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Hispanics and diabetes

Hispanics had higher death rates than whites from diabetes

The two leading causes of death in Hispanics are heart disease and cancer
Foreign-born Hispanics experience better health and fewer health risks than US-born Hispanics for some key health indicators such as cancer, heart disease, obesity, hypertension, and smoking

The first national study on Hispanic health risks and leading causes of death in the United States by the Centers for Disease Control and Prevention (CDC) showed that similar to non-Hispanic whites (whites), the two leading causes of death in Hispanics are heart disease and cancer. Fewer Hispanics than whites die from the 10 leading causes of death, but Hispanics had higher death rates than whites from diabetes and chronic liver disease and cirrhosis. They have similar death rates from kidney diseases, according to the new Vital Signs.

Health risk can vary by Hispanic subgroup. For example, nearly 66 percent more Puerto Ricans smoke than Mexicans. Health risk also varies partly by whether Hispanics were born in the US or in another country. Hispanics are almost three times as likely to be uninsured as whites. Hispanics in the US are on average nearly 15 years younger than whites, so taking steps now to prevent disease could mean longer, healthier lives for Hispanics.

“Four out of 10 Hispanics die of heart disease or cancer. 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,” said CDC Director Dr Tom Frieden. “Health professionals can help Hispanics protect their health by learning about their specific risk factors and addressing barriers to care.”

This Vital Signs report recommends that doctors, nurses and other health professionals:

  • Work with interpreters to eliminate language barriers when patients prefer to speak Spanish.
  • Counsel patients with or at high risk for high blood pressure, diabetes, or cancer on weight control and diet.
  • Ask patients if they smoke and, if they do, help them quit.
  • Engage community health workers (promotores de salud) to educate and link people to free or low-cost services.

Hispanic and other Spanish-speaking doctors and clinicians, as well as community health workers or promotores de salud, play a key role in helping to provide culturally and linguistically appropriate outreach to Hispanic patients.

The Vital Signs report used recent national census and health surveillance data to determine differences between Hispanics and whites, and among Hispanic subgroups. Hispanics are the largest racial and ethnic minority group in the US Currently, nearly one in six people living in the U.S. (almost 57 million) is Hispanic, and this is projected to increase to nearly one in four (more than 85 million) by 2035.

Despite lower overall death rates, the study stressed that Hispanics may face challenges in getting the care needed to protect their health. Socio-demographic findings include:

  • About one in three Hispanics have limited English proficiency;
  • About one in four Hispanics live below the poverty line, compared with whites; and
  • About one in three has not completed high school.

These socio-demographic gaps are even wider for foreign-born Hispanics, but foreign-born Hispanics experience better health and fewer health risks than US-born Hispanics for some key health indicators such as cancer, heart disease, obesity, hypertension, and smoking, the report said.

The report also found different degrees of health risk among Hispanic by country of origin:

  • Mexicans and Puerto Ricans are about twice as likely to die from diabetes as whites. Mexicans also are nearly twice as likely to die from chronic liver disease and cirrhosis as whites.
  • Smoking overall among Hispanics (14 percent) is less common than among whites (24 percent), but is high among Puerto Rican males (26 percent) and Cuban males (22 percent).
  • Colorectal cancer screening varies for Hispanics ages 50 to 75 years. ◦About 40 percent of Cubans get screened (29 percent of men and 49 percent of women).
  • About 58 percent of Puerto Ricans get screened (54 percent of men and 61 percent of women).

Hispanics are as likely as whites to have high blood pressure. But Hispanic women with high blood pressure are twice as likely as Hispanic men to get it under control.

“Obesity cuts across ethnicity,” said Dr John M. Morton, president of the American Society for Metabolic and Bariatric Surgery (ASMBS). “And while obesity is significantly higher in the Hispanic population, the utilisation of proven and effective treatments for obesity among this group, including bariatric surgery, remains significantly lower than in the general population. Insurance coverage and cultural issues certainly play a role, but the medical community can certainly do a better job in working with this community.”

Data from the Bariatrics Outcomes Longitudinal Database (BOLD) in 2010, a self-reported bariatric surgery patient information database, showed that out of a total of 57,918 patients, 78 percent were described as Causasian, while only 6 percent were Hispanic.

“The two biggest health threats to the Hispanic community are the twin epidemics of obesity and diabetes,” said Dr. Morton. “There is a real need to reach out to this community with culturally sensitive information and education about the benefits of weight loss and the role bariatric surgery can potentially play in improving health and extending life. This is a population that can benefit from bariatric surgery, and they should certainly not be ignored.”

Dr Jaime Ponce, past president of the ASMBS added, “It’s critical for the medical community to come together to address the underlying social, economic, cultural and environmental factors that contribute to high obesity and diabetes rates and pose a serious threat to the health and future of our next generation.”

Read more from the ASMBS here

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