Stereotypes of smokers held by Hispanic and white non-Hispanic smokers

A group of Hispanic and White non-Hispanic smokers were asked to report the stereotypes they hold of smokers in general. All respondents tended to think that smokers were Nervous, Friendly, and Sociable; although White non-Hispanics felt more certain than Hispanics that smokers were Friendly, Aggressive, Sociable, Attractive, and Feminine. Factor analyses of the responses showed three common (across ethnicity) factors: Sociability, Self-Presentation, and Nervousness. Only the Self-Presentation factor showed statistically significant differences between the two ethnic groups. The amount of cigarettes smoked had no effect on the stereotypes but the more highly acculturated Hispanics showed stereotypes that resembled those of the White non-Hispanics.     

Prevalence of white coat hypertension in underweight and overweight subjects

The aim of the present study was to determine if there is any association between white coat hypertension (WCH) and body mass index. The study was performed in two phases. In the first phase, we studied consecutive underweight patients, while in the second phase, age-matched consecutive normal weight, overweight, and obese cases were studied. Although we detected 61 cases in the underweight group with a mean age of 24.1 years, we could only detect 12 age-matched cases in the obesity group, and thus the obesity group was not used for comparison. When we looked at the prevalences of sustained normotension (NT), WCH, and HT in the groups, there were gradual and significant increases in the prevalences of WCH in addition to the gradual and significant decreases in the sustained NT from the underweight towards the normal weight and overweight groups. Eventually, only 31.5% of the overweight group had sustained NT, even though the mean age of the cases was very young. Due to the gradually increased prevalence of WCH from the underweight towards the normal weight and overweight groups, parallel to the already known increasing prevalences of HT, type 2 diabetes mellitus, hyperbetalipoproteinemia, dyslipidemia, and coronary heart disease and the very low prevalence of sustained NT among the overweight cases even in the early decades here, WCH should preferentially be accepted as an alarming sign of excess weight and many associated disorders in the future, rather than just being considered a predisposing factor of HT or atherosclerosis alone.     

Modifiable risks of incident functional dependence in Hispanic and non-Hispanic white elders: the San Luis Valley Health and Aging Study

PURPOSE: This study identified modifiable risks associated with incident functional dependence, compared their effects, and estimated the percent risk attributable to each factor, by ethnicity. DESIGN AND METHODS: The prospective study cohort comprised 751 rural Hispanic and non-Hispanic White elders from southern Colorado who reported no dependence in basic and instrumental activities of daily living (ADLs and IADLs) at baseline. Logistic regression modeled the effects of physical inactivity, nutritional risk, smoking, and falls on incident disability 22 months later, with and without adjustment for baseline ADL and IADL difficulty. Population attributable risk percentages assessed these modifiable risks by ethnicity. RESULTS: Each risk factor multiplied the likelihood of incident dependence by 1.4 or more, adjusted for covariates. Attributable risk percentages ranged from 8% to 32% depending on risk factor, ethnicity, and baseline ADL and IADL difficulty status. Attributable risk was generally greater among Hispanic elders, the result of higher prevalence of most of the risk factors. IMPLICATIONS: Interventions targeted at inadequate nutrition, inactivity, smoking, and preventable falls offer opportunities to reduce incident functional disability, especially among Hispanic elders.     

Difference in airflow obstruction between Hispanic and non-Hispanic White female smokers

Smoking-related respiratory diseases are a major cause of morbidity and mortality. However, the relationship between smoking and respiratory disease has not been well-studied among ethnic minorities in general and among women in particular. The objective of this cross-sectional study was to evaluate the risk of airflow obstruction and to assess lung function among Hispanic and non-Hispanic White (NHW) female smokers in a New Mexico cohort. Participants completed a questionnaire detailing smoking history and underwent spirometry testing. Outcomes studied included airflow obstruction, selected lung function parameters, and chronic mucus hyper-secretion. Chi square, logistic, and linear regression techniques were utilized. Of the 1,433 eligible women participants, 248 (17.3%) were Hispanic; and 319 had airflow obstruction (22.3%). Hispanic smokers were more likely to be current smokers, and report lower pack-years of smoking, compared to NHW smokers (p < 0.05 for all analyses). Further, Hispanic smokers were at a reduced risk of airflow obstruction compared to NHW smokers, with an O.R. of 0.51, 95% C.I. 0.34, 0.78 (p = 0.002) after adjustment for age, BMI, pack-years and duration of smoking, and current smoking status. Following adjustment for covariates, Hispanic smokers also had a higher mean absolute and percent predicted post-bronchodilator FEV(1)/FVC ratio, as well as higher mean percent predicted FEV(1) (p < 0.05 for all analyses). Hispanic female smokers in this New Mexico-based cohort had lower risk of airflow obstruction and better lung function than NHW female smokers. Further, smoking history did not completely explain these associations.     

Comparison of frequency of coronary artery calcium in healthy Hispanic versus non-Hispanic white men by electron beam computed tomography

We recently demonstrated in subjects referred for the evaluation of cardiovascular disease that coronary atherosclerosis and coronary artery calcium (CAC) were reduced in Hispanics compared with non-Hispanic whites (NHWs). We now evaluate whether this ethnic disparity is present in a unselected healthy cohort of men. Despite the apparently worse risk factor profile, mean and median levels of CAC trended lower in Hispanic men, and the distribution of CAC scores differed from that of NHW (p <0.05), with fewer Hispanic subjects having CAC scores that are generally equated with extensive atherosclerotic burden (>400). These results demonstrate that healthy Hispanic men have reduced CAC compared with age-matched NHW men and this occurs despite evidence for a worse cardiovascular risk profile.     

广西白裤瑶族人群高血压患病率调查

目的 了解广西白裤瑶族人群高血压的患病情况及其影响因素. 方法 采用分层随机整群抽样方法对1170名≥15岁白裤瑶族人群的血压、身高、体重、体质指数、腰围、血脂及载脂蛋白进行测定,并将其结果与1173名当地的汉族人群作比较. 结果 广西白裤瑶族人群标准化高血压患病率明显低于当地的汉族人群(11.53%比16.79%,P＜0.01);白裤瑶族人群平均收缩压、舒张压和脉压水平也明显低于汉族人群[分别为(115.7±16.3)mm Hg比(120.0±16.3)mm Hg(1 mm Hg=0.133 kPa),P＜0.01;(74.1±9.4)mm Hg比(75.9±10.4)mm Hg,P＜0.01和(41.6±12.0)mmHg比(44.2±11.2)mm Hg,P＜0.01].白裤瑶族人群高血压患病与性别、年龄、体力活动、体质指数、腰围、总能量、总脂肪和钠盐摄人量呈正相关,与教育水平呈负相关,而汉族人群高血压患病与性别、年龄、体力活动、喝酒、体质指数、腰围、总能量、总脂肪和钠盐摄入量呈正相关,与教育水平呈负相关.白裤瑶族和汉族人群高血压的知晓率为11.81%比21.76%(P＜0.05),治疗率为5.51%比12.95%(P＜0.05),控制率为2.36%比8.29%(P＜0.05). 结论 广西白裤瑶族人群高血压患病率显著低于汉族人群,可能与其特殊的饮食习惯、低盐摄入、生活方式以及遗传因素等有关.     

The Medical Dialogue: Disentangling Differences between Hispanic and non-Hispanic Whites

BACKGROUND Patients’ race and ethnicity play an important role in quality of and access to healthcare in the United States. OBJECTIVES To examine the influence of ethnicity – Hispanic whites vs. non-Hispanic whites – on respondents’ self-reported interactions with healthcare providers. To understand, among Hispanic whites, how demographic and socioeconomic characteristics impact their interactions with healthcare providers. DESIGN Cross-sectional analysis of the 2002 Medical Expenditure Panel Survey, a nationally representative survey on medical care conducted by the Agency for Healthcare Research and Quality. PARTICIPANTS Civilian, noninstitutionalized U.S. population aged ≥18 years who reported visiting a healthcare provider within the past 12 months prior to data collection. RESULTS After controlling for several demographic and socioeconomic covariates, compared to non-Hispanic whites (reference group), Hispanic whites who had visited a doctor’s office or clinic in the past 12 months were more likely to report that their healthcare provider “always” listened to them [odds ratio (OR) = 1.36, 95% confidence interval (CI) 1.21–1.53], explained things so that they understood (OR = 1.25, 95% CI 1.10–1.41), showed respect for what they had to say (OR = 1.52, 95% CI 1.35–1.72), and spent enough time with them (OR = 1.22, 95% CI 1.08–1.38). However, Hispanics were less likely to indicate that their health care provider “always” gave them control over treatment options (OR = 0.83, 95% CI 0.72–0.95) as compared to non-Hispanics. Within the Hispanic population exclusively, age, place of residence, census region, health insurance status, and presence of a usual source of care influenced self-reported interactions with healthcare providers. CONCLUSION Hispanic white respondents were more likely to report that some aspects of provider–patient interactions were indicative of high quality, whereas those related to decision-making autonomy were not. These somewhat paradoxical results should be examined more fully in future research.     

Motor vehicle crash fatalities: A comparison of Hispanic and non-Hispanic motorists in Colorado

STUDY OBJECTIVES: We compare the population-based death rates from traffic crashes in the Hispanic and non-Hispanic white populations in a single state, and compare fatally injured Hispanic and non-Hispanic drivers with respect to safety belt use, alcohol involvement, speeding, vehicle age, valid licensure, and urban-rural location. METHODS: Hispanic and non-Hispanic white motorists killed in traffic crashes in 1991-1995 were studied (n=2,272). Data from death certificates (age, sex, education, race, and ethnicity) and the Fatality Analysis Reporting System (FARS; driver, vehicle, and crash information) were merged. Average annual age-adjusted fatality rates were calculated; to compare Hispanic and non-Hispanic white motorists, rate ratios (RR) and 95% confidence intervals (CIs) were calculated. Odds ratios (ORs), adjusted for age, sex, and rural locale, were calculated to measure the association between Hispanic ethnicity and driver and crash characteristics. RESULTS: Eighty-five percent of FARS records were matched to death certificates. Compared with non-Hispanic white motorists, Hispanics had higher crash-related fatality rates overall (RR 1.75, 95% CI 1.60 to 1.92) and for drivers only (RR 1.62, 95% CI 1.41 to 1.85). After adjustment for age, sex, and rural locale, Hispanic drivers had higher rates of safety belt nonuse (OR 1.81, 95% CI 1.20 to 2.72), legal alcohol intoxication (OR 2.73, 95% CI 1.97 to 3.79), speeding (OR 1.36, 95% CI 0.99 to 1.88), and invalid licensure (OR 2.58, 95% CI 1.78 to 3.75). The average vehicle age for Hispanic drivers (10.1 years, 95% CI 9.3 to 11.0) was greater than for non-Hispanic white motorists (8.8 years, 95% CI 8.4 to 9.2). CONCLUSION: Compared with non-Hispanic whites, Hispanic drivers have higher rates of safety belt nonuse, speeding, invalid licensure and alcohol involvement, with correspondingly higher rates of death in traffic crashes. As traffic safety emerges as a public health priority in Hispanic communities, these data may help in developing appropriate and culturally sensitive interventions.     

Factors Associated with Hispanic/non-Hispanic White Colorectal Cancer Screening Disparities

Background  In the United States, Hispanics are less likely to undergo colorectal cancer (CRC) screening than non-Hispanic whites (whites). Objective  To examine factors associated with disparities in CRC screening between whites and Hispanic national origin subgroups. Design  Cross-sectional analysis of 1999–2005 Medical Expenditure Panel Survey data. Participants  Respondents aged >50 years self-identifying as non-Hispanic white (18,733) or Hispanic (3686)—the latter of Mexican (2779), Cuban (336), Puerto Rican (376), or Dominican (195) origin. Measurements  Dependent variable: self-report of up to date CRC screening, defined as fecal occult blood testing within 2 years and/or lower endoscopy at any time. Independent variables: ethnicity/race, country of origin, interview language, socio-demographics, and access to care. Results  Unadjusted CRC screening rates were highest in whites [mean (standard error), 55.9 (0.6) %], and lowest in Dominicans [28.5 (4.2) %]. After demographic adjustment, CRC screening was significantly lower for Mexicans [adjusted odds ratio (95% confidence interval), 0.46 (0.40, 0.53), p < 0.001)], Puerto Ricans [0.65 (0.47, 0.91), p = 0.01], and Dominicans [0.30 (0.19, 0.45), p < 0.001] versus whites. With further adjustment for language, socioeconomic factors, and access, Hispanic/white disparities were not significant, while among Hispanics, Cubans were more likely to be screened [1.57 (1.15, 2.14), p = 0.01]. Conclusions  Factors associated with CRC screening disparities between Hispanics and non-Hispanic whites appear similar among Hispanic sub-groups. However, the relative contribution of these factors to disparities varies by Hispanic national origin group, suggesting a need for differing approaches to increasing screening for each group.     

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.     

Relationship of abdominal obesity measured by DXA and waist circumference with insulin sensitivity in Hispanic and non-Hispanic white individuals: the San Luis Valley Diabetes Study

BACKGROUND: To determine if dual-energy X-ray absorptiometry (DXA) measures of trunk fat, a user-defined abdominal region of interest (ROI) and waist circumference (WC) differ in their association with insulin sensitivity among Hispanics and non-Hispanic whites (NHW) or explain any ethnic differences in insulin sensitivity. METHODS: A cross-sectional study of data collected (1997-98) as part of the longitudinal San Luis Valley Diabetes Study was utilized. There were 664 non-diabetic participants including 349 women (220 NHW, 139 Hispanic) and 305 men (197 NHW, 108 Hispanic), average age 63 years. Measurements included body mass index, WC and DXA measures of total and abdominal fat. Fasting glucose and insulin were used to estimate insulin sensitivity using the QUICKI index. A 2-h oral glucose tolerance test was used to classify participants with normal glucose tolerance (NGT) or impaired glucose tolerance (IGT). RESULTS: Among women with NGT, Hispanics had lower insulin sensitivity, with DXA trunk fat explaining the most variance in QUICKI and 54% of the ethnic difference in QUICKI after adjusting for total body fat and lean mass. Among men with NGT, there were no differences between Hispanics and NHW in insulin sensitivity or any differences in the association of the abdominal fat measures with insulin sensitivity. Among men and women with IGT, the fat distribution variables explained little variance in QUICKI. CONCLUSIONS: DXA measures of trunk fat provide additional information over WC and the DXA abdominal ROI measure about ethnic differences in insulin sensitivity between older Hispanic and NHW women with NGT.     

Self-reported health status of vietnamese and non-Hispanic white older adults in california

Vietnamese Americans are a rapidly growing minority group in the United States, yet little is known about their health status. Chronic medical conditions and self-rated health of older Vietnamese Americans were compared with those of non-Hispanic white adults living in California using the 2001 and 2003 California Health Interview Surveys (CHISs). The CHIS employed a random-digit-dial telephone survey, and its sample is representative of California's noninstitutionalized population. The sample included 359 Vietnamese and 25,177 non-Hispanic white adults aged 55 and older. Vietnamese and non-Hispanic white adults were compared in terms of limitations in activities of daily living, chronic medical conditions (diabetes mellitus, hypertension, heart disease, asthma), mental health care, and self-reported health, adjusting for age, sex, and education. Vietnamese were more likely than white participants to report needing help for mental health problems (adjusted odds ratio (aOR)=2.1, 95% confidence interval (CI)=1.4-3.1) but less likely to have had their medical providers discuss their mental health problems with them (aOR=0.3, 95% CI=0.1-0.5). In addition, Vietnamese participants reported significantly worse health than white adults on five of eight domains of the Medical Outcomes Survery 12-item Short Form survey (P<.006). Clinicians caring for older Vietnamese individuals should be aware of the high risk for mental health needs in this population and should initiate discussions about mental health with their patients. Further research is needed to better understand why older Vietnamese Americans are at higher risk for worse self-reported health than older white adults.     

Associations between surrogate measures of insulin resistance and waist circumference,cardiovascular risk and the metabolic syndrome across Hispanic and non‐Hispanic white populations

Aims We evaluated the relations between surrogate indices of insulin resistance and waist circumference, metabolic syndrome and coronary heart disease risk across Hispanic and non‐Hispanic white populations. Methods The study was a cross‐sectional analysis of participants without diabetes in the San Antonio Heart Study, Mexico City Diabetes Study and Spanish Insulin Resistance Study. We evaluated commonly used indices of insulin resistance, including homeostasis model assessment, McAuley’s index, Gutt’s insulin sensitivity index, Avignon’s insulin sensitivity index and the Stumvoll index with and without demographics, the modified Matsuda index and the product of the triglycerides and glucose index. The metabolic syndrome was defined by American Heart Association/National Heart, Lung, and Blood Institute criteria and coronary heart disease risk by Framingham risk scores. Results The Stumvoll index with demographics and the Avignon’s insulin sensitivity index had the strongest correlations with waist circumference across populations. The triglycerides and glucose and McAuley’s indices had the most robust correlations with Framingham risk score. The triglycerides and glucose index had the greatest ability to detect individuals with the metabolic syndrome and ≥ 10% coronary heart disease risk. Some indices display significant variability in the strength of the relationship with adiposity and coronary heart disease risk across populations. Conclusions There are significant differences between insulin resistance indices regarding the ability to detect the metabolic syndrome and coronary heart disease risk across populations. Studies may need to consider the index of insulin resistance that best suits the objectives.     

Aging versus disease: the opinions of older black, Hispanic, and non-Hispanic white Americans about the causes and treatment of common medical conditions.

BACKGROUND: Little is known about how older people interpret disease and how those interpretations might relate to use of medical services. OBJECTIVE: To assess opinions of older subjects about the cause and treatment of common diseases and how they are related to health behaviors. DESIGN: In-home interview of a population-based sample (n = 601) of noninstitutionalized black, Hispanic, and non-Hispanic white American men and women aged 75 and older in Galveston County, Texas. RESULTS: Substantial proportions of the subjects considered heart disease, arthritis, or difficulty sleeping to be a normal part of aging. In multivariate analyses including age, gender, education, marital status, living arrangement, global self-rating of health, and comorbidity, older black subjects were less likely to view heart disease (OR = 0.41; 95% CI, 0.26-0.64), arthritis (OR = 0.48; 95% CI, 0.31-0.73), or sleep problems (OR = 0.50; 95% CI, 0.32-0.77) as a normal part of aging than were non-Hispanic whites. Blacks were more than three times as likely to attribute heart disease to overwork or stress than were non-Hispanic whites. In multivariate analyses, subjects who considered all three of the medical conditions to be a normal part of aging ("fatalistic") were less likely to have received preventive medical services in the previous year (OR = 0.13; 95% CI, 0.02-0.96), and subjects who felt that nothing could be done to treat any of the conditions ("nihilistic") were less likely to have a regular physician (OR = 0.24; 95% CI, 0.08-0.74). CONCLUSIONS: Substantial numbers of older subjects are fatalistic about the cause of disease and/or nihilistic about its treatment. These attitudes are associated with decreased utilization of health services. Attempts to improve the health of underserved groups should employ interventions that are sensitive to the health beliefs of the targeted group.     

Prevalence of hypertension in white, black and Asian diabetics in a district hospital diabetic clinic

In a District General Hospital Diabetic Clinic 40.0% of a random sample of diabetics under the age of 65 years of age were hypertensive. Black patients (48.9%) had greater (p less than 0.05) prevalence of hypertension than Whites (37.5%) and Asians (35.4%). Hypertension was more prevalent in females (49.1%) than males (33.0%) (p less than 0.001) in each ethnic group except Asians, and patients not receiving insulin had greater prevalence (45.6%) than those on insulin (30.7%) (p less than 0.001), except black diabetics where the reverse was found. There was a positive relationship between age and systolic (p less than 0.00001) and diastolic blood pressure (p less than 0.00001) and a negative association between duration of diabetes and diastolic blood pressure (p less than 0.004) on multiple regression analysis but no relationship was noted between blood pressure and either weight or blood glucose. Forty-six percent of all hypertensives were receiving conventional anti-hypertensive drug therapy; 38.7% were normotensive with similar results in each ethnic group and between the sexes. Isolated systolic hypertension was the commonest form of hypertension (48.3%) with isolated diastolic hypertension (4.9%) the rarest. These findings were observed regardless of the ethnic group or gender. Although in the majority of cases hypertension was mild these data confirm the importance of routine blood pressure measurement in diabetic patients.     

Prevalence and risk factors for isolated untreated systolic hypertension in rural Mongolian and Han populations

OBJECTIVE: The objective of this study was to assess the prevalence and correlative risk factors of isolated untreated systolic hypertension and other hypertension subtypes among Mongolians and Han rural adults of China. METHODS AND RESULTS: The study was conducted in 2004-2006 and used a multistage cluster sampling method to select a representative sample. A total of 41,356 people who did not take antihypertensive drugs during the last 2 weeks and aged 35 years or older were examined. A survey on blood pressure and associated risk factors was carried out. Overall, 10.2% of rural adults had isolated systolic hypertension, 6.3% had isolated diastolic hypertension and 15.3% had systolo-diastolic hypertension (Han: 9.8%, 6.2%, 14.7%; Mongolians: 11.6%, 6.4%, 17.6%, respectively). The prevalence of ISH and SDH increased with age. Mongolians had a higher prevalence of ISH and SDH than Han people. Age, gender, BMI, and salt intake were risk factors of ISH and SDH both for Han people and Mongolians. CONCLUSIONS: Hypertension was very common in rural people of China, and it was associated with many risk factors. These results place great emphasis on the urgent need for a public health programme to improve the detection, prevention and treatment of hypertension in the rural population of China.