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PubMed2000

Comparison of Florida Hispanic and non-Hispanic Caucasian women in their health beliefs related to breast cancer and health locus of control.

PURPOSE/OBJECTIVES: To compare Florida Hispanic and non-Hispanic Caucasian women in their health beliefs about breast cancer and health locus of control (LOC). DESIGN: Exploratory, comparative. SETTING: A variety of healthcare settings in an urban area in Florida. SAMPLE: Hispanic (n = 113) and non-Hispanic (n = 197) Caucasian women who could read and understand either English or Spanish. METHODS: The Health Screening Questionnaire, which assesses health beliefs and health LOC, was administered in either Spanish or English, and the results were analyzed. MAIN RESEARCH VARIABLES: Attitudes about health in general, perceptions about susceptibility to cancer, beliefs about benefits of early diagnosis, and perceptions about the seriousness of cancer; LOC. FINDINGS: Florida Hispanic women are better educated than the Mexican American Hispanic women described in the literature. Hispanic and non-Hispanic women were significantly different in their health beliefs and LOC. With age and education controlled statistically, these differences remained. Hispanic women who preferred to speak/read English were more like the non-Hispanic women in their responses than were the women who preferred Spanish. CONCLUSIONS: Cultural differences exist between Hispanic and non-Hispanic women; however, differences also exist between groups of Hispanic women in Florida versus Hispanics in the southwestern United States. IMPLICATIONS FOR NURSING PRACTICE: Outreach programs for cancer screening should be culturally relevant and may need to be different for subgroups of Hispanics in the United States.

Age Factors↗
PubMed2004

Hospice use by Hispanic and non-Hispanic white cancer decedents.

OBJECTIVE: To investigate rates of hospice use between Hispanic and non-Hispanic white Medicare beneficiaries diagnosed with cancer using data from a large, population-based study. DATA SOURCES: Secondary data from the linked SEER-Medicare database including the SEER areas of Los Angeles, San Francisco, and San Jose-Monterey, California, and the state of New Mexico. All subjects were Hispanic or non-Hispanic whites, aged 67 and older, had a cancer diagnosis of breast, colorectal, lung, or prostate cancer from 1991-1996, and died of cancer from 1991-1998. STUDY DESIGN: This study employed a retrospective cohort design to compare rates of hospice use between Hispanics and non-Hispanic whites across patient characteristics and over time. PRINCIPAL FINDINGS: Rates of hospice use were similar for Hispanics (39.2 percent) and non-Hispanic whites (41.5 percent). In a bivariate logistic regression model, Hispanics were significantly less likely to use hospice than non-Hispanic whites (OR 0.91; 95 percent CI 0.85-0.97). However, after adjusting for age, marital status, sex, educational attainment, income, urban versus rural residence, and type of insurance using multivariate logistic regression analysis, the estimated odds for being a hospice user among Hispanics is similar to the odds of being a hospice user among non-Hispanic whites (OR 1.05; 95 percent CI 0.98-1.13). Stratified analyses revealed significant differences between ethnic groups in the use of hospice by type of insurance and SEER area, indicating interactions between ethnicity and these variables. CONCLUSIONS: Our findings indicate similar rates of hospice use for Hispanics and non-Hispanic whites diagnosed with one of the four leading cancers. Additional studies from other national registries may be necessary to confirm these findings.

Aged↗
PubMed1994

Ethnic differences in stroke mortality between non-Hispanic whites, Hispanic whites, and blacks. The National Longitudinal Mortality Study.

BACKGROUND AND PURPOSE: Although US blacks are known to have an excess stroke mortality compared with US whites, little is known about the stroke burden of the Hispanic white population. This report will provide estimates of the relative burden of stroke mortality in the US black and Hispanic population relative to the white population and examine the consistency of this relation across age. METHODS: Data were from participants aged > 45 years from the National Longitudinal Mortality Study. There were 1844 stroke deaths among 239,734 non-Hispanic whites, 46 deaths among 12,527 Hispanic whites, and 234 deaths among 23,468 black participants. Standard statistical methods were used to examine the ethnic differences in stroke mortality. RESULTS: The hazard ratios for black men and women (relative to non-Hispanic whites) were nearly identical, at > 4.0 at age 45 but marginally < 1.0 by age 85. For both Hispanic men and women, the hazard ratios (relative to non-Hispanic whites) were approximately 1.0 at age 45 but were marginally significantly < 1.0 at older ages. The ethnic differences in stroke death rates reveal differences in age distributions of age at fatal stroke between these groups. Approximately 6% of fatal strokes for non-Hispanic whites occurred before age 60, whereas > 15% occurred in both Hispanic whites and blacks. CONCLUSIONS: These results suggest that (1) for Hispanics, stroke risk is similar to that for non-Hispanic whites at young ages but is marginally lower at older ages, (2) the excess stroke mortality in blacks mainly occurs at younger ages (between 45 and 55 years), and (3) the relation between stroke risk for blacks and Hispanics relative to whites is similar by sex. The impact of age on relative stroke mortality would argue against simple age adjustment for describing ethnic differences in stroke mortality. Finally, proportionally, more strokes occur at older ages in non-Hispanic whites than in either US blacks or Hispanic whites.

Age Factors↗
PubMed1999

Cancer among Hispanic children in California, 1988-1994: comparison with non-Hispanic white children.

BACKGROUND: There has been a perception that California Hispanic children have an unusually high cancer incidence rate, but to the authors' knowledge the only information regarding cancer rates in this population has been the tabular data published in reports issued by the California Department of Health Services. The California Cancer Registry has collected data regarding all cancers diagnosed in California since 1988. METHODS: Data regarding all invasive cancers diagnosed in California Hispanic children age <15 years during the 7-year period 1988-1994 were analyzed. Cancers were grouped according to the International Classification for Childhood Cancers. Age-adjusted and age specific incidence rates were compared with the corresponding incidence rates among non-Hispanic white children. RESULTS: Based on available demographic information, the overall incidence rate of cancer was approximately 7% lower among California children classified as Hispanic than among non-Hispanic white children. Hispanic children had higher incidence rates of lymphoid leukemia and gonadal germ cell tumors and a lower incidence rate of astrocytomas and carcinomas than non-Hispanic white children. CONCLUSIONS: These data do not confirm the perception that California Hispanic children have an unusually high cancer incidence rate but there were notable differences between Hispanic and non-Hispanic white children with regard to the incidence rates of certain cancers. The perception may be due in part to the fact that childhood malignancies represented 3.1% of all cancers diagnosed among Hispanics but only 0.5% of all cancers diagnosed among non-Hispanic whites. This is explained by the lower incidence rate of cancer among California Hispanic adults than among non-Hispanic white adults and the difference in the age distribution of the two populations.

Adolescent↗
PubMed2002

Differences between Hispanics and non-Hispanic Whites in use of hospital procedures for cerebrovascular disease.

OBJECTIVE: This study examined disparities in the use of in-hospital diagnostic and therapeutic procedures for Hispanics with cerebrovascular disease compared to their non-Hispanic White counterparts. DESIGN: This is a cross-sectional study using 1996 hospital administrative data. METHODS: Hispanics and non-Hispanic Whites with diagnosis codes indicating occlusion or stenosis of precerebral arteries or transient cerebral ischemia were included, with a total of 18,674 New York patients (5.1% Hispanic) and 22,624 California patients (11.1% Hispanic). Adjusted odds ratios compared Hispanics with non-Hispanic Whites for six diagnostic and therapeutic procedures for cerebrovascular disease, controlling for patient and hospital characteristics. RESULTS: Hispanics had higher rates of non-invasive diagnostic procedures (head CT scan, head/neck diagnostic ultrasound, echocardiogram, and head MRI). The odds of invasive diagnostic testing (cerebral arteriogram) and therapeutic procedures (carotid endarterectomy) were lower for Hispanics. Most findings remained unchanged in logistic regression models with patient and hospital characteristics. Adding a measure of the concentration of Hispanic patients by hospital eliminated or reduced observed differences between Hispanics and Whites. CONCLUSIONS: Controlling for each hospital's experience with Hispanic patients eliminated or reduced the magnitude of the disparities in procedure use, suggesting that the concentration of Hispanic patients in a hospital is associated with different patterns of procedure use.

Adult↗
PubMed2005

Colorectal carcinoma screening among Hispanics and non-Hispanic whites in a rural setting.

BACKGROUND: Colorectal carcinoma ranks as the second most common cancer and the second leading cause of cancer death in the United States. Hispanics are less likely than their non-Hispanic white counterparts to have ever received a fecal occult blood test (FOBT) or sigmoidoscopy/colonoscopy. Little is known about the barriers to screening in the Hispanic population. METHODS: The authors used baseline data from a community randomized trial of cancer prevention to compare screening prevalence and the associations between reported barriers and screening participation between Hispanics (n = 137) and non-Hispanic whites (n = 491) age > or = 50 years. RESULTS: Hispanics were less likely than non-Hispanic whites to have ever received an FOBT (P = 0.003) or sigmoidoscopy/colonoscopy (P = 0.001). No significant difference across ethnic groups was observed in the prevalence of recent screening using FOBT (29.8% for Hispanics vs. 34.5% for non-Hispanic whites; P = 0.41), but recent use of sigmoidoscopy/colonoscopy was lower for Hispanics (24.1% for Hispanics vs. 33.7% for non-Hispanic whites; P 0.06). Lacking health care coverage or having few years of education were directly associated with failure to ever receive an FOBT or sigmoidoscopy/colonoscopy. CONCLUSIONS: Interventions to improve adherence to colorectal carcinoma screening recommendations among Hispanics should target initial screening examinations, particularly among those lacking health care coverage or having low levels of education.

Aged↗
PubMed2005

Genetic, anthropometric, and lifestyle factors associated with IGF-1 and IGFBP-3 levels in Hispanic and non-Hispanic white women.

Circulating concentrations of IGF-I and IGFBP-3 are associated with risk of pre-menopausal breast cancer. Racial differences in levels of these factors have been reported, and determinants of IGF-I and IGFBP-3 levels within racial and ethnic groups are unclear. In this study we examine genetic, anthropometric, diet, and lifestyle factors that may predict serum levels of IGF-I and IGFBP-3 among Hispanic and non-Hispanic white women. A sample of healthy controls participating in the SHINE (Southwest Hormone, Insulin, Nutrition, and Exercise Study) case-control breast cancer in Arizona, Colorado, New Mexico, and Utah were included in these analyses. Subjects included 210 Hispanic and 284 non-Hispanic white women. Hispanic women had significantly lower levels of IGFBP-3 (mean=3764.3 mcg/ml) after adjusting for age, body size, physical activity, menopausal status, and dietary factors than non-Hispanic white women (mean = 4058.0 mcg/ml; p<0.01). The CC genotype of the -202 A>C polymorphism of the IGFBP3 gene was associated with lower IGFBP-3 levels in both ethnic groups. The frequency of the IGFBP3 C allele differed between Hispanic (0.65) and non-Hispanic white women (0.53), but serum levels of IGFBP-3 were lower for Hispanic women than non-Hispanic after accounting for IGFBP3 genotype. Body size indicators, vigorous physical activity, and dietary factors appeared to influence serum levels of IGF-1 and the ratio of IGF-1 to IGFBP-3 in pre-menopausal women more than in post-menopausal women. On the other hand, using aspirin/NSAIDs appeared to increase IGFBP-3 levels significantly among pre-menopausal Hispanic women. Results from this study suggest that differences in IGFBP-3 levels exist in Hispanic and non-Hispanic white women. These differences could be due to the combined effects of genetic and behavioral factors which could account for ethnic differences in the risk of breast cancer and other chronic diseases.

Adult↗
PubMed1993

Calcium intakes of Mexican Americans, Cubans, Puerto Ricans, non-Hispanic whites, and non-Hispanic blacks in the United States.

OBJECTIVE: To compare dietary calcium intakes from food in Mexican Americans, Cubans, Puerto Ricans, non-Hispanic whites, and non-Hispanic blacks aged 11 through 74 years. DESIGN: Population survey data from the Hispanic Health and Nutrition Examination Survey and the second National Health and Nutrition Examination Survey were used to calculate calcium intake from a single 24-hour recall. These data were compared by age and sex between the five population groups. Food sources of calcium in the three Hispanic groups were also examined using 24-hour recall data. SUBJECTS: The sample consisted of 11,773 non-Hispanic whites, 1,728 non-Hispanic blacks, 4,739 Mexican Americans, 1,076 Cubans, and 1,835 Puerto Ricans. MAIN OUTCOME MEASURES: Mean calcium intake, percentage intake of Recommended Dietary Allowance, and, for Hispanics, food sources of calcium. STATISTICAL ANALYSES: Means were compared within age and sex groups between the five population groups using a t test. RESULTS: Calcium intakes from food in the three Hispanic groups were similar to intakes of non-Hispanic whites and higher than intakes of non-Hispanic blacks. Although dairy foods were the main sources of calcium for Hispanics, corn tortillas were important calcium sources among Mexican Americans. Women consumed less calcium than the Recommended Dietary Allowance in all age and racial or ethnic groups. APPLICATIONS: When assessing calcium intakes of the three Hispanic groups, ethnic differences in food sources of calcium need to be considered. Efforts to increase calcium intake in Hispanics also need to account for ethnic differences.

Adolescent↗
PubMed2006

Disparities in contraceptive knowledge, attitude and use between Hispanic and non-Hispanic whites.

BACKGROUND: Higher rates of unwanted pregnancies and lower rates of contraceptive use have been reported among Hispanic women than among non-Hispanic whites. Despite these differences, it is unclear how these groups differ with respect to various psychosocial factors that are associated with contraceptive decision making, including contraceptive knowledge, attitudes, self-efficacy and social support. METHODS: A total of 443 sexually active, nonpregnant, low-income women (137 non-Hispanic whites, 74 US-born Hispanics and 231 non-US-born Hispanics) were surveyed at two publicly funded clinics. RESULTS: The greatest number of barriers to the effective use of contraception was seen among non-US-born Hispanic women. Fewer differences emerged between US-born Hispanics and whites, although differences continued to exist between the two groups in certain key areas. As compared to non-Hispanic whites, US-born Hispanic women had lower levels of social support for and self-efficacy in contraceptive use, desired larger families, had more religious objections to using birth control and were more those likely to believe that birth control use is the responsibility of women. As compared to whites, both US and non-US-born Hispanic women had significantly lower rates of ever-use of contraceptives that are highly effective in preventing pregnancy or in preventing disease transmission, and higher rates of unintended pregnancies. All associations were independent of known confounders. CONCLUSION: Despite improvements in contraceptive knowledge and attitude, birth control and disease-preventive practices did not improve significantly among Hispanics who were born in the United States. Hispanic women are at higher risk for unintended pregnancy than are non-Hispanic whites, irrespective of their US nativity.

Adult↗
PubMed1998

Differences in breast cancer stage at diagnosis between non-Hispanic white and Hispanic populations, San Diego County 1988-1993.

The incidence of breast cancer in the U.S. is lower among Hispanic women than non-Hispanic white women. However, population-based studies show that Hispanic women are more likely to be diagnosed at a later stage than non-Hispanic whites. We aimed to determine whether: 1) a lower proportion of breast cancer was diagnosed at early vs. late stages in Hispanic compared to non-Hispanic white women from 1988-93 in San Diego County, and 2) lower income is related to later stage at diagnosis for both groups. All incident cases of breast cancer in San Diego County from the California Cancer Registry (10,161 cases) were stratified by 'early' (in situ or localized) or 'late' (regional or distant) stage, and by race/ethnicity. Annual average age-adjusted incidence rates/100,000 (AAIR) were calculated. Incidence rate ratios (IRR) (AAIR for early stages divided by AAIR for late stages) were used as a surrogate of early detection. AAIRs for early and late stage disease were significantly higher for non-Hispanic whites (89.3, 42.3) than Hispanic women (46.7, 27.2). The IRR was significantly higher for non-Hispanic whites than Hispanics, (2.11 vs 1.72, p = 0.01). This difference was greatest among women under 50 years old (IRR difference 0.63), and not apparent for women 65 or older (IRR difference 0.06). There was also an association between increasing census tract per capita income and higher rates of early stage disease among non-Hispanic whites but not Hispanics. Results suggest that Hispanic women and lower income women should be targeted for early detection.

Adolescent↗
PubMed2002

Low vitamin B-12 intake and status are more prevalent in Hispanic older adults of Caribbean origin than in neighborhood-matched non-Hispanic whites.

Vitamin B-12 deficiency is a recognized problem among older adults, although vitamin B-12 status among differing ethnic groups remains unclear. We examined vitamin B-12 intake and status in a representative sample of elderly Hispanics of Caribbean origin (Puerto Rican and Dominican) and non-Hispanic whites. Dietary intake and plasma values were available for 347 Puerto Ricans, 102 Dominicans and 154 non-Hispanic whites (60-93 y). Relative to non-Hispanic whites, Hispanics had significantly lower vitamin B-12 intake and plasma concentrations; 17% of Hispanics and 10% of non-Hispanic whites had concentrations < 185 pmol/L (P < 0.05). Among Hispanics, log transformed vitamin B-12 intake was significantly associated with plasma concentration (beta = 60 pmol/L per log unit vitamin B-12 intake, P < 0.002 for supplement users and beta = 74 pmol/L per log unit vitamin B-12 intake, P < 0.01 for nonsupplement users). Intake and plasma concentrations were significantly associated among non-Hispanic whites only when supplement users were included (beta = 95 pmol/L per log unit vitamin B-12 intake, P < 0.0001). Hispanic supplement users (18%) had higher plasma concentrations than did nonsupplement users (364 +/- 17 and 297 +/- 8 pmol/L, respectively, P < 0.001). For Hispanics, consumption of breakfast cereal > 4 times/wk compared to no cereal was protective against lower plasma concentrations (8 vs. 24% < 185 pmol/L, P < 0.01). Approximately 40% of both groups with plasma vitamin B-12 < 185 pmol/L had homocysteine > 14 micromol/L, relative to < 17% of those with B-12 > 185 pmol/L. The high prevalence of low vitamin B-12 status in elderly Hispanics appears largely attributed to inadequate intake. As in other populations, sources of unbound vitamin B-12 such as supplements and fortified cereal appear to be protective. Dietary intervention programs targeted to the Hispanic population should promote these vitamin B-12 sources.

Aged↗
PubMed1998

Higher instrumental activities of daily living disability in Hispanics compared with non-Hispanic whites in rural Colorado. The San Luis Valley Health and Aging Study.

This study examined Hispanic versus non-Hispanic white patterns of needing assistance with instrumental activities of daily living (IADL). The authors interviewed 798 Hispanic and 614 non-Hispanic white residents of rural Colorado, who were aged 60 years and older between 1993 and 1995. Seventy-five participants were nursing home residents at the time of the interview. Community-dwelling Hispanics were 1.6 times as likely as non-Hispanic whites to need assistance with at least one IADL task (95% confidence interval 1.25-2.13). A larger proportion of disabled non-Hispanic whites were in nursing homes but, after including nursing home residents, Hispanics remained significantly more likely to need assistance on at least one IADL task (odds ratio = 1.49, 95% confidence interval 1.16-1.93). Hispanics were also more likely to have difficulty on observed performance tasks. The Hispanic excess was not removed by adjusting for chronic disease, reported difficulty walking, or income. English language proficiency adjustment lowered the Hispanic excess, but adjusting for years of education or Mini-Mental State Examination scores more completely removed the ethnic differences. Higher education was protective for both Hispanic and non-Hispanic white elderly. Efforts to further investigate what facets or correlates of education are operating may offer useful insights into limiting IADL difficulties in future cohorts.

Activities of Daily Living↗
PubMed2006

A comparison of perinatal HIV prevention opportunities for Hispanic and non-Hispanic women in California.

Using a semi-structured survey and convenience sample of pregnant/recently delivered Hispanic (n = 453) and non-Hispanic (n = 904) women in four California counties, this study compared rates of timely prenatal care (PNC) initiation, HIV test counseling, test offering, and test acceptance in PNC between Hispanic and non-Hispanic women. Hispanic women were less likely to report timely PNC initiation (69.3% vs. 80.4%, p < .0001), receiving test offer (69.5% vs. 76.7%, p = .002), and ever having been tested (77.3% vs. 87.9%, p < .0001) than non-Hispanic women. Hispanic women were more likely to report not knowing where to go (p = .04) and having no insurance (p < .001), transportation (p = .001), and child care (p = .007) as reasons for late PNC start. Both Hispanic and non-Hispanic women most commonly accepted a test offer for their health/health of their baby; Hispanic women were more likely to accept based on doctor/nurse recommendation (80.1% vs. 62.7%, p < .001). A quarter of Hispanic and non-Hispanic women reported they didn't feel they had a choice or that test was done automatically. Efforts to improve perinatal HIV prevention opportunities for all women in California are required. Furthermore, Hispanic women may have disparities in receipt of prenatal care and HIV test offer that need additional attention.

Adolescent↗
PubMed1989

Prevalence and risk factors of diabetic retinopathy in non-Hispanic whites and Hispanics with NIDDM. San Luis Valley Diabetes Study.

Diabetic retinopathy (DR) is the leading cause of blindness in adults in the United States. Because photocoagulation can reduce the incidence of blindness from severe DR by approximately 50%, it is important to identify people at increased risk for DR so that appropriate treatment can be accomplished. Use of populations at increased risk for diabetes may identify groups at increased risk for complications. A recent report from the San Antonio Heart Study showed that Mexican Americans were at greater risk for servere DR than non-Hispanic Whites. To compare the prevalence of DR between non-Hispanics and Hispanics in southern Colorado, 279 people with non-insulin-dependent diabetes mellitus (NIDDM) were identified, and retinal photographs identified the presence and severity of retinopathy. The worse eye was used to classify the severity of DR for each patient. Ninety percent of the subjects (166 Hispanics and 85 non-Hispanic Whites) were classified by retinopathy level. The duration-adjusted prevalence of any DR was 41.8% in Hispanics and 54.1% in non-Hispanic Whites. Severe DR (preproliferative and proliferative) occurred in 18.5% of the Hispanics and in 21.3% of the non-Hispanic Whites. The odds ratio for any DR, comparing Hispanics with non-Hispanic Whites adjusted for other risk factors, was 0.40 (95% confidence interval = 0.21, 0.76). Other risk factors for the presence of any retinopathy included use of exogenous insulin, increased duration of diabetes, younger age at diagnosis, increased glycosylated hemoglobin level, and increased systolic blood pressure. These data suggest that, compared with non-Hispanic Whites, Hispanics in Colorado may be at decreased risk for diabetic retinopathy.

Adult↗
PubMed1997

Insulin sensitivity and acute insulin response in African-Americans, non-Hispanic whites, and Hispanics with NIDDM: the Insulin Resistance Atherosclerosis Study.

NIDDM is usually characterized by beta-cell failure and decreased insulin sensitivity. It has been reported that a high proportion of African-American NIDDM subjects are insulin sensitive. To examine this issue, we determined insulin sensitivity (S(I)) in 479 NIDDM subjects by minimal model analyses of frequently sampled intravenous glucose tolerance (FSIGT) from the Insulin Resistance Atherosclerosis Study (IRAS), a large multicenter study of insulin sensitivity and cardiovascular risk in African-Americans, Hispanics, and non-Hispanic whites. The African-Americans and non-Hispanic whites were sampled in Los Angeles and Oakland, California. The non-Hispanic whites and Hispanics were sampled in San Antonio, Texas, and San Luis Valley, Colorado. We defined the proportion of insulin-sensitive (S(I)) subjects as > or =1.61 min-1 x microU-1 x ml-1, which is above the median for nondiabetic subjects of all ethnic groups in the IRAS. Using this definition, the proportion of insulin-sensitive diabetic subjects was very low in all ethnic groups (non-Hispanic whites [14.3%] vs. African-Americans [6.5%], P = 0.039 in Los Angeles and Oakland; non-Hispanic whites [6.8%] vs. Hispanics [4.9%], P = 0.737 in San Luis Valley and San Antonio). These results were also similar in newly diagnosed mildly hyperglycemic diabetic subjects. In addition, these results were not affected by the adjustment for differences in obesity, body fat distribution, and severity of hyperglycemia. Even in nonobese subjects (with BMI <30 kg/m2), the proportion of insulin-sensitive subjects (S(I) > or =1.61 min-1 x microU-1 x ml-1) was low (3.6-9.7%). The acute insulin response (AIR) was significantly higher in African-Americans than in non-Hispanic whites; there were no ethnic differences in AIR between Hispanics and non-Hispanic whites. There were no significant ethnic differences for non-insulin-mediated glucose disposal (S(G)). We conclude that the number of insulin-sensitive NIDDM subjects is low and similar among non-Hispanic whites, Hispanics, and African-Americans in the U.S.

Black or African American↗
PubMed1991

Microvascular complications of NIDDM in Hispanics and non-Hispanic whites. San Luis Valley Diabetes Study.

The goal of this article was to examine the differences in the rates of microvascular complications of non-insulin-dependent diabetes mellitus (NIDDM) in Hispanic and non-Hispanic white subjects. This was a geographically based case-control study where prevalent cases of NIDDM were identified in medical records. Subjects attended a 4-h clinic to confirm NIDDM diagnosis and assess complication end points. Retinopathy was defined by stereofundus photographs. Distal symmetric neuropathy was determined by standardized clinical examination. Nephropathy was indicated by serum creatinine level, urine protein-creatinine ratio, and urine albumin concentration. This study consisted of 279 NIDDM subjects confirmed by oral glucose tolerance test and World Health Organization criteria aged 20-74 yr (187 Hispanic and 92 non-Hispanic white subjects). Duration-adjusted prevalence of retinopathy was significantly higher in non-Hispanic white subjects (54.1 per 100, 95% confidence interval [CI] 44.4-63.7) than in Hispanics (41.8 per 100, 95% CI 34.8-48.8). This excess occurred only in non-Hispanic white subjects with background retinopathy but not in those with more severe retinopathy. Hispanics and non-Hispanic white subjects did not differ significantly for the prevalence of neuropathy (31.6 per 100 in non-Hispanic white subjects and 26.3 per 100 in Hispanics) or nephropathy by any measure. There were no significant differences in duration of diabetes or mean glycohemoglobin levels between ethnic groups. Microvascular complications of NIDDM are not in excess among Colorado Hispanics, and retinopathy may be somewhat more common in non-Hispanic white people.

Adult↗
PubMed2000

Physician expression of empathy and positiveness to Hispanic and non-Hispanic white patients during medical encounters.

BACKGROUND: This study examined the extent to which physicians expressed empathy and positiveness to Hispanic and non-Hispanic white patients during primary care visits. METHODS: Twenty-seven family practice and internal medicine resident physicians at the University of New Mexico Health Sciences Center were audiotaped in 1995 with 427 adult patients who were fluent in English or Spanish. The tapes were reviewed and organized to measure how frequently physicians expressed empathy and positiveness to patients. RESULTS: Physicians expressed empathy at equal rates to Hispanic and non-Hispanic white patients. When examining only Hispanic patients, physicians were significantly more likely to express empathy to patients who they knew better. Physicians expressed positiveness to non-Hispanic white patients more often than to Hispanic patients. When examining only Hispanic patients, physicians were more likely to express positiveness to patients who they knew better, who rated their health better, and who were more educated. When examining only non-Hispanic white patients, physicians were more likely to express positiveness to older and male patients than to younger and female patients. Also, female and younger physicians were significantly more likely to express positiveness to non-Hispanic white patients than male and older physicians were. CONCLUSIONS: Our findings illustrate that the resident physicians expressed empathy equally well to Hispanic and non-Hispanic white patients but that resident physicians need further training on how to express positiveness to patients from different ethnic backgrounds, especially Hispanic patients.

Adult↗
PubMedDate not supplied

Prevalence of self-reported illnesses in elderly Hispanic and non-Hispanic Whites in New Mexico.

OBJECTIVE: To report on the prevalences of self-reported illnesses from the New Mexico Elder Health Survey. DESIGN: Randomized community-based cross-sectional survey of elderly (> or = 65 years of age) Hispanics and non-Hispanic Whites. METHOD: Analysis of data from the 883 participants in the New Mexico Elder Health Survey. RESULTS: Complete data on 848 subjects were available for this analysis: Hispanic males, 212; Hispanic females, 189; non-Hispanic White males, 236; non-Hispanic White females, 211. The mean age was 74 years (age range 65-98). Hispanics had fewer years of school and lower income. Hispanics reported a significantly (P<.05) higher prevalence of type 2 diabetes; leg ulcers/pressure sores; and Parkinson's Disease. Non-Hispanic Whites reported a significantly (P<.05) higher prevalence of asthma; circulatory problems; stomach (not ulcers), intestinal or gallbladder disease; urinary tract disorders (other than kidney disease); and cancer. Prevalence odds ratios and confidence intervals were calculated. Hispanic males reported a higher prevalence of type 2 diabetes (OR 1.88, CI 1.10-3.26, P = .02), and lower prevalences of asthma (OR 0.43, CI 0.18-0.93, P = .04); urinary tract disorders, other than kidney disease (OR 0.59, CI 0.38-0.91, P = .01); and cancer (OR 0.31, CI 0.13-0.68, P = .005). Hispanic females reported a higher prevalence of diabetes (OR 3.01, CI 1.48-6.50, P = .003), and a lower prevalence of glaucoma (OR 0.48, CI 0.22-1.00, P = .05). These differences remained significant after adjustment for age, education, income, and language. CONCLUSION: There are significant differences in the prevalences of self-reported illnesses between Hispanic and non-Hispanic White elderly.

Aged↗