Digestive Disease Disparities in the Prevalence and Screening of Hispanic Population in Omaha, Nebraska

Abstract

Purpose: The Hispanic population in the United States of America, according to the 2004 U.S. Census Bureau update, is now the largest minority group yet medical research in this population is limited. It is more so in the area of digestive diseases. Our aim with this study was to elucidate better the prevalence and screening on some common digestive diseases. Our data was obtained from a Creighton University primary care clinic that serves the Hispanic population of Omaha, NE. Methods: This is a retrospective study of 630 randomly selected clinic charts. Each chart was reviewed for medical, social history, clinical presentation, and health screening of eleven common digestive diseases in the United States. The one-sample z-test for proportions was used in all statistical analyses. Results: 630 patient charts were reviewed. 240 patients were male; 390 were female. 370 patients were 19 to 50 years old; 230 patients were aged 50 to 79. No statistical difference existed between the study population and the U.S. population with regards to the prevalence of colorectal cancer (CRC). However, of 230 persons eligible for CRC screening, 22.3% (P < 0.05) were offered screening which is below the 42.5% of eligible U.S. patients who underwent screening in year 2000. The prevalence in cholethiasis in the study population was 18% (P < 0.05) which is higher than the U.S. published prevalence. 157 (25%) patients have GERD in the study population which is higher than U.S. population prevalence. This is higher than recently published reports among the Hispanic population. 6 patients (1%, P < 0.05) had Hepatitis B, which is below the U.S. population prevalence. In addition, one patient had Hepatitis C (0.3%) but no significant statistical difference existed when compared to the U.S. population. No difference in IBD, IBS and PUD were noted. The Body Mass Index could be calculated for all but 32 patients. 170 were obese (BMI 30 to <35), and 210 were morbidly obese (BMI > 35). The prevalence of obesity and morbid obesity is 63% (P < 0.05), U.S. prevalence is 30%. Conclusion: Our findings reflect some similarities to already existing data, but also there were surprising differences. This population has a higher prevalence of Gastroesophageal reflux disease when compared to the U.S. population, which is in contrast to data found in the literature. In addition, Hepatitis B was found to have much lower prevalence than reported in the literature. These differences have no clear etiology. Also, there is a marked disparity in colorectal cancer screening when compared to the U.S. population. The reason for this disparity is also unclear and need further investigation. Lastly, the prevalence for obesity and morbid obesity in this population was found to be much higher.