Association of acculturation and country of origin with self-reported hypertension and diabetes in a heterogeneous Hispanic population

BMC Public Health

Lenny López³  LeRoi S Hicks¹  Fátima Rodriguez² 

[1] Division of Hospital Medicine, University of Massachusetts Medical Center and University of Massachusetts Medical School, 365 Plantation Street, Worcester, MA, USA;Harvard Medical School, 25 Shattuck Street, 02115, Boston, MA, USA;The Division of General Internal Medicine and Brigham and Women’s Academic Hospitalist Program, Brigham and Women’s Hospital, 75 Francis Street, 02115, Boston, MA, USA

关键词: Hispanic;    Diabetes;    Hypertension;    Ethnicity;    Acculturation;   

Others  :  1163120
DOI  :  10.1186/1471-2458-12-768

 received in 2012-05-04, accepted in 2012-08-30,  发布年份 2012

【 摘 要 】

Background

Hispanics are the fasting growing population in the U.S. and disproportionately suffer from chronic diseases such as hypertension and diabetes. Little is known about the complex interplay between acculturation and chronic disease prevalence in the growing and increasingly diverse Hispanic population. We explored the association between diabetes and hypertension prevalence among distinct U.S. Hispanic subgroups by country of origin and by degree of acculturation.

Methods

We examined the adult participants in the 2001, 2003, 2005, and 2007 California Health Interview Survey (CHIS). Using weighted logistic regression stratified by nativity, we measured the association between country of origin and self-reported hypertension and diabetes adjusting for participants’ demographics, insurance status, socio-economic status and degree of acculturation measured by citizenship, English language proficiency and the number of years of residence in the U.S.

Results

There were 33,633 self-identified Hispanics (foreign-born: 19,988; U.S.-born: 13,645). After multivariable adjustment, we found significant heterogeneity in self-reported hypertension and diabetes prevalence among Hispanic subgroups. Increasing years of U.S. residence was associated with increased disease prevalence. Among all foreign-born subgroups, only Mexicans reported lower odds of hypertension after adjustment for socioeconomic and acculturation factors. Both U.S.-born and foreign-born Mexicans had higher rates of diabetes as compared to non-Hispanic whites.

Conclusions

We found significant heterogeneity among Hispanics in self-reported rates of hypertension and diabetes by acculturation and country of origin. Our findings highlight the importance of disaggregation of Hispanics by country of origin and acculturation factors whenever possible.

【 授权许可】

   
2012 Rodriguez et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]U.S. Census Bureau: Population Estimates. Available at: http://www.census.gov. webcite Accessed on August 19, 2011
• [2]Davidson JA, Kannel WB, Lopez-Candales A, Morales L, Moreno PR, Ovalle F, Rodriguez CJ, Rodbard HW, Rosenson RS, Stern M: Avoiding the looming Latino/Hispanic cardiovascular health crisis: a call to action. Ethn Dis 2007, 17(3):568-573.
• [3]Gu Q, Burt VL, Paulose-Ram R, Yoon S, Gillum RF: High blood pressure and cardiovascular disease mortality risk among U.S. adults: the third National Health and Nutrition Examination Survey mortality follow-up study. Ann Epidemiol 2008, 18(4):302-309.
• [4]Hajjar I, Kotchen TA: Trends in prevalence, awareness, treatment, and control of hypertension in the United States, 1988–2000. JAMA 2003, 290(2):199-206.
• [5]Burt VL, Cutler JA, Higgins M, Horan MJ, Labarthe D, Whelton P, Brown C, Roccella EJ: Trends in the prevalence, awareness, treatment, and control of hypertension in the adult US population. Data from the health examination surveys, 1960 to 1991. Hypertension 1995, 26(1):60-69.
• [6]Cowie CC, Rust KF, Byrd-Holt DD, Eberhardt MS, Flegal KM, Engelgau MM, Saydah SH, Williams DE, Geiss LS, Gregg EW: Prevalence of diabetes and impaired fasting glucose in adults in the U.S. population: National Health And Nutrition Examination Survey 1999–2002. Diabetes Care 2006, 29(6):1263-1268.
• [7]Kirk DS: The neighborhood context of racial and ethnic disparities in arrest. Demography 2008, 45(1):55-77.
• [8]McWilliams JM, Meara E, Zaslavsky AM, Ayanian JZ: Differences in control of cardiovascular disease and diabetes by race, ethnicity, and education: U.S. trends from 1999 to 2006 and effects of medicare coverage. Ann Intern Med 2009, 150(8):505-515.
• [9]Wong MD, Shapiro MF, Boscardin WJ, Ettner SL: Contribution of major diseases to disparities in mortality. N Engl J Med 2002, 347(20):1585-1592.
• [10]Fiscella K, Holt K: Racial disparity in hypertension control: tallying the death toll. Ann Fam Med 2008, 6(6):497-502.
• [11]Borrell LN, Crawford ND, Dallo FJ, Baquero MC: Self-reported diabetes in Hispanic subgroup, non-Hispanic black, and non-Hispanic white populations: National Health Interview Survey, 1997–2005. Public Health Rep 2009, 124(5):702-710.
• [12]Eamranond PP, Wee CC, Legedza AT, Marcantonio ER, Leveille SG: Acculturation and cardiovascular risk factor control among Hispanic adults in the United States. Public Health Rep 2009, 124(6):818-824.
• [13]Abraido-Lanza AF, Armbrister AN, Florez KR, Aguirre AN: Toward a theory-driven model of acculturation in public health research. Am J Public Health 2006, 96(8):1342-1346.
• [14]Kandula NR, Diez-Roux AV, Chan C, Daviglus ML, Jackson SA, Ni H, Schreiner PJ: Association of acculturation levels and prevalence of diabetes in the multi-ethnic study of atherosclerosis (MESA). Diabetes Care 2008, 31(8):1621-1628.
• [15]Alegria M: The challenge of acculturation measures: what are we missing? A commentary on Thomson & Hoffman-Goetz. Soc Sci Med 2009, 69(7):996-998.
• [16]Amaro H, Zambrana RE: Criollo, mestizo, mulato, LatiNegro, indigena, white, or black? The US Hispanic/Latino population and multiple responses in the 2000 census. Am J Public Health 2000, 90(11):1724-1727.
• [17]The California Health Interview Survey (CHIS). Available at: http://www.chis.ucla.edu. webcite Accessed on July 23, 2011
• [18]Lara M, Gamboa C, Kahramanian MI, Morales LS, Bautista DE: Acculturation and Latino health in the United States: a review of the literature and its sociopolitical context. Annu Rev Public Health 2005, 26:367-397.
• [19]Goel MS, McCarthy EP, Phillips RS, Wee CC: Obesity among US immigrant subgroups by duration of residence. JAMA 2004, 292(23):2860-2867.
• [20]Barcenas CH, Wilkinson AV, Strom SS, Cao Y, Saunders KC, Mahabir S, Hernandez-Valero MA, Forman MR, Spitz MR, Bondy ML: Birthplace, years of residence in the United States, and obesity among Mexican-American adults. Obesity (Silver Spring) 2007, 15(4):1043-1052.
• [21]Mainous AG, Diaz VA, Geesey ME: Acculturation and healthy lifestyle among Latinos with diabetes. Ann Fam Med 2008, 6(2):131-137.
• [22]Lutsey PL, Diez Roux AV, Jacobs DR, Burke GL, Harman J, Shea S, Folsom AR: Associations of acculturation and socioeconomic status with subclinical cardiovascular disease in the multi-ethnic study of atherosclerosis. Am J Public Health 2008, 98(11):1963-1970.
• [23]Gallo LC, de Los Monteros KE, Allison M, Roux AD, Polak JF, Watson KE, Morales LS: Do socioeconomic gradients in subclinical atherosclerosis vary according to acculturation level? Analyses of Mexican-Americans in the multi-ethnic study of atherosclerosis. Psychosom Med 2009, 71(7):756-762.
• [24]Diez Roux AV, Detrano R, Jackson S, Jacobs DR, Schreiner PJ, Shea S, Szklo M: Acculturation and socioeconomic position as predictors of coronary calcification in a multiethnic sample. Circulation 2005, 112(11):1557-1565.
• [25]Wassel CL, Pankow JS, Peralta CA, Choudhry S, Seldin MF, Arnett DK: Genetic ancestry is associated with subclinical cardiovascular disease in African-Americans and Hispanics from the multi-ethnic study of atherosclerosis. Circ Cardiovasc Genet 2009, 2(6):629-636.
• [26]Hajat A, Lucas JB, Kington R: Health outcomes among Hispanic subgroups: data from the National Health Interview Survey, 1992–95. Adv Data 2000, 310:1-14.
• [27]Kimbro RT, Bzostek S, Goldman N, Rodriguez G: Race, ethnicity, and the education gradient in health. Health Aff (Millwood) 2008, 27(2):361-372.
• [28]Acevedo-Garcia D, Soobader MJ, Berkman LF: The differential effect of foreign-born status on low birth weight by race/ethnicity and education. Pediatrics 2005, 115(1):e20-e30.
• [29]Morales LS, Lara M, Kington RS, Valdez RO, Escarce JJ: Socioeconomic, cultural, and behavioral factors affecting Hispanic health outcomes. J Health Care Poor Underserved 2002, 13(4):477-503.
• [30]Wingo PA, Kulkarni A, Borrud LG, McDonald JA, Villalobos SA, Green DC: Health disparities among Mexican American women aged 15–44 years: National Health and Nutrition Examination Survey, 1999–2004. Am J Public Health 2009, 99(7):1300-1307.
• [31]Moran A, Roux AV, Jackson SA, Kramer H, Manolio TA, Shrager S, Shea S: Acculturation is associated with hypertension in a multiethnic sample. Am J Hypertens 2007, 20(4):354-363.
• [32]Herman WH, Ma Y, Uwaifo G, Haffner S, Kahn SE, Horton ES, Lachin JM, Montez MG, Brenneman T, Barrett-Connor E: Differences in A1C by race and ethnicity among patients with impaired glucose tolerance in the Diabetes Prevention Program. Diabetes Care 2007, 30(10):2453-2457.
• [33]Perez-Escamilla R: Acculturation, nutrition, and health disparities in Latinos. Am J Clin Nutr 2011, 93(5):1163S-1167S.
• [34]Giles WH, Croft JB, Keenan NL, Lane MJ, Wheeler FC: The validity of self-reported hypertension and correlates of hypertension awareness among blacks and whites within the stroke belt. Am J Prev Med 1995, 11(3):163-169.
• [35]Vargas CM, Burt VL, Gillum RF, Pamuk ER: Validity of self-reported hypertension in the National Health and Nutrition Examination Survey III, 1988–1991. Prev Med 1997, 26(5 Pt 1):678-685.
• [36]Robinson JR, Young TK, Roos LL, Gelskey DE: Estimating the burden of disease Comparing administrative data and self-reports. Med Care 1997, 35(9):932-947.