Health risks in Hispanics vary by their country or region of origin, and by whether they were born in the United States or not, according to a report from the US Centers for Disease Control and Prevention (CDC).
Kenneth Dominguez, MD, MPH, from the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention at the CDC, and colleagues present their findings in an early release May 5 in the Mortality and Morbidity Weekly Report.
Dr Dominguez and CDC Director Tom Frieden, MD, MPH, reported on the first national study on Hispanic health risks and leading causes of death in the United States at a CDC telebriefing today.
"While the overall health status has some good news in terms of the overall death rate [and] lower smoking rate, there's still a real challenge in many preventable cancers, heart attacks, [and] strokes that can be addressed by stopping smoking and improving control of blood pressure," Dr Frieden said.
Hispanics are the largest racial and ethnic minority group in the United States, representing an estimated 17.7% of the US population, and this figure is expected to rise to 25% by 2035.
The researchers analyzed four national datasets to compare Hispanics overall, non-Hispanic whites, and Hispanic country/region of origin subgroups (Hispanic origin subgroups) for top causes of death, prevalence of diseases and associated risk factors, and health services use. The researchers generally restricted their analyses to ages 18 to 64 years, and stratified them further by sex and nativity.
Hispanics had a 24% lower all-cause death rate and lower death rates for nine of the top 15 causes of death, but they had higher death rates from diabetes (51% higher), chronic liver disease and cirrhosis (48%), essential hypertension and hypertensive renal disease (8%), and homicide (96%), and higher prevalence of diabetes (133%) and obesity (23%) compared with non-Hispanic whites.
"US Hispanics are on average nearly 15 years younger than whites, so early intervention might have a broader impact on Hispanics in preventing chronic diseases that can manifest decades later," the authors write.
"Hispanics face challenges in getting care needed to protect their health," Dr Frieden said. "Many social factors affect how, how often, and how well Hispanics get healthcare."
Almost half (41.5%) of Hispanics had no health insurance compared with 15.1% of whites. More Hispanics than whites reported that they had delayed or not obtained necessary medical care because of cost (15.5% vs 13.6%).
"Hispanics are twice as likely to live below the poverty line and almost three times more likely to be uninsured than whites. As doctors, we can do a lot to help reduce the barriers our Hispanic patients face," Dr Frieden explained. Hispanics were also more likely to have less than a high school education.
Varies by Hispanic Subgroup
Self-reported smoking prevalences among Hispanics varied by Hispanic origin and by sex. Hispanics born in the United States had higher prevalences of obesity (30% higher), hypertension (40% higher), smoking (72% higher), heart disease (89% higher), and cancer (93% higher) compared with Hispanics born outside the United States.
Those from Mexico and Puerto Rico are approximately twice as likely to die from diabetes as whites. Mexicans are also almost twice as likely to die from chronic liver disease and cirrhosis compared with whites.
Smoking is less common overall among Hispanics (14%) than among whites (24%), but is high among men from Puerto Rico (26%) and Cuba (22%). Almost 66% more Puerto Ricans smoke than Mexicans.
Approximately 40% of Cubans aged 50 to 75 years get screened for colorectal cancer (29% of men and 49% of women) compared with 58% of Puerto Ricans (54% of men and 61% of women) and 58.7% of whites.
Hypertension is about as likely among Hispanics as whites, but Hispanic women with hypertension are twice as likely to get control of it as Hispanic men.
"One thing that's clear is that it's not genetics, because people's genes don't change when they come to this country, and what we find is that the longer people stay in this country, the longer the factors in our environment that may promote obesity or increase smoking rates may influence their health," Dr Frieden said.
"In terms of…why US-born Hispanics have worse prevalences of a lot of these conditions…it has a lot to do with the types of foods that are marketed toward folks. For example, sugary drinks [and] fatty foods get a lot of play on [television]," Dr Dominguez said. "Supersized" portions served in many fast food outlets also play a role, he said.
"By not smoking and staying physically active, such as walking briskly for 30 minutes a day, Hispanics can reduce their risk for these chronic diseases and others such as diabetes," Dr Frieden said. "Health professionals can help Hispanics protect their health by learning about their specific risk factors and addressing barriers to care."
Physicians, nurses, and other healthcare professionals should:
Use interpreters when working with patients who prefer to speak Spanish, and have education materials in Spanish and English.
Educate patients with or at high risk for hypertension, diabetes, or cancer regarding weight control and diet.
Ask patients about smoking, and if they do smoke, help them quit.
Use community health workers (promotores de salud) to educate people and link them to free or low-cost services.
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Cite this: Hispanic Subgroups Have Different Health Risks, CDC Says - Medscape - May 05, 2015.