Disparities in Chronic Disease Prevalence Among Non-Hispanic Whites: Heterogeneity Among Foreign-Born Arab and European Americans.

Abstract

We estimated and compared the sex- and age-adjusted prevalence of chronic diseases (diagnosis only and comorbidity) among US- and foreign-born whites from Europe and the Arab Nations and examined associations between region of birth and chronic disease. We evaluated 213,644 adults using restricted data from the National Health Interview Survey (2000-2011) by (1) chronic disease diagnosis only (heart disease, asthma, cancer, diabetes, ulcer, or obesity) and (2) comorbidity (none, diagnosis only, comorbid). We used logistic regression to examine associations between region of birth and chronic disease while controlling for confounders. Foreign-born whites from the Arab Nations had a higher prevalence of being diagnosed with ulcer (4%) compared to US- and European-born whites (2%). Foreign-born whites from the Arab Nations had a lower prevalence of comorbid cancer (1%) and ulcer (3%) yet had higher estimates of comorbid heart disease (18%), asthma (5%), and obesity (13%) when compared to European-born whites (all ps<0.05). Arab Americans had the highest prevalence of comorbid diabetes (8%) compared to both European- (5%) and US-born whites (6%). In multivariate logistic regression models, Arab Americans had a lower odds of reporting cancer, heart disease, and asthma before and after controlling for covariates. Our study builds on existing literature for Arab Americans as the first study evaluating chronic disease prevalence among foreign-born whites from countries in the Arab League of Nations geographically located in the Middle East. Methodologically robust studies are needed to better understand the influence of acculturation, country of origin, and other characteristics influencing health among foreign-born whites.