Hypertension and diabetes prevalence among U.S. Hispanics by country of origin: the National Health Interview Survey 2000-2005

Lina P Pabon-Nau, Amy Cohen, James B Meigs, Richard W Grant
Journal of General Internal Medicine 2010, 25 (8): 847-52

BACKGROUND: Despite their diverse cultural origins, Hispanics in the US are generally studied as a single ethnic group.

OBJECTIVES: 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.

MAIN RESULTS: 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.

CONCLUSIONS: The prevalence of hypertension and diabetes varies significantly among Hispanics by country of origin. Health disparities research should include representation from all Hispanic subgroups.

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