Monroy-Iglesias Maria J, Zuckerman Gabrielle, Wang Peng, Derkach Andriy, O'Connell Kelli, Lund Jennifer L, Du Mengmeng, Bhimani Jenna, Giovannucci Edward L, Schwartz Todd A, Kantor Elizabeth D
Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Department of Biostatistics, University of North Carolina, Chapel Hill, NC, USA.
J Racial Ethn Health Disparities. 2025 May 30. doi: 10.1007/s40615-025-02500-y.
Mexican Americans are less likely than non-Hispanic Whites to report prescription drug use. This study explores mediating factors, disparities within chronic conditions, and variations in prescription drug use by nativity.
We analyzed data from the National Health and Nutrition Examination Survey (2005-2016). Using survey-adjusted logistic regression models adjusted for age and gender, we estimated odds ratios (OR) for the association between ethnicity and prescription drug use in the past 30 days. Mediation analyses identified factors explaining this association. We also examined medication use for chronic conditions (diabetes, hypertension, hyperlipidemia, and depression) and variations in use by nativity.
Mexican Americans had lower odds of using prescription drugs (adjusted OR (aOR) 0.38; 95% CI 0.34-0.42). In mediation analyses, lack of prescription drug coverage (proportion mediated (PM) 34.4%; 95% CI 25.1-46.7) and ≤2 health visits per year (PM 19.9%; 95% CI 13.6-28.1). explained a significant portion of the disparity. Contrastingly, poor health status narrowed the gap (PM -13.8%; 95% CI -16.3- -11.1). Mexican Americans with hypertension (AOR 0.79; 95% CI 0.64-0.96) and depression (AOR 0.50; 95% CI 0.33-0.75) had lower odds of receiving medication. Immigrant Mexican Americans had lower odds of using prescription drugs (aOR 0.25; 95% CI 0.22-0.29) compared to U.S.-born individuals (aOR 0.62; 95% CI 0.54-0.73).
This study highlights an unmet treatment need for those with chronic conditions in the Mexican American community, with particularly notable disparities among immigrant Mexican Americans. Addressing these issues is crucial for improving healthcare equity.
墨西哥裔美国人报告使用处方药的可能性低于非西班牙裔白人。本研究探讨中介因素、慢性病内部的差异以及出生地对处方药使用的影响。
我们分析了国家健康与营养检查调查（2005 - 2016年）的数据。使用经年龄和性别调整的调查校正逻辑回归模型，我们估计了过去30天内种族与处方药使用之间关联的比值比（OR）。中介分析确定了解释这种关联的因素。我们还研究了慢性病（糖尿病、高血压、高脂血症和抑郁症）的用药情况以及出生地导致的用药差异。
墨西哥裔美国人使用处方药的几率较低（校正后OR（aOR）为0.38；95%置信区间为0.34 - 0.42）。在中介分析中，缺乏处方药保险（中介比例（PM）为34.4%；95%置信区间为25.1 - 46.7）以及每年健康就诊次数≤2次（PM为19.9%；95%置信区间为13.6 - 28.1）解释了很大一部分差异。相反，健康状况不佳缩小了差距（PM为 - 13.8%；95%置信区间为 - 16.3 - - 11.1）。患有高血压（AOR为0.79；95%置信区间为0.64 - 0.96）和抑郁症（AOR为0.50；95%置信区间为0.33 - 0.75）的墨西哥裔美国人接受药物治疗的几率较低。与在美国出生的个体（aOR为0.62；95%置信区间为0.54 - 0.73）相比，移民墨西哥裔美国人使用处方药的几率较低（aOR为0.25；95%置信区间为0.22 - 0.29）。
本研究突出了墨西哥裔美国人群体中慢性病患者未得到满足的治疗需求，尤其是移民墨西哥裔美国人之间存在显著差异。解决这些问题对于改善医疗保健公平性至关重要。
