEE ATTACHED]. THE OTHER AD DISTORTS THE TRUTH THE OLD FASHIONED WAY. IT WRENCHES QUOTES OUT OF CONTEXT AND TRIES TO GIVE THE IMPRESSION THAT FOREIGNERS -- IN THIS CASE, OUR MEXICAN NEIGHBORS -- SOMEHOW WILL POISON AMERICAN CITIZENS. - 6 - I FIND THESE ADS PERSONALLY OFFENSIVE. THEY PROMOTE NOTHING MORE THAN PREJUDICE AND RACISM. THEY ALSO MISS THE POINT. FREE TRADE ENCOURAGES ECONOMIC GROWTH AND INTERNATIONAL UNDERSTANDING. IT ENABLES US TO BUILD BONDS OF COMMON INTEREST AND COMMON EXPERIENCE. IT MAY BE THE MOST EFFECTIVE ANTIDOTE TO THE KIND OF POISON THESE ADS SPREAD AMONG OUR PEOPLE.]] - 7 - OPEN MARKETS AND FREE TRADE MEAN STRONGER ALLIANCES AND BETTER RELATIONS. IT MEANS WE BECOME BETTER NEIGHBORS, BECAUSE WE'LL BRING OUT THE BEST IN PEOPLE -- NOT THE WORST. TAKE A LOOK AT WHAT THE NORTH AMERICAN FREE TRADE AGREEMENT WILL CREATE: THE LARGEST, RICHEST MARKET IN THE WORLD. THAT'S 360 MILLION CONSUMERS AND $6 TRILLION IN ANNUAL OUTPUT. - 8 - AND TAKE A LOOK AT THE ALMOST 130 PERCENT INCREASE IN OUR EXPORTS TO MEXICO OVER THE PAST FOUR YEARS. THIS EXPORT BOOM HAS CREATED 264,000 NEW EXPORT-RELATED JOBS IN THE UNITED STATES. AND EACH ADDITIONAL BILLION DOLLARS IN EXPORTS TO MEXICO WILL CREATE APPROXIMATELY 20,000 NEW JOBS HERE IN THE UNITED STATES. - 9 - So YOU SEE, WE HAVE MUCH TO GAIN FROM EXTENDING FAST TRACK -- A NEW ERA OF OPEN, FREE AND FAIR TRADE -- A FUTURE OF UNPRECEDENTED ECONOMIC GROWTH AND REGIONAL HARMONY. THE VOTE ON FAST TRACK REALLY IS A VOTE ON WHAT KIND OF OUTLOOK WE SHARE -- ONE OF OPTIMISM AND INTEGRITY, OR ONE OF SELF-DOUBT AND PETTY PREJUDICE. - 10 - A "YES" VOTE MEANS A VOTE FOR "GOOD FAITH" AND THE STRENGTH OF OUR WORD. WE WILL NOT ALLOW THE FEARMONGERS TO CONTROL OUR AGENDA. WE MUST RELY ON OUR BETTER SELVES -- OUR TRUER SELVES. FAST TRACK PLAYS A CRITICAL ROLE IN HELPING THE UNITED STATES COMPETE IN A WORLD UNITED BY BONDS OF COMMERCE. - 11 - WE WILL NEED YOUR SUPPORT IN PERSUADING CONGRESS TO EXTEND FAST TRACK PROCEDURES. WE WILL NEED YOUR HELP AS BUSINESSMEN AND WOMEN, AS ENTREPRENEURS, AS MEN AND WOMEN FROM ALL WALKS OF LIFE. BUT MOST OF ALL, WE NEED YOUR HELP AS AMERICANS COMMITTED TO THE IDEALS OF FREEDOM AND OPPORTUNITY. HELP US BUILD GOOD FAITH WITH OUR FRIENDS AND NEIGHBORS. - 12 - HELP US DEVELOP BETTER WORKING RELATIONS WITH CONGRESS. LET US SHOW OUR BETTER SELVES TO THE WHOLE WORLD. WITH YOUR HELP, I KNOW WE WILL SUCCEED. ONCE AGAIN, THANK YOU AND GOD BLESS EACH OF YOU. ### Grant/Cawley May 7, 1991 / 1 p.m. A:ADS / Draft two BRIEF REMARKS: HISPANIC BUSINESS LEADERS / FREE TRADE THE INDIAN TREATY ROOM THURSDAY, MAY 9, 1991 9:30 A.M. ( (Acknowledgements)) First of all, welcome to the White House. We've all been very concerned lately with two vital issues: America's ability to compete in the global marketplace and our ability to negotiate with our trading partners. The two concerns meet in an issue that we all care about deeply: the "fast track" procedures that I've asked Congress to extend. Fast track procedures let us negotiate in good faith with our trading partners and work in concert with Congress. They simply ensure that we will not alter agreements that our negotiators have reached with their counterparts. Fast-track doesn't take away Congress' power to accept or reject trade agreements. Congress will still have its say -- in a yes-or-no vote -- because fast track does not guarantee approval of any agreement. And we have promised to consult closely with Congress during the course of trade talks. Fast track's main virtue is this: It prevents 11th-hour changes to agreements we have reached, changes that force everyone involved to start from scratch. Congress first gave the president fast track authority in 1974, and we have used it in negotiating three major trade agreements since. As many of you know, fast track also can play 2 a role in helping us complete three other important trade initiatives: The Uruguay Round of GATT talks; the North American Free Trade Agreement and the Enterprise for the Americas Initiative. Unfortunately, some opponents of free trade have decided to mount a smear campaign in hopes of derailing fast-track. Ignoring the facts, they have tried to frighten people with scare tactics and race-baiting. I've got a couple examples of this disgusting propaganda with me today. Here's one ad that questions the health and sanitary habits of Hispanic people -- [HOLD UP TWO ADS -- SEE ATTACHED]. The other ad distorts the truth the old fashioned way. It wrenches quotes out of context and tries to give the impression that foreigners -- in this case, our Mexican neighbors -- somehow will poison American citizens. I find these ads personally offensive. They promote nothing more than prejudice and racism. Although it really shouldn't be necessary, let me set the record straight. According to the American Journal of Public Health, Mexicans and Mexican Americans have better birth outcomes, lower drug use, and healthier diets than non-Hispanic whites. This information was further supported by the January 1991 issue of the Journal of the American Medical Association. There is no evidence that trade agreements with Mexico -- agreements that fast-track procedures would facilitate -- will have any adverse impact on the quality of our food or water. 3 But there's another point: Free trade encourages economic growth and international understanding. It enables us to build bonds of common interest and common experience. It may be the most effective antidote to the kind of poison these ads spread among our people. Open markets and free trade mean stronger alliances and better relations. It means we become better neighbors, because we'll bring out the best in people -- not the worst, as our opponents want. One ad reads: "There's a lot at stake here. But a lot of important considerations are getting pushed aside in the fast track rhetoric." I couldn't agree more on this narrow point. Important considerations have been pushed aside -- by the people who sponsor these ads. Take a look what the North American Free Trade Agreement will create: the largest, richest market in the world. That's 360 million consumers and $6 trillion in annual output. And take a look at the 130 percent increase in our exports to Mexico over the past four years. This export boom has created 264,000 new jobs in the United States. And each additional billion dollars in exports will create 20,000 new jobs here in the United States. I didn't read about that in those ads. So you see, we have much to gain from extending fast track - - a new era of open, free and fair trade -- a future of unprecedented economic growth and regional harmony. 4 A "yes" vote on fast-track really is a vote on what kind of outlook we share -- one of optimism and integrity, or one of self-doubt and petty prejudice. A "yes" vote means a vote for "good faith" and the strength of our word. We can't allow bigots and fearmongers to control our agenda. We must rely on our better selves -- our truer selves. Fast track plays a critical role in helping the United States compete in a world newly united by bonds of commerce. We will need your support as Hispanic leaders in persuading Congress to extend fast-track procedures. We will need your help as businessmen and women, as entrepreneurs, as men and women from all walks of life. But most of all, we need your help as Americans committed to the ideals of freedom and opportunity. Help us build good faith with our friends and neighbors. Help us develop better working relations with Congress. And help us stifle the voices that want to replace reason with rancor, cooperation with discrimination. With your help, I know we will succeed. Once again, thank you and God bless each of you. # # # Grant/Cawley May 7, 1991 / 1 p.m. A:ADS / Draft three BRIEF REMARKS: HISPANIC BUSINESS LEADERS / FREE TRADE THE INDIAN TREATY ROOM THURSDAY, MAY 9, 1991 10:10 A.M. Welcome to the White House. We've all been very concerned lately with two vital issues: America's ability to compete in the global marketplace and our ability to negotiate with our trading partners. The two concerns meet in an issue that we all care about deeply: the "fast track" procedures that I've asked Congress to extend. Fast track procedures let us negotiate in good faith with our trading partners and work in concert with Congress. They simply ensure that we will not alter agreements that our negotiators have reached with their counterparts. Fast track doesn't take away Congress' power to accept or reject trade agreements. Congress will still have its say -- in a yes-or-no vote -- because fast track does not guarantee approval of any agreement. And I will consult Congress closely during the course of trade talks, as called for by fast track. We have pursued fast-track in a bipartisan manner -- and we shall do the same in working through trade agreements. Fast track's main virtue is this: It prevents 11th-hour changes to agreements we have reached, changes that force everyone involved to start from scratch. Congress first established fast track procedures in 1974, and we have used it in negotiating three major trade agreements 2 since. As many of you know, fast track also plays an essential role in helping us advance three other important trade initiatives: The Uruguay Round of GATT talks; the North American Free Trade Agreement and the Enterprise for the Americas Initiative. Unfortunately, some opponents of free trade have resorted to scare tactics in trying to derail fast track. [[I've brought along a couple of examples of this stuff. Here's one ad that questions the health and sanitary habits of Hispanic people -- [HOLD UP TWO ADS -- SEE ATTACHED]. The other ad distorts the truth the old fashioned way. It wrenches quotes out of context and tries to give the impression that foreigners -- in this case, our Mexican neighbors -- somehow will poison American citizens. ]] I find these ads personally offensive. They promote nothing more than prejudice and racism. They also miss the point. Free trade encourages economic growth and international understanding. It enables us to build bonds of common interest and common experience. It may be the most effective antidote to the kind of poison these ads spread among our people. Open markets and free trade mean stronger alliances and better relations. It means we become better neighbors, because we'll bring out the best in people -- not the worst. Take a look at what the North American Free Trade Agreement will create: the largest, richest market in the world. That's 360 million consumers and $6 trillion in annual output. 3 And take a look at the almost 130 percent increase in our exports to Mexico over the past four years. This export boom has created 264,000 new export-related jobs in the United States. And each additional billion dollars in exports to Mexico will create approximately 20,000 new jobs here in the United States. So you see, we have much to gain from extending fast track -- a new era of open, free and fair trade -- a future of unprecedented economic growth and regional harmony. The vote on fast track really is a vote on what kind of outlook we share -- one of optimism and integrity, or one of self-doubt and petty prejudice. A "yes" vote means a vote for "good faith" and the strength of our word. We will not allow the fearmongers to control our agenda. We must rely on our better selves -- our truer selves. Fast track plays a critical role in helping the United States compete in a world united by bonds of commerce. We will need your support in persuading Congress to extend fast track procedures. We will need your help as businessmen and women, as entrepreneurs, as men and women from all walks of life. But most of all, we need your help as Americans committed to the ideals of freedom and opportunity. Help us build good faith with our friends and neighbors. Help us develop better working relations with Congress. Let us show our better selves to the whole world. With your help, I know we will succeed. Once again, thank you and God bless each of you. # # # THE WHITE HOUSE WASHINGTON May 8, 1991 MEMORANDUM FOR THE PRESIDENT THROUGH: TONY SNOW TS FROM: MARY KATE GRANT mkg SUBJECT: HISPANIC BUSINESS LEADERS MEETING ON FREE TRADE I. SUMMARY with Hispanic business leaders, to be held Thursday, May 9, at Attached for your review are brief remarks for your meeting 10:10 a.m. in the Indian Treaty Room. You will be addressing a crowd of about 80 on the issue of fast track. Tentatively, Ambassador Hills will be speaking before you; Ambassador Gustavo Petricioli of Mexico will be present. II. DISCUSSION Your remarks take the high road, and denounce the scare tactics used by some of those opposed to fast track -- particularly a series of print ads, which are attached. Document No 23428455 WHITE HOUSE STAFFING MEMORANDUM 91 MAY 9 A10: 04 DATE: 5/8/91 ACTION/CONCURRENCE/COMMENT DUE BY: --- SUBJECT: PRESIDENTIAL REMARKS: HISPANIC BUSINESS LEADERS MEETING ON FREE TRADE ACTION FYI ACTION FYI VICE PRESIDENT MCCLURE SUNUNU PETERSMEYER SCOWCROFT PORTER DARMAN ROGICH BRADY SMITH BROMLEY UNTERMEYER CARD BOSKIN DEMAREST MARTINEZ FITZWATER ROGERS GRAY SNOW HOLIDAY REMARKS: The attached has been forwarded to the President. RESPONSE: PHILLIP D. BRADY Assistant to the President and Staff Secretary Ext. 2702 THE WHITE HOUSE WASHINGTON SLHAY -8 PM 5:51 5: May 8, 1991 MEMORANDUM FOR THE PRESIDENT THROUGH: TONY SNOW TS FROM: MARY KATE GRANT mkg SUBJECT: HISPANIC BUSINESS LEADERS MEETING ON FREE TRADE I. SUMMARY Attached for your review are brief remarks for your meeting with Hispanic business leaders, to be held Thursday, May 9, at 10:10 a.m. in the Indian Treaty Room. You will be addressing a crowd of about 80 on the issue of fast track. Tentatively, Ambassador Hills will be speaking before you; Ambassador Gustavo Petricioli of Mexico will be present. II. DISCUSSION Your remarks take the high road, and denounce the scare tactics used by some of those opposed to fast track -- particularly a series of print ads, which are attached. Grant/Cawley May 7, 1991 / 1 p.m. A:ADS / Draft three BRIEF REMARKS: HISPANIC BUSINESS LEADERS / FREE TRADE THE INDIAN TREATY ROOM THURSDAY, MAY 9, 1991 10:10 A.M. Welcome to the White House. We've all been very concerned lately with two vital issues: America's ability to compete in the global marketplace and our ability to negotiate with our trading partners. The two concerns meet in an issue that we all care about deeply: the "fast track" procedures that I've asked Congress to extend. Fast track procedures let us negotiate in good faith with our trading partners and work in concert with Congress. They simply ensure that we will not alter agreements that our negotiators have reached with their counterparts. Fast track doesn't take away Congress' power to accept or reject trade agreements. Congress will still have its say -- in a yes-or-no vote -- because fast track does not guarantee approval of any agreement. And I will consult Congress closely during the course of trade talks, as called for by fast track. We have pursued fast-track in a bipartisan manner -- and we shall do the same in working through trade agreements. Fast track's main virtue is this: It prevents 11th-hour changes to agreements we have reached, changes that force everyone involved to start from scratch. Congress first established fast track procedures in 1974, and we have used it in negotiating three major trade agreements 2 since. As many of you know, fast track also plays an essential role in helping us advance three other important trade initiatives: The Uruguay Round of GATT talks; the North American Free Trade Agreement and the Enterprise for the Americas Initiative. Unfortunately, some opponents of free trade have resorted to scare tactics in trying to derail fast track. [[I've brought along a couple of examples of this stuff. Here's one ad that questions the health and sanitary habits of Hispanic people -- [HOLD UP TWO ADS -- SEE ATTACHED]. The other ad distorts the truth the old fashioned way. It wrenches quotes out of context and tries to give the impression that foreigners -- in this case, our Mexican neighbors -- somehow will poison American citizens. ]] I find these ads personally offensive. They promote nothing more than prejudice and racism. They also miss the point. Free trade encourages economic growth and international understanding. It enables us to build bonds of common interest and common experience. It may be the most effective antidote to the kind of poison these ads spread among our people. Open markets and free trade mean stronger alliances and better relations. It means we become better neighbors, because we'll bring out the best in people -- not the worst. Take a look at what the North American Free Trade Agreement will create: the largest, richest market in the world. That's 360 million consumers and $6 trillion in annual output. 3 And take a look at the almost 130 percent increase in our exports to Mexico over the past four years. This export boom has created 264,000 new export-related jobs in the United States. And each additional billion dollars in exports to Mexico will create approximately 20,000 new jobs here in the United States. So you see, we have much to gain from extending fast track -- a new era of open, free and fair trade -- a future of unprecedented economic growth and regional harmony. The vote on fast track really is a vote on what kind of outlook we share -- one of optimism and integrity, or one of self-doubt and petty prejudice. A "yes" vote means a vote for "good faith" and the strength of our word. We will not allow the fearmongers to control our agenda. We must rely on our better selves -- our truer selves. Fast track plays a critical role in helping the United States compete in a world united by bonds of commerce. We will need your support in persuading Congress to extend fast track procedures. We will need your help as businessmen and women, as entrepreneurs, as men and women from all walks of life. But most of all, we need your help as Americans committed to the ideals of freedom and opportunity. Help us build good faith with our friends and neighbors. Help us develop better working relations with Congress. Let us show our better selves to the whole world. With your help, I know we will succeed. Once again, thank you and God bless each of you. # # # KaLL CaLL ApriL29 29 p.7 U.S. - MEXICO TRADE NEGOTIATIONS Fast Track W hat would fast track trade fast track rhetoric. In terms of negotiations between the U.S. safe food and drinking water. and Mexico really produce? there is already a problem of crisis Could Be From the standpoint of food proportions along both sides of safety and water quality, it would the border. Fast track is not a Hazardous To make an already deplorable framework for solving these situation worse. problems. What we drink. This issue-and its long-term Your Health political and economic Mexican border towns like ramifications-deserves a lot Matamoros and Juarez have more than a simple up or down virtually no sewage facilities for vote by Congress. their populations that swell as the maquiladora plants expand. With Congress should reject fast no treatment facilities, health track it's a shortcut to disaster. FAST problems abound on both sides of the border. TRACK In San Elizario, Texas, for example, 90 percent of the people have Hepatitis A by the time they reach age 30. Nogales, Arizona, has a Hepatitis A rate 20 times the U.S. national average. What we eat. DISASTER With no treatment facilities, TO produce destined for export may be irrigated with polluted water. including raw sewage. Irapuato, a town in Guanajuato is an example. There's a lot at stake here. But a lot of important considerations are getting pushed aside in the AEL-CIO 815 SIXTEENTH STREET, N.W. WASHINGTON, D.C. 20006 POISON! Fast Track Environmental specialists-especially those concerned about water-say the (border) area's natural resources cannot handle the extra economic development free-trade advocates The More You Read foresee. -The Economist April 20, 1991 The Worse It Gets Indiscriminate dumping or long-term storage of industrial garbage and hazardous wastes is trashing the landscape and poisoning the water and soil. FAST -U.S. News & World Report May 6. 1991 SHORTENT TRACK Uncontrolled air and water pollution is rapidly deteriorating and seriously affecting the health and future economic vitality on both sides of the border. -American Medical Association June, 1990 TO DISASTER Their very success (the maquiladoras) is helping turn much of the border region into a sinkhole of abysmal living conditions and environmental degradation. -Wall Street Journal September 27, 1989 T he case against fast track free This issue-and its long-term trade negotiations between the political and economic U.S. and Mexico grows ramifications-deserves a lot stronger every day. There's a lot more than a simple up or down more at stake here than the fast vote by Congress. track rhetoric would lead you to Congress should reject fast track believe. it's a shortcut to disaster. AFL-CIO 815 SIXTEENTH STREET, N.W. WASHINGTON, D.C. 20006 Document No. 236286SS WHITE HOUSE STAFFING MEMORANDUM DATE: 5/8/91 ACTION/CONCURRENCE/COMMENT DUE BY: TODAY 5/8/91 1:00PM SUBJECT: BRIEF REMARKS: HISPANIC BUSINESS LEADERS/ FREE TRADE ACTION FYI ACTION FYI VICE PRESIDENT MCCLURE omaster SUNUNU PETERSMEYER SCOWCROFT PORTER DARMAN ROGICH N/V BRADY SMITH BROMLEY UNTERMEYER CARD BOSKIN N/C DEMAREST MARTINEZ FITZWATER ROGERS GRAY N/C SNOW HOLIDAY REMARKS: Please forward your comments directly to Tony Snow, Rm. 122, x2930, no later than 1:00 p.m., TODAY, WEDNESDAY, MAY 8, with a copy to this office. RESPONSE: PHILLIP D. BRADY Assistant to the President and Staff Secretary Ext. 2702 Grant/Cawley May 7, 1991 / 1 p.m. 91 MAY -8 AM 8: 00 A:ADS / Draft two BRIEF REMARKS: HISPANIC BUSINESS LEADERS / FREE TRADE THE INDIAN TREATY ROOM THURSDAY, MAY 9, 1991 9:30 A.M. ((Acknowledgements)) First of all, welcome to the White House. We've all been very concerned lately with two vital issues: America's ability to compete in the global marketplace and our ability to negotiate with our trading partners. The two concerns meet in an issue that we all care about deeply: the "fast track" procedures that I've asked Congress to extend. Fast track procedures let us negotiate in good faith with our trading partners and work in concert with Congress. They simply ensure that we will not alter agreements that our negotiators have reached with their counterparts. Fast-track doesn't take away Congress' power to accept or reject trade agreements. Congress will still have its say in a yes-or-no vote -- because fast track does not guarantee approval of any agreement. And we have promised to consult closely with Congress during the course of trade talks. Fast track's main virtue is this: It prevents 11th-hour changes to agreements we have reached, changes that force everyone involved to start from scratch. Congress first gave the president fast track authority in 1974, and we have used it in negotiating three major trade agreements since. As many of you know, fast track also can play 2 a role in helping us complete three other important trade initiatives: The Uruguay Round of GATT talks; the North American Free Trade Agreement and the Enterprise for the Americas Initiative. Unfortunately, some opponents of free trade have decided to mount a smear campaign in hopes of derailing fast-track. Ignoring the facts, they have tried to frighten people with scare tactics and race-baiting. I've got a couple examples of this disgusting propaganda with me today. Here's one ad that questions the health and sanitary habits of Hispanic people -- [HOLD UP TWO ADS -- SEE ATTACHED]. The other ad distorts the truth the old fashioned way. It wrenches quotes out of context and tries to give the impression that foreigners -- in this case, our Mexican neighbors -- somehow will poison American citizens. I find these ads personally offensive. They promote nothing more than prejudice and racism. Although it really shouldn't be necessary, let me set the record straight. According to the American Journal of Public Health, Mexicans and Mexican Americans have better birth outcomes, lower drug use, and healthier diets than non-Hispanic whites. This information was further supported by the January 1991 issue of the Journal of the American Medical Association. There is no evidence that trade agreements with Mexico -- agreements that fast-track procedures would facilitate -- will have any adverse impact on the quality of our food or water. 3 But there's another point: Free trade encourages economic growth and international understanding. It enables us to build bonds of common interest and common experience. It may be the most effective antidote to the kind of poison these ads spread among our people. Open markets and free trade mean stronger alliances and better relations. It means we become better neighbors, because we'll bring out the best in people -- not the worst, as our opponents want. One ad reads: "There's a lot at stake here. But a lot of important considerations are getting pushed aside in the fast track rhetoric." I couldn't agree more on this narrow point. Important considerations have been pushed aside -- by the people who sponsor these ads. Take a look what the North American Free Trade Agreement will create: the largest, richest market in the world. That's 360 million consumers and $6 trillion in annual output. And take a look at the 130 percent increase in our exports to Mexico over the past four years. This export boom has created 264,000 new jobs in the United States. And each additional billion dollars in exports will create 20,000 new jobs here in the United States. I didn't read about that in those ads. So you see, we have much to gain from extending fast track - - a new era of open, free and fair trade -- a future of unprecedented economic growth and regional harmony. extending 4 A "yes" vote on fast-track really is a vote on what kind of outlook we share -- one of optimism and integrity, or_one of - self-doubt and petty prejudice. A "yes" vote means a vote for "good faith" and the strength of our word. We can't allow bigots and fearmongers to control our agenda. We must rely on our better selves -- our truer selves. Fast track plays a critical role in helping the United States compete in a world newly united by bonds of commerce. We will need your support as Hispanic leaders in persuading Congress to extend fast-track procedures. We will need your help as businessmen and women, as entrepreneurs, as men and women from all walks of life. But most of all, we need your help as Americans committed to the ideals of freedom and opportunity. Help us build good faith with our friends and neighbors. Help us develop better working relations with Congress. And help us stifle the voices that want to replace reason with rancor, cooperation with discrimination. with your help, I know we will succeed. Once again, thank you and God bless each of you. # # # KaLL CaLL ApriL29 29 p.7 U.S. - MEXICO TRADE NEGOTIATIONS Fast Track W hat would fast track trade fast track rhetoric. In terms of negotiations between the U.S. safe food and drinking water, and Mexico really produce? there is already a problem of crisis Could Be From the standpoint of food proportions along both sides of safety and water quality, it would the border. Fast track is not a Hazardous To make an already deplorable framework for solving these situation worse. problems. What we drink. This issue-and its long-term Your Health political and economic Mexican border towns like ramifications-deserves a lot Matamoros and Juarez have more than a simple up or down virtually no sewage facilities for vote by Congress. their populations that swell as the maquiladora plants expand. With Congress should reject fast no treatment facilities, health track it's a shortcut to disaster. FAST problems abound on both sides of the border. TRACK In San Elizario, Texas, for example, 90 percent of the people have Hepatitis A by the time they INSTRUET reach age 30. Nogales, Arizona. has a Hepatitis A rate 20 times the U.S. national average. What we eat. DISASTER With no treatment facilities, TO produce destined for export may be irrigated with polluted water, including raw sewage. Irapuato. a town in Guanajuato, is an example. There's a lot at stake here. But a lot of important considerations are getting pushed aside in the AFL-CIO 815 SIXTEENTH STREET, N.W. WASHINGTON, D.C. 20006 POISON! Fast Track Environmental specialists-especially those concerned about water-say the (border) area's natural resources cannot handle the extra economic development free-trade advocates The More You Read foresee. -The Economist April 20, 1991 The Worse It Gets Indiscriminate dumping or long-term storage of industrial garbage and hazardous wastes is trashing the landscape and poisoning the water and soil. FAST -U.S. News & World Report May 6, 1991 SHORTERT TRACK Uncontrolled air and water pollution is rapidly deteriorating and seriously affecting the health and future economic vitality on both sides of the border. -American Medical Association June, 1990 TO DISASTER Their very success (the maquiladoras) is helping turn much of the border region into a sinkhole of abysmal living conditions and environmental degradation. -Wall Street Journal September 27, 1989 T he case against fast track free This issue-and its long-term trade negotiations between the political and economic U.S. and Mexico grows ramifications-deserves a lot stronger every day. There's a lot more than a simple up or down more at stake here than the fast vote by Congress. track rhetoric would lead you to believe. Congress should reject fast track it's a shortcut to disaster. AFL-CIO 815 SIXTEENTH STREET, N.W. WASHINGTON, D.C. 20006 Document No. 235552SS WHITE HOUSE STAFFING MEMORANDUM 91 MAY 9 A10: 04 DATE: 5/8/91 ACTION/CONCURRENCE/COMMENT DUE BY: --- SUBJECT: DEPARTURE STATEMENT FOLLOWING MEETING WITH SEC. GENERAL DE CUELLAR ACTION FYI ACTION FYI VICE PRESIDENT MCCLURE SUNUNU PETERSMEYER SCOWCROFT PORTER DARMAN ROGICH BRADY SMITH BROMLEY UNTERMEYER CARD ROGERS DEMAREST SNOW FITZWATER FIRESTONE GRAY HOLIDAY REMARKS: The attached has been forwarded to the President. RESPONSE: PHILLIP D. BRADY Assistant to the President and Staff Secretary Ext. 2702 THE WHITE HOUSE WASHINGTON 91 MAY -7 PM 4:51 May 7, 1991 MEMORANDUM FOR THE PRESIDENT THROUGH: TONY SNOW TS FROM: DAN McGROARTY Durcr SUBJECT: DEPARTURE STATEMENT FOLLOWING MEETING WITH SECRETARY GENERAL PEREZ DE CUELLAR I. SUMMARY On Thursday, May 9, at 1:15 p.m., you and Secretary General Perez de Cuellar will give departure statements at the Diplomatic Entrance. II. DISCUSSION Your remarks (6 minutes, cards) focus on the UN's recent string of successes and on the common challenges we face in the Persian Gulf and beyond. # # # McGroarty/Dooley May 7, 1991 4:00 pm [CUELLAR] PRESIDENTIAL REMARKS: STATEMENT FOLLOWING MEETING WITH SECRETARY GENERAL PEREZ DE CUELLAR THE DIPLOMATIC ENTRANCE MAY 9, 1991 1:15 p.m. Mr. Secretary General: it has been my pleasure to welcome you to the White House today -- to discuss with you the many issues now on the world's agenda. In a moment, I'll speak about a few of the common challenges we face. But before I do, permit me a personal observation. I often think back to the times we worked together as Perm Reps 20 years ago -- and I still wonder how it is I ended up with the easier job. The problems that arrive at your doorstep often are the product of years of violence and strife. It falls to you to find -- through so much hatred and bitterness -- the path to peace. For 10 years now you've led the UN. Your years as Secretary General could merely have been difficult -- a study in stubborn hope. Instead, they have proved momentous -- historic. During your years of service, the UN has come of age. After decades of ideological stalemate, conflict and Cold War -- the UN has at long last taken a major step forward as a true force for peace. Today, the UN can lay claim to a string of successes stretching across the globe. In Africa, the UN played a leading in the birth of an independent Namibia. Elsewhere on the African continent, the UN now works to end the war in Angola, and resolve the future of the Western Sahara. / Across Asia, the UN 2 continues to play a critical role in peacemaking efforts in Afghanistan and Cambodia. / Right here in our own hemisphere, the UN has helped the people of Nicaragua and Haiti exercise their right to choose their own government -- and is working to bring peace to El Salvador. And of course, there is the United Nation's role in the liberation of Kuwait. The United Nations sent its strong, steady signal every step of the way. Defending the defenseless against aggression. Keeping faith with its founding principles. Standing fast for what is good and right. Mr. Secretary General, a great measure of this success belongs to you, my friend: the product of your patience and perseverance, your immeasurable diplomatic skill -- your unwavering desire for peace. // But for each success -- new challenges remain. Mr. Secretary General, consider the unprecedented responsibilities placed upon your good offices and the UN Secretariat by Security Council Resolution 687: the Administration of UNIKOM, / the Special Commission for eliminating Iraq's weapons of mass destruction, / the Compensation Commission, / the UN's role in demarcating the Iraq-Kuwait border, developing guidelines for the arms embargo against Iraq, and encouraging arms control in the region -- all of these are daunting tasks which will challenge the UN as never before. Mr. Secretary General, we are responding to another challenge, too -- the need to protect and care for tens of 3 thousands of refugees who fled home and hearth to escape the brutality of one man, Saddam Hussein. / For our part, the U.S. has responded to this human wave of tragedy with massive emergency relief for the refugees in Northern Iraq and Turkey. Working with other nations -- in close consultation with you, sir -- and in accord with Resolution 688, we are building temporary camps to encourage these people to come down from the mountains into the camps -- and ultimately to their own villages and towns. We have always looked at this relief effort as limited in duration. We are now in the process of turning these efforts over to the UN. We look forward to working with the United Nations to hasten the day when all these refugees can return home -- free from fear, free to live in peace. // In the South, American soldiers provided refuge and care to thousands of Iraqis. Those who sought refuge are now safe in Iran or Saudi Arabia. The Blue Helmets are on the scene, and UN relief agencies are providing assistance to those Iraqis who have chosen to remain in the area where the UN is now working. The UN's work in Iraq is just one of many challenges. Beyond the Gulf, we must work to strengthen the UN system itself through appropriate reforms -- to deliver development assistance where needed -- and to chart a common course of action on global issues ranging from the environment to international drug trafficking to terrorism. / And we must build on the UN's ability to respond to humanitarian crises which -- as we've seen 4 most recently in the heart-wrenching ordeal of Bangladesh -- speak a universal language of simple human compassion. // Mr. Secretary General, meeting these challenges is the work of the United States -- and the United Nations. I thank you for travelling to Washington, so that we could continue our practice of close consultations -- and I congratulate you, on behalf of the American people, for doing the world's work -- the work of peace. # # # Document No. 236286SS 91 MAY 8 WHITE HOUSE STAFFING MEMORANDUM DATE: 5/8/91 ACTION/CONCURRENCE/COMMENT DUE BY: TODAY 5/8/91 1:00PM SUBJECT: BRIEF REMARKS: HISPANIC BUSINESS LEADERS/ FREE TRADE ACTION FYI ACTION FYI VICE PRESIDENT MCCLURE SUNUNU PETERSMEYER SCOWCROFT PORTER DARMAN ROGICH BRADY SMITH BROMLEY UNTERMEYER CARD BOSKIN DEMAREST MARTINEZ FITZWATER ROGERS GRAY SNOW HOLIDAY REMARKS: Please forward your comments directly to Tony Snow, Rm. 122, x2930, no later than 1:00 p.m., TODAY, WEDNESDAY, MAY 8, with a copy to this office. RESPONSE: Attach PHILLIP D. BRADY Assistant to the President and Staff Secretary Ext. 2702 Grant/Cawley May 7, 1991 / 1 p.m. 91 MAY -8 AM 8: 00 A:ADS / Draft two BRIEF REMARKS: HISPANIC BUSINESS LEADERS / FREE TRADE THE INDIAN TREATY ROOM THURSDAY, MAY 9, 1991 9:30 A.M. ((Acknowledgements) ) First of all, welcome to the White House. We've all been very concerned lately with two vital issues: America's ability to compete in the global marketplace and our ability to negotiate with our trading partners. The two concerns meet in an issue that we all care about deeply: the "fast track" procedures that I've asked Congress to extend. Fast track procedures let us negotiate in good faith with our trading partners and work in concert with Congress. They simply ensure that we will not alter agreements that our negotiators have reached with their counterparts. Fast-track doesn't take away Congress' power to accept or reject trade agreements. Congress will still have its say -- in a yes-or-no vote -- because fast track does not guarantee approval of any agreement. And we have promised to consult closely with Congress during the course of trade talks. Fast track's main virtue is this: It prevents 11th-hour changes to agreements we have reached, changes that force everyone involved to start from scratch. Congress first gave the president fast track authority in 1974, and we have used it in negotiating three major trade agreements since. As many of you know, fast track also can play WE HAVE UNDERTAKEN THIS IN A BIPARTISAN MANNER- MMCH THE SAME way WE WILL NEGOTIATE OUD TREATIES - 2 a role in helping us complete three other important trade initiatives: The Uruguay Round of GATT talks; the North American Free Trade Agreement and the Enterprise for the Americas Initiative. Unfortunately, some opponents of free trade have decided to mount a smear campaign in hopes of derailing fast-track. Ignoring the facts, they have tried to frighten people with scare AWFVL tactics 7 and race-baiting. I've got a couple examples of this disgusting propaganda with me today. Here's one ad that questions the health and sanitary habits of Hispanic people -- [HOLD UP TWO ADS -- SEE ATTACHED]. The other ad distorts the truth the old fashioned way. It wrenches quotes out of context and tries to give the impression that foreigners -- in this case, our Mexican neighbors -- somehow will poison American citizens. I find these ads personally offensive. They promote nothing more than prejudice and racism. Although it really shouldn't be necessary, let me set the record straight. According to the American Journal of Public Health, Mexicans and Mexican Americans have better birth outcomes, lower drug use, and healthier diets than non-Hispanic whites. This information was further supported by the January 1991 issue of the Journal of the American Medical Association. There is no evidence that trade agreements with Mexico -- agreements that fast-track procedures would facilitate -- will have any adverse impact on the quality of our food or water. 3 But there's another point: Free trade encourages economic growth and international understanding. It enables us to build bonds of common interest and common experience. It may be the most effective antidote to the kind of poison these ads spread among our people. Open markets and free trade mean stronger alliances and better relations. It means we become better neighbors, because we'll bring out the best in people -- not the worst, as our opponents want. One ad reads: "There's a lot at stake here. But a lot of important considerations are getting pushed aside in the fast track rhetoric." I couldn't agree more on this narrow point. Important considerations have been pushed aside -- by the people who sponsor these ads. Take a look what the North American Free Trade Agreement will create: the largest, richest market in the world. That's 360 million consumers and $6 trillion in annual output. And take a look at the 130 percent increase in our exports to Mexico over the past four years. This export boom has created 264,000 new jobs in the United States. And each additional billion dollars in exports will create 20,000 new jobs here in the United States. I didn't read about that in those ads. So you see, we have much to gain from extending fast track - - a new era of open, free and fair trade -- a future of unprecedented economic growth and regional harmony. 4 A "yes" vote on fast-track really is a vote on what kind of outlook we share -- one of optimism and integrity, or_one of self-doubt and petty prejudice. A "yes" vote means a vote for "good faith" and the strength of our word. We can't allow bigots and fearmongers to control our agenda. We must rely on our better selves -- our truer selves. Fast track plays a critical role in helping the United States compete in a world newly united by bonds of commerce. We will need your support as Hispanic leaders in persuading Congress to extend fast-track procedures. We will need your help as businessmen and women, as entrepreneurs, as men and women from all walks of life. But most of all, we need your help as Americans committed to the ideals of freedom and opportunity. Help us build good faith with our friends and neighbors. Help us develop better working relations with Congress. And help us stifle the voices that want to replace reason with rancor, cooperation with discrimination. with your help, I know we will succeed. Once again, thank you and God bless each of you. # # # KaLL CaLL ApriL29 29 p.7 U.S. - MEXICO TRADE NEGOTIATIONS Fast Track W hat would fast track trade fast track rhetoric. In terms of negotiations between the U.S. safe food and drinking water, and Mexico really produce? there is already a problem of crisis Could Be From the standpoint of food proportions along both sides of safety and water quality, it would the border. Fast track is not a Hazardous To make an already deplorable framework for solving these situation worse. problems. What we drink. This issue-and its long-term Your Health political and economic Mexican border towns like ramifications-deserves a lot Matamoros and Juarez have more than a simple up or down virtually no sewage facilities for vote by Congress. their populations that swell as the maquiladora plants expand. With Congress should reject fast no treatment facilities, health track it's a shortcut to disaster. FAST problems abound on both sides of the border. TRACK In San Elizario, Texas, for example, 90 percent of the people have Hepatitis A by the time they reach age 30. Nogales, Arizona. has a Hepatitis A rate 20 times the U.S. national average. What we eat. DISASTEN With no treatment facilities, TO produce destined for export may be irrigated with polluted water, including raw sewage. Irapuato, a town in Guanajuato. is an example. There's a lot at stake here. But a lot of important considerations are getting pushed aside in the AFL-CIO 815 SIXTEENTH STREET, N.W. WASHINGTON, D.C. 20006 POISON! Fast Track Environmental specialists-especially those concerned about water-say the (border) area's natural resources cannot handle the extra economic development free-trade advocates The More You Read foresee. -The Economist April 20, 1991 The Worse It Gets Indiscriminate dumping or long-term storage of industrial garbage and hazardous wastes is trashing the landscape and poisoning the water and soil. FAST -U.S. News & World Report TRACK May 6, 1991 Uncontrolled air and water pollution is rapidly deteriorating SHORTENT and seriously affecting the health and future economic vitality on both sides of the border. -American Medical Association June, 1990 TO DISASTER Their very success (the maquiladoras) is helping turn much of the border region into a sinkhole of abysmal living conditions and environmental degradation. -Wall Street Journal September 27, 1989 T he case against fast track free This issue-and its long-term trade negotiations between the political and economic U.S. and Mexico grows ramifications-deserves a lot stronger every day. There's a lot more than a simple up or down more at stake here than the fast vote by Congress. track rhetoric would lead you to believe. Congress should reject fast track it's a shortcut to disaster. AFL-CIO 815 SIXTEENTH STREET, N.W. WASHINGTON, D.C. 20006 Document No. 236286SS WHITE 8 MEMORANDUM DATE: 5/8/91 ACTION/CONCURRENCE/COMMENT DUE BY: TODAY 5/8/91 1:00PM SUBJECT: BRIEF REMARKS: HISPANIC BUSINESS LEADERS/ FREE TRADE ACTION FYI ACTION FYI VICE PRESIDENT MCCLURE SUNUNU PETERSMEYER SCOWCROFT PORTER DARMAN ROGICH BRADY SMITH BROMLEY UNTERMEYER CARD BOSKIN DEMAREST MARTINEZ FITZWATER ROGERS GRAY SNOW HOLIDAY REMARKS: Please forward your comments directly to Tony Snow, Rm. 122, x2930, no later than 1:00 p.m., TODAY, WEDNESDAY, MAY 8, with a copy to this office. RESPONSE: See comments PHILLIP D. BRADY Assistant to the President and Staff Secretary Ext. 2702 Grant/Cawley May 7, 1991 / 1 p.m. 91 MAY -8 AM 8: 00 A:ADS / Draft two BRIEF REMARKS: HISPANIC BUSINESS LEADERS / FREE TRADE THE INDIAN TREATY ROOM THURSDAY, MAY 9, 1991 9:30 A.M. ( (Acknowledgements) ) First of all, welcome to the White House. We've all been very concerned lately with two vital issues: America's ability to compete in the global marketplace and our ability to negotiate with our trading partners. The two concerns meet in an issue that we all care about deeply: the "fast track" procedures that I've asked Congress to extend. Fast track procedures let us negotiate in good faith with our trading partners and work in concert with Congress. They simply ensure that we will not alter agreements that our negotiators have reached with their counterparts. Fast-track doesn't take away Congress' power to accept or reject trade agreements. Congress will still have its say -- in a yes-or-no vote -- because fast track does not guarantee approval of any agreement. And we have promised to consult closely with Congress during the course of trade talks. Fast track's main virtue is this: It prevents 11th-hour changes to agreements we have reached, changes that force everyone involved to start from scratch. Congress first gave established the president procedurestor fast track authority in 44864 Martin 1974, and we have used it in negotiating three major trade agreements since. As many of you know, fast track also can play 2 a role in helping us complete three other important trade initiatives: The Uruguay Round of GATT talks; the North American Free Trade Agreement and the Enterprise for the Americas Initiative. Unfortunately, some opponents of free trade have decided to mount a smear campaign in hopes of derailing fast-track. Ignoring the facts, they have tried to frighten people with scare tactics and race-baiting. I've got a couple examples of this disgusting propaganda with me today. Here's one ad that questions the health and sanitary habits of Hispanic people -- [HOLD UP TWO ADS -- SEE ATTACHED]. The other ad distorts the truth the old fashioned way. It wrenches quotes out of context and tries to give the impression that foreigners -- in this case, our Mexican neighbors -- somehow will poison American citizens. I find these ads personally offensive. They promote nothing more than prejudice and racism. Although it really shouldn't be necessary, let me set the record straight. According to the American Journal of Public Health, Mexicans and Mexican Americans have better birth outcomes, lower drug use, and healthier diets than non-Hispanic whites. This information was further supported by the January 1991 issue of the Journal of the American Medical Association. There is no evidence that trade agreements with Mexico -- agreements that fast-track procedures would facilitate -- will have any adverse impact on the quality of our food or water. 3 But there's another point: Free trade encourages economic growth and international understanding. It enables us to build bonds of common interest and common experience. It may be the most effective antidote to the kind of poison these ads spread among our people. Open markets and free trade mean stronger alliances and better relations. It means we become better neighbors, because we'll bring out the best in people -- not the worst, as our opponents want. One ad reads: "There's a lot at stake here. But a lot of important considerations are getting pushed aside in the fast track rhetoric." I couldn't agree more on this narrow point. Important considerations have been pushed aside -- by the people who sponsor these ads. Take a look what the North American Free Trade Agreement will create: the largest, richest market in the world. That's 360 million consumers and $6 trillion in annual output. And take a look at the 130 percent increase in our exports to Mexico over export-related the past four years. This export boom has created 264,000 new jobs in the United States. And each additional Martin billion dollars in exports to Mexico will create 20,000 approximately new jobs here in X4864 the United States. I didn't read about that in those ads. So you see, we have much to gain from extending fast track - - a new era of open, free and fair trade -- a future of unprecedented economic growth and regional harmony. 4 A "yes" vote on fast-track really is a vote on what kind of outlook we share -- one of optimism and integrity, or_one of self-doubt and petty prejudice. A "yes" vote means a vote for "good faith" and the strength of our word. We can't allow bigots and fearmongers to control our agenda. We must rely on our better selves -- our truer selves. Fast track plays a critical role in helping the United States compete in a world newly united by bonds of commerce. We will need your support as Hispanic leaders in persuading Congress to extend fast-track procedures. We will need your help as businessmen and women, as entrepreneurs, as men and women from all walks of life. But most of all, we need your help as Americans committed to the ideals of freedom and opportunity. Help us build good faith with our friends and neighbors. Help us develop better working relations with Congress. And help us stifle the voices that want to replace reason with rancor, cooperation with discrimination. with your help, I know we will succeed. Once again, thank you and God bless each of you. # # # KaLL CaLL ApriL29 p.7 U.S. - MEXICO TRADE NEGOTIATIONS Fast Track W hat would fast track trade fast track rhetoric. In terms of negotiations between the U.S. safe food and drinking water, and Mexico really produce? there is already a problem of crisis Could Be From the standpoint of food proportions along both sides of safety and water quality, it would the border. Fast track is not a Hazardous To make an already deplorable framework for solving these situation worse. problems. What we drink. This issue-and its long-term Your Health political and economic Mexican border towns like ramifications-deserves a lot Matamoros and Juarez have virtually no sewage facilities for more than a simple up or down vote by Congress. their populations that swell as the maquiladora plants expand. With Congress should reject fast no treatment facilities, health track it's a shortcut to disaster. FAST problems abound on both sides of the border. TRACK In San Elizario, Texas, for example, 90 percent of the people have Hepatitis A by the time they INSIHONS reach age 30. Nogales, Arizona, has a Hepatitis A rate 20 times the U.S. national average. What we eat. DISASTER With no treatment facilities, TO produce destined for export may be irrigated with polluted water, including raw sewage. Irapuato. a town in Guanajuato. is an example. There's a lot at stake here. But a lot of important considerations are getting pushed aside in the AEL-CIO 815 SIXTEENTH STREET, N.W. WASHINGTON, D.C. 20006 POISON! Fast Track Environmental specialists-especially those concerned about water-say the (border) area's natural resources cannot handle the extra economic development free-trade advocates The More You Read foresee. -The Economist April 20, 1991 The Worse It Gets Indiscriminate dumping or long-term storage of industrial garbage and hazardous wastes is trashing the landscape and poisoning the water and soil. FAST -U.S. News & World Report May 6, 1991 SHORTENT TRACK Uncontrolled air and water pollution is rapidly deteriorating and seriously affecting the health and future economic vitality on both sides of the border. -American Medical Association June, 1990 TO DISASTEN Their very success (the maquiladoras) is helping turn much of the border region into a sinkhole of abysmal living conditions and environmental degradation. -Wall Street Journal September 27, 1989 T he case against fast track free This issue-and its long-term trade negotiations between the political and economic U.S. and Mexico grows ramifications-deserves a lot stronger every day. There's a lot more than a simple up or down more at stake here than the fast vote by Congress. track rhetoric would lead you to believe. Congress should reject fast track it's a shortcut to disaster. AFL-CIO 815 SIXTEENTH STREET, N.W. WASHINGTON, D.C. 20006 3433 Document No. 236286SS WHITE HOUSE STAFFING MEMORANDUM 91 MAY DATE: 5/8/91 ACTION/CONCURRENCE/COMMENT DUE BY: TODAY 5/8/91 1:00PM SUBJECT: BRIEF REMARKS: HISPANIC BUSINESS LEADERS/ FREE TRADE ACTION FYI ACTION FYI VICE PRESIDENT MCCLURE SUNUNU PETERSMEYER SCOWCROFT PORTER DARMAN ROGICH BRADY SMITH BROMLEY UNTERMEYER CARD BOSKIN DEMAREST MARTINEZ FITZWATER ROGERS GRAY SNOW HOLIDAY REMARKS: Please forward your comments directly to Tony Snow, Rm. 122, x2930, no later than 1:00 p.m., TODAY, WEDNESDAY, MAY 8, with a copy to this office. RESPONSE: May 8, 1991 TO: TONY SNOW NSC concurs with the attached, as revised. PHILLIP D. BRADY Assistant to the President Brent Scowcroft and Staff Secretary Ext. 2702 CC: Phillip Brady RECEIVED 91 MAY 8 A8. 53 a veing Grant/Cawley May 7, 1991 / 1 p.m. 91 MAY -8 AM 8: 00 A:ADS / Draft two BRIEF REMARKS: HISPANIC BUSINESS LEADERS / FREE TRADE THE INDIAN TREATY ROOM THURSDAY, MAY 9, 1991 9:30 A.M. ((Acknowledgements)) First of all, welcome to the White House. We've all been very concerned lately with two vital issues: America's ability to compete in the global marketplace and our ability to negotiate with our trading partners. The two concerns meet in an issue that we all care about deeply: the "fast track" procedures that I've asked Congress to extend. Fast track procedures let us negotiate in good faith with our trading partners and work in concert with Congress. They simply ensure that we will not alter agreements that our negotiators have reached with their counterparts. Fast-track doesn't take away Congress' power to accept or reject trade agreements. Congress will still have its say -- in a yes-or-no vote -- because fast track does not guarantee approval of any agreement. And we have promised to consult closely with Congress during the course of trade talks. Fast track's main virtue is this: It prevents 11th-hour changes to agreements we have reached, changes that force everyone involved to start from scratch. Congress first gave the president fast track authority in 1974, and we have used it in negotiating three major trade agreements since. As many of you know, fast track also can play 2 a role in helping us complete three other important trade initiatives: The Uruguay Round of GATT talks; the North American Free Trade Agreement and the Enterprise for the Americas Initiative. Unfortunately, some opponents of free trade have decided to mount a smear campaign in hopes of derailing fast-track. Ignoring the facts, they have tried to frighten people with scare tactics and race-baiting. I've got a couple examples of this this is disgusting propaganda with me today. Here's one ad that implies just as as that fast track will lead to raw sewage disease, and contaminated food questions the health and sanitary habits of Hispanic people -- distortal supplies to our country [HOLD UP TWO ADS -- SEE ATTACHED]. The other ad distorts the truth the old fashioned way. It wrenches quotes out of context and tries to give the impression that foreigners -- in this case, our Mexican neighbors -- somehow will poison American citizens. I find these ads personally offensive. They promote nothing more than prejudice and racism. Although it really shouldn't be necessary, let me set the record straight. According to the American Journal of Public Health Mexicans and Mexican Americans have better birth ? outcomes, lower drug use, and healthier diets than non-Hispanic whites. This information was further supported by the January 1991 issue of the Journal of the American Medical Association. There is no evidence that trade agreements with Mexico -- agreements that fast-track procedures authority would facilitate -- will make possible have any adverse impact on the quality of our food or water. Economic growth for all is the best way to attack pollution it permits acquisition of state of the art environmentally Sound plant and equipment, 3 But there's another point: Free trade encourages economic growth and international understanding. It enables us to build bonds of common interest and common experience. It may be the most effective antidote to the kind of poison these ads spread among our people. Open markets and free trade mean stronger alliances and better relations. It means we become better neighbors, because we'll bring out the best in people -- not the worst, as our opponents want. One ad reads: "There's a lot at stake here. But a lot of important considerations are getting pushed aside in the fast track rhetoric." I couldn't agree more on this narrow point. Important considerations have been pushed aside -- by the people who sponsor these ads. Take a look what the North American Free Trade Agreement will create: the largest, richest market in the world. That's 360 million consumers and $6 trillion in annual output. And take a look at the 130 percent increase in our exports to Mexico over the past four years. This export boom has created 264,000 new jobs in the United States. And each additional billion dollars in exports will create 20,000 new jobs here in the United States. I didn't read about that in those ads. So you see, we have much to gain from extending fast track - - a new era of open, free and fair trade -- a future of unprecedented economic growth and regional harmony. 4 A "yes" vote on fast-track really is a vote on what kind of outlook we share -- one of optimism and integrity, or_ one of self-doubt and petty prejudice. A "yes" vote means a vote for "good faith" and the strength of our word. We can't allow bigots and fearmongers to control our agenda. We must rely on our better selves -- our truer selves. Fast track plays a critical role in helping the United States compete in a world newly united by bonds of commerce. We will need your support as Hispanic leaders in persuading Congress to extend fast-track procedures. We will need your help as businessmen and women, as entrepreneurs, as men and women from all walks of life. But most of all, we need your help as Americans committed to the ideals of freedom and opportunity. Help us build good faith with our friends and neighbors. Help us develop better working relations with Congress. And help us stifle the voices that want to replace reason with rancor, cooperation with discrimination. with your help, I know we will succeed. Once again, thank you and God bless each of you. # # # KaLL CaLL ApriL29 p.7 U.S. - MEXICO TRADE NEGOTIATIONS Fast Track W /hat would fast track trade fast track rhetoric. In terms of negotiations between the U.S. safe food and drinking water, and Mexico really produce? there is already a problem of crisis Could Be From the standpoint of food proportions along both sides of safety and water quality, it would the border. Fast track is not a Hazardous To make an already deplorable framework for solving these situation worse. problems. What we drink. This issue-and its long-term Your Health political and economic Mexican border towns like ramifications-deserves a lot Matamoros and Juarez have more than a simple up or down virtually no sewage facilities for vote by Congress. their populations that swell as the maquiladora plants expand. With Congress should reject fast no treatment facilities, health track it's a shortcut to disaster. FAST problems abound on both sides of the border. TRACK In San Elizario, Texas, for example, 90 percent of the people have Hepatitis A by the time they INSTRUET reach age 30. Nogales, Arizona, has a Hepatitis A rate 20 times the U.S. national average. What we eat. DISASTER With no treatment facilities, TO produce destined for export may be irrigated with polluted water, including raw sewage. Irapuato, a town in Guanajuato, is an example. There's a lot at stake here. But a lot of important considerations are getting pushed aside in the AFL-CIO 815 SIXTEENTH STREET, N.W. WASHINGTON, D.C. 20006 POISON! Fast Track Environmental specialists-especially those concerned about water-say the (border) area's natural resources cannot handle the extra economic development free-trade advocates The More You Read foresee. -The Economist April 20, 1991 The Worse It Gets Indiscriminate dumping or long-term storage of industrial garbage and hazardous wastes is trashing the landscape and poisoning the water and soil. FAST -U.S. News & World Report TRACK May 6, 1991 Uncontrolled air and water pollution is rapidly deteriorating SHORTENT and seriously affecting the health and future economic vitality on both sides of the border. -American Medical Association June, 1990 TO DISASTEN Their very success (the maquiladoras) is helping turn much of the border region into a sinkhole of abysmal living conditions and environmental degradation. -Wall Street Journal September 27, 1989 T he case against fast track free This issue-and its long-term trade negotiations between the political and economic U.S. and Mexico grows ramifications-deserves a lot stronger every day. There's a lot more than a simple up or down more at stake here than the fast vote by Congress. track rhetoric would lead you to believe. Congress should reject fast track it's a shortcut to disaster. AFL-CIO 815 SIXTEENTH STREET, N.W. WASHINGTON, D.C. 20006 Document No. 236286SS WHITEY HOUSE STAFFING MEMORANDUM DATE: 5/8/91 ACTION/CONCURRENCE/COMMENT DUE BY: TODAY 5/8/91 1:00PM SUBJECT: BRIEF REMARKS: HISPANIC BUSINESS LEADERS/ FREE TRADE ACTION FYI ACTION FYI VICE PRESIDENT MCCLURE SUNUNU PETERSMEYER SCOWCROFT PORTER DARMAN ROGICH BRADY SMITH BROMLEY UNTERMEYER CARD BOSKIN DEMAREST MARTINEZ FITZWATER ROGERS GRAY SNOW HOLIDAY REMARKS: Please forward your comments directly to Tony Snow, Rm. 122, x2930, no later than 1:00 p.m., TODAY, WEDNESDAY, MAY 8, with a copy to this office. RESPONSE: see comments. Thanks. Holly Williamson 5-8-91 PHILLIP D. BRADY Assistant to the President and Staff Secretary Ext. 2702 THE WHITE HOUSE WASHINGTON May 8, 1991 MEMORANDUM FOR TONY SNOW FROM: HOLLY WILLIAMSON NW SUBJECT: Hispanic Business Leaders Speech Please see the attached text with specific line-by-line suggestions as well as the general comments noted below. 1. USTR felt very strongly about all of their comments as marked up on the attached text. 2. USTR felt that all racial/bigotry references had to come out. It appears there was a discussion among the senior fast track group that even though Deputy Secretary DeArment was using that tough language that it was not appropriate for the President's use. The Department of Interior concurred stating that you should not mix race into the 2 important criticisms we are hearing: job losses and environment. OCA staff also felt the racial/bigotry references should be toned down. The Department of Labor had one person flag that same language because it seemed inappropriate for the President to use. (The above includes the paragraph on Mexicans and Mexican- Americans at the bottom of page 2 -- it poses too many complicated questions and problems. For example, why compare that information on Mexican-Americans to non-Hispanic whites instead of American blacks?) Attachment Grant/Cawley e May 7, 1991 / 1 p.m. 91 MAY -8 AM 8: 00 a A:ADS / Draft two BRIEF REMARKS: HISPANIC BUSINESS LEADERS / FREE TRADE THE INDIAN TREATY ROOM THURSDAY, MAY 9, 1991 9130 A.M. ((Acknowledgements)) First of all, welcome to the White House. We've all been very concerned lately with two vital issues: America's ability to compete in the global marketplace and our ability to negotiate with our trading partners. The two concerns meet in an issue that we all care about deeply: the "fast track" procedures that I've asked Congress to extend. Fast track procedures let us negotiate in good faith with our trading partners and work in concert with Congress. They simply ensure that we will not alter agreements that our negotiators have reached with their counterparts. Fast-track dcesn't take away Congress' power to accept or reject trade agreements. Congress will still have its say -- in a yes-or-no vote -- because fast track does not guarantee I will consult approval of any agreement. And we have promised to consult VUSTR closely with Congress during the course of trade talks/\ Fast as called for by the fast tinch. track's main virtue is this: It prevents 11th-hour changes to agreements we have reached, changes that force everyone involved to start from scratch. Congress first gave the president fast track authority in 1974, and we have used it in negotiating three major trade agreements since. As many of you know, fast track/also is can essential play USTR essential (it is not surplasing 2 Erole in helping advance three other important trade & JUSTR + initiatives: The Uruguay Round of GATT talks; the North American OCA Free Trade Agreement and the Enterprise for the Americas Initiative. Unfortunately, some opponents of free trade have decided to mount a smear campaign in hopes of derailing fast-track. Ignoring the facts, they have tried to frighten people with scare USM DOI + tactics, and race baiting. I've got a couple examples OF this USTR & DOI disgussing propaganda with me today. Mere ad that These ads try to scare americans usm/DOI questions the health and sanitary habits of Hispanic people -- in to thinking that fast trach threatens our health. These ads w/ DOI [HOLD UP TWO ADS --- SEE ATTACHED]. ^The other ad distorts the /USTRIPOI. truth the old fashioned way. 11 wrenches quotes out of context They use scare words and USDRI DOF and tries to give the impression that foreigners -- in this case, our Mexican neighbors -- somehow will poison American citizens. I find these ads personally offensive. They promote nothing more than prejudice, and recism. WATRIDOJ Although it really shouldn't be necessary, let me set the record straight. According to the American Journal of Public VOCA Health, Mexicans and Mexican Americans have better birth outcomes, lower drug use, and healthier diets than non-Hispanic whites, This information was further supported by the January 1991 issue of the Journal of the American Medical Association. A There is no evidence that trade agreements with Mexico -- astoc an agreements that fast-track procedures would facilitate -- will not have any adverse impact on the quality of our food or water. 3 But there's another point: Free trade encourages economic growth and international understanding. It enables us to build bonds of common interest and common experience. It may be the most effective antidote to the kind of poison these ads spread among our people. Open markets and free trade mean stronger alliances and better relations. It means we become better neighbors, because we'll bring out the best in people -- not the worst, as our opponents want. One ad reads: "There's a lot at stake here. But a lot of important considerations are getting pushed aside in the fast track rhetoric." I couldn't agree more on this narrow point. Important considerations have been pushed aside -- by the people who sponsor these ads. at Take a looks what the North American Free Trade Agreement will create: the largest, richest market in the world. That's 360 million consumers and $6 trillion in annual output. And take a look at the 130 percent increase in our exports to Mexico over the past four years. This export boom has created 264,000 new jobs in the United States. And each additional USTR billion dollars in exports will create/20,000 almost new jobs here in the United States. I didn't read about that in those ads. So you see, we have much to gain from extending fast track - - a new era of open, free and fair trade -- a future of unprecedented economic growth and regional harmony. 4 1 A "yes" vote on fast-track really is a vote on what kind of outlook we share -- one of optimism and integrity, or_one of self-doubt and petty prejudice. A "yes" vote means a vote for USTR "good faith" and the strength of our word. We can't allow begine and fearmongers to control our agenda. We must rely on our better selves -- our truer selves. Fast track plays a critical role in helping the United States compete in a world newly united by bonds of commerce. We will need your support as Hispanic leaders in persuading Congress to extend fast-track procedures. We will need your help as businessmen and women, as entrepreneurs, as men and women from all walks of life. But most of all, we need your help as Americans committed to the ideals of freedom and opportunity. Help us build good faith with our friends and neighbors. Help us develop better working relations with Congress. And help us stifle the voices that want to replace reason with rancor, cooperation with discrimination. with your help, I know we will succeed. Once again, thank you and God bless each of you. # # # KaLL CaLL ApriL29 29 p.7 U.S M'EXICO TRADE NEGOIATIONS Fast Track W hat would fast track trade fast track rhetoric. In terms of negotiations between the U.S. safe food and drinking water. and Mexico really produce? there is already 8 problem of crisis Could Be From the standpoint of food proportions along both sides of safety and water quality, it would the border. Fast track is not a Hazardous To make an already deplorable framework for solving these situation worse. problems. What we drink. This issue-and its long-term Your Health Mexican border towns like political and economic ramifications-deserves a lot Matamoros and Juarez have virtually no sewage facilities for more than a simple up or down vote by Congress. their populations that swell as the maquiladora plants expand. With Congress should reject fast no treatment facilities. hesith track it's a shortcut to disaster. FAST problems abound on both sides of the border. TRACK In San Elizario, Texas, for example. 90 percent of the people have Hepatitis A by the time they reach age 30. Nogales, Arizona. has a Hepatitis A rate 20 times the U.S. national average. What we eat. TO DISASTENT With no treatment facilities. produce destined for export may be irrigated with polluted water. including raw sowage. Irapuato, & town in Guansjuato, is an example. There's a lot at stake here. But a lot of important considerations are getting pushed aside in the AFL-CIO 815 SISTEENTH STREET, N.W. WASHINGT ON, D.C. 20006 POISON! Fast Track Environmental specialists-especially those concerned about water-say the (border) area's natural resources cannot handle the extra economic development free-trade advocates The More You Read foresee. -The Economist April 20. 1991 The Worse It Gets Indiscriminate dumping or long-term storage of Industrial garbage and hazardous wastes is trashing the landscape and poisoning the water and soil. -U.S. News & World Report FAST May 6, 1991 TRACK Uncontrolled air and water pollution is rapidly deteriorating and seriously affecting the health and future economic vitality on both sides of the border. American Medical Association June, 1990 DISASTER Their very success (the maquiladoras) is helping turn much of TO the border region into a sinkhole of abysmal living conditions and environmental degradation. -Wall Street Journal September 27, 1989 T he case against fast track free This issue-and its long-term trade negotiations between the political and economic U.S. and Mexico grows ramifications-deserves a lot stronger every day. There's a lot more than a simple up or down more at stake here than the fast vote by Congress. track rhetoric would lead you to Congress should reject fast track believe. it's a shortcut to disaster. AFL-CIO 815 SIXTEENTH STREET. N.W. WASHINGTON, D.C. 20006 Document No. 236286SS 91 MAY WHITEAHOUSE STAFFING MEMORANDUM DATE: 5/8/91 ACTION/CONCURRENCE/COMMENT DUE BY: TODAY 5/8/91 1:00PM SUBJECT: BRIEF REMARKS: HISPANIC BUSINESS LEADERS/ FREE TRADE ACTION FYI ACTION FYI VICE PRESIDENT MCCLURE SUNUNU PETERSMEYER SCOWCROFT PORTER DARMAN ROGICH BRADY SMITH BROMLEY UNTERMEYER CARD BOSKIN DEMAREST MARTINEZ FITZWATER ROGERS GRAY SNOW HOLIDAY REMARKS: Please forward your comments directly to Tony Snow, Rm. 122, x2930, no later than 1:00 p.m., TODAY, WEDNESDAY, MAY 8, with a copy to this office. RESPONSE: delintate so of he he make can chooses. easily the AA aid drop section A substantive comments PHILLIP D. BRADY Assistant to the President and Staff Secretary Ext. 2702 Grant/Cawley May 7, 1991 / 1 p.m. 91 MAY -8 AM 8: 00 A:ADS / Draft two BRIEF REMARKS: HISPANIC BUSINESS LEADERS / FREE TRADE THE INDIAN TREATY ROOM THURSDAY, MAY 9, 1991 9:30 A.M. ((Acknowledgements)) First of all, welcome to the White House. We've all been very concerned lately with two vital issues: America's ability to compete in the global marketplace and our ability to negotiate with our trading partners. The two concerns meet in an issue that we all care about deeply: the "fast track" procedures that I've asked Congress to extend. Fast track procedures let us negotiate in good faith with our trading partners and work in concert with Congress. They simply ensure that we will not alter agreements that our negotiators have reached with their counterparts. Fast-track doesn't take away Congress' power to accept or reject trade agreements. Congress will still have its say -- in a yes-or-no vote -- because fast track does not guarantee approval of any agreement. And we have promised to consult closely with Congress during the course of trade talks. Fast track's main virtue is this: It prevents 11th-hour changes to agreements we have reached, changes that force everyone involved to start from scratch. Congress first gave the president fast track authority in 1974, and we have used it in negotiating three major trade agreements since. As many of you know, fast track also can play 2 a role in helping us complete three other important trade initiatives: The Uruguay Round of GATT talks; the North American Free Trade Agreement and the Enterprise for the Americas Initiative. Unfortunately, some opponents of free trade have decided to of mount a smear campaign in hopes of derailing fast-track, ignoring the facts, they have tried to frighten people with scare tactics.and race baiting. I've got a couple examples.ef this brought along disgusting propaganda with me today. Here's one ad that questions the health and sanitary habits of Hispanic people -- [HOLD UP TWO ADS -- SEE ATTACHED]. The other ad distorts the truth the old fashioned way. It wrenches quotes out of context and tries to give the impression that foreigners -- in this case, our Mexican neighbors -- somehow will poison American citizens. I find these ads personally offensive. They promote nothing more than prejudice and racism. Although it really shouldn't be necessary, let me set the record straight. According to the American Journal of Public Health, Mexicans and Mexican Americans have better birth outcomes, lower drug use, and healthier diets than non-Hispanic whites. This information was further supported by the January 1991 issue of the Journal of the American Medical Association. There is no evidence that trade agreements with Mexico : agreements that fast-track procedures would facilitate -- will have any adverse impact on the quality of our food or water. 3 But there's another point: Free trade encourages economic growth and international understanding. It enables us to build bonds of common interest and common experience. It may be the most effective antidote to the kind of poison these ads spread among our people. Open markets and free trade mean stronger alliances and better relations. It means we become better neighbors, because we'll bring out the best in people -- not the worst, as our opponents want. One ad reads "There's a lot at stake here. But a lot of important considerations are getting pushed aside in the fast track rhetoric." I couldn't agree more on this narrow point. Important considerations have been pushed aside -- by the people who sponsor these ads. Take a look what the North American Free Trade Agreement will create: the largest, richest market in the world. That's 360 million consumers and $6 trillion in annual output. And take a look at the 130 percent increase in our exports to Mexico over the past four years. This export boom has created 264,000 new jobs in the United States. And each additional billion dollars in exports will create 20,000 new jobs here in the United States. I didn't read about that in those ads. So you see, we have much to gain from extending fast track - - a new era of open, free and fair trade -- a future of unprecedented economic growth and regional harmony. 4 A "yes" vote on fast-track really is a vote on what kind of outlook we share -- one of optimism and integrity, or_one of self-doubt and petty prejudice. A "yes" vote means a vote for will not the "good faith" and the strength of our word. We can't allow bigots and fearmongers to control our agenda. We must rely on our better selves -- our truer selves. Fast track plays a critical role in helping the United States compete in a world newly united by bonds of commerce. We will need your support as Hispanic leaders in persuading Congress to extend fast-track procedures. We will need your help as businessmen and women, as entrepreneurs, as men and women from all walks of life. But most of all, we need your help as Americans committed to the ideals of freedom and opportunity. Help us build good faith with our friends and neighbors. Help us develop better working relations with Congress. And help us stifle the voices that want to replace reason with rancor, cooperation with discrimination. with your help, I know we will succeed. Once again, thank you and God bless each of you. # # # KaLL CaLL ApriL29 29 p.7 U S - MEXICO TRADE NEGOTIATIONS Fast Track W hat would fast track trade fast track rhetoric. In terms of negotiations between the U.S. safe food and drinking water, and Mexico really produce? there is already a problem of crisis Could Be From the standpoint of food proportions along both sides of safety and water quality, it would the border. Fast track is not a Hazardous To make an already deplorable framework for solving these situation worse. problems. What we drink. This issue-and its long-term Your Health political and economic Mexican border towns like ramifications-deserves a lot Matamoros and Juarez have more than a simple up or down virtually no sewage facilities for vote by Congress. their populations that swell as the maquiladora plants expand. With Congress should reject fast no treatment facilities, health track it's a shortcut to disaster. FAST problems abound on both sides of the border. TRACK In San Elizario, Texas, for example, 90 percent of the people have Hepatitis A by the time they reach age 30. Nogales, Arizona, has a Hepatitis A rate 20 times the U.S. national average. What we eat. DISASTER With no treatment facilities, TO produce destined for export may be irrigated with polluted water, including raw sewage. Irapuato. a town in Guanajuato is an example. There's a lot at stake here. But a lot of important considerations are getting pushed aside in the AFL-CIO 815 SIXTEENTH STREET, N.W. WASHINGTON, D.C. 20006 POISON! Fast Track Environmental specialists-especially those concerned about water-say the (border) area's natural resources cannot handle the extra economic development free-trade advocates The More You Read foresee. -The Economist April 20, 1991 The Worse It Gets Indiscriminate dumping or long-term storage of industrial garbage and hazardous wastes is trashing the landscape and poisoning the water and soil. FAST -U.S. News & World Report TRACK May 6, 1991 Uncontrolled air and water pollution is rapidly deteriorating SHORTENT and seriously affecting the health and future economic vitality on both sides of the border. -American Medical Association June, 1990 TO DISASTEN Their very success (the maquiladoras) is helping turn much of the border region into a sinkhole of abysmal living conditions and environmental degradation. -Wall Street Journal September 27, 1989 T he case against fast track free This issue-and its long-term trade negotiations between the political and economic U.S. and Mexico grows ramifications-deserves a lot stronger every day. There's a lot more than a simple up or down more at stake here than the fast vote by Congress. track rhetoric would lead you to believe. Congress should reject fast track it's a shortcut to disaster. AFL-CIO 815 SIXTEENTH STREET, N.W. WASHINGTON, D.C. 20006 carolyns Comments THE WHITE HOUSE WASHINGTGrant/Cawley May 7, 1991 / 1 p.m. A:ADS / Draft two BRIEF REMARKS: HISPANIC BUSINESS LEADERS / FREE TRADE THE INDIAN TREATY ROOM THURSDAY, MAY 9, 1991 9:30 A.M. FYI: ((Acknowledgements)) coming from Shiree. First of all, welcome to the White House. We've all been very concerned lately with two vital issues: America's ability to compete in the global marketplace and our ability to negotiate with our trading partners. The two concerns meet in an issue that we all care about deeply: the "fast track" procedures that I've asked Congress to extend. Fast track procedures let us negotiate in good faith with our trading partners and work in concert with Congress. They simply ensure that we will not alter agreements that our negotiators have reached with their counterparts. Fast-track doesn't take away Congress' power to accept or reject trade agreements. Congress will still have its say -- in a yes-or-no vote -- because fast track does not guarantee approval of any agreement. And we have promised to consult closely with Congress during the course of trade talks. Fast track's main virtue is this: It prevents 11th-hour changes to agreements we have reached, changes that force everyone involved to start from scratch. Congress first gave the president fast track authority in 1974, and we have used it in negotiating three major trade agreements since. As many of you know, fast track also can play Id like at the to studies look done, am interpreting My instinct 2 this stuff. is that this # is problematic. THE WHITE HOUSE Im concerned about the "Mexican + WASHINGTON Mex-American"qualifier; and a role in helping us complete three other important trade 2 the statement on diets. initiatives: The Uruguay Round of GATT talks; the North American Free Trade Agreement and the Enterprise for the Americas Initiative. mount a smear campaign in hopes of derailing fast-track. Ignoring the facts, they have tried to frighten people with scare tactics and race-baiting. I've got a couple examples of this disgusting propaganda with me today. Here's one ad that see aTTached from the Hispanic HELITH organization. They wrote the press release from which M.K. got this language when I called to verify the info, they wanted to send a revised # that more closely follows the Journal pieces. Unfortunately, some opponents of free trade have decided to questions the health and sanitary habits of Hispanic people -- [HOLD UP TWO ADS -- SEE ATTACHED]. The other ad distorts the truth the old fashioned way. It wrenches quotes out of context and tries to give the impression that foreigners -- in this case, our Mexican neighbors -- somehow will poison American citizens. I find these ads personally offensive. They promote nothing more than prejudice and racism. It was an article published in the JPH; doesn't necessarily reflect their views. Although it really shouldn't be necessary, let me set the record straight. According to the American Journal of Public Health, Mexicans and Mexican Americans have better birth outcomes, lower drug use, and healthier diets than non-Hispanic it's a weekly, not whites. This information was further supported by the January a monthly pub. 1991 issue of the Journal of the American Medical Association. There is no evidence that trade agreements with Mexico -- agreements that fast-track procedures would facilitate -- will have any adverse impact on the quality of our food or water. Note: Porter's office contacted the Surgeon Generals Office, among others, and it seems that everyone is uncomfortable w/ this #. THE WHITE HOUSE 3 WASHINGTON But there's another point: Free trade encourages economic growth and international understanding. It enables us to build bonds of common interest and common experience. It may be the most effective antidote to the kind of poison these ads spread among our people. Open markets and free trade mean stronger alliances and better relations. It means we become better neighbors, because we'll bring out the best in people -- not the worst, as our opponents want. One ad reads: "There's a lot at stake here. But a lot of important considerations are getting pushed aside in the fast track rhetoric." I couldn't agree more on this narrow point. Important considerations have been pushed aside -- by the people who sponsor these ads. Take a look what the North American Free Trade Agreement will create: the largest, richest mårket in the world. That's 360 million consumers and $6 trillion in annual output. Cit's nearly 130%] And take a look at the 130 percent increase in our exports to Mexico over the past four years. This export boom has created 264,000 new jobs in the United States. And each additional (almost) billion dollars in exports will create/20,000 new jobs here in the United States. I didn't read about that in those ads. So you see, we have much to gain from extending fast track - - a new era of open, free and fair trade -- a future of unprecedented economic growth and regional harmony. THE WHITE HOUSE 4 WASHINGTON A "yes" vote on fast-track really is a vote on what kind of outlook we share -- one of optimism and integrity, or one of self-doubt and petty prejudice. A "yes" vote means a vote for "good faith" and the strength of our word. We can't allow bigots and fearmongers to control our agenda. We must rely on our better selves -- our truer selves. Fast track plays a critical role in helping the United States compete in a world newly united by bonds of commerce. We will need your support as Hispanic leaders in persuading Congress pandering ? How about "as community leaders', to extend fast-track procedures. We will need your help as etc. businessmen and women, as entrepreneurs, as men and women from all walks of life. But most of all, we need your help as Americans committed to the ideals of freedom and opportunity. Help us build good faith with our friends and neighbors. Help us develop better working relations with Congress. And help us stifle the voices that want to replace reason with rancor, cooperation with discrimination. With your help, I know we will succeed. Once again, thank you and God bless each of you. # # # Extended Page 1.1 May 8, 1991 Quite the contrary to the AFL-CIO claims of poor health among Mexicans, the December 1990 supplement of the American Journal of Public Health, published under the auspices of the National Coalition of Hispanic Health and Human Services Organizations (COSSMHO), shows that first generation Mexican Americans have better birth outcomes, lower drug use, and healthier diets than second generation Mexican Americans. Furthermore, federal data (Secretary's Task Force on Black and Minority Health, the National Center for Health Statistics, and the National Institute on Drug Abuse) indicates that Mexican Americans have better birth outcomes, lower drug use, and healthier diets than non-Hispanic whites. From: Adolph Falcón Nt'l Coalition of Hispanic HHS Organizations (COSSMHO) 202/371-2100 MAY-, 8-91 WED 12:25 COSSMHO P.01 .... COSSMHO .... highlights Facsimile Transmission bee TO: CAROCYN CAULEY Date: FAX Number: 456-6218 FROM: Adolph P. Falcón National Coalition of Hispanic Health and Human Services Organizations 1030 15th Street, N.W.; Suite 1053 Washington, D.C. 20005 (202) 371-2100 FAX Number (202) 371-6968 If document needs re-transmission, wait 10 minutes and then contact Demitria Johnson at (202) 371-2100. This is page # 1 of 25 Note: R hope this is helpful Please call me with any questions. PLEASE DELIVER IMMEDIATELY!! TIME SENSITIVE MATERIALS!! 8-91 WED 12:27 COSSMHO IX. Acculturation and Marijuana and Cocaine Use: Findings from HHANES 1982-84 HORTENSIA AMARO, PHD. RUPERT WHITAKER. GERALD COPPMAN, MS, AND TIMOTHY HEEREN, PHD Abstract: We examined the relation berween acculturation and with marijuana and cocaine use among Mexican Americans and illicitidrug use among Hispanics in the United States emptoying data Puerto Ricans of lower educational attainment than among those of from the 1982-84 Hispanic Health and Nutrition Evaluation Survey higher educational attainment. Significant interactions between lan- (HHANES). Across all Hispanic groups. acculturation into us guage USE and other factors such as sex. marital status, and place of society. as reflected in English longuage use, was associated with birth were also associated with marijuana and cocaine use. These higher rates of illicit drug use even after sociodemographic variables results suggest that the experience of acculturation. especially as it such as gender, agc. income. and education were considered. relates to drug use, is closely tied to the social and economic context Significant Interactions between language and education indicated in which an individual lives. 1Am J Public Health 1990; 80(Suppl): that the predominant use of English was more strongly associated 54-60.) Introduction than acculturative factors. Morcover, the possible interac- tions between acculturation and sociodemographic factors, Drug use has long been recognized as a major public such as sex and other demographic variables, have not yet health problem in the United States.' and increasing indica- been systematically investigated. tors of serious use in the last two decades have prompted " This paper investigates the extent to which illicit drug surge in research to identify patterns and risk factors for drug use among Mexican American, Puerto Rican, and Cuban use in general populations. 2.3 However, these studies have American adults is associated with place of birth and lan- generally not provided reliable epidemiological data on drug guage use as indicators of acculturation, and whether this use among minorities, especially Hispanics. When data on relation differs across gender, age, and socioeconomic status. Hispanics have been reported, most studies have failed to distinguish between Mexican Americans, Puerto Ricans, and Cuban Americans. Failure to specify results by Hispanic Methods subgroup greatly limits the usefulness of such reports for The methods and sampling design used in the Hispanic public health efforts since, by the year 2000, Hispanics will be Health and Nutrition Evaluation Survey (HHANES) are the largest minority group in the United States. While described in detail elsewhere, 19 Briefly, the HHANES is a ancedotal, clinical, and some community-based studies SUB- complex, multistage, stratified, clustered sample of house- gest that drug use may be a significant problem in Hispanic holds drawn from three geographic regions (i.e., Southwest- communities,5-11 information on general drug use prevalence ern US, Northeastern US. and Dade County, Florida) with and the associated risk factors in specific Hispanic groups is the largest national concentrations of Hispanics. Households essential for prevention and intervention efforts in this were screened for eligible respondents, who were asked population. general information about individuals in the household. The One critical experience shared by all Hispanic subgroups second part of the study involved physical examination and is the process of acculturation or culture change resulting interview at a nearby mobile examination unit. Questions on from continuous. first hand contact with the United States drug use were included in the Adult Sample Questionnaire culture. Since acculturation may involve changes in atti- Supplement and administered in the interview portion of the tudes, norms, and practices regarding use of ifficit drugs. it is study to individuals 12 to 74 years of age.¹⁹ important to understand the relation of acculturation to drug The present analyses include respondents 20 years of age use. Psychoactive drug use among Hispanics may be gener- and older who self-identified as Mexican American in the ally associated with increased levels of acculturation into US Southwestern US sample, Puerto Rican in the Northeastern norms and lifestyle. 12-15 Some research has suggested US sample, or Cuban American in the Dade County, Florida that acculturation may be more strongly associated with the sample and who completed the physical examination and use of some psychoactive substances, such as alcohol. among interview portions of the study. All respondents were asked women than men. Whether acculturation is also more questions on marijuana use, but only those younger than 45 strongly associated with illicit drug use among women than years were asked questions about cocaine use. While the men has not yet been investigated. While these findings on HHANES also included questions on use of inhalants and acculturation are suggestive. their generalizability has been sedatives, data on these substances are not included in this limited due to the sclect and small samples in the reported paper due to an insufficient number of users, The participa- studies. Most such studies have been limited to one specific tion rates for those approached, aged 20-74. were 58.4 Hispanic group or have not identified the group tinder study. percent among Cuban Americans, 69.2 percent among Puerto It is also unclear from previous research whether accultur- Ricans, and 70.2 percent among Mexican Americans. The ation is associated with increased drug use in all Hispanic non-response rate for drug questions did not exceed 1.3 groups. Furthermore, because acculturation is associated percent. The Mexican American sample includes 3,303 re- with improved sociocconomic status, 19 it is unclear 10 what spondents (ages 20-74) who were asked about marijuana use extent increased drug use is prompted by economic rather and 2.054 (ages 20-45) who were asked about cocaine use; the Puerto Rican sample, 1,209 and 673 respondents respec- tively. and the Cuban American sample, 858 and 348 respon- NOTE: Author affiliations are listed elsewhere under CONTRIBUTORS. dents respectively. 54 AJPH December 1990, Vol. 80, Supplement 8-91 WED COSSMHO P.03 ACCULTURATION/MARIJUANA AND COCAINE USE Questions on drug use were limited to whether the group) The indicators of acculturation included in the model respondent had ever used the drug in question (lifetime use) were: birthplace (continental US/not continental US), and and the most recent periods of use. Due to the small number the language index score described previously (range from 1 of respondents who reported use in the last month and use in 305 Only English to $ III Only Spanish). Proe LOGIST the last six months, analyses were conducted only on lifetime accounts for sample weights but not design effects:22 there- and previous year's use (no/yes) of marijuana and cocaine. fore standard errors were corrected for a design effect of 1.5 Information was also obtained on sociodemographic charac- when calculating p-values and confidence limits. teristics such as sex, age, marital status, years of education, Multivariate analysis to test interactions between accul- current employment status, and yearly household income. turation measures and sociodemographic variables: For The HHANES acculturation measure, originally developed each: Dapanic group and drug, the model described above for the Mexican American sample, is based on eight items served as the basic model to which interaction terms were measuring language use, ethnic identification, and birthplace added and tested one at a time. The interaction terms tested of respondent and respondent's parents. An analysis of the were: language use by birthplace, language use by gender, distribution of these items for Puerto Ricans and Cuban language use bylage, language use by income, language use Americans revealed that responses to some of these items are by education, and language use by marital status. Interac- highly skowed, rendering the measure inappropriate for tions between language use and birthplace and language use general use across all Hispanic groups. To develop an and each of the sociodemographic variables in the model acculturation measure that was equally applicable to all were tested individually. groups, the highly skewed items were deleted and accultur- Test of the final model with all interaction terms: A final ation was measured by: 1) place of birth (coded as within or model for each drug and Hispanic group--which included all outside the continental US); and 2) a language index derived sociodemographic variables, language use, place of birth and from the simple mean of self-ratings on language spoken, all significant interactions as determined in the previous language preferred, language written, and language read step then tested. Language use as a measure of accul- (each scored English only sm 1, mostly English TEP 2, both turation rather than birthplace was chosen for the interac- English and Spanish # 3, mostly Spanish 4, Spanish only tions because preliminary analyses showed this variable to be at 5), and language of interview (coded as English = 1. most closely associated with drug use. Spanish #: 5). Results Statistical Analyses Sample Characteristics Age adjusted rates for marijuana and cocoine use: Marijuana and cocaine use rates were calculated for each Table 1 presents selected weighted sample characteris- tics foreach Hispanic group. With the exception of the Puerto Hispanic subgroup by gender. Marijuana and cocaltie use rates were calculated adjusting for age by a direct standard- Rican sample, which was predominantly female, gender representation was approximately equal. Since drug use ization method. That is, each of the three Hispanic samples patterns have been shown to vary substantially by gender, was weighted to reflect the age distribution of the combined the overrepresentation of females in the Puerto Rican sample weighted sample which reflects the Hispanic population in of the HHANES needs to be considered in the interpretation the United States. Standard errors were calculated account- of the findings. The Mexican American and Puerto Rican ing for design effects using the RTIFREQS procedure in samples were younger, had a lower yearly family income, and SAS.20 These standard errors were used to calculate 95 have Idss formal education than the Cuban American sample. percent confidence intervals for drug use rates from each of The Puerto Rican sample had a greater proportion of indi- the three Hispanic populations. viduals who were unemployed and not currently married Marijuana and cocaine use by place of birth and lan- compared to the other Hispanic samples. Nearly 60 percent guage use: Marijuana and cocaine use rates by place of birth of Mexican Americans were born in the United States and language use were calculated. The RTIFREQS proce- mainland, while this was true for only 21 percent of Puerto dure in SAS was employed to calculate use rate estimates and their standard errors while accounting for design effects. Ricans and 2 percent of Cuban Americans. Scores on the language use index indicate that Cuban Americans used Multivariate analysis to assess relationship of accultur- Spanish more than English, Puerto Ricans were equally ation to drug use controlling for socioeconomic factors: To divided in language use. and Mexican Americans used investigate whether indicators of acculturation were inde- pendently associated with drug use after the effects of English more than Spanish. socioeconomic factors were removed, a series of logistic Drug Use regression analyses were conducted using LOGIST proce- Age-adjusted rates for marijuana use: The age-adjusted dure in SAS.21 The analyses were conducted separately for rates shown in Table 2 indicate that nearly half of Mexican Mexican Americans and Puerto Ricans; the number of users American and Puerto Rican men reported having used in the Cuban American sample was too small for multivariate marijuana at some point in their lives, while 30.7 percent of analysis to be meaningful. Use in the year prior to interview Cuban American men reported ever using marijuana. Use of (no/yes) was chosen as the dependent variable for the marijuana la the previous year among Hispanic men was analyses because it was the most recent measure of drug use reported by 26.6 percent of Puerto Ricans, 22 percent of with a sufficiently large sample to allow multivariate analy- Mexican Americans, and 12.5 percent of Cuban Americans. ses. The sociodemographic variables in the model were: sex Lifetime use of marijuana was reported by 30.8 percent (male/female), respondent's age (continuous), yearly family of Puerto Rican women, but only 19.5 percent of Mexican income (<$20,000/a>$20,000), currently employed (no/yes), American women and 11.5 percent of Cuban American years of education (0-17), and marital status (measured by women. Compared to lifetime use, use of marijuana in the two dummy variables: separated/divorced/widowed [nolyes] previous year was reported by fewer women than men in all and never married [no/yes], with married as the comparison Hispanic groups. Compared to Mexican American (6.6 per- AJPH December 1990, Vol. 80, Supplement 55 8-91 WED 12:29 COSSMHO AMARO, ET AL. TABLE 1-Selected Weighted Sample Characteristics of Hispanic Sub- rates for lifetime cocaine use indicate that 40.6 percent of all group Puerto Rican men reported ever using cocaine and 26.9 percent reported using cocaine in the previous year. Among Mexican Puorto Cubari Mexican American men, 19.6 percent reported ever using American Ricon American Characteristics (N * 3,303) (N 14 1,209) (N will 058) cocaine and 10.8 percent reported using cocaine in the previous year. One-fifth (20.3 percent) of Cuban American % % % men reported ever using cocaine and 17.1 percent said they Sex used cocaine in the previous year. Female 50.3 62.7 445 Among women, 21.2 percent of all Puerto Rican women Male 49.7 37.3 55.5 reported lifetime use of cocaine, while 6.4 percent of Mexican Ago (years) 20-28 36.9 32.8 18.8 American and 7.2 percent of Cuban American women re- 30-39 27.6 27.4 21.8 ported ever using cocaine. Use of cocaine in the previous 40.44" 7.5 11.4 10.7 year was reported by 13.6 percent of Puerto Rican women but 45-49 6.9 8.8 10.0 only 2.1 percent of Mexican American and 2.7 percent of 50* 20.9 20.3 37.8 Cuban American women. Yearly family income <$20,000 64.6 70.0 57.7 Marijuana and cocaine use by place of birth and lan- -$20,000 35.4 30.0 42.3 guage use: Figures 1 through 4 present the estimates of use Employed 62.2 47.6 67.5 and 95 percent confidence intervals (CI) for marijuana and Education (years) 28 33.7 21.3 27.2 cocaine use in the previous year by birthplace and language 8-11 24.4 31.5 19.0 index. Use of marijuana and cocaine was reported more often 12 23.8 20.5 23.7 by US-born Hispanic men and women of all groups than by >12 16.1 17.8 30.2 those who were born outside the continental US (see Figures Marital status Nover married 14.5 23.4 12.6 1 and 2). Overall, the use of marijuana and cocaine use was Married 72.0 51.6 69.3 highest among English-speaking Hispanic men and women Sep/Div/Wid 13.5 25.0 18.1 than among those who were bilingual, who in turn were US-born 59.3 21.5 2.3 generally more likely to report drug use than those who were Language LIERS English only 26.2 18.2 4.0 primarily Spanish-spenkers (see Figures 3 and 4). As found in Montly English 30.3 24.0 7.9 corlier analyses, in comparison to the other Hispanic groups, Both-equally 12.0 17.4 19.5 Puerto Rican men and women reported the highest use of Mostly Spanish 19,7 31.2 42.7 marijuana and cocaine across language categories and birth- Spanish only 12.9 9.2 26.6 place. It should be noted, however, that sample sizes become very small, especially where drug use among Cuban Amer- a) The age category of 40- 49 years in siplit into two groups bacause the questions on docalne use word saked only of respondents ages 20-44 icaus was reported by birthplace and language use, making b) Reform only to Individuals born in the continental us. these estimates highly unstable. TABLE 2-Age-adjustod Rates of Drug Use among Hispanic Mon and Multivariate Analysis Women (95 percent confidence Intervate) Table 3 presents odds ratios of sociocconomic and Mexican Puedo Cuban acculturation variables for use of marijuana and cocaine in American Richn American the previous year among Mexican Americans and Puerto Ricans. The Cuban American sample of users was too small Marijuana % % % Males (N - 1,450) (N an 440) (N (A) 373) to conduct multivariate analysis. The odds ratios were Provious year 22.0 26.0 12.5 (19.2, 24.8) (21.9, 31.3) (5.0, 19.1) Lifetime 48.8 49.5 30.7 Males Females (45.6, 52.0) (41.3, 57.7) (24.5, 37.0) 100 Fomalos (N th 1,853) (N - 769) (N - 485) Provious year 6.6 12.5 3.8 90 (4.7. 8.5) (9.6. 15.2) (1.2, (5.4) 80 Lifetime 19.4 30.8 11.5 (15.8, 23.0) (26.9, 34.7) (5.5. 17.5) 70 ISSI US Born Males (N 4b 903) IN - 231) (N 14 141) 10.8 Percent Not US Born Cocalho 60 Provious year 20.9 17.1 (7.6, 14.0) (1B.7, 35.1) (7.5, 26.7) 50 Lifetime 19.6 40.8 20.3 40 (14.6, 24.8) (32 0, 49.2) (8.6. 31.8) Females (N - 1,151) (N & 442) (N - 207) 30 Previous year 2.1 13.6 2.7 (0.8, 3.9) (9.8. 17.4) (0.0. 5.4) 20 Lifelimo 6.4 21.2 7.2 10 (4.9. 7.9) (16.5, 25.9) (4.3. 11.0) 0 Mexican Puerto Cuban Mexicon Puerto Cuhan Rican Ricun cent) and Cuban American women (3.8 percent). Puerto FIGURE I--Percent of Mexican American, Puerto Ricart, and Cubun American Rican women reported the highest rate of marijuana use (12.5 mates and fenules who reported using marljuana in the previous year by birthplace percent) in the previous year. NOTE: Only upper 95 percent confidence limits are presented. The upper and Age-adjusted rates for cocaine use: The age-adjusted lower limits are equidistant. 56 AJPH December 1990, Vol. 80, Supplement 8-91 WED 12:30 COSSMHO P.05 ACCULTURATION/MARIJUANA AND COCAINE USE Males Funales Males Females 100 100 90 90 80 BO ISS US Marn 70 NO Not us Born 70 English Dominent Dilligual Percent 60 60 Spanish Dominant 50 Percent 50 40 40 30 30 20 30 10 10 0 0 Puarto Cuban Mexican Puerto Qubon Mexican Puerto Cuban Mexicon Puerto Cubon Mexican Richa Rionn Rition Ricen FIGURE 2--Perent of Mexican American, Poerto Rican, and American FIGURE 1-Percent of Mexican American, Puerto Rican, and Cuban American males find Females who reported using cocaine in the previous year by birthplace males and Temales who reported using cocaine In the previous year by language NOTE: Only upper 95 percent confidence firstes are presented. The upon and use, lower finits are oquidistant. NOTE: Only upper 95 percent confidence limits are presented. The upper and lower inits are equidistant. developed with separate multivariate logistic regressions for each cthnic group/drug combination. never-married status (p < .03) were found. These interactions suggest that among Mexican Americans, speaking English Marijuana Use was more strongly associated with a higher rate of marijuana Marijuana use and acculturation effects: In both Mex- use in the previous year among: women in comparison to ican Americans and Puerto Ricans, language use was signif- men; those who have less formal education in comparison to those with more formal education; and those who were icantly associated with marijuana use in the previous year, even after sociodemographic factors were considered. The married compared to those who were not married. odds of using marjuana were eight times greater for Mexican Among Puerto Ricans. marijuana use in the previous Americans and five times greater among Puerto Ricans who year was most often reported by males (p < .0001), young were English-speaking than among Spanish-speakers. adults (p < .0001), individuals with less education (p < .05), Marijuana use and interaction effects: A final model, and those who were predominantly English-speaking (p < which included the significant interactions (see Methods) in .02). One marginally significant interaction (language by addition to the basic model presented in Table 3. was tested education, P < .08) suggests that use of English among Puerto separately for Mexican Americans (x2 If 611.84, df #: 12, P < Ricans was more strongly associated with a higher rate of .0001) and Puerto Ricans (x² - 236.78, df Me 10, P < .0001). marijuana use in the previous year among those with less education than among those with more education. Among Mexican Americans, marijuana use in the pro- vious year was often reported by those who were younger (p Cocaine Use < .0001), not employed (p < .05). separated/divorced/ widowed (p < .0002), and never married (p < .03). In Cocaine use and acculturation effects: Once sociode- addition, significant interactions between language and sex (p mographic variables were taken into account, language use < .02), language and education (p < .05). and language and was significantly associated with use of cocaine in the previous year among both Mexican Americans and Puerto Ricans (Table 3). The odds of using cocaine were 25 times Males Females greater among Mexican Americans who scored toward the 100 English-dominant end of the language use index than among 90 those who were Spanish-dominant. Among Puerto Ricans, English-speakers were two times more likely than were 80 NO English Dominent MI Bilingual Spanish-speakers to report cocaine use in the previous year, 70 LD Spentah Domment bitt the association was weak. Cocalne use and interaction effects: A final model. Percent 60 which included the basic model presented in Table 3 in 50 addition to all significant interactions, was tested separately 40 for Mexican Americans (x² BE 257.22, df и 11, p < .0001) and 30 Puerto Ricans (x² #1 158.29. df - 12, P < .0001). 20 Among Mexican Americans, cocaine use in the previous year was most likely to be reported by those who were: male 10 (p < .0001). young adults (p < .0001), less educated (p < 0 .002), separated, divorced or widowed (p < .006), English- Mexican Puerto Cutran Mexican Puerio Coban Ricen Hiema speakers (p < .0001). and born in the US (p < .005). Two FIGURE 3-Percent of Mexican American, Puerto Rican, and Caban American significant interactions between language and birthplace (p < males and females who reported estag marijuana in the previous year by .001) and language and education (p < .001) suggest that use language use, NOTE: Only upper 95 percent confidence limits are presented. The upper and of English was more strongly associated with a higher rate of lower limits are equidistant. cocaine use among Mexican Americans who were US-born 57 AJPH December 1990, Vol. 60, Supploment WED COSSMHO P.06 AMARO, ET AL. TASLE 3--Odds Ration (95 percent confidence/Intervats) of Suclosconomic and Acculturation Variables for Usolot Marijuria and Cocaine In the Previous Year among Mexican Americans and Puerto Ricans, Multivariate Legistic Regressions Mexican Amoricans Puorto Ricans Murijuana Cocaine Marijuana Cocaine OR OR OR OR Variables (95% CI) (95% Ci) (95% CI) (95% CI) Sex Male.vs. female 7.17 7.52 3.14 2.66 (4.78, 10.75) (4.11. 13.77) (1.93.5.11) (1.58, 4.49) Age 20 VG 40 years 8.33 6.44 6.03 9.17 (5.21. 13.32) (2.74,15.15) (3.26, 11.15) (3.63, 23.16) Yearly Family income <$20K VS H$20K 1.15 0.75 0.67 0.65 (0.81, 1.63) (0.47, 1.20) (0.40. 1.13) (0.36, 1.17) Employment Employed VS not 0.66 0.94 1.21 1.98 (0.45, 0.96) (0.53, 1.67) (0.72, 2.02) (1.12.3.50) Education 8 VS 16 yours 0.79 1.24 0.91 0.95 (0.48, 1.29) (0.60, 2.54) (0.43. 1.91) (0.42, 2.16) Marital Status Sup/div/wid VS married 2.53 2.76 1.68 3.70 (1.54. 4.15) (1.37,5.51) (0.89.3.18) (2.03, 6.74) Single VG married 0.84 1.14 1.10 2.55 (0.56, 1.26) (0.67, 1.95) (0.G2, 1.94) (1.37,4.75) Birthplace 0.92 US vs not us 1.54 1.03 1.44 (0.75,3.17) (0.50, 2.14) (0.88, 2.49) (0.37,2.31) Language Use English VS Spanish 6.02 25.44 5.32 2.19 (3.40,21.66) (0.56, 98.68) (1.83. 15.46) (0.69, 6.95) ChiSquare 472.02 198.98 306,71 123.57 p .0001 0001 0001 .0001 than among those who were Mexican-born and among those presation is found in the data from the National Houschold who had low educational attainment than among those with Survey,3 in which prevalence of lifetime and previous year high educational attainment. marijuana and cocaine use was highest among those living in Among Puerto Ricans, cocaine uso in the previous year the Northeast region of the US. However, the lifetime and was reported most often by those who were young adults (p previous year rates for cocaine use among Puerto Ricans in < .00013, employed (p < .04), separated, widowed or the HHANES were higher than those reported in the general divorced (p < ,0001), never married (p < .005), and born in population of the US Northeast corridor. For example, data the US mainland (p < .05). Significant interactions between from the National Household Survey indicate that 8 percent language and birthplace (p < .04) and language and sex/(p < of women, and 18 percent of men in the general Northeast .005) suggest that greater use of English was more strongly population have used cocaine at some point in their lives. associated with a higher rate of cocaine use among men than These rates were much lower than those estimated for Puerto among women and among Puerto Ricans born on the island Ricans from the HHANES (21.2 percent and 40.6 percent, than those born on the US mainland. In addition, a marginally respectively). Comparisons of estimates for use of cocaine in significant interaction between language and education (p if the previous year follow a similar pattern, suggesting that use .07) suggests that the use of English was more strongly of cocaine cannot be attributed solely to the geographic associated with cocaine use among Puerto Ricans of low location. educational attainment than those with higher educational The results also indicate that acculturation into US attainment. society. as reflected by language use, was accompanied by a higher prevalence of illicit drug use. This relationship holds Discussion true even when sociodemographic variables are taken into The results indicate that the rate of marijuana and account. Yet, the relative strength of the association between cocaine use among Hispanics, especially among Puerto acculturation measures and drug use varied across Hispanic Ricans, is higher than that for non-Hispanic Whites:- Be- subgroup and by drug. While the cross-sectional design of cause previous large-scale studies have not distinguished this study docs not allow. for an analysis of the process of between the three largest Hispanic groups. the higher rates of acculturation, the results lead us to believe that it is important drug use among Puerto Ricans may havel been diluted by to develop research to further investigate the nature of the combining them with other Hispanics. who have drug use acculturation process among Hispanic subgroups and its rates similar to those reported for non-Hispanic Whites. relationships to drug use. It is possible that the higher rates of drug use among One possible factor which influences the impact of Puerio Ricans compared to other Hispanic groups reflect acculturation on drug use is the social context of drug use in regional patterns of drug use. Some support for this Inter- the native country. For example, it is possible that drug 58 AJPH Docember 1990, Vol. 80, Supplement Extended Page 6.1 factors which impact drug use among Hispanics living in the of the process or acculturation among ruspanes and other US mainland, research is needed on social froms and drug immigrant groups. use pract in the countries from which Hispanics originate. The present findings also indicate the need for further The results also suggest that the relation of acculturation studies of drug use among Hispanics, especially Puerto to drug use differs across education levels. Acculturation, as Ricans on the mainland and on the island. Because of the measured by language use, had the strongest relation to drug close political, economic, and legal ties between Puerto Rico use among those who were lenst educated. Mexican Amer- and the United States mainland, and because of the contin- loans and Puerto Ricans who were highly acculturated, but other migration to and from Puerto Rico, drug availability and had dot enjoyed access to educational resources of American norms of drug use in the continental US may have a direct society, were most likely to report marijuana and cocaine effect on drug use among Puerto Ricans living on the island. use. Similar findings indicating that high acculturation is Met. Paceto Rico is not usually included in national studies of associated with alcohol use among poor Hispanic men have drug use. leaving a critical gap in knowledge about a sub- been reported in the literature. 17123.26 Acculturation, when stantial Hispanic population in the US. Further. public accompanied by poverty and/or lack of access to education, education campaigns and prevention efforts to reduce initi- may resemble what Berry termed "marginalization. 127 In ation into drug use have not typically included Puerto Ricans this type of acculturation. an individual loses essential on the island. Policy initiatives are needed to develop and features of his/her culture and at the same time has: not implement prevention programs aimed at the Puerto Rican entered the larger society. This type of acculturation results population on both the island and in the mainland. Such in feelings of alienation and loss of identity: is highly mitiatives should include ongoing mechanisms for gathering stressful, and places an individual at high risk for poor mental information on drug use among Puerto Ricans. health outcomes. Our: findings also suggest that, in some cases, the relationship of acculturation to drug use varies by sex, Orice ACKNOWLEDGMENTS socioeconomic factors were considered, the gender gap in This Investigation was funded by a grant from the National Coalition of marijuana use was relatively small among Mexican Ameri- Hispinic Health and Human Services Organizations (COSSMIIO), Washing- cans who speak primarily Spanish. This contrasts with the min. DC. The anthors wish to thank Drs. Douglas Anglin and Nancy Felipe Russo rates of drug use among those who were predominantly for their helpful suggestions on an earlier draft. English-speaking. for whom the rates were much higher among men than among women. Yet, the relative difference in drug use between Spanish- and English-speakers was REFERENCES larger among women than men. This finding is consistent with 1. MeChlothtin WH: Drug use and abuse. Annu Rev Psychol 1975; 26:45-65. 2. Johnston LD. 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In: Padilla AM (ed): Acculturation: Theory, Models, and Serds 25. Graves TD: Acculturation, access and alcohol in a tricthnic community. New Findings. AAAS Sclocted Symposion 39. Boulder: CO: Westview Am Anthropol 1967; 69:306-321. Picks, 1980. 16. Madgen W, The alcoholic agringado. Am Anthropol 1964; 66:355-361.27. 19, Delgado 1. Jobnson C. Roy 1. Trevino EM: 1. Hispinite Health and 27. Berry JW. Kim U: Acculturation and mental health. In: Dasen PR, Derry Nutrition Examination Survey, Mothodological Considerations Am JW. Sactorius N (eds): Health and Cross-Cultural Psychology. London: Public Health 1990; @0(Suppl):6-10. Sage Publications. 1968. 60 AJPH December 1990, Vol. 80, Supplement WED 12:35 COSSMHO P - GUENDELMAN, ET AL. grams) at birth?" and "What is the total number of live determined by the question "Do you currently smoke ciga- births you have had?" rettes?": and 3) interval, in years, since the last Pap smear B For primipara. "Did this (the only) child weigh loss test, recoded into four ordinal categories ranging from last than S½ pounds (2,500 grams) at birth?" two weeks to never. Other questions asked of all women were "What is the Medical factors include: 1) self-reported physician- total number of miscarriages you have had?" and diagnosed blood pressure or hypertension; 2) Quotelet index, "How many times have you been pregnant?" i.e., a body mass index based on self-reported weight at age Generation, which is determined by the birthplace of the 25 and height (weight/height2). On the basis of the pairwise subjects. was selected as the primary independent variable. analyses described above, three additional variables were To allow for sufficient sample size, the original three- included in the model for miscarriages, namely: self-reported generation coding given in the data tape (first generation born physician diagnosed diabetes, heart problems, and self- in Mexico: second generation not born in Moxico, one or both perceived health status ranging from very good to poor. parents born in Mexico: third or higher generation, neither Differences between the two generational groups for parent born in Mexico) was collapsed into two groups: 1) each independent and outcome variable were examined by subjects born in Mexico whose parents wereborn outside the performing Student's two sample t-tests for the continuous US, and 2) subjects born in the US who had at least one variables and chi-square tests for the categorical variables. parent born In Mexico or of Mexican descent. Since the HHANES is a multistage, stratified probability Other social, behavioral, and medical variables were sample of clusters of persons in area-based segments, initially screened if they have been reported in the literature estimates were weighted using the "examined weights" and as significantly related to birthweight or miscarriages in complex design effects were taken into account using the non-Hispanic populations. 19.14 Only those variables that were Super Carp program. 20 To facilitate presentation, only the tleast moderately associated (p % .20) with LBW in pairwise weighted values and statistics are presented in the genera- analyses and/or with miscarriages in separato pairwise anal- tional profile in Table 1. yses (adjusting for number of live births and number of Logistic regression was used (SAS Logist procedure)21 pregnancies, respectively) were included for further study. to examine the effects of generation on each outcome variable The social variables considered in the prodictive models controlling for the social, medical, and behavioral factors for LBW and miscarriages are: 1) Medicaid coverage in the studied. Only cases which had complete information on all last 12 months prior to the interview: 2) highest grade of these variables were included in the analyses (n = 1,078). We regular school completed; 3) family income which is the ran simultaneous logistic regressions for all women and then combined income obtained in the last 12 months from jobs, separate models for primipara and multipara. From these public assistance, rents, interests or other sources; 4) marital results we estimated odds ratios and their 95 percent confi- status which refers to whether a spouse is living in the home; dence intervals. For continuous or ordinal predictors, stan- and 5) age in years at the time of the interview. dardized odds ratios are estimated. These are presented in The behavioral factors are: 1) current drinker status Tables 2-5. To check whether the statistical significance of determined by asking of non-abstainers whether they have some variables might be affected by collinearity with other had a drink in the last 28 days; 2) current smoker status variables, the simultaneous logistic procedure was followed TABLE 1-Maternal Characteristics by Goneration for Hispanic Women, HNANES 1982-84 First Goneration Second Generation and Beyond Weighted Weighted Characteristics N 543 Moon or %* S.E. N - 847 Moon or %* S.E. 0" Social Education, M in yours 543 M and 7.1 0.2 847 M 2% 10.6 0,3 .000 Income, M in $1.000 643 M we 14.1 0.3 847 M - 15.8 0.4 .009 increments Medicaid last 12 months 541 6.9% 1.4 842 8.6% 1.1 .168 Married 541 75.8% 2.3 847 70.0% 20 .004 Age, M in years 543 M be 34.1 0.5 847 M as 34.3 0.4 .763 Live births, M number 543 M ** 3.3 0.8 847 M HD 3.1 0.4 .827 Behavioral Current smoker 528 21.1% 1.3 798 28.1% 1.6 .009 Current drinker 542 6.0% 1.0 847 12.4% 1.3 .005 Nover had a Pap smoor 538 11.1% 1.3 832 3.3% 1,1 .002 Biological History of high blood pressure 543 21.4% 2.2 847 22.4% 1.9 740 Quotolet Indox at age 25 446 801 Low Quototat Index 30.8% 1.6 28.6% 1.4 Medium Quotelet index 56.8% 23 55.7% 1.7 .517 High Quotolet Indox 12.5% 2.3 15.7% 2.7 Mistory of diabetes 543 5.1% 0.5 847 8.0% 0.4 .002 History of heart problems 543 2.4% 0.6 646 4.8% 0.8 .043 Porceived health status. M 542 M del 3.28 0.03 847 M - 2.83 0.04 .000 Pregnancies, M number 543 M Rd 3.9 0.7 847 M - 3.7 0.6 .834 SOURCE: Hisprinic Health and Nutrition Examination Survey, 1082-1984. "Complex dosign effects also taken into account. "p values represent the significance lovel for the first and second generation comparison in the weighted analysis. 62 AJPH December 1990, Vol. 80, Supplement WED 2 COSSMHO PERINATAL HEALTH AMONG MEXICAN AMERICANS up with a backwards stepwise regression. 21 Data in the TABLE Adjusted Odde Ratios* for Low Birthweight (n - 1078) models were weighted according to the scaled weighting procedure proposed by the National Center for Health Adjusted Statistics, where the sum of the weights is equal to the Variables Odde Ratios* 95% CI observed sample size. The results on Tables 2-5 were also examined adjusting for complex design effects using the Generation (0 and first, 1 ** second or 1.73 1.11,2.71 estimated average design effect of 1.5 as described by boyond) Number of live births 1.37 1.13,1.67 Delgado, et at. Age at injerview 1.13 0.91,1.41 Marital status (0 à no spouse home: 0.92 0.58,1.47 Results 1 - spouse at home) Years of inducation 0.93 0.75, 1.15 Generational Profiles of Maternal Characteristics income 0.93 0.75, 1.14 Medicaid coverage (0 @d no: 1 0.83 0.39, 1.78 The two generational groups were similar with respect to yes) age at interview (34.1 years for the first and 34.3 years for the Current drinker status (0 abstainer; 0.76 0.41,1.40 second) and the proportion of primiparous women (19.7 1 in drinker) percent in the first and 20.8 percent in the second). The Current arnoker status (0 a no: 1 - 1.58 1.05,2.38 findings in Table I indicate that a variety of significant yes) interval alsos last Pap smoar 1.01 0.84, 1.21 changes take place between the first and second generationior Low Quelleter Indox at age 25 (o 1.46 beyond. Second generation women have H significantly no: 1 in yes) higher educational attainment than first generation women. High Qualifiet Index at age 25 (0 EM 1.26 On the average they have 31/2 more years of formal schooling. no: 1 (M yes) History of high blood pressure (0 - 1.25 0.82, 1.91 Family income is also significantly higher in the second no: 1 or yes) generation despite the fact that, compared with the first generation, there are more women living withouth spouse at SOURCE: Hispanic Health and Nutrition Examination Survey: 1902-04 home. From B behavioral standpoint, far more second gen- Logistic regression analysis techniques were used to obtain the adjusted odde ratios. "For the continuous and ordinal veriables, itvo birthe, age at interview, education, Income cration women are smokers and drinkers than first generation and interved africe last pap smear, standardized odds ration are presented. (The add: rollo women. However, significantly fewer second generation of LBW for the increase of one standard doviation of the prodictor.) "To dynlum the Quototar Index (a nominal variable with 3 categories). a x² tost statistic women have never had a Pap sinear compared with those in with 2 D.F. WILG obtained from the difference of two log likelihood functions and was found the first: significant differences in high blood pressure or to the not Etallatically significant. Quetelet index were found between the two generations. but second generation women had significantly higher propor- 3-Adjusted Odds Retios* for Low Birthweight among Primipa- tions of physician-diagnosed diabetes and heart problems. rous Women (n # 107) Despite reporting more medical problems, second generation women perceived their health status significantly better than Adjusted first generation women. Variables Odds Ratios* 95% CI Generational Effects on Low Birthweight Generation (0 stim first, 1 TO second or boyond) 4.08 0.81, 20.45 The percentage of low birthweight out of the total live Age at Interview 0.97 0.53. 1.77 births for Mexican origin mothers is 5.3 (S.E. 5% 0.04). This Markel status (0 45% no spouse home, 1 - spouse 1.23 0.31, 1.51 estimate is similar to the rates based on birth certificate data at home). Years of education 0.98 0.51, 1.91 reported by Williams (5.3 percent) and Ventura* (5.6 per- income 1.32 0.68,2.59 cent) and higher than those reported by Scribner and Dwyer's Medicald coverage (0 " no: 1 & yes) 0.30 0.02,4.18 (4.8 percent) using an HHANES sample of older women up Currentidrinker status (0 - abstainer: 1 - 0.93 0.78, 1.11 to age 74. Similar to Scribner and Dwyer. we found that LBW drinker) Current smoker status (0 the no; 1 TO yes) 0.62 0.16,2.43 rates differ significantly for the two generational groups. Out Intervalisinco last Pap smoar 1.87 1.09,3.20 of the total live births for the first generation 3.9 percent (S.E. Low Quotolet Index at age 25 (0 - no; 1 & yes) 1.28 as 0.7) are of LBW. whereas out of the total live births the High/Quetaletet index at age 25 (0 an no; 1 to yes) 1.06 ** second generation, 6.1 percent (S.E. = 0.7) are of LBW. The History Not high blood pressure (0 an no: 1 226 yes) 5.07 1.59, 16.20 generational effects on LBW are significant, even after SOURCE: Hispanic Health and Nutrition Examination Survey: 1062-84 adjusting, in a logistic regression model. for the social, regression analysis techniques word used to obtain the adjusted adds ratios. behavioral and medical characteristics. The risk of LBW is TO the continuous and ordinal variables, standardized odde ratios are presented. 1,73 times higher (95% CI 525' 1.11, 2.71) in the second *TO evaluate the Quotelet Index (a nominal variable with 3 categories), 4 tost statistic with 208 was obtained from the difference of two log likolihood functions and was found generation compared with the first (Table 2); This result to be not itatistically significant. remains significant even after adjusting for complex design effects. potential confounders included in the logistic regression We examined the generational differences in birthweight model, the risk of LBW is approximately four times higher for outcomes in the two parity groups and found that. in the first second than first generation primiparous women (OR 4.08; generation. the LBW rate was 6.3 percent (S.E. use 1.8) in primipara and 3.8 percent (S.E. = 0.05) in multipara. In the 95% CI - 0.81, 20.45). The risk factor, however, was not second generation, primipara also had higher rates: 9.7 statistically significant at the p - .05 level, possibly due to percent (S.E. - 2.4) compared with 5.9 percent (S.E. IIII. 0.06) small sample size. The risk for LBW is five times higher for in multipara. These estimates indicate that although the primiparous women with a physician-diagnosed history of percentage of LBW increases in the second generation, in high blood pressure (OR 5.07; 95% CI = 1.59, 16.20) and it both generations primipara have LBW rates diat are almost almost doubles when the interval since last Pap smear is 1.5 times Higher than multipara. greater than one standard deviation from the mean (OR 1.87; As shown in Table 3, we found that after adjusting for the 95% CI RED 1.09. 3.20). After adjusting for complex design AJPH December 1990, Vol. 80, Supplement 63 8-91 WED COSSMHO GUENDELMAN. ET AL. effects, the only significant prodictor that remained was blood TABLE 5-Adjusted Oddn Ratios* for Miscarriages (n at 1076) pressure. The effect of generation on LBW was significant for Adjusted Variables Odds Ratios* 95% CI multiparous women. The findings in Table 4 show that the risk of LBW is almost double for second generation women Generation (O - first, 1 #: second or beyond) 0.81 0.57, 1.15 (OR 1.69; 95% CI any 1.05, 2.84) and for current smokers (OR Pregnancy number 3.92 3.09,4,96 1.79; 95% CI an 1.16, 2.76). Smoking remained a significant Age at Interview 0.68 0.56, 0.82 predictor even after adjusting for complex design effects. Marital status (0 an no spouse home, 1 tool spouse 0.69 0.47, 1.03 Results similar to those obtained with the logistic regression at home) Yours of education 1.25 1.04,1.51 techniques were obtained when doing backwards stepwise Income 1,15 0.97, 1,37 regressions for primipara and multipara. Medicaid coverage (0 - no: 1 or yes) 0.96 0.52, 1.75 Current drinker status (0 of abstainer: 1 in 0.99 0.60. 1.61 Generational Effects on Miscarriages drinken Current smoker status (0 - no: 1 An yes) 1.11 0.78, 1.58 The percentage of miscarriages out of the total number Interval since last Pap smoar 0.91 0.78, 1.08 Low Quetolet Indox at age 25 (0 - no: 1 - yos) 1.13 of pregnancies for Mexican origin mothers is 12.7 percent High Quotelet Indox at age 25 (0 a no: 1 - yes) 0.96 R$ (S.E. to 0.59). This rate falls within the expected range for History of high blood pressure (0 - no; 1 go yes) 1.23 0.86, 1.76 spontaneous abortions in the mainstream population. 14 Fur- History of diabetes (0 or no; 1 - yes) 1.25 0.70, 2.24 History of heart problems (0 TF no: 1 our yes) 1.07 0.52,2.20 thermore, the rates for the two generational groups are not significantly different. Out of the total number of pregnancies Perceived health status 1.09 0.93, 1.29 for the first generation, 13.1 percent (S.E. TIV 0.99) have had SOURCE: Hapanic Health and Nutrition Examination Survey: 1982-84 miscarriages. For the second generation the percentage of *Logistin regression analysis techniques ware used to obtain the adjusted odde ratios. miscarriages is 12. 5 percent (S.E. 24 0.60). For the continuous and ordinal variables, standardized odde ration are presented. To evaluate the Quotatot Indox (a nominal variable with 3 cutegories). ax" tost statistic Using logistic regression, we examined whether gener- with 2 D.F. was obtained from the difference of two log likelihood functions and was found ation becomes & significant predictor or miscarriages after to be not statistically significant. adjusting for the social, behavioral and medical factors listed in Table 5. Generation was not a significant predictor of including generation and found that it was not a significant miscarriages (OR 0.81; 95% CI - 0.57, 1.15). The adjusted predictor of miscarriages. odds ratios reported in Table 5 indicate that miscatriages Nor was generation a significant predictor of miscar- increase 1.25 times with every increase in one standard riages when logistic models were constructed separately for deviation in education (95% CI this 1.04, 1.51); it increases 1.47 primipara and multipara (primipara: OR 0.76; 95% CI = 0.31, times (95% CI - 1.79. 1.22) with every decrease in one 1.87; multipara: OR 0.91: 95% CI = 0.62, 1.34). However, for standard deviation in age and 1.43 times among women primipara, an older age at interview (OR 1.74; 95% CI = 1.17, without a spouse living at home (95% CI ICE 2.13, 0.97). 2.57) and Medicaid coverage (OR 3.30 95% CI M .93; 11.69) Education and age remained significant after adjusting for was. positively associated with miscarriages, whereas in complex design effects. multipara age and socioeconomic factors were inversely Since Scribner and Dwycr' reported that generation associated with miscarriages (age OR 0.64; 95% CI = 0.52, was not as strong a predictor of pregnancy outcome as 0.78; income OR 1.17; 95% CI = 0.97, 1.42; education OR acculturation, we examined the role of acculturation in 1.22; 95% CI If 1.00, 1.49). predicting miscarriages. Like Scribner and Dwyer, we looked at the effect of the acculturation index with and without Discussion TABLE A--Adjusted Odda Ratios* for Low Birthweight embing Multipa- The findings from this study show that for the Mexican rous Women (n = 892) origin population in the United States the percentage of LBW was 5.3 and the percentage of miscarriages was 12.7. Adjusted Whereas the incidence of LBW in this population is lower Variables Odds Bation" 95% a than that for the general population, the rate of miscarriages seems similar to what is expected for the mainstream popu- Congration (0 in first, 1 as second or beyond) 1.69 1.05, 2.84 Number of live births 1.37 1,11,1.58 lation. 3,8.14 Ago at Interview 1.18 1.05, 1.33 Mexican Americans are a heterogeneous group and our Marital status (0 29 no spouse home, 1 ** spouse 0.86 0.52, 1.44 analysis demonstrates that wide variations are found accord- of home) ing to generation and parity. US-born Mexican Americans Years of education 0.92 0,73, 1.16 income 0.09 0.79, 1,11 are at 60 percent higher risk for LBW than Mexico-born Modicald coverage (0 - no: 1 the yes) 0.97 0.43. 2.20 women. Furthermore. the rate of LBW among US-born Current drinker status (c MP abstainer: 1 Me) 0.79 0.41, 1.32 primipara at 9.7 percent begins to approximate that of the drinker) Current smoker status (0 - no: 1 - yes) 1.79 1,16,2.76 Black population. 19 Interval since last Pap smoar 0.89 0.72, 1,09 The findings, based on a rich array of variables, further Low Quotelet Indox at age 25 (0 - no; 1 - you) 1.46 demonstrate that across generations, significant changes take High Quetelet Index at age 26 (0 M/D no: 1 In t you) 1.38 place in certain bio-social-behavioral characteristics of moth- History of high blood pressure (0 - no; 1 and yes) 0.95 0.00, 1.51 ers which are associated with pregnancy outcomes (Table 1). While second generation Mexican American women show a SOURCE: Hispanic Health and Nutrition Exercination Survey: 1982-84 *Logistic regronation analysis techniques were and to obtain the adjusted odda ration. higher educational and income status and more use of health "For the continuous ark! ordinal variables, standardized additionals the presented. care relative to their first generation counterparts, certain To evaluate the Quatetet Index to nominal variable with 3 calegories), AX cont claimatic with 2 D.F. was obtained from the difference of two log likethood functions and was found behavioral characteristics such as smoking and drinking to to not statistically significant. behaviors actually deteriorate in the second generation. The 64 AJPH Docember 1990, Vol. 80, Supplement 8-91 WED 12:39 COSSMHO P.05 PERINATAL HEALTH AMONG MEXICAN AMERICANS second generation also has higher rates of physician-diagnosed extent to which prematurity or intrauterine growth retarda- diabetes and heart problems. However. this could be a result tion determine pregnancy outcomes in each generation. This of improved access to care rather than to poor health status. is a question that cannot be addressed in the HHANES. Our multivariate models indicate that generation is a significant predictor of LBW but not of miscarriages. This evidence points to two important findings: first, even after ACKNOWLEDGMENTS controlling for other factors. US-born Mexican origin women This investigation was funded by a grant from the National Coalition of Hispanic Health and Human Services Organizations (COSSMHO), Washing- of the second generation or beyond have a higher likelihood too. DC. of giving birth to LBW infants; and second, these patterns are The authors would like to thank Olivia Carter-Pokras. Katherine Flegal, not consistent for all pregnancy outcomes. and Peter Gerdsen at NCHS for theirhelpful comments. Special thanks are also According to the acculturation model, the behaviors or extended to Mury Maddox-Gonzalez. MD. MPH. and Jose Enz. MD. MPH. for their help in the early stages of the study. lifestyles that protect women against adverse pregnancy outcomes are associated with a Mexican cultural orientation which predates pregnancy. If this were the case, we would REFERENCES have expected that generation (as a proxy for acculturation) 1. Williams RL, Binkin NJ. Clingman EJ: Pregnancy outcomes among Sponish-surnume women in California. Am I Public Health 1986; 76:387- would have been a significant predictor, not only of LBW but 391. also of miscarriages. Evidence from this study does not 2. Agairee ST, to KL: Maternal and Child Health Profile for Hispanics in support this conclusion. The findings show no significant California. Sacramento, California: Health Officers Association of Cali- effects of generation or the acculturation index on miscar- fornia, Border Maternal and Child Health Project, 1985. 3. Shiono Pit. Klebanoff MA. Graubard BI, Bernedes HW. Rhoads GG: riages. Rather than cultural factors, the results suggest that Birthweight among women of different ethnic group. JAMA 1986: 225:48- socioeconomic, genetic, and unaccounted medical factors 52. are better predictors of miscarriages in Latinas. 4. National Center for Health Statistics, Ventura SJ: Births of Hispanic Furthermore, the findings do not support the hypothesis Parentage, 1980. Monthly Vital Statistics Report, Vol. 32. No. 6. Supple- ment. DHHS Pub. No. PHS 83-1120. Hyartsville. MD: NCHS. Public that increased fetal losses explain the more favorable LBW Health Service, September 1983. outcomes in first generation Mexiean-Americans. 12.13 The 5. National Center for Health Statistics. Ventura SJ: Births of Hispanic 13.1 percent miscarriage rate in the first generation was very parentage. 1981. Monthly Vital Statistics Report, Vol. 33. No. 8. Supple- similar to the 12.5 percent found in the second generation. ment. DHHS Pub. No. PHS 85-1120. Hyattsville, MD: NCHS. Public Health Service. December 1984. However, the possibility of reporting bias cannot be 6, National Center for Health Statistics, Ventura SJ: Births of Hispanic discounted in this study. Underreporting miscarriages among Paramage. 1982. Monthly Vital Statistics Report. Vol. 34, No. 4. Supple- first generation women could occur as a result of less ment. Hyattsville, MD: NCHS. Public Health Service. July 1985. education which leads to less body awareness or less likeli- 7. Ventura SJ. Tallet SM: Childbearing characteristics of US- and foreign- hood of recognition of miscarriages. Furthermore, compared born Hispanic mothers. Public Health Rep 1985: 100:647-652. 8. Dowling PT. Fisher M: Material Dictors and low birthweight infants: A with US-born, Mexico-born women are more likely to seek comparison of Blacks with Mexican Americans. J Fam Pract 1987: prenatal care late or none at all.s and thus are loss likely to 25:153-158, receive a medical diagnosis if miscarriages occur. Con- 9. Gayle AD. Dibley MJ. Marks JS. Trowbridge FL.: Malnutrition in the first versely, because induced abortion in Mexico is illegal. two years of life. Am 1 Dis Child 1987: 141:531-534. 10. Scribuer R, Dwyer J: Acculturation and low birth weight among Latinos Mexico-born women could be misreporting induced abortion in the Hispinic HANES. Am I Public Health 1989: 79:1263-1267. as miscurriages to make it more acceptable. 24 The possibility 11. Markides K, Coroil J: The health of Hispanics in the southwestern United of measurement error also arises given the potential ambi- States: ## epidemiological paradox. Public Health Rep 1986: 101:253-265. guity concerning what events actually constitute a miscar- 12. Holderson J. Daudistel H: Infant mortality of the Spanish surname population. Sec Sci J 1982: 19:68-78. riage. We suspect that miscarriages may be more prone to 13. Eberstein 1. Pol L: Mexican-American ethnicity. socio-economic status. reporting bias than LBW. particularly among less educated and infant mortality: A county level analysis. Soc Sci J 1982: 19:61-71. women. Hence, further studies are needed to confirm the 14. Kline 3. Stein 2: Spontaneous abortion (miscarriage). In: Bracken M (ed): validity of the fetal loss hypothesis. Perinaral Epidemiology. Ch 2. New York: Oxford University Press, 1984. 15. Mines R. Kearney M: The Health of Tulare County Farmworkers: A Because the HHANES is a cross-sectional, retrospec- Report of 1981 Survey & Ethnographic Research for the Tulare County tive survey, variables do not necessarily measure the condi- Department of Health. Sacramento: California Dept of Health. 1982. tions or behaviors at the time of birth, hence possibly washing 16. De la Torre A. Rush 1.: The effects of health care uccess on maternal and away some of the effects. In this study. the recall blas was as infant health of California migrant seasonal farm worker women. Border Health 1987; 3:18-25. long as 40 years and no attempts at verifying the accuracy of 17. Eisner V. Brazie JV. Pratt MW, Hexter AC: The risk of low birthweight. the miscarriage or LBW information given to the mother at Am J Public Health 1979: 69:387-893. the time of delivery were made in the HHANES. Neverthe- 18. National Center for Health Statistics: Plan and operation of the Hispanic less, some of the traditional risk factors c.g. smoking for Health and Nutrition Examination Survey 1982-84. Vital & Health Statistics Series 1. No. 19. DHHS Pub. No. PHS 85-1321. Washington, LBW and e.g. age for miscarriages are corroborated using the DC: NCHS, Public Health Service. September 1985. HHANES data. Furthermore, the results of LBW are con- 19. Institute of Medicine: Preventing Low Birthweight. Washington, DC: sistent with those found by Williams, it al.' in California. The National Academy Press. 1985. latter found that the lower rates of LBW among Mexico-borni 20. Hidiroglou MA. Fuller WA, Hickman RD: Super Carp. 6th Ed. Ames. IA: Survey Section Statistical Laboratory. Towa State University. October compared with US-born women of Mexican origin could not 1980. be the result of systematic underreporting by Mexican 21. Harrell F: The Logist Procedure: SAS Supplemental Library User's women. Guide. SAS Institute, 1980. In conclusion, the findings from the HHANES suggest 22. National Center for Health Statistics, Division of Health Examination Statistics: Analytic guidelines and reliability criteria for analyzing HANES that cultural explanations of differential pregnancy outcomes dive. Hyattsville, MD: NCHS. 1989. in women of Mexican origin must be restricted to LBW. The 23. Delgado 1L. Johnson CL, Roy 1. Trevino FM: Hispanic Health and evidence strongly argues for the need to include generation as Nutrition Examination Survey. Methodological considerations. Am J a risk factor when doing studies of LBW in Mexican- Public Health 1990: 80(Suppl):6-10. 24, Combs 1. Freedman R. Namboodiri D: Inferences about abortion from Americans. Further studies are also needed to assess the fetal mortality data. Popul Stud 1969: 23:247-265. AJPH December 1990, Vol. 80. Supplement 65 WED COSSMHO - III. Health Risk Behaviors of Hispanics in the United States: Findings from HHANES, 1982-84 GARY MARKS. PHD, MELINDA GARCIA. PHD, AND JULIA M. SOLIS, PHD Abstract: With data from the Hispanic Health and Nutrition American men and women). The Puerto Ricans' diet was less Examination Survey (HHANES). we examined several health risk bulanced than that of the other two groups. For each sample, more behaviors (cigarette smoking. alcohol use. dietary practices. and mon than women had not had a routine physical or dental examina- recency of health screening) of Mexican American, Cuban Ameri- don within the past five years: the recency of screening was lowest can. and Puerto Rican adults (ages 20-74). For each sample, 2 greater for Mexican American men. Screening (including Pap smear for the percentage of men than women smoked cigarettes and used alcohol. women) was lower for those who smoked cigarettes and for those Heavy smoking (20+ cigarettes per day) was most provatent for with poor dietory practices, indicating that many Hispanics at special Cubon American males, and heavy drinking (1.00+ oz ethanol por risk of disease underutilize preventive health services, increasing the day) was most prevalent for Mexican American and Puerto Rican likelihood of diagnosis at a later stage of illness. [Am / Public Health men. Acculturation correlated positively with alcohol use (particu- 1990: 80(Suppl):20-26.) larly for females) and negatively with dictary balance (for Mexican Introduction Methods Compared to non-Hispanic Whites in the United States. Sample Mexican Americans underutilize preventive health services The study used data from the Hispanic Health and such as routine physical check-ups, dental and eye exami- Nutrition Examination Survey (HHANES), conducted by nations, and prenatal care.1-3 When they present with an the National Center for Health Statistics (NCHS) from illness, the illness frequently is at a later stage. Conse- 1982-1984. This survey sampled Mexican Americans from quently, Mexican Americans are at greater risk of morbidity five southwestern states, Cuban Americans from Dade and mortality than the general United Status population.* County (Miami) Florida, and Puerto Ricans from the Now The screening behavior of persons of Mexican heritage York City area. For detailed information about the complex has been shown to be affected by: access to care; such as sampling design see the methodological paper by Delgado, et having à regular family physician and health insurance al,29 at the beginning of this supplement and the NCHS plan coverage;2.3.5.9 cultural variables such as adaptation to the and operation of HHANES. practices of American society 5,10.12 and sociodemographic Our analyses focused on adults (20-74 years of age) from factors such as income, education, age, and gender: 13.14 The caub of these three samples. Table 1 presents the total sample extent to which utilization of preventive health services is sizes in this age range. the analytic sample sizes, and selected influenced by attitudinal and behavioral factors. however, sample characteristics. Analyses were restricted to eligible has received much less attention. Hispanic sumple persons who provided data on each variable Attitudes about health are reflected in many behaviors. used in this study. or the total number of Mexican Ameri- For example, those who smoke cigarettes heavily, 15-17 drink cans. Cuban Americans, and Puerto Ricans (20-74) sampled, alcohol lexcessively, 18,19 or maintain an unbalanced and 85 percent, 86 percent, and 87 percent, respectively, were unvaried diet (e.g., high in fried meats and low in fruits, included in the analytic samples. vegetables, and fiber17.20,21) place themselves at increased risk of specific diseases. such UN cancer of the lungs. Measures pancreas, colorectal area. and prostate. 17.20-35 and hyperten- sion and coronary heart disease 26.27 Idently, individuals who Health Service Utilization-Recency of physical exam- engage in these "health risk behaviors" should use screening ination was measured by asking "How long has it been since services regularly in order to monitor their health status. We you had a routine physical examination, that is, not for a suspect; however, that (after controlling for income, educa- particular illness. but for a general check up?" Responses tion, age, and acculturation) they use those services less were coded on a 5-point scale ranging from "never" [1] to frequently than individuals who do not engage in such "less than one year ago" [5]. Recency of dental examination behaviors, based on the assumption that such behaviors are WAS assessed by asking how long it was since they saw a components of a constellation that emanstes from a general dentist or dental hygienist for dental care (coded from "ndver" [1] to "six months ago or less" [6]). Recency of Pap attitude toward health promotion and disease prevention. smear was examined for the women ("never" [1] to "less This eluster of behaviors is likely to contribute to the than one year ago" [7]). presence of illness and to diagnosis at a later stage. Cigarette Smoking-This behavior was measured two We provide data on the prevalence of these health risk ways: (a) a dichotomous measure reflected whether or not the behaviors among Mexican American, Cuban American, and respondent was a current cigarette smoker (current smoker BE Puerto Rican adults, and examine the extent to which 1; does not currently smoke cigarettes, cigars, or pipes = 0; recency of screening (physical and dental examination. Pap the few persons who smoked cigars or pipes only were not smeat) is correlated with them. included in the analyses); or (b) among current cigarette smokers, each was assigned a score indicating the number of cigarettes smoked per day. These two measures allowed us NOTE: Author affiliations are listed elsewhere under CONTRIBUTORS. to examine whether the effects of smoking are due to more 20 AJPH December 1990, Vol. 80, Supplement 8-91 WED COSSMHO P.07 HEALTH RISK BEHAVIORS TABLE 1--Sample Characteristics Mexidan Americans Cuban Americans Puerto Ricans Age range (years) 20-74 20-74 20-74 Total sample (20-74) 3326 865 1220 Analytic sample size 2824 745 1066 Mon 1249 330 389 Women 1675 415 677 M # M F M F Marital Status % Married-spouse in home 76.5 65.8 74.6 85.6 60.5 39.0 % Married-spouse not home 2.0 1.9 1.3 1.6 2.8 5.1 % Widowed 1.1 6.3 0.5 78 0.3 5.8 % Divorced 3.7 7.5 7.8 12.0 7.5 13.4 % Separated 1.0 6.4 1.8 3.1 4.4 14.3 % Nover married 14.9 121 14.2 10.0 24.5 22.4 Age (years) % 20-30 41.4 39.5 23.6 20.1 35.0 34.6 % 31-40 28.0 25.9 17.6 22.9 27.6 27.9 % 41-50 13.3 14.1 23.5 22.9 16.3 19.6 % 51-74 17.3 20.5 35.0 34.1 21.1 17.9 Annual Family income % Loss than $10,000 23.1 33.6 20.6 29.0 29.2 44.6 % $10,000-$19,909 37.9 33.7 33.4 30.3 34.8 29.0 % $20,000-$29.999 21.1 18.1 22.6 17.7 17.4 10.9 % $30,000 and above 17.9 14.0 23.4 23.0 18.6 15.5 Education % Loss than 7 years 27.9 30.9 22.2 22.6 16.3 16.4 % 7-11 years 26.6 26.5 24.9 21.9 36.1 35.9 % 12 years 24.1 24.2 21.3 27.2 26.4 30.1 % 18 or more 21.4 16.5 31.6 28.3 19.2 17.6 The percentages for marital status. age, income, and aducation words eniculated with nample weights (examination weights). smoking status (smoker VS nonsmoker) or to magnitude of diet soda), cake, cookies, chips, sugar, etc. The overall diet smoking among current smokers. index was formed by splitting the distribution of scores for Alcohol Use-Alcohol consumption was grouped into dictary balance and the distribution of scores for "junk food" four volume levels: (a) little or no current use (fewer than 12 at their respective medians. Those high on dietary balance drinks of Becr, wine, or liquor in one's entire life or in any one and low on "junk food" intake were assigned a score of 3; year, or no current use); (b) light regular/occasional drinkers those high on each dimension received a score of 2; those low (light regular drinkers consumed an average of 0.01 to D. 21 02 on each dimension received a score of 1; and those low on of ethanol per day, occasional drinkers drank in the light balance and high on "Junk food" were assigned a score of 0. ethanol range or above but did so irregularly); (c) moderate This Index was used in the correlations and regression regular drinkers (an average of 0.22 to 0.99 oz of ethanol per analyses. For descriptive purposes, we calculated the num- day) and (d) heavy regular drinkers (an average of 1.00 or ber of the five food groups from which respondents had caten more oz of ethanol per day). The ethanol scale was con- one or more Food items daily, and the percentage who had structed by NCHS using a conversion factor in which one 02 eaten one or more "junk food" items daily. of beer contains 0.04 OZ of ethanol, one OZ of wine contains Acculturation-This variable was measured with eight 0. 15 oz of ethanol, and one OZ of hard liquor contains 0.45 oz items pertaining to spoken and written language and to ethnic of ethanol. identification. The items represent a subset of the 20-item Diet Index-Diet was assessed with a food itdm and "Acculturation Rating Scale for Mexican Americans" de- consumption frequency checklist similar to that used by veloped by Cuellar, of at.st others. 17.20.22.23 Respondents reported on all food items 1. What language do you speak? consumed in the past three months. They indicated whether 2. What language do you prefer? they had eaten the food item daily (coded as a score of 3), 3. What language do you read better? weekly (2), less than once a week (1), or never (0). We 4. What language do you write better? constructed an overall diet index that consisted of two These four measures (as well as the four below) were components. One component was the extent to which an coded so that higher scores reflected a stronger English individual's diet was balanced. Specific food items were language/American orientation. Items 1-4 ranged from grouped into dairy products, ments (including poultry and "Spanish only" (1), to the midpoint "Spanish and English fish), fruits, vegetables, and grains/cereals. For each person, equally" (3), to "English only" (5). The four remaining items scores were averaged separately for each food group, and measured ethnic identification: then the five subscale scores were averaged. Higher overall $. What ethnic identification do you use? scores indicated a more balanced diet (i.e., frequent con- 6. What ethnic identification does/did your mother use? sumption of foods in each group). The second component 7. What ethnic identification does/did your father use? consisted of a "junk food" factor, i.e., the extent to which an 8. Where was the birthplace of yourself, your mother, individual consumed Items such as candy. sodas (excluding your father? AJPH December 1990, Vol. 80, Supplement 21 WED 12:43 COSSMHO P.08 MARIKS, ET AL. For the Mexican American sample, the response codes by B weighted ordinary least-squares analysis. We should for items 5-7 ranged from "Mexican" (1). to "Mexican emphasize that although certain variables were examined as American" (3), to "Anglo or other" (5). For the Cuban "predictors," the HHANES is a cross-sectional design; thus, Americans and Poerto Ricans, responses to items 5-7 had it does not provide evidence regarding cause and effect. highly restricted variance; almost all of the Cuban Americans (and their parents) identified themselves as "Cuban"; the same situation occurred for the Puerto Ricans. Thus, these Results items could not be used meaningfully for these two groups. Prevalence of Henlth Risk Behaviors Item 8 was coded to establish generation. The scale runged from "first generation (respondent born in country of origin)" For each sample, behaviors that increase one's risk of (1) to "third or higher generation (respondent and both illness and disease were more prevalent for men than women. parents born in US)" (4). This item could not be used for the A greater percentage of the men smoked cigarettes and drank Cuban Americans and Puerto Ricans again because of re- alcohol heavily (Table 2). Heavy cigarette smoking was most stricted variance; 97.5 percent of the Cuban Americans (age prevalent for Cuban American men, and heavy drinking most 20-74) and 80.5 percent of the Puerto Ricans (age 20-74) were prevalent for Mexican American and Puerto Rican males. first generation. Thus, for these two samples, only the four Distary balance was somewhat lower for men than women, language items were used to assess acculturation. These four and lower for the Puerto Ricans compared to the other two items were standardized to a mean of zero and variance of groups, Further, for each sample, more men than women had one (to give each item equal weight) and then averaged to not had a physical or dental examination within the last five create a composite score for the Cuban Americans and years. These gender differences occurred for those above, as Puèrto Ricans. For the Mexican Americans, all eight items well as for those below, the median on the acculturation were standardized and then averaged to create the accultur- index. The utilization of the health services was especially ation score. Demographic information on annual income. low for the Mexican American men. Table 2 also indicates education, and age was also included in the analyses. that use of the preventive services was lower for the Mexican Americans than the Cuban Americans and Puerto Ricans. Data Analysis One explanation for this difference is that fewer Mexican Analyses were performed separately for each of the Americans had some form of health insurance coverage.5 three samples, and separately for men and women applying Correlation of Health Risk Behaviors with Acculturation and normalized sample weights (examination weigh(s) We Sociodemographics analyzed the weighted prevaience of each health risk behav- for as well as the weighted Pearson correlation of these With only a few exceptions, the pattern of the correla- behaviors with acculturation, education, income, and age, dons was similar for men and women, and for each sample Our primary hypothesis was examined with multiple regres- (Table 3). Because of the relatively large sample sizes, many sion analysis. The regression model for each dependent of the coefficients were statistically significant even though measure (i.e., utilization variable) included as predictors the their absolute magnitudes were low. There were, however, three health risk behaviors, acculturation, and the three several meaningful effects. The strongest associations in- sociodemographic variables. The predictors were entered volved acculturation, which correlated with increased alco- into the equation simultancously. Prior to conducting these hol consumption (particularly for the women of each sample), tests, a statistical program (SESUDAAN) was run to and with lower diet scores for the Mexican American men calculate the average design effect for each predictor vari- and women. As age increased, alcohol consumption de- able. This average design effect was used to conservatively creased; the correlations between age and cigarette smoking adjust theistandard error of a regression coefficient generated and between age and diet were small. Those with more TABLE 2-Weighted Prevalence of Houlth Risk Behaviors Mexican Americans Cuban Americans Puerto Ricans Males Fomales Malos Females Malos Females Percent current cigarette smoker 43.9 24.2 45.1 23.9 41.9 33.5 Percent smoking 20/F cigarettes por day 13.7 M.S 27.3 11.9 22.0 12.2 Percent current alcohol user 77.4 34.7 68.9 22.8 70.8 32,6 Percont drinking 1.00+ oz ethanol per day 17.1 1.2" 9.2 0.4* 17.1 2.5" Dietary balance" 0-1 22.4 16.9 14.8 13.0 29.0 30.3 2-3 50.8 $1.0 57.3 52.1 50.1 49.5 4-6 26.7 32.1 27.9 34.9 20.9 20.2 "Junk food" intake" 67.4 61.0 75.3 75.7 79.1 73.9 Percent having last physical examination over is years ago or never 46.1 37.5 33.0 22.7 31.8 19,4 Percent having last dontal examination over 5 years ago or never 29.9 21.7 16.5 9.6 19.1 9.5 Parcent having last Pap smear over 5 years ago or nover 15.4 17.8 13.3 Entries B/O not aga-edjusted. "An Actorisk next to an entry Indicates that the statutic should to viewed equitiously because if does not meat the minimum reliability standard due to amall coll size, *Tho adulto for distory billance Indicates the number of Healthy food groups train which vie netdon has outen one or more food Items daily. The entites for "junk food" indicate the percentage who had enter and or more food" nome dully. 22 AJPH December 1990, Vol. 80, Supplement 1 WED COSSMHO HEALTH RISK BEHAVIORS TABLE 3-Correlation of Health Risk Behaviors with Acculturation and Sociodemographics Age Education Income Acculturation M F M F M F M F Mexican Americans Smoking .01 01 -,12 -..01 -.17 -.07 -.06 .09 Alcohol use -.11 -13 12 .20 .10 .10 .11 .30 Diet Indox .04 .08 .00 .03 .06 .05 -,12 -.12 Cuban Americans Smoking -.10 --,11 0.00 03 .04 -.05 -.15 -.01 Alcohol use -.18 - 29 ,10 30 .13 .21 .13 .36 Dist Indox --.01 10 .09 .12 .05 .06 .04 .03 Puerto Ricans Smoking -.00 -.13 .13 .01 -.18 --,06 -.07 .17 Alcohol use -.13 --.17 .05 .25 -,01 12 .04 .26 Diet Index .03 .16 .07 .15 11 .13 .06 -.03 Entiles are weighted Pedroon dorrulations. Cigarette smoking wes a dichotomous variable with current smoker ## 1 and nonsmoker * 0. education and higher income (especially the women) con- findings were strongest for the Mexican American and Cuban sumed a greater volume of alcohol. American men: for these two groups, the results were consistent across levels of acculturation. The relation be- Correlates of Screening tween smoking and screening for the Puerto Rican men and Smoking-In separate regression analyses the two cig- women was generally in the predicted direction, although arette smoking measures were examined as predictors of very weak. recency of screening. Only the dichotomous measure was Diet-Dietary practices were associated with screening, significant, which suggests that the key factor associated with especially for the Mexican American women. Among this screening activity was whether or not one smokes, not subgroup. those with poorer diets (i.e., low in balance and necessarily the amount one smokes. As seen in Table 4, high in "junk food" intake) were less recent users of the among the Mexican Americans and Cuban Americans, smok- health services (Tables 4 and 5). This association was not ers were less recent users of the health services than were the qualified by the degree of acculturation of the Mexican nonsmokers. These effects are seen more concretely in Table American women. 5, which presents the weighted prevalence of recent utiliza- An interesting pattern emerged for the diet and smoking tion by smoking status (not controlling for other factors). The variables for the Mexican American sample. Whereas the TABLE Regression Analyses of Health Risk Behaviors, Acculturation, and Sociodemographics Prodicting Recency of Screening Males Females Physical Physical Examination Dontal Examination Examination Dental Examination Pap Smear b SE b SE b SE b SE b SE Mexican Americans Smoking -.139 .085 -.354 103 -.085 .089 -.086 .092 .013 .107 Diet Indox 101 .046 .043 .055 .130 .039 .168 .040 .110 .047 Alcohol --.079 .039 .086 .047 -.050 .090 .118 .091 .108 .106 Acculturation .244 .084 .117 .103 .119 .008 .011 .101 .166 .118 Education .050 .020 .001 .025 041 .023 .005 .023 ,038 .027 Income .015 ,003 .031 .007 013 .006 .029 .007 .025 .007 Age .014 .004 014 .00% .012 .004 .008 .004 -.011 .004 Cuban Americans Smoking -275 .158 -.412 .167 -.207 .152 -.107 .155 -,342 .203 Diat Index .087 .072 .075 .078 -011 .059 ,063 .060 .125 .078 Alcohol .013 .062 .010 -087 --.308 .148 -.134 .148 -.198 .191 Acculturation .095 .120 209 .127 111 .117 .261 .119 .183 .154 Education .053 .023 .018 .025 .083 .022 .026 .022 .010 .029 .011 .031 012 -,014 .011 012 .011 .031 .015 Income .005 Age .020 .007 .002 007 .007 .006 .000 ,005 -,014 .008 Puerto Ricans Smoking -.037 .146 -.084 .166 -.050 .132 .043 .148 .218 .178 Diet Indox .053 .071 .057 .052 .057 .064 -.012 .072 .136 .087 Alcohol -.020 .076 -.145 .079 -.073 .096 -.008 .108 +.122 .131 Acculturation .182 .130 .074 .140 -.086 .148 -,167 .164 --.171 .199 Education .053 .025 .048 .029 .034 .025 .003 .029 .031 .035 Income ->.006 .013 .016 .015 001 .016 .010 .018 .015 .022 Age .022 .009 .000 010 .007 .004 --004 .005 .008 .006 Entrior Fro weighted regression coofficients and adjusted standard The health service incecures wore coded with higher numbers Indicating more recent use of the service. Cigarette amoking was a dicholomous variable with current smoker as 1 and nonemoker - a. AJPH December 1990, Vol. 80, Supplement 23 8-91 WED 12:45 COSSMHO P.10 MARKS, ET AL. TABLE 5--Weightod Prevatence of Recont Screening by Health Risk Behaviors Males Fomales Physical Dental Physical Dental Pap Recency: 0-2 yrs 0-2 yru 0-2 yrs 0-2 yrs 0-2 yrs Moxican Americans Cigarette smoking Smoker 29.7 42.1 42,3 57.3 75.6 Nonsmoker 37.4 56.9 47.3 62.2 76.0 Diat" Low 31.0 46.3 42.7 55.0 72.8 High 37.0 53.6 49,3 67.0 79.2 Alcohol use Moderato/high 30.6 52.2 45.2' 70.01 None/low 83.0* 36.7 47.9 46,2 60.3 75.3 Cuban Americans Cigarette smoking Smoker 34.6 51.8 $4.1 70.6 59.4 Nonsmoker 40.6 71,4 60.2 73.6 71.5 Diet Low 38.9 59.3 57.3 71.7 66.9 High 46.9 65 8 60.2 74.0 70.4 Alcohol Libe Moderate/high 41.1 60.2 61.4* 70.0* 89.4° None/low 441 64.0 58.7 73.0 67.7 Puerto Ricens Cigarette smoking Smoker 45.7 59.8 50.0 74.9 80.5 Nonamoker 49.3 63.5 63.5 74.9 76.8 Diot Low 46.6 50.9 55.9 72.9 76.0 High 48.6 66,0 67.6 76.7 82.6 Alcohol use Moderate/high 44.9 $0.4 54.3" 81.1" 76.5' None/low 49.9 64.5 62.8 74.3 79.6 Entrios are not age-adjusted. "An astorisk next to an untry Indicates that the statific should be viewed daullously because 11 does not moot the minimum reliability standard due to small coll size. "The "low" diet score includes Individuals VAID reselved a of 0 or 1 on the overall (flot index: the "high" diet score Includes persons who received a score of 2 or 3 on the overall street Indeic association between dictary behavior and screening was American men and women) were related to more recent use stronger for the women than the men, the relation between of the services, although the regression weights were small. smoking and screening was stronger for the men than the The effects of age were minimal. women. These gender-specific associations were not as clear for the Cuban Americans or Puerto Ricans. Discussion Alcohol-The results for alcohol consumption were mixed. Some of the regression coefficients suggested that Cigarette smoking, poor dietary practices, and excessive heavier drinking tended to associate with less redent use of alcohol consumption place individuals at risk of specific the health services (e.g., Mexican American men/physical disease. 20-27 Ideally, those who engage in these health risk examination), while other coefficients suggested the oppo- behaviors should use preventive health services regularly in site. We attempted to clarify the picture by examining a order to monitor their health status. The present study subset of heavy drinkers who did not suffer from chronic demonstrated several instances in which those at risk were illnesses (diabetes, heart disease, hypertension) that may screened less recently than those not at risk. Such underu- necessitate regular visits to a physician. Analyses of this tilization increases the likelihood of diagnosis of illness at a subsct, however, yielded essentially the same null and mixed later stage. results. Second, among those with no chronic illnesses we For each sample, risk of disease was greater for men than compared screening rates for two extreme groups: non- women. Men were more likely to be smokers, heavier drinkers versus heavy drinkers (those drinking an average of smokers, and heavier alcohol users; also, their screening 1.00 or more oz of othanol per day). Again. most of the results rates were much lower than the women's. These gender were nonsignificant. Thus, the hypothesis regarding the differences held across level of acculturation, which suggests association between heavy drinking and infrequent use of that similar results would be found in non-Hispanic popula- preventive health services was not confirmed. tions. Acculturation and Soclodemographics-These factors The gender effects may stem from sex-role norms. The did not produce strong effects. Increased acculturation strong emphasis in our society on self-reliance and indepen- tended to be associated with greater recency of screening for dence for men may contribute to their less-than-optimal the Mexican Americans and Cuban Americans. Higher levels health attitudes and practices. Further, these norms may of education and higher income (primarily for the Mexican influence personal beliefs about one's invulnerability to 24 AJPH December 1990, Vol. 80, Supplement 8-91 WED 12:46 COSSMHO - 1 HEALTH RISK BEHAVIORS illness, 34 which may be held more strongly by Hispanic men clearly or consistently. The variable beliefs about the effects than Hispanic wonten. Such beliefs are likely to impact of alcohol use may have contributed to the inconsistent negatively on proventive action. 35 findings for alcohol consumption and medical screening. We found significant positive correlations between ac- culturation and alcohol consumption. especially for the women of each sample. These findings are consistent with the ACKNOWLEDGMENTS acculturation model of alcohol use. 36-28 which emphasizes This investigation was funded by a grant from the National Coalition of normative influence on behavior. The dominant norms guid- Hispanic Health and Human Services Organizations (COSSMHO). Washing- ing alcohol consumption among non-Hispanic women are kon. DC. more liberal than the cultural norms for Hispanic women- non-Hispanic women drink more frequently and drink greater REFERENCES quantities of alcohol than Hispanic women in general 30 As 1. Garein 1A. Rumaldo 2J: Utilization of dental health services by Chicanos Hispanic women acculturate. their drinking increases Be- and Angles. I Health See Behav 1978: 19:428-436. cause their behavior becomes more strongly need by 2. Roberts RE. Lee GS: Medical care use by Mexican Americans: Evidence the norms and practices of the dominant group. The smaller from the human popularion laboratory studies. Med Care 1980: 18:266-81. correlation between acculturation and alcohol use for His- 3. Anderson R, Lewis S2. Gischello AL. Aday LA. Chin G: Access to medical care among the Hisponic population of the southwest United panic men may reflect the fact that, although the specific States. ,1 Health Suc Behav 1981: 22:78-89. pattern of frequency versus quantity of alcohol consumed 4. Chavez LR. Cornellus WA. Jones OW: Mexican immigrants and the differs somewhat between Hispanic and non-Hispanic utilization of US health services: The case of San Diego. See Sci Med 1985: 21:93-102. males," the drinking norms for these two groups are fairly 3. Solis JM. Marks o. Garcia M. Shelton D: Acculturation, necess to care. similar. and Hispanies' use of preventive health services. Am J Public Health 1990: Health risk behaviors such as cigarette smoking and poor #0(Suppl):11-19. dietary practices were associated with less recent screening 6. Daty M. Osborne C. Clark G, McGuire W: Mexican-American brenst activity. In particular. for the Mexican American and Cuban cancer patients have " worse prognosis (Abstract). Proc Am Soe Clin Oncel 1983: 2:C-18. American men, cigarette smoking correlated strongly with 7. University of Southern California: Cancer Surveillance Program. Los less recent utilization of routine dental and physical exami- Angeles: USC Comprehensive Cancer Center, 1982. nations; for the women especially the Mexican American 8. Villatreal SF: Current issues in Hispanic health. In Dialogue on Health women), poor dictary practices correlated strongly with less Concerns for Hispanics. Washington. DC: US Department of Health and Human Services. 1984. recent screening, including Pap smear. Because the 9. Aday LA. Anderson RM: The national profile of access to medical care: HHANES was a cross-sectional design, we cannot conclude Where do we stand? Am 3 Public Health 1984: 74:1331-1339. that cigarette smoking or poor dictary practices causes one to 10. Marks GM. Solis JM. Richardson JL. Collins LM. Birba L. Hisserich JC: use screening services infrequently, Rather, the data suggest Health behavior of elderly Hispanic women: Does cultural assimilation make a difference? Am J Public Health 1987: 77:1315-1319. that these behaviors tend to co-occur. At the outset, we 11. Dayo RA. Dichi AK, Hazuda H, Stern MP: A simple language-based suggested that the relationships may stem from a common acculturation scale for Mexican Americans: Validation and application to factor, namely one's underlying attitude toward health pro- health care research. Ant 3 Public Health 1985: 75:51-55. motion and disease prevention. It is also quite possible, 12. Chesney AP, Chavira JA, Hall RP. Gary HE: Barriers to medical care of Mexican Americans: The role of social class, acculturation, and social however, that some smokers may actively avoid check-ups isolation. Med Care 1982; 20:883-891. front doctors because of their anxiety about receiving nega- 13. Richardson JL. Marks G, Solis JM. Collins LC, Birba L. Hisserich JC: tive feedback about their health or licing told by the physician Frequency and adequacy of breast cancer screening among olderly to quit smoking. Alternatively, some smokers may still be Hispanic women. Prev Med 1987: 16:761-774. 14. Roberts RE, Lee ES: Health practices among Mexican Americans: unaware of the link between smoking and disease. or may Further evidence from the human population laboratory studies. Prev Med discount or deny that link, and thus use screening services 1980;9;675-688. infrequently. These possibilities are not limited (t) any one 15. US Department of Health and Human Services: The Health Consequences subpopulation. The fact that we found the same inverse of Smoking-Cardiovascular Disease: A report of the Surgeon General. DHIIS pub. no. (PHS)84-50204. Washington. DC: Govt Printing Office. association between smoking and utilization for high and low 1984. acculturated Mexican American and Cuban American men 16, US Department of Health and Humma Services: The Health Consequences suggests that our findings would generalize to non-Hispanic of Smoking-Cancer: A report of the Surgeon General. DHSS pub. no. White populations. We should note. however, that although (PH1S)82-50179). Washington, DC: Govt Printing Office, 1982. 17. Norell SE. Ahlbom A. Erwald R. Jacobson G. Lindaberg-Navier 1. Olin the associations may hold for each of these groups. the R. Tornberg B. Wiechel K: Diet and panerentic concer: A case-control absolute level of medical screening is lower among Hispan- study. Am 1 Epidemal 1986: 124:894-902. ics, 18. Fifth special report to the US Congress on alcohol and health. DHIIS pub. Finally, alcohol consumption was not strongly or con- no. (ADM)84-1291. Washington, DC: Govt Printing Office, 1984. 19. Gouden T. Doyle IT: Drinking and mortality: The Albany study. Am J sistently related to screening in any of the three samples. Epidemial 1987; 125:263-270. Unfortunately. the present data do not permit a conclusion 20. Byers TE, Graham S. Haughey BP. Marshall JR. Swanson MK: Diet and regarding the role of this health risk behavior in screening lung cincer risk: Findings from the western New York diet study. Am J Epidemial 1987: 125:351-363. activity. One potentially important factor, however, is a 21. Rosen M. Nystrom L. Wall $: Diet and cancer mortality in the counties person's perception of the health effects of alcohol use, which of Sweden. Am I Epidemol 1968; 127:42-49. is likely to vary considerably among individuals, For exam- 22. Stryker WS. Kaplan LA. Stein EA, Stampfer MJ. Sober A, Willett WC: ple, some people with a relatively positive attitude toward The relation of diet, cigarette smoking, and alcohol consumption to plasma health promotion may drink moderately/heavily due to the beta-enrotene and alpha-tecopherol levels. Am J Epidemol 1988; 127:283- 296. fact that they perceive the risk of drinking to be slight. Others 23. Kolonel LN, Yoshizawa CN. Hankin JH: Dict and prostatic cancer: A may perceive the risk of drinking differently. This variability care-control study in Hawaii. Am J Edpidemio) 1988: 127:999-1012. may occur because, compared to the clear media message 24. Gwinn ML., Webster LA. Lee NC. Layde PM, Rubin GL: Alcohol consumption and ovarian cancer risk. Am J Epidemicl 1986: 123:759-766. about the negative effects of smoking cigarettes. the health 25. Friedman LA. Kimball AW; Coronary heart disease mortality and alcohol consequences of alcohol have not been communicated as consumption in Framingham. Am J Epidemol 1986: 124:481-489. AJPH December 1900. Vol, 80. Supplement 25 norty MAY- 8-91 WED 12:51 COSSMHO P.13 a Table 9: Characteristic Mexican-American Foods and Food Choices PROTEIN Meat: beef, pork, lamb, tripe, sausage (chorizo), FOODS bologna, bacon Poultry: chicken Eggs Legumes: pinto beans, pink beans, garbonzo beans, lentils Nuts: peanuts, peanut butter MILK AND MILK Milk: fluid, flavored, evaporated, condensed PRODUCTS Cheese: American, Monterey jack, Hoop Ice cream GRAIN PRODUCTS Rice, tortillas: com, flour, oatmeal, dry cereals: comflakes, sugar coated; noodles spaghetti, white bread, sweet bread (pan dulce) VEGETABLES Avocado, cabbage, carrots, chilies, corn, green beans, lettuce, onion, peas, potato, prickly pear cactus leaf (nopales), spinach, sweet potato, bomato, zucchini FRUITS Apple, apricots, banana, guava, lemon, mango, melons, orange, peach, prickly pear cactus fruit (tuna), zapote (or sapote) OTHER Salsa (tomato-pepper onion relish), chili sauce, guacamole, lard (manteca), pork cracklings, fruit drinks, Kool-aid, carbonated beverages, beer, coffee SOURCE: California Department of Health, 1975, Table 9 Mexican American and Puerto Rican diets are generally favorable from a chronic disease risk perspective." Fiber content is high. Animal fat content is an important component of Hispanic diets but its proportional contribution to calories is less than in typical U.S. diets. The high carbohydrate content does pose a potential risk of excess caloric intake if the meal pattern shifts from the tradition of taking a heavy meal at midday to the U.S. practice of having the beaviest meal in the evening-particularly if the heavy meal. evening meal is added to, rather than substituted for, the midday 149 MAY- 8-91 WED 12:52 COSSMHO P.14 CDC-PNSS data for 1977-81 and 1982 (Centers for Disease Control, 1983; Trowbridge, 1983) for children less than 2 years of age do not show an excess prevalence of low weight for height or low height for age among Hispanic children, compared with reference standards or with white children in the data base. However, an excess prevalence of low height for age (linear growth stunting) is implied in the data for children over 2 years old; for example, the prevalence among Hispanic children was 16% (vs. 5% expected and 6% among white children) in 1982. Findings of an excess prevalence of growth stunting among Hispanic American children have also been reported in several other studies (Yanochik-Owen and White, 1977; Lowenstein, 1981, Dewey, 1983, Alvarez et al., 1984). The Alvarez et al. (1984) data for Hispanic children in an inner-city neighborhood health center population during 1978 also indicated a 13% prevalence of acute undernutrition (primarily moderate rather than severe levels of underweight, according to the ratio of observed weight to the age-appropriate NCHS median). The prevalence of short stature was greater among immigrant than among U.S. born Hispanic children. A few additional sources have reported low iron intakes, low blood iron status, or low intakes of other nutrients among Hispanic children or adolescents (Yanochik-Owen and White, 1977; Haider and Wheeler, 1980, Lowenstein, 1981). The 1977-1981 CDC-PNSS hemoglobin data did not indicate an excess prevalence of low values among Hispanic children (Centers for Disease Control, 1983). Data from the National School Lunch Program evaluation did not find major differences between the 24 hour dietary intakes of Hispanic VS. white children, although it was noted that Hispanic children were more likely than white children to have energy and calcium intakes below the RDA (Vermeersch et al., 1984). Overall, these data do not give an impression of any clear pattern of dietary deficiency. The data on stunting are much more consistent. An excess prevalence of overweight has also been a common finding among Hispanic American children (Yanochik-Owen, 1977; Lowenstein, 1981; Centers for Disease Control, 1983; Trowbridge, 1983). According to CDC-PNSS reports for 1977-1982, the prevalence of high weight for height among Hispanic infants was somewhat greater than expected but was similar to that among white children in the data base. Among older Hispanic children the prevalence of high weight for height was higher than expected and higher than for the white children (Centers for Disease Control, 1983; Trowbridge, 1983). 5.2.2 Adults Cardenas et al. (1976) reported that intakes of meats, milk, fruits and vegetables were lower for primigravid Mexican American women than "average" Anglo women. Thirty-nine percent of the Mexican American women were overweight or obese at the first visit. Hunt et al. (1979) reported that 85% of low income Mexican American pregnant women had reported intakes below 2/3 of the 20 mg/day RDA for zinc; 153 8-91 WED 12:53 COSSMHO Monthly Vital Statistics Report 39 Table 25. Birth and fertility rates, by Hispanic origin of mother: Total of 11 reporting States, 1988 Origin of mother Hispanic All Puerto Other Non- origins Total Maxican Riczin Cuban Maasure Hispanic' Hispanic2 10.9 24.1 23.2 19.6 0.8 34.2 15.7 Birth rate 70.5 96.4 98.0 07.9 47.7 118.6 65.7 Fertility rote "instudes Centrel and South American and Other and unknown Hispitale origin. Sincludes origin mill stated state per 1,000 total population *Plate your 1,000 women Aged 15-44 years. NOTE The 11 States die Arizona, California, Colorado. Fiorida, Illinois, Indiana, New Jousery, New Mexico, New York, Ohio, and Texas. Table 26. Live births by age and Hispanic origin of mother and by race of child for mothers of non-Hispanic origin: Total of 30 reporting States and the District of Columbia, 1988 Origin of mother Hisparte Non-Hispanic Central and Other and All Puarto South unknown Age of mother origins' Total Mexican Alcan Cuban American Hispanic Total² White Black All agos 2,856,492 449,604 271,170 40,202 10,189 57,610 64,403 2,247,312 1,652,782 455,883 Under 15 years 7,951 1,621 1,021 243 14 06 257 6,094 1,585 4,300 15-19 years 354,357 72,237 45,820 9,643 605 4,576 11,593 268,652 158,776 99,900 16 years 19,326 4,257 2,732 596 26 222 681 14,465 5,062 8,271 16 years 41,226 9,123 5,801 1,289 80 446 1,507 30,691 15,296 14,326 17 yours 71,233 14,877 9,300 2,125 108 823 2,463 33,734 30,646 21,171 18 years 96,333 19,685 12,403 2.593 170 1,236 3,180 74,095 45,591 20,202 19 years 124,239 24,315 15,434 3,040 220 1,859 3,762 95,067 61,581 29,870 20-24 years 779,714 143.226 89,155 15,924 2,428 15,820 19,800 601,033 423,225 149,398 25-29 years 894,985 126,830 74,100 11,652 4,056 18,799 18,214 715,280 557,121 113,244 30-34 years 586,732 72,305 41,503 6.109 2,166 12.260 10,258 473,098 373,047 63,245 35-39 years 201,567 28,027 16,327 2.210 803 5,114 3,573 58,807 121,648 22,218 40-44 years 30,104 5,104 3.059 434 109 900 22,944 16,915 3,439 45-40 years 1,082 254 176 17 8 43 754 465 139 includes origin not stated. Includes reces dihar than white and black. Table 27. Percent of births with selected characteristics, by Hisponic origin of origin: Total of 30 reporting States and the District of Columbia, 1988 The mother and Birth Outcomes by race of child checks for mothers out. of non-Hispanic Origin of mother Hispanic Non-Hispanic Contral and Ollier and All Puoito South unknown Characterfstic origins' Total Mexican Ricon Cuban American Hispanic Total² White Black Fourth and higher order births 10.2 156 181 12.3 5.0 11.7 12.1 9.2 7.6 14.1 Births to unmarried mothors 26.2 34.0 30.6 53.3 16.3 36.4 35.5 24.9 14.9 63.7 Mothers completing 12 years or more or school 3 78.4 57.5 43.1 54.8 01.9 68.2 65.9 70.8 83.4 68.5 Mothers born in the United States 83.4 430 40.9 63.4 169 3.9 83.7 91.1 95.4 92.1 Mothers who began prenatal care In the first trimester 75.0 613 56.3 63.2 834 62.8 67.3 77.3 82.0 60.8 Mothers who had late or no pronatal care 65 121 13.9 10.2 3.6 9.9 8.8 5.6 4.1 10.9 Births of low birth weight 7.0 6.2 5.6 0.4 5.9 5.6 6.8 7.2 5.6 13.1 Protorm birthest 104 108 106 13.3 9.0 10.1 10.8 10.4 8.2 18.5 i-minute Apgar score loss than 7 6 8.5 7.3 7.8 6.8 4 9 6.0 0.3 8.7 6.0 11,2 5-minuto Apgar score less than 7 A 1.6 1.4 1.3 1.6 10 1.2 1.6 1.6 1.3 2.9 "Includes origination stated. Rincludes than white and black, *Excludes data for California, Now York State (exclusive of New York City), Texas, and Washington, which did not imquire reporting of educational Attainment of mother. Birth weight of less than 2,500 grams (5 lb. e oz.). osorri pilor to 37 completed wheke of gestation *Excludes detailer California and Texas. which did not require reporting of either of:5-minute Appal score 8-91 WED 12:54 COSSMHO P.16 ANY ILLICIT DRUG USE TABLE 2-8 WHITES ANY ILLICIT DRUG USE: EVER, PAST YEAR, AND PAST MONTH (1990) BY SEX AND AGE GROUPS FOR WHITES EVER USED USED PAST YEAR USED PAST MONTH RATE ESTIMATES Observed Observed Observed Estimate 95% C.I. Estimate 96% C.I. Estimate 95% C.I. AGE 12-17 24.0 x (20.9-27.4) X 10.9 % (14.4-19.8) % 8.9 % ( 6.9-11.5) % 18-25 59.3 (56.3-63.2) 30.2 (25.6-34.0) 16.0 (13.5-19.0) 26-34 67.6 (04.0-71.1) 22.4 (19.3-25.7) 9.6 ( 7.1-12.6) 35+ 26.0 (23.8-28.3) 6.7 ( 4.4- 7.4) 2.6 ( 1.8- 3.5) SEX MALE 42.2 (39.4-45.0) 14.8 (12.8-17.2) 7.5 ( 6.2- 9.2) FEMALE 34.3 (31.4-37.3) 11.6 (10.1-13.2) 5.0 ( 4.1- 6.1) TOTAL 38.1 (36.2-40.1) 13.1 (11.7-14.7) 6.2 ( 5.3- 7.3) POPULATION ESTIMATES (IN THOUSANDS) AGE 12-17 3,393 ( 2,968- 3,509) 2,305 ( 2,041- 2,796) 1,263 ( 977- 1,622) 18-25 12,607 (11,761-13,426) 6,414 ( 5,661- 7,221) 3,411 ( 2,861- 4,044) 26-34 19,031 (18,764-20,839) 6,550 ( 5,672- 7,535) 2,787 ( 2,091- 3,684) 35+ 24,132 (22,158-26,276) 6,302 ( 4,104- 6,623) 2,330 ( 1,856- 3,268) SEX MALE 31,982 (29,873-34,129) 11,245 ( 9,688-13,029) 5,713 ( 4,872- 6,981) FEMALE 27,981 (25,625-30,437) 9,421 ( 8,210-10,784) 4,079 ( 3,348- 4,960) TOTAL 59,963 (68,931-63,057) 20,667 (18,456-23,086) 9,791 ( 8,383-11,448) TABLE 2-C ANY ILLICIT DRUG USE HISPANICS ANY ILLICIT DRUG USE: EVER, PAST YEAR, AND PAST MONTH (1990) not BY SEX AND AGE GROUPS FOR HISPANICS EVER USED USED PAST YEAR RATE ESTIMATES USED Lower checks. any out Observed Observed Observed Estimate 95% C.I. Estimate 96% C.I. Estimate 95% C.I. AGE 12-17 21.1 % (17.2-25.7) X 17.0 % (13.4-21.3) % 6.5 % ( 4.2- 9.8) % 18-26 47.3 (41.6-53.2) 27.3 (22.0-33.3) 11.4 ( 8.8-14.7) 26-34 45.0 (38.9-51.2) 20.1 (16.3-24.6) 9.4 ( 6.7-13.0) 35+ 22.8 (19.3-26.9) 6,6 ( 3.8- 7.9) 3.0 ( 1.8- 5.0) SEX MALE 40.5 (36,6-44.4) 19.0 (18.2-22.2) 8.8 ( 6.8-11.2) FEMALE 24.8 (21.4-28.4) 10.6 ( 6.3-13.3) 4.5 ( 3.3- 6.1) TOTAL 32.6 (30.2-35.1) 14.8 (12.9-16.8) 6.8 ( 5.5- 7.9) POPULATION ESTIMATES (IN THOUSANDS) AGE 12-17 468 ( 381- 559) 378 ( 298- 471) 143 ( 93- 217) 18-25 1,419 ( 1,246- 1,594) 818 ( 859- ($66 342 ( 263- 441) 26-34 1,692 ( 1,485- 1,926) 767 ( 613- 925) 353 ( 253- 488) 36+ 1,544 ( 1,302- 1,816) 371 ( 265- 535) 202 ( 121- 335) SEX MALE 3,163 ( 2,864- 3,472) 1,486 ( 1,264- 1,737) 688 ( 535- 879) FEMALE 1,960 ( 1,695- 2,251) 838 ( 681- 1,061) 353 ( 258- 480) TOTAL 6,123 ( 4,745- 5,516) 2,822 ( 2,037- 2,839) 1,041 ( 865- 1,250) *Low precision; no estimates reported Source: National Institute on Drug Abuse, 1928 National Household Survey on Drug Abuse 18 Document No. 236286SS WHITE HOUSE STAFFING MEMORANDUM DATE: 5/8/91 ACTION/CONCURRENCE/COMMENT DUE BY: TODAY 5/8/91 1:00PM SUBJECT: BRIEF REMARKS: HISPANIC BUSINESS LEADERS/ FREE TRADE ACTION FYI ACTION FYI VICE PRESIDENT MCCLURE SUNUNU PETERSMEYER SCOWCROFT PORTER DARMAN ROGICH BRADY SMITH BROMLEY UNTERMEYER CARD BOSKIN DEMAREST MARTINEZ FITZWATER ROGERS GRAY SNOW HOLIDAY REMARKS: Please forward your comments directly to Tony Snow, Rm. 122, x2930, no later than 1:00 p.m., TODAY, WEDNESDAY, MAY 8, with a copy to this office. RESPONSE: Herenica from Onver P John natters, Chif of stoff Uin marked Jenn Balestrier- ept 2992 VEOB 176 PHILLIP D. BRADY pup2 fee p2 Assistant to the President and Staff Secretary Ext. 2702 Grant/Cawley May 7, 1991 / 1 p.m. 91 MAY -8 AM 8: 00 A:ADS / Draft two BRIEF REMARKS: HISPANIC BUSINESS LEADERS / FREE TRADE THE INDIAN TREATY ROOM THURSDAY, MAY 9, 1991 9:30 A.M. ((Acknowledgements) First of all, welcome to the White House. We've all been very concerned lately with two vital issues: America's ability to compete in the global marketplace and our ability to negotiate with our trading partners. The two concerns meet in an issue that we all care about deeply: the "fast track" procedures that I've asked Congress to extend. Fast track procedures let us negotiate in good faith with our trading partners and work in concert with Congress. They simply ensure that we will not alter agreements that our negotiators have reached with their counterparts. Fast-track doesn't take away Congress' power to accept or reject trade agreements. Congress will still have its say -- in a yes-or-no vote -- because fast track does not guarantee approval of any agreement. And we have promised to consult closely with Congress during the course of trade talks. Fast track's main virtue is this: It prevents 11th-hour changes to agreements we have reached, changes that force everyone involved to start from scratch. Congress first gave the president fast track authority in 1974, and we have used it in negotiating three major trade agreements since. As many of you know, fast track also can play 2 a role in helping us complete three other important trade initiatives: The Uruguay Round of GATT talks; the North American Free Trade Agreement and the Enterprise for the Americas Initiative. Unfortunately, some opponents of free trade have decided to mount a smear campaign in hopes of derailing fast-track. Ignoring the facts, they have tried to frighten people with scare tactics and race-baiting. I've got a couple examples of this disgusting propaganda with me today. Here's one ad that questions the health and sanitary habits of Hispanic people -- [HOLD UP TWO ADS -- SEE ATTACHED]. The other ad distorts the truth the old fashioned way. It wrenches quotes out of context and tries to give the impression that foreigners -- in this case, our Mexican neighbors -- somehow will poison American citizens. I find these ads personally offensive. They promote nothing more than prejudice and racism. Although it-really shouldn't be necessary, let me set the record straight. According to the American Journal of Public Health Mexicans and Mexican Americans have better birth outcomes lower drug use, and healthier diets than non Hispanic whites This information was further supported by the January 1991 issue of the Journal of the American Medical Association. There is no evidence that trade agreements with Mexico -- agreements that fast-track procedures would facilitate -- will have any adverse impact on the quality of our food or water. 3 But there's another point: Free trade encourages economic growth and international understanding. It enables us to build bonds of common interest and common experience. It may be the most effective antidote to the kind of poison these ads spread among our people. Open markets and free trade mean stronger alliances and better relations. It means we become better neighbors, because we'll bring out the best in people -- not the worst, as our opponents want. One ad reads: "There's a lot at stake here. But a lot of important considerations are getting pushed aside in the fast track rhetoric." I couldn't agree more on this narrow point. Important considerations have been pushed aside -- by the people who sponsor these ads. Take a look what the North American Free Trade Agreement will create: the largest, richest market in the world. That's 360 million consumers and $6 trillion in annual output. And take a look at the 130 percent increase in our exports to Mexico over the past four years. This export boom has created 264,000 new jobs in the United States. And each additional billion dollars in exports will create 20,000 new jobs here in the United States. I didn't read about that in those ads. So you see, we have much to gain from extending fast track - - a new era of open, free and fair trade -- a future of unprecedented economic growth and regional harmony. 4 A "yes" vote on fast-track really is a vote on what kind of outlook we share -- one of optimism and integrity, or_one of self-doubt and petty prejudice. A "yes" vote means a vote for "good faith" and the strength of our word. We can't allow bigots and fearmongers to control our agenda. We must rely on our better selves -- our truer selves. Fast track plays a critical role in helping the United States compete in a world newly united by bonds of commerce. We will need your support as Hispanic leaders in persuading Congress to extend fast-track procedures. We will need your help as businessmen and women, as entrepreneurs, as men and women from all walks of life. But most of all, we need your help as Americans committed to the ideals of freedom and opportunity. Help us build good faith with our friends and neighbors. Help us develop better working relations with Congress. And help us stifle the voices that want to replace reason with rancor, cooperation with discrimination. With your help, I know we will succeed. Once again, thank you and God bless each of you. # # # KaLL CaLL ApriL 29 p.7 U.S. - MEXICO TRADE NEGOTIATIONS' Fast Track W hat would fast track trade fast track rhetoric. In terms of negotiations between the U.S. safe food and drinking water, and Mexico really produce? there is already a problem of crisis Could Be From the standpoint of food proportions along both sides of safety and water quality, it would the border. Fast track is not a Hazardous To make an already deplorable framework for solving these situation worse. problems. What we drink. This issue-and its long-term Your Health political and economic Mexican border towns like ramifications-deserves a lot Matamoros and Juarez have more than a simple up or down virtually no sewage facilities for vote by Congress. their populations that swell as the maquiladora plants expand. With Congress should reject fast no treatment facilities, health track it's a shortcut to disaster. FAST problems abound on both sides of the border. TRACK In San Elizario, Texas, for example, 90 percent of the people have Hepatitis A by the time they reach age 30. Nogales, Arizona, has a Hepatitis A rate 20 times the U.S. national average. What we eat. DISASTER With no treatment facilities, TO produce destined for export may be irrigated with polluted water, including raw sewage. Irapuato, a town in Guanajuato, is an example. There's a lot at stake here. But a lot of important considerations are getting pushed aside in the AFL-CIO 815 SIXTEENTH STREET, N.W. WASHINGTON, D.C. 20006 POISON! Fast Track Environmental specialists-especially those concerned about water-say the (border) area's natural resources cannot handle the extra economic development free-trade advocates The More You Read foresee. -The Economist April 20, 1991 The Worse It Gets Indiscriminate dumping or long-term storage of industrial garbage and hazardous wastes is trashing the landscape and poisoning the water and soil. FAST -U.S. News & World Report TRACK May 6, 1991 Uncontrolled air and water pollution is rapidly deteriorating SHORTENT and seriously affecting the health and future economic vitality on both sides of the border. --American Medical Association June, 1990 TO DISASTER Their very success (the maquiladoras) is helping turn much of the border region into a sinkhole of abysmal living conditions and environmental degradation. -Wall Street Journal September 27, 1989 T he case against fast track free This issue-and its long-term trade negotiations between the political and economic U.S. and Mexico grows ramifications-deserves a lot stronger every day. There's a lot more than a simple up ordown more at stake here than the fast vote by Congress. track rhetoric would lead you to believe. Congress should reject fast track it's a shortcut to disaster. AFL-CIO 815 SIXTEENTH STREET, N.W. WASHINGTON, D.C. 20006 THE WHITE HOUSE wWASHINGTON May 8, 1991 MEMORANDUM FOR TONY SNOW FROM: ROGER B. PORTER RBP SUBJECT: Presidential Remarks: Hispanic Business Leaders/Free Trade We have reviewed the attached draft remarks from a policy standpoint and have noted several suggestions on the draft. We recommend deleting the last paragraph on page two concerning health comparisons between Mexicans and non- Hispanic whites. We are not confident that this data can be substantiated with sufficient certainty. Additionally, at the top of page four we recommend changing the sentence to delete the word "yes." Because the fast track legislation is being considered as a motion to deny extension, a "yes" vote will actually end the fast track authorization. CC: Phillip D. Brady 91 MAY 8 36 Document No. 236286SS WHITE HOUSE STAFFING MEMORANDUM DATE: 5/8/91 ACTION/CONCURRENCE/COMMENT DUE BY: TODAY 5/8/91 1:00PM SUBJECT: BRIEF REMARKS: HISPANIC BUSINESS LEADERS/ FREE TRADE ACTION FYI ACTION FYI VICE PRESIDENT MCCLURE SUNUNU PETERSMEYER SCOWCROFT PORTER DARMAN ROGICH BRADY SMITH BROMLEY UNTERMEYER CARD BOSKIN DEMAREST MARTINEZ FITZWATER ROGERS GRAY SNOW HOLIDAY REMARKS: Please forward your comments directly to Tony Snow, Rm. 122, x2930, no later than 1:00 p.m., TODAY, WEDNESDAY, MAY 8, with a copy to this office. RESPONSE: PHILLIP D. BRADY Assistant to the President and Staff Secretary Ext. 2702 Grant/Cawley May 7, 1991 / 1 p.m. 91 MAY -8 AM 8: 00 A:ADS / Draft two BRIEF REMARKS: HISPANIC BUSINESS LEADERS / FREE TRADE THE INDIAN TREATY ROOM THURSDAY, MAY 9, 1991 9:30 A.M. ((Acknowledgements) First of all, welcome to the White House. We've all been very concerned lately with two vital issues: America's ability to compete in the global marketplace and our ability to negotiate with our trading partners. The two concerns meet in an issue that we all care about deeply: the "fast track" procedures that I've asked Congress to extend. Fast track procedures let us negotiate in good faith with our trading partners and work in concert with Congress. They simply ensure that we will not alter agreements that our negotiators have reached with their counterparts. Fast-track doesn't take away Congress' power to accept or reject trade agreements. Congress will still have its say ----- in a yes-or-no vote -- because fast track does not guarantee approval of any agreement. And we have promised to consult closely with Congress during the course of trade talks. Fast track's main virtue is this: It prevents 11th-hour changes to agreements we have reached, changes that force everyone involved to start from scratch. Congress first gave the president fast track authority in 1974, and we have used it in negotiating three major trade agreements since. As many of you know, fast track also can play 2 to ADVANCE a role in helping us complete I three other important trade initiatives: The Uruguay Round of GATT talks; the North American Free Trade Agreement and the Enterprise for the Americas Initiative. Unfortunately, some opponents of free trade have decided to mount a smear campaign in hopes of derailing fast-track. Ignoring the facts, they have tried to frighten people with scare tactics and race-baiting. I've got a couple examples of this disgusting propaganda with me today. Here's one ad that questions the health and sanitary habits of Hispanic people -- [HOLD UP TWO ADS -- SEE ATTACHED]. The other ad distorts the truth the old fashioned way. It wrenches quotes out of context and tries to give the impression that foreigners -- in this case, our Mexican neighbors -- somehow will poison American citizens. I find these ads personally offensive. They promote nothing more than prejudice and racism. Although it really shouldn't be necessary, let me set the A STUDY PUBLISHED IN record straight. According to the American Journal of Public CONCUDED THAT Health, Mexicans and Mexican Americans have better birth outcomes, lower drug use, and healthier diets than non-Hispanic whites. This information was further supported by the January 1991 issue of the Journal of the American Medical Association. There is no evidence that trade agreements with Mexico -- agreements that fast-track procedures would facilitate -- will have any adverse impact on the quality of our food or water. 3 But there's another point: Free trade encourages economic growth and international understanding. It enables us to build bonds of common interest and common experience. It may be the most effective antidote to the kind of poison these ads spread among our people. Open markets and free trade mean stronger alliances and better relations. It means we become better neighbors, because we'll bring out the best in people -- not the worst, as our opponents want. One ad reads: "There's a lot at stake here. But a lot of important considerations are getting pushed aside in the fast track rhetoric." I couldn't agree more on this narrow point. Important considerations have been pushed aside -- by the people who sponsor these ads. Take a look what the North American Free Trade Agreement will create: the largest, richest market in the world. That's 360 million consumers and $6 trillion in annual output. And take a look at the 130 percent increase in our exports to Mexico over the past four years. This export boom has created 264,000 new jobs in the United States. And each additional billion dollars in exports will create 20,000 new jobs here in the United States. I didn't read about that in those ads. So you see, we have much to gain from extending fast track - - a new era of open, free and fair trade -- a future of unprecedented economic growth and regional harmony. for 4 A "yes" "yes vote on fast-track really is a vote on what kind of outlook we share -- one of optimism and integrity, or.one of i self-doubt and petty prejudice. A "yes" vote means a vote for "good faith" and the strength of our word. We can't allow bigots and fearmongers to control our agenda. We must rely on our better selves -- our truer selves. Fast track plays a critical role in helping the United States compete in a world newly united by bonds of commerce. We will need your support as Hispanic leaders in persuading Congress to extend fast-track procedures. We will need your help as businessmen and women, as entrepreneurs, as men and women from all walks of life. But most of all, we need your help as Americans committed to the ideals of freedom and opportunity. Help us build good faith with our friends and neighbors. Help us develop better working relations with Congress. And help us stifle the voices that want to replace reason with rancor, cooperation with discrimination. with your help, I know we will succeed. Once again, thank you and God bless each of you. # # # KaLL CaLL ApriL29 29 p.7 U.S. - MEXICO TRADE NEGOTIATIONS Fast Track hat would fast track trade W fast track rhetoric. In terms of negotiations between the U.S. safe food and drinking water, and Mexico really produce? there is already a problem of crisis Could Be From the standpoint of food proportions along both sides of safety and water quality, it would the border. Fast track is not a Hazardous To make an already deplorable framework for solving these situation worse. problems. What we drink. This issue-and its long-term Your Health political and economic Mexican border towns like ramifications-deserves a lot Matamoros and Juarez have more than a simple up or down virtually no sewage facilities for vote by Congress. their populations that swell as the maquiladora plants expand. With Congress should reject fast track no treatment facilities, health it's a shortcut to disaster. FAST problems abound on both sides of the border. TRACK In San Elizario, Texas, for example, 90 percent of the people have Hepatitis A by the time they INSTRONS reach age 30. Nogales, Arizona. has a Hepatitis A rate 20 times the U.S. national average. What we eat. DISASTER With no treatment facilities, TO produce destined for export may be irrigated with polluted water, including raw sewage. Irapuato. a town in Guanajuato, is an example. There's a lot at stake here. But a lot of important considerations are getting pushed aside in the AFL-CIO 815 SIXTEENTH STREET, N.W. WASHINGTON, D.C. 20006 POISON! Fast Track Environmental specialists-especially those concerned about water-say the (border) area's natural resources cannot handle the extra economic development free-trade advocates The More You Read foresee. -The Economist April 20, 1991 The Worse It Gets Indiscriminate dumping or long-term storage of industrial garbage and hazardous wastes is trashing the landscape and poisoning the water and soil. FAST -U.S. News & World Report May 6, 1991 SHORTENT TRACK Uncontrolled air and water pollution is rapidly deteriorating and seriously affecting the health and future economic vitality on both sides of the border. -American Medical Association June, 1990 TO DISASTER Their very success (the maquiladoras) is helping turn much of the border region into a sinkhole of abysmal living conditions and environmental degradation. -Wall Street Journal September 27, 1989 T he case against fast track free This issue-and its long-term trade negotiations between the political and economic U.S. and Mexico grows ramifications-deserves a lot stronger every day. There's a lot more than a simple up or down more at stake here than the fast vote by Congress. track rhetoric would lead you to believe. Congress should reject fast track it's a shortcut to disaster. AFL-CIO 815 SIXTEENTH STREET, N.W. WASHINGTON, D.C. 20006 Document No. 236286SS WHITE HOUSE STAFFING MEMORANDUM DATE: 5/8/91 ACTION/CONCURRENCE/COMMENT DUE BY: TODAY 5/8/91 1:00PM SUBJECT: BRIEF REMARKS: HISPANIC BUSINESS LEADERS/ FREE TRADE ACTION FYI ACTION FYI VICE PRESIDENT MCCLURE SUNUNU PETERSMEYER SCOWCROFT PORTER DARMAN ROGICH BRADY SMITH BROMLEY UNTERMEYER CARD BOSKIN DEMAREST MARTINEZ FITZWATER ROGERS GRAY SNOW HOLIDAY REMARKS: Please forward your comments directly to Tony Snow, Rm. 122, x2930, no later than 1:00 p.m., TODAY, WEDNESDAY, MAY 8, with a copy RESPONSE: to KSR this office. PHILLIP D. BRADY Assistant to the President and Staff Secretary Ext. 2702 Grant/Cawley May 7, 1991 / 1 p.m. 91 MAY -8 AM 8:00 A:ADS / Draft two BRIEF REMARKS: HISPANIC BUSINESS LEADERS / FREE TRADE THE INDIAN TREATY ROOM THURSDAY, MAY 9, 1991 9:30 A.M. ((Acknowledgements) First of all, welcome to the White House. We've all been very concerned lately with two vital issues: America's ability to compete in the global marketplace and our ability to negotiate with our trading partners. The two concerns meet in an issue that we all care about deeply: the "fast track" procedures that I've asked Congress to extend. Fast track procedures let us negotiate in good faith with our trading partners and work in concert with Congress. They simply ensure that we will not alter agreements that our negotiators have reached with their counterparts. Fast-track doesn't take away Congress' power to accept or reject trade agreements. Congress will still have its say -- in a yes-or-no vote -- because fast track does not guarantee approval of any agreement. And we have promised to consult closely with Congress during the course of trade talks. Fast track's main virtue is this: It prevents 11th-hour changes to agreements we have reached, changes that force everyone involved to start from scratch. Congress first gave the president fast track authority in 1974, and we have used it in negotiating three major trade agreements since. As many of you know, fast track also can play 2 a role in helping us complete three other important trade initiatives: The Uruguay Round of GATT talks; the North American Free Trade Agreement and the Enterprise for the Americas Initiative. Unfortunately, some opponents of free trade have decided to mount a smear campaign in hopes of derailing fast-track. Ignoring the facts, they have tried to frighten people with scare tactics and race-baiting. I've got a couple examples of this disgusting propaganda with me today. Here's one ad that questions the health and sanitary habits of Hispanic people -- [HOLD UP TWO ADS -- SEE ATTACHED]. The other ad distorts the truth the old fashioned way. It wrenches quotes out of context and tries to give the impression that foreigners -- in this case, our Mexican neighbors -- somehow will poison American citizens. I find these ads personally offensive. They promote nothing more than prejudice and racism. Although it really shouldn't be necessary, let me set the record straight. According to the American Journal of Public Health, Mexicans and Mexican Americans have better birth outcomes, lower drug use, and healthier diets than non-Hispanic whites. This information was further supported by the January 1991 issue of the Journal of the American Medical Association. There is no evidence that trade agreements with Mexico -- agreements that fast-track procedures would facilitate -- will have any adverse impact on the quality of our food or water. 3 But there's another point: Free trade encourages economic growth and international understanding. It enables us to build bonds of common interest and common experience. It may be the most effective antidote to the kind of poison these ads spread among our people. Open markets and free trade mean stronger alliances and better relations. It means we become better neighbors, because we'll bring out the best in people -- not the worst, as our opponents want. One ad reads: "There's a lot at stake here. But a lot of important considerations are getting pushed aside in the fast track rhetoric." I couldn't agree more on this narrow point. Important considerations have been pushed aside -- by the people who sponsor these ads. Take a look what the North American Free Trade Agreement will create: the largest, richest market in the world. That's 360 million consumers and $6 trillion in annual output. And take a look at the 130 percent increase in our exports to Mexico over the past four years. This export boom has created 264,000 new jobs in the United States. And each additional billion dollars in exports will create 20,000 new jobs here in the United States. I didn't read about that in those ads. So you see, we have much to gain from extending fast track - - a new era of open, free and fair trade -- a future of unprecedented economic growth and regional harmony. 4 A "yes" vote on fast-track really is a vote on what kind of outlook we share -- one of optimism and integrity, or_one of - self-doubt and petty prejudice. A "yes" vote means a vote for "good faith" and the strength of our word. We can't allow bigots and fearmongers to control our agenda. We must rely on our better selves -- our truer selves. Fast track plays a critical role in helping the United States compete in a world newly united by bonds of commerce. We will need your support as Hispanic leaders in persuading Congress to extend fast-track procedures. We will need your help as businessmen and women, as entrepreneurs, as men and women from all walks of life. But most of all, we need your help as Americans committed to the ideals of freedom and opportunity. Help us build good faith with our friends and neighbors. Help us develop better working relations with Congress. And help us stifle the voices that want to replace reason with rancor, cooperation with discrimination. with your help, I know we will succeed. Once again, thank you and God bless each of you. # # # KaLL CaLL ApriL 29 p.7 U.S. - MEXICO TRADE NEGOTIATIONS Fast Track W hat would fast track trade fast track rhetoric. In terms of negotiations between the U.S. safe food and drinking water, and Mexico really produce? there is already a problem of crisis Could Be From the standpoint of food proportions along both sides of safety and water quality, it would the border. Fast track is not a make an already deplorable framework for solving these Hazardous To situation worse. problems. What we drink. This issue-and its long-term Your Health political and economic Mexican border towns like ramifications-deserves a lot Matamoros and Juarez have more than a simple up or down virtually no sewage facilities for vote by Congress. their populations that swell as the maquiladora plants expand. With Congress should reject fast no treatment facilities, health track it's a shortcut to disaster. FAST problems abound on both sides of the border. TRACK In San Elizario, Texas, for example, 90 percent of the people have Hepatitis A by the time they INSTRONS reach age 30. Nogales, Arizona. has a Hepatitis A rate 20 times the U.S. national average. What we eat. DISASTER With no treatment facilities, TO produce destined for export may be irrigated with polluted water, including raw sewage. Irapuato. a town in Guanajuato is an example. There's a lot at stake here. But a lot of important considerations are getting pushed aside in the AFL-CIO 815 SIXTEENTH STREET, N.W. WASHINGTON, D.C. 20006 POISON! Fast Track Environmental specialists-especially those concerned about water-say the (border) area's natural resources cannot handle the extra economic development free-trade advocates The More You Read foresee. -The Economist April 20, 1991 The Worse It Gets Indiscriminate dumping or long-term storage of industrial garbage and hazardous wastes is trashing the landscape and poisoning the water and soil. FAST -U.S. News & World Report May 6, 1991 SHORTENT TRACK Uncontrolled air and water pollution is rapidly deteriorating and seriously affecting the health and future economic vitality on both sides of the border. -American Medical Association June, 1990 TO DISASTED Their very success (the maquiladoras) is helping turn much of the border region into a sinkhole of abysmal living conditions and environmental degradation. -Wall Street Journal September 27, 1989 T he case against fast track free This issue-and its long-term trade negotiations between the political and economic U.S. and Mexico grows ramifications-deserves a lot stronger every day. There's a lot more than a simple up or down more at stake here than the fast vote by Congress. track rhetoric would lead you to Congress should reject fast track believe. it's a shortcut to disaster. AFL-CIO 815 SIXTEENTH STREET, N.W. WASHINGTON, D.C. 20006 Grant/Cawley STHFFED May 7, 1991 / 1 p.m. 91 MAY 8 A 24 A:ADS / Draft two BRIEF REMARKS: HISPANIC BUSINESS LEADERS / FREE TRADE THE INDIAN TREATY ROOM THURSDAY, MAY 9, 1991 9:30 A.M. ( (Acknowledgements)) First of all, welcome to the White House. We've all been very concerned lately with two vital issues: America's ability to compete in the global marketplace and our ability to negotiate with our trading partners. The two concerns meet in an issue that we all care about deeply: the "fast track" procedures that I've asked Congress to extend. Fast track procedures let us negotiate in good faith with our trading partners and work in concert with Congress. They simply ensure that we will not alter agreements that our negotiators have reached with their counterparts. Fast-track doesn't take away Congress' power to accept or reject trade agreements. Congress will still have its say -- in a yes-or-no vote -- because fast track does not guarantee approval of any agreement. And we have promised to consult closely with Congress during the course of trade talks. Fast track's main virtue is this: It prevents 11th-hour changes to agreements we have reached, changes that force everyone involved to start from scratch. Congress first gave the president fast track authority in 1974, and we have used it in negotiating three major trade agreements since. As many of you know, fast track also can play 2 a role in helping us complete three other important trade initiatives: The Uruguay Round of GATT talks; the North American Free Trade Agreement and the Enterprise for the Americas Initiative. Unfortunately, some opponents of free trade have decided to mount a smear campaign in hopes of derailing fast-track. Ignoring the facts, they have tried to frighten people with scare tactics and race-baiting. I've got a couple examples of this disgusting propaganda with me today. Here's one ad that questions the health and sanitary habits of Hispanic people -- [HOLD UP TWO ADS -- SEE ATTACHED]. The other ad distorts the truth the old fashioned way. It wrenches quotes out of context and tries to give the impression that foreigners -- in this case, our Mexican neighbors -- somehow will poison American citizens. I find these ads personally offensive. They promote nothing more than prejudice and racism. Although it really shouldn't be necessary, let me set the record straight. According to the American Journal of Public Health, Mexicans and Mexican Americans have better birth outcomes, lower drug use, and healthier diets than non-Hispanic whites. This information was further supported by the January 1991 issue of the Journal of the American Medical Association. There is no evidence that trade agreements with Mexico -- agreements that fast-track procedures would facilitate -- will have any adverse impact on the quality of our food or water. 3 But there's another point: Free trade encourages economic growth and international understanding. It enables us to build bonds of common interest and common experience. It may be the most effective antidote to the kind of poison these ads spread among our people. Open markets and free trade mean stronger alliances and better relations. It means we become better neighbors, because we'll bring out the best in people -- not the worst, as our opponents want. One ad reads: "There's a lot at stake here. But a lot of important considerations are getting pushed aside in the fast track rhetoric." I couldn't agree more on this narrow point. Important considerations have been pushed aside --- by the people who sponsor these ads. Take a look what the North American Free Trade Agreement will create: the largest, richest market in the world. That's 360 million consumers and $6 trillion in annual output. And take a look at the 130 percent increase in our exports to Mexico over the past four years. This export boom has created 264,000 new jobs in the United States. And each additional billion dollars in exports will create 20,000 new jobs here in the United States. I didn't read about that in those ads. So you see, we have much to gain from extending fast track - - a new era of open, free and fair trade -- a future of unprecedented economic growth and regional harmony. 4 A "yes" vote on fast-track really is a vote on what kind of outlook we share -- one of optimism and integrity, or one of self-doubt and petty prejudice. A "yes" vote means a vote for "good faith" and the strength of our word. We can't allow bigots and fearmongers to control our agenda. We must rely on our better selves -- our truer selves. Fast track plays a critical role in helping the United States compete in a world newly united by bonds of commerce. We will need your support as Hispanic leaders in persuading Congress to extend fast-track procedures. We will need your help as businessmen and women, as entrepreneurs, as men and women from all walks of life. But most of all, we need your help as Americans committed to the ideals of freedom and opportunity. Help us build good faith with our friends and neighbors. Help us develop better working relations with Congress. And help us stifle the voices that want to replace reason with rancor, cooperation with discrimination. with your help, I know we will succeed. Once again, thank you and God bless each of you. # # # RaLL CaLL ApriL29 29 p.7 U.S. - MEXICO TRADE NEGOTIATIONS Fast Track W hat would fast track trade fast track rhetoric. In terms of negotiations between the U.S. safe food and drinking water, and Mexico really produce? there is already a problem of crisis Could Be From the standpoint of food proportions along both sides of safety and water quality, it would the border. Fast track is not a Hazardous To make an already deplorable framework for solving these situation worse. problems. What we drink. This issue-and its long-term Your Health political and economic Mexican border towns like ramifications-deserves a lot Matamoros and Juarez have more than a simple up or down virtually no sewage facilities for vote by Congress. their populations that swell as the maquiladora plants expand. With Congress should reject fast no treatment facilities, health track it's a shortcut to disaster. FAST problems abound on both sides of the border. TRACK In San Elizario, Texas, for example, 90 percent of the people have Hepatitis A by the time they SHORTENT reach age 30. Nogales, Arizona, has a Hepatitis A rate 20 times the U.S. national average. What we eat. With no treatment facilities, TO produce destined for export may be irrigated with polluted water, including raw sewage. Irapuato, a town in Guanajuato, is an example. There's a lot at stake here. But a lot of important considerations are getting pushed aside in the AEL-CIO 815 SIXTEENTH STREET, N.W. WASHINGTON, D.C. 20006 POISON! Fast Track Environmental specialists-especially those concerned about water-say the (border) area's natural resources cannot handle the extra economic development free-trade advocates The More You Read foresee. -The Economist April 20, 1991 The Worse It Gets Indiscriminate dumping or long-term storage of industrial garbage and hazardous wastes is trashing the landscape and poisoning the water and soil. FAST -U.S. News & World Report May 6, 1991 SHORTENT TRACK Uncontrolled air and water pollution is rapidly deteriorating and seriously affecting the health and future economic vitality on both sides of the border. -American Medical Association June, 1990 TO DISASTER Their very success (the maquiladoras) is helping turn much of the border region into a sinkhole of abysmal living conditions and environmental degradation. -Wall Street Journal September 27, 1989 T he case against fast track free This issue-and its long-term trade negotiations between the political and economic U.S. and Mexico grows ramifications-deserves a lot stronger every day. There's a lot more than a simple up or down more at stake here than the fast vote by Congress. track rhetoric would lead you to Congress should reject fast track believe. it's a shortcut to disaster. AFL-CIO 815 SIXTEENTH STREET, N.W. WASHINGTON, D.C. 20006 THE WHITE HOUSE Office of the Press Secretary For Immediate Release May 9, 1991 REMARKS BY THE PRESIDENT TO HISPANIC ALLIANCE Indian Treaty Room Old Executive Office Building 10:19 A.M. EDT THE PRESIDENT: Thank you very much. And some of that has to do, I think, with my fibrillating heart -- (laughter) -- but it's all right. I just came back from Bethesda and really got a wonderful report. I won't go into the clinical assessment, but it's great. I just take something to do with the thyroid, and the heart is perfect. So I'm very lucky -- very, very lucky. (Applause.) I came over to talk to you today about an issue that is really of vital concern to me, and I think of our country. And I have some talking points here, but let me just put them away and speak from the heart. I see my friend, the Ambassador, here, and I have great respect for him. And I might say I have enormous respect for President Salinas of Mexico. And he is taking that country that we all love and moving it in a direction that we can all admire. And it would be a terrible tragedy if we took this Fast-Track authority from Mexico and pulled it away and turned it down. I think it would send an outrageously bad symbol, not only to Mexico, but to the countries to the south. We've got a real opportunity while I'm President to build stronger relations with South America. I've been down there, I've talked endlessly to the Presidents of the various countries. Just the other day, Gus, Carlos Andres Perez of Venezuela was in. He doesn't benefit from a free trade agreement with Mexico, but he said, you cannot let this fail. The signal that this would send through our part of the world would just be unconscionable. And so I am committed to this. And I'm committed to it not just because it's good for Mexico. I'm the President of the United States, and all of us are citizens of the United States. Gus, that leaves you out -- (laughter.) But we've got to do what's in the best interest of the United States. And this is in the best interest of the United States. And I can understand the concerns about the environment, but as Ambassador Hills tells you, we have good answers for that. Mexico is moving on their own. Carlos closed down PEMEX refinery, an enormously difficult political move for him. And yet, he did it. And many other businesses that were polluting have closed down. And the way to help with pollution on the border is to raise the standard of living down there so people can have more money to put into these things that we hold near and dear to our hearts. And S.O I approach this on a foreign policy basis as thinking that it's essential. And I approach it in terms of our own economy as thinking it's essential. We think it will create jobs. I am offended, frankly, by some of the advertising I've seen that I honestly find discriminatory. And I don't like it and I'm troubled by it. I can understand a labor union person wondering whether it's going to cause drops, but I think we have good answers for it. And I think the answer is it will add to American jobs. And I'm going to keep working with Carla Hills to get that message out to the United MORE - 2 - States Congress. But I really wanted to come over to exhort you all to sally forth to the Hill up there. You've got many friends up there -- and use your best influence in the best tradition of persuasion of the Congress to make them understand that the Fast-Track authority will create jobs, it will open up more trade between countries, it will raise the standards of living along the border on both sides, in my view, and it's going to be a wonderful thing. And I want our administration, indeed, to be firmly committed in terms of free trade, because history shows it results in prosperity. And so this is where we stand. And I thank you all very, very much for your interest in it. And do exactly what Carla Hills tells you to do. Thank you all very much. (Applause.) END 10:24 A.M. EDT