Borrell Luisa N, Crawford Natalie D, Dailo Florence J
Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W. 168th St., New York, NY 10032, USA.
Public Health Rep. 2007 Sep-Oct;122(5):616-25. doi: 10.1177/003335490712200509.
We investigated the effect of race among Hispanic and non-Hispanic people on self-reported diabetes after adjusting for selected individual characteristics and known risk factors.
Using the National Health Interview Survey 2000-2003, these analyses were limited to Hispanic and non-Hispanic people who self-identified as white or black/African American for a final sample of 117,825 adults, including 17,327 Hispanic people (with 356 black and 16,971 white respondents).
The overall prevalence of diabetes was 7.2%. After adjusting for selected covariates, Hispanic white and black respondents were 1.56 (95% confidence interval [CI] 1.32, 1.83) and 2.64 (95% CI 1.10, 6.35) times more likely to report having diabetes than non-Hispanic white respondents. The estimate for non-Hispanic black respondents was 1.45 (95% CI 1.29, 1.64). When compared to low-income non-Hispanic white respondents, low-income Hispanic white respondents (odds ratio [OR] 1.64; 95% CI 1.26, 2.19) and non-Hispanic black respondents (OR 1.71; 95% CI 1.38, 2.11) were more likely to report having diabetes. Hispanic black people born in the U.S. were 3.54 (95% CI 1.27, 9.82) times more likely to report having diabetes when compared to Hispanic white people born in the U.S. In comparison to non-Hispanic white respondents, the odds of reporting diabetes decreased for non-Hispanic black respondents, while the odds remained constant for Hispanic white respondents (p-value for interaction between survey year and race/ethnicity = 0.03).
This study suggests that race may be a proxy for unmeasured exposures among non-Hispanic and Hispanic people. Thus, given the importance of race on health and the racial heterogeneity among Hispanic people, race among Hispanic people should be investigated whenever the data allow it.
在调整选定的个体特征和已知风险因素后,我们调查了西班牙裔和非西班牙裔人群中种族对自我报告糖尿病的影响。
利用2000 - 2003年美国国家健康访谈调查,这些分析仅限于自我认定为白人或黑人/非裔美国人的西班牙裔和非西班牙裔人群,最终样本为117,825名成年人,其中包括17,327名西班牙裔人(356名黑人受访者和16,971名白人受访者)。
糖尿病的总体患病率为7.2%。在调整选定的协变量后,西班牙裔白人及黑人受访者报告患有糖尿病的可能性分别是非西班牙裔白人受访者的1.56倍(95%置信区间[CI] 1.32, 1.83)和2.64倍(95% CI 1.10, 6.35)。非西班牙裔黑人受访者的估计值为1.45(95% CI 1.29, 1.64)。与低收入非西班牙裔白人受访者相比,低收入西班牙裔白人受访者(优势比[OR] 1.64;95% CI 1.26, 2.19)和非西班牙裔黑人受访者(OR 1.71;95% CI 1.38, 2.11)报告患有糖尿病的可能性更大。与在美国出生的西班牙裔白人相比,在美国出生的西班牙裔黑人报告患有糖尿病的可能性高3.54倍(95% CI 1.27, 9.82)。与非西班牙裔白人受访者相比,非西班牙裔黑人受访者报告患糖尿病的几率降低,而西班牙裔白人受访者的几率保持不变(调查年份与种族/族裔之间的交互作用p值 = 0.03)。
本研究表明,种族可能是非西班牙裔和西班牙裔人群中未测量暴露因素的替代指标。因此,鉴于种族对健康的重要性以及西班牙裔人群中的种族异质性,只要数据允许,就应调查西班牙裔人群中的种族情况。