Acculturation and diabetes among hispanics: Evidence from the 1999-2002 National Health and Nutrition Examination Survey
Acculturation and diabetes among hispanics: Evidence from the 1999-2002 National Health and Nutrition Examination Survey
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DOI：
10.1177/003335490612100112
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发表时间：
2006-01-01
影响因子：
3.3
通讯作者：
Diaz, VA
中科院分区：
文献类型：
--
作者：
Mainous, AG;Majeed, A;Diaz, VA
Objective.在美国，西班牙裔个体的糖尿病患病率高于非西班牙裔白色个体;然而，尚不清楚西班牙裔糖尿病的风险是否因文化适应水平而异。本研究的目的是探讨文化适应与西班牙裔美国人糖尿病患病率和控制的关系。我们对1999-2002年的全国健康和营养检查调查（NHANES）进行了分析，NHANES是美国非制度化人口的全国代表性样本。我们评估了西班牙裔成年人（≥ 18岁，未加权n=2,696）的数据，分析了诊断的糖尿病、血糖血压和血脂控制，以及根据文化适应（通过语言和出生在美国以外）测量的糖尿病并发症。文化适应度低的西班牙裔更有可能没有常规的医疗保健场所，没有医疗保险，教育水平低。在调整后的分析中，通过语言测量，文化适应度低的个体更容易患糖尿病（比值比[OR] 1.90，95%置信区间[Cl] 1.02，3.54）。在确诊糖尿病的个体中，文化适应和糖尿病控制之间没有显著的联系。而语言适应能力低的个体更易发生糖尿病并发周围神经病变（OR 4.01，95%CI 1.40，11.48）。即使在控制了包括健康保险和教育在内的各种人口特征之后，通过语言测量的文化适应与西班牙裔人的糖尿病和并发症有关。调查结果表明，即使在“单一”少数民族群体内，疾病流行率和并发症以及获得医疗保健的机会也存在差异。
Objective. Hispanic individuals in the United States have a greater prevalence of diabetes mellitus than non-Hispanic white individuals; however, it is unclear whether Hispanics' risk of diabetes differs based on their level of acculturation. The purpose of our research was to examine acculturation among Hispanic Americans with respect to prevalence and control of diabetes.Methods. We conducted an analysis of the National Health and Nutrition Examination Survey (NHANES), 1999-2002, a nationally representative sample of the noninstitutionalized U.S. population. We evaluated data on Hispanic adults (>= 18 years of age, unweighted n=2,696), analyzing diagnosed diabetes, glycemic blood pressure and lipid control, and diabetes complications according to acculturation as measured by language and birth outside the United States.Results. Hispanics with low acculturation were more likely to be without a routine place for health care, have no health insurance, and have low levels of education. In adjusted analyses, individuals with low acculturation, measured by language, were more likely to have diabetes (odds ratio [OR] 1.90, 95% confidence interval [Cl] 1.02, 3.54). Among individuals with diagnosed diabetes, no significant association was yielded between acculturation and diabetes control. However, individuals with low language acculturation were more likely to have the diabetes complication of peripheral neuropathy (OR 4.01, 95% Cl 1.40, 11.48).Conclusions. Acculturation as measured through language is associated with diabetes and complications among Hispanics even after controlling for a variety of demographic characteristics including health insurance and education. The findings suggest that even within a "single" minority ethnic group, there are differences in disease prevalence and complications and access to health care.