Hypertension and Diabetes Prevalence Among U.S. Hispanics by Country of Origin: The National Health Interview Survey 2000-2005
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Despite their diverse cultural origins, Hispanics in the US are generally studied as a single ethnic group.
1) Assess demographic and disease-related differences among U.S. Hispanics by country of origin, and 2) Examine the mediating roles of socioeconomic status and acculturation on disease prevalence in these subgroups.
Design and Participants
Using data from the 2000-2005 National Health Interview Survey (NHIS), we compared characteristics of Mexican-Americans with Hispanics originally from: Mexico, Puerto Rico, Central/South America, Cuba, and Dominican Republic (n = 31,240). We stratified the analysis by foreign versus US-born Hispanic subgroups and modeled hypertension and diabetes prevalence, adjusting for demographic and acculturation differences.
The six Hispanic subgroups were significantly diverse in all measured variables. Prevalence of hypertension (32%) and diabetes (15%) was highest in foreign-born Puerto Ricans. After adjusting for age, BMI, smoking, socioeconomic status and acculturation in foreign-born Hispanics, Puerto Ricans (OR = 1.76 [95% CI: 1.23, 2.50], p = 0.002) and Dominicans (OR = 1.93 [1.24, 3.00], p = 0.004), had higher prevalence of hypertension relative to Mexican-Americans. Adjusted diabetes prevalence among foreign-born Hispanics was half or less in Cubans (OR = 0.42 [0.25, 0.68] p < 0.001), Dominicans (OR = 0.48 [0.26, 0.91], p = 0.02) and Central/South Americans (OR = 0.51 [0.33, 0.78], p = 0.002) relative to Mexican-Americans. Among US-born Hispanic subgroups, Cubans had lower hypertension (OR = 0.53, [0.33, 0.83], p = 0.006) and Mexicans (OR = 0.76 [0.60, 0.98], p = 0.03) had lower diabetes prevalence compared to Mexican-Americans in adjusted models.
The prevalence of hypertension and diabetes varies significantly among Hispanics by country of origin. Health disparities research should include representation from all Hispanic subgroups.
KEY WORDSdiabetes health status hypertension immigrant health vulnerable populations
This study was funded by grant number T32HP11001 from the Health Resources and Services Administration of the Department of Health and Human Services to support the Harvard Medical School Fellowship in General Medicine and Primary Care. This study was also funded by Aetna Foundation Inc. to support the Aetna/Disparities Solutions Center Fellowship of Massachusetts General Hospital. The study content is solely the responsibility of the authors and do not necessarily represent the official views of the Department of Health and Human Services.
Conflicts of Interest
Dr. Grant was supported by an NIDDK Career Development Award (K23 DK067452). Dr. Meigs was supported by NIDDK K24 DK080140. Dr. Meigs currently has research grants from GlaxoSmithKline and Sanofi-Aventis, and has consulting agreements with GlaxoSmithKline, Sanofi-Aventis, Interleukin Genetics, Kalypsis, and Outcomes Science.
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