Diabetes prevalence among diverse Hispanic populations: considering nativity, ethnic discrimination, acculturation, and BMI

Abstract

Purpose

To compare prevalence of self-reported diabetes between U.S. state-born, Puerto Rico-born, Mexico-born, Cuba-born, and South/Central America-born Hispanic groups, and examine whether risk for diabetes differs by country of origin and experiences with discrimination when accounting for BMI.

Methods

Data from 6223 Hispanic respondents from the nationally representative NESARC-III study was used. Sociodemographic characteristics were compared across nativity groups, and adjusted odds of self-reported diabetes diagnosis (past year) tested. Differences by perceived discrimination (using endorsement of individual items assessing specific experiences) and by nativity were examined when accounting for sociodemographic characteristics, acculturation, and BMI.

Results

Prevalence of self-reported diabetes diagnosis was significantly higher among the Puerto Rico-born Hispanics, and remained significantly elevated when adjusting for perceived discrimination, acculturation, and health risk behaviors. When adjusting further for BMI, there were no significant differences in the odds of diabetes by nativity. Prevalence of lifetime perceived discrimination was significantly lower among Cuba-born Hispanics. Mean BMI was significantly lower in South/Central America-born Hispanic individuals relative to U.S. state-, Mexico-, and Puerto Rico-born Hispanic groups. Higher BMI was associated with significantly greater risk of diabetes diagnosis across groups.

Conclusion

Marked heterogeneity exists in prevalence and in factors associated with diabetes risk and weight status across Hispanic groups in the U.S. Experiences with discrimination may play an important role in accounting for these differences. This should be considered when planning future research to inform the most optimal patient-centered prevention efforts.

Level of evidence

Level III, Evidence obtained from well-designed cohort analytic study.

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Data availability statement

The data that support the findings of this study are available from the National Institute on Alcohol Abuse and Alcoholism (NIAAA). Restrictions apply to the availability of these data, which were used under license for this study. Data are available at https://www.niaaa.nih.gov/research/nesarc-iii/nesarc-iii-data-access with the permission of NIAAA. The NESARC-III Codebook with all individual items asked of respondents is also available: https://www.niaaa.nih.gov/research/nesarc-iii/general-codebook.

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Acknowledgements

RK contributed to the conceptualization, discussion, writing, and editing of the manuscript. CG contributed to the conceptualization, discussion, writing and editing of the manuscript. EV contributed to the conceptualization, discussion, data analyses, and editing of the manuscript. TU contributed to conceptualization, discussion, data analyses, writing, and editing of the manuscript.

Funding

The article was prepared using a limited access dataset obtained from the National Institute on Alcohol Abuse and Alcoholism. CG was supported, in part, by Grants from the National Institutes of Health (R01 DK114075, R01 DK112771, R01 DK49587). This article does not reflect the opinions or views of the National Institute of Diabetes and Digestive and Kidney Diseases, the National Institute on Alcohol Abuse and Alcoholism, or the United States Government.

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Correspondence to Rebecca C. Kamody.

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Conflict of interest

Although CG reports no relevant direct or indirect conflicts of interest with respect to this study, he reports having received in the past 12 months honoraria for CME-related lectures and royalties from academic books published by Guilford Press and Taylor & Francis Publishers. RK, EV, and TU have no conflicts of interest to disclose.

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The NESARC-III was approved by the NIH Institutional Review Board (IRB). This study was deemed exempt from IRB review by the University of Albany for use of publicly available de-identified data.

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Kamody, R.C., Grilo, C.M., Vásquez, E. et al. Diabetes prevalence among diverse Hispanic populations: considering nativity, ethnic discrimination, acculturation, and BMI. Eat Weight Disord (2021). https://doi.org/10.1007/s40519-021-01138-z

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Keywords

  • Hispanics
  • Diabetes mellitus
  • Health status disparities
  • Discrimination
  • Acculturation