Abstract
Diabetes is a leading cause of morbidity and mortality in the United States, especially in minority communities. In mortality research, Hispanics are frequently studied as a homogeneous group. The present study was undertaken to compare diabetes deaths among persons of Hispanic origin by disaggregating groups in order to determine whether the components in the Hispanic label have differential mortality. Data utilized were from the US National Longitudinal Mortality Study. Cox proportional hazards regression models were fitted to the data. Findings showed that individuals in the broader Hispanic label were 28% more likely to die from diabetes mellitus than non-Hispanic whites (ARR = 1.28, CI = 1.05, 1.55). When groups were broken down, it was observed that Mexicans were 50% more likely to die of diabetes than their non-Hispanic white counterparts. No other Hispanic origin group was significantly associated with diabetes mortality risk. Education and family income were strong predictors of mortality, regardless of Hispanic origin grouping. It was concluded from the analysis that future behavioral and social science research would be more informative if the broader Hispanic label was broken down into subcategories. Failure to do so might lead to drawing false inferences as a finding may well hold for one group within the Hispanic label, but not for others.
Highlights
Diabetes is a heterogeneous group of metabolic disorders marked by hyperglycemia due to insulin resistance or diminished capacity by the pancreas to produce insulin [1,2,3]
Using α = 0.01 at 7 degrees of freedom, the calculated chi-squared (232.11) was significantly different from the critical value (18.475). These findings suggest that socioeconomic position explains part of the racial/ethnic differences observed in mortality from diabetes
Data analysis provided evidence that when Hispanics are lumped together under a broad umbrella, they are much more likely to die of diabetes than whites
Summary
Diabetes is a heterogeneous group of metabolic disorders marked by hyperglycemia (high serum glucose) due to insulin resistance or diminished capacity by the pancreas to produce insulin [1,2,3]. Recent data show that in 2007, among all age groups in the United States, 23.6 million persons (7.8% of the population) had diabetes [5] Of this number, 17.9 million comprised individuals diagnosed with the disease; the undiagnosed consisted of 5.7 million [5]. Diabetes prevalence rates among persons older than 20 years show that in 2005, while 6.6% of non-Hispanic whites had diabetes, visible minority group members had much higher rates. They were 7.6% for Asian Americans, 10.4% for Hispanics, and 11.8% for non-Hispanic African Americans.
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