Journal of Immigrant and Minority Health

, Volume 18, Issue 5, pp 1247–1252 | Cite as

Migration, Health Care Behaviors, and Primary Care for Rural Latinos with Diabetes

  • Gerardo Moreno
  • Leo S. Morales
  • Felicia Batts
  • Christine Noguera
  • Marilu Isiordia
  • Carol M. Mangione
Brief Communication


Many US Latinos migrate or travel between the US and Mexico on a regular basis, defined as circular migration. Latinos with diabetes (n = 250) were surveyed about circular migration and their ability to use medications and perform recommended diabetes self-care activities. A review of medical charts was performed. Twenty-eight percent (n = 70) of patients traveled to Mexico during the last 12 months. Older Latinos were more likely to report traveling to Mexico and back into the US. Among those that traveled, 29 % reported use of less medication than they wanted to or were prescribed because of travel and 20 % ran out of medications. The rate of reported problem areas while traveling were 39 % (27/70) for following a diabetic diet, 31 % (21/70) for taking medication, and 37 % (26/70) for glucose self-monitoring. The results suggest that the structure of primary care and care coordination are important for this population to fully engage in diabetes self-care.


Latinos Diabetes Migration Bi-national healthcare 


Financial Support

Dr. Moreno received support from an NIA (K23 AG042961-01) Paul B. Beeson Career Development Award, the American Federation for Aging Research. Drs. Moreno and Mangione received support from the UCLA Resource Centers for Minority Aging Research Center for Health Improvement of Minority Elderly (RCMAR/CHIME) under NIH/NIA Grant P30-AG021684, and the content does not necessarily represent the official views of the NIA or the NIH. Dr. Mangione received support from the UCLA Clinical and Translational Science Institute through the NIH/National Center for Advancing Translational Science Grant Number UL1TR000124 and Barbara A. Levey & Gerald S. Levey Endowed Chair.

Compliance with Ethical Standards

Conflict of interest



  1. 1.
    Villarejo D, et al. Suffering in silence: a report on the health of California’s agricultural workers. San Francisco: California Institute of Rural Studies; 2000.Google Scholar
  2. 2.
    Ennis SR, Ríos-Vargas M, Albert NG. The Hispanic population: 2010. Census briefs 2010. Washington: US Department of Commerce; 2011.Google Scholar
  3. 3.
    Arcury TA, Quandt SA. Delivery of health services to migrant and seasonal farmworkers. Annu Rev Public Health. 2007;28:345–63.CrossRefPubMedGoogle Scholar
  4. 4.
    Passel JS, Cohn DV. Mexican immigrants: how many come? How many leave?. Washington: Pew Hispanic Center; 2009.Google Scholar
  5. 5.
    Torres JM, Wallace SP. Migration circumstances, psychological distress, and self-rated physical health for Latino immigrants in the United States. Am J Public Health. 2013;103(9):1619–27.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Diamant AL, et al. Diabetes: the growing epidemic. Los Angeles: UCLA Center for Health Policy Research; 2007.Google Scholar
  7. 7.
    Centers for Disease Control and Prevention (CDC). Prevalence of diabetes among Hispanics: selected areas, 1998–2002. MMWR. Atlanta: Centers for Disease Control and Prevention; 2004.Google Scholar
  8. 8.
    Mainous AG 3rd, et al. Quality of care for hispanic adults with diabetes. Fam Med. 2007;39(5):351–6.PubMedGoogle Scholar
  9. 9.
    Harris MI, et al. Racial and ethnic differences in glycemic control of adults with type 2 diabetes. Diabetes Care. 1999;22(3):403–8.CrossRefPubMedGoogle Scholar
  10. 10.
    McWilliams JM, et al. Differences in control of cardiovascular disease and diabetes by race, ethnicity, and education: US trends from 1999 to 2006 and effects of medicare coverage. Ann Int Med. 2009;150(8):505–15.CrossRefPubMedGoogle Scholar
  11. 11.
    Lasater LM, et al. Glycemic control in English- vs Spanish-speaking Hispanic patients with type 2 diabetes mellitus. Arch Int Med. 2001;161(1):77–82.CrossRefGoogle Scholar
  12. 12.
    Lavery LA, et al. Variation in the incidence and proportion of diabetes-related amputations in minorities. Diabetes Care. 1996;19(1):48–52.CrossRefPubMedGoogle Scholar
  13. 13.
    Otiniano ME, et al. Lower extremity amputations in diabetic Mexican American elders: incidence, prevalence and correlates. J Diabetes Complicat. 2003;17(2):59–65.CrossRefPubMedGoogle Scholar
  14. 14.
    American Diabetes Association. Standards of medical care in diabetes–2014. Diabetes Care. 2014;37(Suppl 1):S14–80.CrossRefGoogle Scholar
  15. 15.
    Wirth C, Strochlic R, Getz C. Hunger in the fields: food insecurity among farmworkers in Fresno County. Davis: California Institute for Rural Studies; 2007.Google Scholar
  16. 16.
    Ayala M, et al. In their own words: farmworker access to health care in four California regions. Davis: California Institute for Rural Studies; 2003.Google Scholar
  17. 17.
    Moreno G, Morales LS. Hablamos Juntos (together we speak): interpreters, provider communication, and satisfaction with care. J Gen Int Med. 2010;25(12):1282–8.CrossRefGoogle Scholar
  18. 18.
    Brown AF, et al. Health behaviors and quality of care among Latinos with diabetes in managed care. Am J Public Health. 2003;93(10):1694–8.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Ornelas IJ, Perreira KM. The role of migration in the development of depressive symptoms among Latino immigrant parents in the USA. Soc Sci Med. 2011;73(8):1169–77.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Piwowar A, Knapik-Kordecka M, Warwas M. Oxidative stress and endothelium dysfunction in diabetes mellitus type 2. Pol Merkur Lekarski. 2008;25(146):120–3.PubMedGoogle Scholar
  21. 21.
    Chang CM, et al. Acute and chronic fluctuations in blood glucose levels can increase oxidative stress in type 2 diabetes mellitus. Acta Diabetol. 2012;49(Suppl 1):S171–7.CrossRefPubMedGoogle Scholar
  22. 22.
    Quagliaro L, et al. Intermittent high glucose enhances apoptosis related to oxidative stress in human umbilical vein endothelial cells: the role of protein kinase C and NAD(P)H-oxidase activation. Diabetes. 2003;52(11):2795–804.CrossRefPubMedGoogle Scholar
  23. 23.
    Rizzo MR, et al. Relationships between daily acute glucose fluctuations and cognitive performance among aged type 2 diabetic patients. Diabetes Care. 2010;33(10):2169–74.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Nunez de Jaimes F, et al. Implementation of language assessments for staff interpreters in community health centers. J Health Care Poor Underserved. 2013;24(3):1002–9.CrossRefPubMedGoogle Scholar
  25. 25.
    The Translating Research Into Action for Diabetes. (TRIAD) study: a multicenter study of diabetes in managed care. Diabetes Care. 2002;25(2):386–9.CrossRefGoogle Scholar
  26. 26.
    Carroll D, et al. Findings from the national agricultural worker survey 2001–2002. Washington: US Department of Labor; 2005.Google Scholar
  27. 27.
    Andrade FC. Measuring the impact of diabetes on life expectancy and disability-free life expectancy among older adults in Mexico. J Gerontol B Psychol Sci Soc Sci. 2010;65B(3):381–9.CrossRefPubMedGoogle Scholar
  28. 28.
    Rubalcava LN, et al. The healthy migrant effect: new findings from the Mexican family life survey. Am J Public Health. 2008;98(1):78–84.CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Vargas Bustamante A, et al. Variations in healthcare access and utilization among Mexican immigrants: the role of documentation status. J Immigr Minor Health. 2012;14(1):146–55.CrossRefPubMedGoogle Scholar
  30. 30.
    Quandt SA, et al. Farmworker and farmer perceptions of farmworker agricultural chemical exposure in North Carolina. Hum Organ. 1998;57:359–68.CrossRefGoogle Scholar
  31. 31.
    Kirk JK, et al. Disparities in A1C levels between Hispanic and non-Hispanic white adults with diabetes: a meta-analysis. Diabetes Care. 2008;31(2):240–6.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Gerardo Moreno
    • 1
  • Leo S. Morales
    • 2
  • Felicia Batts
    • 3
  • Christine Noguera
    • 4
  • Marilu Isiordia
    • 5
  • Carol M. Mangione
    • 6
    • 7
  1. 1.Department of Family MedicineDavid Geffen School of Medicine at UCLALos AngelesUSA
  2. 2.School of MedicineUniversity of WashingtonSeattleUSA
  3. 3.Livingston Health Centers, Inc.LivingstonUSA
  4. 4.Community Health Centers, Inc.StocktonUSA
  5. 5.University of California DavisDavisUSA
  6. 6.Division of Health Services Research and General Internal MedicineDavid Geffen School of Medicine at UCLALos AngelesUSA
  7. 7.Department of Health Policy and ManagementUCLA Fielding School of Public HealthLos AngelesUSA

Personalised recommendations