按原籍国划分的美国西班牙裔人群中的高血压和糖尿病患病率：2000 - 2005年国家健康访谈调查
Hypertension and diabetes prevalence among U.S. Hispanics by country of origin: the National Health Interview Survey 2000-2005.
作者信息
Pabon-Nau Lina P, Cohen Amy, Meigs James B, Grant Richard W
机构信息
Division of General Medicine, Massachusetts General Hospital, 50 Staniford Street, 9th floor, Boston, MA 02114, USA.
出版信息
J Gen Intern Med. 2010 Aug;25(8):847-52. doi: 10.1007/s11606-010-1335-8. Epub 2010 May 19.
BACKGROUND
Despite their diverse cultural origins, Hispanics in the US are generally studied as a single ethnic group.
OBJECTIVES
- 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.
背景
尽管美国的西班牙裔有着不同的文化起源，但通常被作为一个单一的种族群体进行研究。
目的
1）按原籍国评估美国西班牙裔在人口统计学和疾病相关方面的差异，以及2）研究社会经济地位和文化适应在这些亚组疾病患病率中的中介作用。
设计与参与者
利用2000 - 2005年国家健康访谈调查（NHIS）的数据，我们比较了墨西哥裔美国人与原籍为墨西哥、波多黎各、中/南美洲、古巴和多米尼加共和国的西班牙裔的特征（n = 31,240）。我们按外国出生与美国出生的西班牙裔亚组对分析进行分层，并对高血压和糖尿病患病率进行建模，同时调整人口统计学和文化适应差异。
主要结果
在所有测量变量中，这六个西班牙裔亚组存在显著差异。外国出生的波多黎各人中高血压患病率（32%）和糖尿病患病率（15%）最高。在对外国出生的西班牙裔的年龄、体重指数、吸烟、社会经济地位和文化适应进行调整后，与墨西哥裔美国人相比，波多黎各人（比值比[OR]=1.76[95%置信区间：1.23, 2.50]，p = 0.002）和多米尼加人（OR = 1.93[1.24, 3.00]，p = 0.004）的高血压患病率更高。在外国出生的西班牙裔中，相对于墨西哥裔美国人，古巴人（OR = 0.42[0.25, 0.68]，p < 0.001）、多米尼加人（OR = 0.48[0.26, 0.91]，p = 0.02）和中/南美洲人（OR = 0.51[0.33, 0.78]，p = 0.002）的调整后糖尿病患病率为墨西哥裔美国人的一半或更低。在出生于美国的西班牙裔亚组中，在调整模型中，与墨西哥裔美国人相比，古巴人高血压患病率较低（OR = 0.53，[0.33, 0.83]，p = 0.006），墨西哥人糖尿病患病率较低（OR = 0.76[0.60, 0.98]，p = 0.03）。
结论
西班牙裔中高血压和糖尿病的患病率因原籍国不同而有显著差异。健康差异研究应纳入所有西班牙裔亚组的代表。
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