Diabetes and Cardiovascular Diseases in Mexican Americans
Diabetes and Cardiovascular Diseases in Mexican Americans
Introduction Diabetes, hypertension, and hypercholesterolemia are common chronic diseases among Hispanics, a group projected to comprise 30% of the US population by 2050. Mexican Americans are the largest ethnically distinct subgroup among Hispanics. We assessed the prevalence of and risk factors for undiagnosed and untreated diabetes, hypertension, and hypercholesterolemia among Mexican Americans in Cameron County, Texas.
Methods We analyzed cross-sectional baseline data collected from 2003 to 2008 in the Cameron County Hispanic Cohort, a randomly selected, community-recruited cohort of 2,000 Mexican American adults aged 18 or older, to assess prevalence of diabetes, hypertension, and hypercholesterolemia; to assess the extent to which these diseases had been previously diagnosed based on self-report; and to determine whether participants who self-reported having these diseases were receiving treatment. We also assessed social and economic factors associated with prevalence, diagnosis, and treatment.
Results Approximately 70% of participants had 1 or more of the 3 chronic diseases studied. Of these, at least half had had 1 of these 3 diagnosed, and at least half of those who had had a disease diagnosed were not being treated. Having insurance coverage was positively associated with having the 3 diseases diagnosed and treated, as were higher income and education level.
Conclusions Although having insurance coverage is associated with receiving treatment, important social and cultural barriers remain. Failure to provide widespread preventive medicine at the primary care level will have costly consequences.
Hispanics are projected to comprise 30% of the US population by 2050. Mexican Americans, the largest ethnically distinct subgroup among Hispanics, are at high risk for becoming overweight or obese, predisposing them to type 2 diabetes and metabolic and cardiovascular disease. These chronic diseases lead to substantial increases in disability and premature death. Identifying and addressing obstacles to the early prevention, diagnosis, and treatment of chronic diseases in this population could allow us to address disparities in disease burdens.
Approximately 50% of Mexican Americans residing on the United States border with Mexico are obese, compared with 39.3% of Mexican Americans nationally. In 2006, the American Diabetes Association estimated prevalence of diabetes among Mexican Americans living along the US border in Texas at 14.7%, considerably higher than the national prevalence among Mexican Americans (10.4%) and non-Hispanic whites (6.5%). Overall age-adjusted prevalence of hypertension in the United States is about 30%. Blacks are most affected (42%); prevalence for non-Hispanic whites is 28.8% and for Mexican Americans, 25.5%. However, in the US-Mexico border region, age-adjusted hypertension is reportedly 47.6%. Elevated low-density lipoprotein (LDL) cholesterol in the United States affects about 33.5% of the population overall and 27.7% of Mexican Americans. These 3 chronic diseases adversely affect the local community, health care system, and economy.
The Cameron County Hispanic Cohort (CCHC), initiated in 2003, is an ongoing study of Mexican American participants from randomly selected households in Brownsville, Cameron County, Texas, on the US-Mexico border. This large cohort study documents sociodemographic, clinical, behavioral, and biologic characteristics of Cameron County Mexican Americans, one of the poorest communities in the United States. This community experiences severe disparities in income, education, and health care access Ninety-two percent of Brownsville's estimated population of 170,000 is Mexican American and have low high school graduation rates and low incomes. The objectives of our study were to use cross-sectional baseline data from the CCHC to determine the extent to which 3 chronic diseases — diabetes, hypertension, and hypercholesterolemia — are undiagnosed and untreated in this minority population with severe health disparities and what factors influence failure to diagnose and treat these diseases.
Abstract and Introduction
Abstract
Introduction Diabetes, hypertension, and hypercholesterolemia are common chronic diseases among Hispanics, a group projected to comprise 30% of the US population by 2050. Mexican Americans are the largest ethnically distinct subgroup among Hispanics. We assessed the prevalence of and risk factors for undiagnosed and untreated diabetes, hypertension, and hypercholesterolemia among Mexican Americans in Cameron County, Texas.
Methods We analyzed cross-sectional baseline data collected from 2003 to 2008 in the Cameron County Hispanic Cohort, a randomly selected, community-recruited cohort of 2,000 Mexican American adults aged 18 or older, to assess prevalence of diabetes, hypertension, and hypercholesterolemia; to assess the extent to which these diseases had been previously diagnosed based on self-report; and to determine whether participants who self-reported having these diseases were receiving treatment. We also assessed social and economic factors associated with prevalence, diagnosis, and treatment.
Results Approximately 70% of participants had 1 or more of the 3 chronic diseases studied. Of these, at least half had had 1 of these 3 diagnosed, and at least half of those who had had a disease diagnosed were not being treated. Having insurance coverage was positively associated with having the 3 diseases diagnosed and treated, as were higher income and education level.
Conclusions Although having insurance coverage is associated with receiving treatment, important social and cultural barriers remain. Failure to provide widespread preventive medicine at the primary care level will have costly consequences.
Introduction
Hispanics are projected to comprise 30% of the US population by 2050. Mexican Americans, the largest ethnically distinct subgroup among Hispanics, are at high risk for becoming overweight or obese, predisposing them to type 2 diabetes and metabolic and cardiovascular disease. These chronic diseases lead to substantial increases in disability and premature death. Identifying and addressing obstacles to the early prevention, diagnosis, and treatment of chronic diseases in this population could allow us to address disparities in disease burdens.
Approximately 50% of Mexican Americans residing on the United States border with Mexico are obese, compared with 39.3% of Mexican Americans nationally. In 2006, the American Diabetes Association estimated prevalence of diabetes among Mexican Americans living along the US border in Texas at 14.7%, considerably higher than the national prevalence among Mexican Americans (10.4%) and non-Hispanic whites (6.5%). Overall age-adjusted prevalence of hypertension in the United States is about 30%. Blacks are most affected (42%); prevalence for non-Hispanic whites is 28.8% and for Mexican Americans, 25.5%. However, in the US-Mexico border region, age-adjusted hypertension is reportedly 47.6%. Elevated low-density lipoprotein (LDL) cholesterol in the United States affects about 33.5% of the population overall and 27.7% of Mexican Americans. These 3 chronic diseases adversely affect the local community, health care system, and economy.
The Cameron County Hispanic Cohort (CCHC), initiated in 2003, is an ongoing study of Mexican American participants from randomly selected households in Brownsville, Cameron County, Texas, on the US-Mexico border. This large cohort study documents sociodemographic, clinical, behavioral, and biologic characteristics of Cameron County Mexican Americans, one of the poorest communities in the United States. This community experiences severe disparities in income, education, and health care access Ninety-two percent of Brownsville's estimated population of 170,000 is Mexican American and have low high school graduation rates and low incomes. The objectives of our study were to use cross-sectional baseline data from the CCHC to determine the extent to which 3 chronic diseases — diabetes, hypertension, and hypercholesterolemia — are undiagnosed and untreated in this minority population with severe health disparities and what factors influence failure to diagnose and treat these diseases.
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