Department of Medicine, Brigham and Women's Hospital, 75 Francis Street, 02115, Boston, MA, USA.
BMC Public Health. 2012 Sep 11;12:768. doi: 10.1186/1471-2458-12-768.
Hispanics are the fasting growing population in the U.S. and disproportionately suffer from chronic diseases such as hypertension and diabetes. Little is known about the complex interplay between acculturation and chronic disease prevalence in the growing and increasingly diverse Hispanic population. We explored the association between diabetes and hypertension prevalence among distinct U.S. Hispanic subgroups by country of origin and by degree of acculturation.
We examined the adult participants in the 2001, 2003, 2005, and 2007 California Health Interview Survey (CHIS). Using weighted logistic regression stratified by nativity, we measured the association between country of origin and self-reported hypertension and diabetes adjusting for participants' demographics, insurance status, socio-economic status and degree of acculturation measured by citizenship, English language proficiency and the number of years of residence in the U.S.
There were 33,633 self-identified Hispanics (foreign-born: 19,988; U.S.-born: 13,645). After multivariable adjustment, we found significant heterogeneity in self-reported hypertension and diabetes prevalence among Hispanic subgroups. Increasing years of U.S. residence was associated with increased disease prevalence. Among all foreign-born subgroups, only Mexicans reported lower odds of hypertension after adjustment for socioeconomic and acculturation factors. Both U.S.-born and foreign-born Mexicans had higher rates of diabetes as compared to non-Hispanic whites.
We found significant heterogeneity among Hispanics in self-reported rates of hypertension and diabetes by acculturation and country of origin. Our findings highlight the importance of disaggregation of Hispanics by country of origin and acculturation factors whenever possible.
西班牙裔是美国人口增长最快的群体，他们不成比例地患有高血压和糖尿病等慢性病。在美国不断增长且日益多样化的西班牙裔人群中，文化适应与慢性病患病率之间的复杂相互作用知之甚少。我们探讨了不同原籍国和文化适应程度的美国西班牙裔亚群中糖尿病和高血压患病率之间的关联。
我们检查了 2001 年、2003 年、2005 年和 2007 年加利福尼亚健康访谈调查（CHIS）的成年参与者。使用按出生地分层的加权逻辑回归，我们测量了原籍国与自我报告的高血压和糖尿病之间的关联，调整了参与者的人口统计学、保险状况、社会经济地位和通过公民身份、英语水平和在美国居住的年数衡量的文化适应程度。
有 33633 名自我认同的西班牙裔人（外国出生：19988 人；美国出生：13645 人）。在多变量调整后，我们发现西班牙裔亚群中自我报告的高血压和糖尿病患病率存在显著异质性。在美国居住的年数增加与疾病患病率增加相关。在所有外国出生的亚群中，只有墨西哥人在调整社会经济和文化适应因素后报告高血压的几率较低。与非西班牙裔白人相比，美国出生和外国出生的墨西哥人均有更高的糖尿病发病率。
我们发现，在文化适应和原籍国方面，西班牙裔人群中自我报告的高血压和糖尿病发病率存在显著异质性。我们的研究结果强调了尽可能按原籍国和文化适应因素对西班牙裔人群进行细分的重要性。
