Regimen Gives Latinas Taste of New Outlook

A year ago, Maria Rubalcaba was overweight and out of shape. She never exercised, and she served her husband and three children meals that would have given the American Heart Assn. palpitations. Her typical dinners consisted of enchiladas or tacos, heavily salted and cooked in lard, with lots of flour tortillas and maybe some vegetables.

Today, the 43-year-old Rubalcaba prances vigorously through her hourlong aerobics classes three days a week at Southcrest Recreation Center in Southeast San Diego. She has lost 25 pounds, reformed her family’s diet and transformed herself.

“Ever since the classes, I’m more sure of myself,” Rubalcaba said, cooling down from a recent workout. “I’m a new Maria.”

The “new Maria,” relaxing in sweats and gray Reeboks and sporting a new stylishly short blond hairdo, said the health, nutrition and exercise classes she started eight months ago have created changes in her life that transcend physical appearance.

Adventures to Her

With her aerobics instructor, Teresa Aparicio, translating her words from Spanish, Rubalcaba said that, although the “old Maria” rarely ventured out of the house on anything other than family errands, the emerging Maria is one who frequently gets out and does things for herself. They are simple things for most people--a daily walk with a friend, visits to a community project--but for her, they are adventures.

After 15 years in the United States, she has decided to sign up for English classes.

“Now I will not miss anything!” she said.

Rubalcaba’s growing independence has not gone unnoticed at home. Her children celebrate the changes, she said, but her husband is upset by them.

Will Look for Work

“At first he didn’t say anything,” she said. “But, little by little, he started showing me he didn’t like my doing more and more things on my own and making decisions.”

Last month, without consulting his wife, Emilio Rubalcaba quietly put their house up for sale. Maria said she doesn’t want to move from the neighborhood where they have lived for 10 years; but when she protested, she said, he told her that, because she was not working, she had no say in the decision.

“So now I’m going to go to work,” Rubalcaba said. “I’m sure I will find a job. I know I don’t have to do it, but I want to.”

Emilio declined to be interviewed, but the reasons for his reaction seemed obvious to some.

Situation Not Uncommon

“When a man that has always ruled the house and has been the boss and the only head of the family loses power a little, he doesn’t like that,” said Sarah Morlett, who has worked as a family counselor for 16 years at the Chicano Federation. “The minute he starts feeling threatened, then he’s going to uproot the family and take off somewhere else.”

Although Morlett said she has seen many situations like the Rubalcabas’ end in divorce, Rubalcaba said she has no fears about her and her husband’s ability to work out their problems. She said that, after looking at houses in other neighborhoods, her husband may be reconsidering the decision himself.

Bea Roppe, the Mexican-American health educator who spearheaded Por La Vida (“For Life”), the health education program responsible for the changes in Rubalcaba, sympathizes with the discomfort her husband may be feeling, and noted that the changes are dramatic ones for both.

“Neither of them has role models for being different,” Roppe said. “It’s hard. . . . but this isn’t a dress rehearsal, this is Maria’s time to live.”

Por La Vida, a joint project of UC San Diego and San Diego State University, addresses a number of health problems prevalent among Latinos in the United States. Because of their diet, nutrition is a prime concern.

According to program dietitian Joan Rupp, 45% of Latino women are obese, contrasted with 29% of Anglo women. She said diabetes, a disease exacerbated by obesity, is 2 to 3 1/2 times more prevalent among Latinos.

“If someone is genetically inclined to be diabetic, obesity can trigger it,” she said.

Rupp also noted that, although the incidence of high blood pressure appears to be slightly lower among Latinos, they have significantly less awareness of the problem than do Anglos. For example, a 1982-1984 study by the National Center for Disease Statistics showed that only 54% of Latinos were aware of hypertension, compared with studies that showed awareness in 65% to 90% of Anglos.

Traditional Efforts Lacking

Por La Vida decided to focus on the elements of Latino culture: foods high in fat and salt, as well as poor exercise habits. Funded as a pilot project by the Kaiser Family Foundation, the program tested an innovative method for offering health and nutrition information to the Latino community.

Traditional efforts to provide health information to Latinos have been limited to translating English-language materials into Spanish, and they are notoriously ineffective, Roppe said.

Por La Vida took a new approach to Latino health education by building on the strong communication channels among the Mexican-American women in Southeast San Diego who are “the family’s food gatekeepers,” she said.

3 Community Leaders

The program recruited three women who were recognized leaders in their Southeast neighborhoods, and to whom other women habitually went for advice. These natural leaders were trained and paid to serve as consejeras , organizers and teachers of the health classes.

Thirty-five women were invited to participate--a dozen or so in each class--either by the consejeras or by friends. Rubalcaba was recruited by her friend Ceci Saenz to join a class led by Carmen Sanchez, which met at the Baptist Church on Epsilon Street.

At least 30 of the 35 women were monolingual, said Roppe.

The series of eight weekly two-hour classes began in August. The women learned about lowering salt, fat and sugar intake and increasing fiber. They received hints about how to introduce the changes gently to their families, such as gradually decreasing the amount of salt in their cooking by using a little less each time.

New Way of Cooking

“My way of cooking has changed completely,” said Rubalcabas. “I try everything possible now to use less salt, sugar, white flour and fat.”

She said a typical meal at her home these days might be chicken sauteed in a little margarine, rice, and a vegetable salad or steamed vegetables. Instead of flour tortillas, she gives her family corn tortillas and whole wheat bread. Rubalcaba, who received only a sixth-grade education in her native Jalisco, Mexico, said she is trying to give her own children--Margarita, 13, Felipe, 11, and Marcia, 4--nutritional knowledge she never had.

“I didn’t know before that my old ways were unhealthy,” she said. “I don’t want my children to make the mistakes I was making before.”

Although Aparicio’s aerobics class was not part of the Por La Vida program, as a member of the program’s staff she invited participants to attend the free class. They were also encouraged to walk. The major content of Por La Vida was health and nutrition, but a significant byproduct was what Roppe called “self-efficacy.”

Talked of Strengths

“One of the early Por La Vida sessions was called ‘Fuerte de Mi Vida’--’Strength of My Life,’ ” Roppe said. “It gave the women a chance to talk about those strengths no one had ever recognized.

“Getting them talking about their lives helped open them up to what they thought they could do,” she said. “We asked them, ‘How possible do you think it is for you to lower the salt intake?’ They were given the chance to say, ‘Well, I think it’s pretty possible.’ And, when you say that, there’s a lot of power in it.”

Por La Vida’s slogan was “Mujeres Decididas” (“Women Making Decisions”). As the women decided to cook healthier foods and to exercise, and saw their decisions become reality, their increased self-confidence inevitably spilled over into the rest of their lives, Roppe said.

Continued to Meet

Among the decisions made by Rubalcaba’s group was to continue meeting after Por La Vida officially ended in October. They expanded from the initial nutrition and exercise curriculum to sessions on peaceful child discipline, cardiopulmonary resuscitation, sexually transmitted diseases, immigration, job skills and adult education opportunities.

“These women had been socially isolated,” Roppe said. “Now they know that, whatever they attempt, they’ve got a social support network behind them.”

Roppe said she has received criticism from some of her Latino friends who say that, by encouraging the Por La Vida women to gain independence, she is interfering in Latino culture.

Oppression of Women

“The oppression of women has nothing to do with my culture,” she said. “I have a very beautiful culture, a proud heritage. We’re all macho in that we’re proud, and we should be. But the oppression of women has nothing to do with it.”

Nevertheless, reactions like Emilio Rubalcaba’s were not uncommon among the Por La Vida families. Aparicio said one man followed his wife to her aerobics class because he couldn’t believe she wasn’t meeting a man.

Roppe said the UCSD-SDSU team learned April 12 that it has received funding from the state Department of Health Services to offer the program to 200 women over the next two years. In part because of their experience with families like the Rubalcabas, the new project will also include outreach to the women’s families--particularly to their husbands.

“We really want to reach out to the Mexican male,” Roppe said.