Gender-Ethnic Specific Patterns of Chronic Conditions and Health Care Utilization Among Latino Americans

Purpose: Latinos are the largest ethnic minority population in the United States(US).  It is estimated that by 2050, 24% of the US population will be Latino. There have been reports from large-sample studies on health disparities experienced by Latino Americans, especially from the National Latino and Asian American Study(NLAAS), the first nationally representative study of Latino Americans. Few studies, however, have examined the gender-ethic specific information on their overall physical and behavioral health patterns. The three major subgroups of Latino Americans(Cubans, Mexicans, and Puerto Ricans) vary considerably regarding ancestral origins, race/ethnicity, geographic locations, socioeconomic status, and cultural-political experiences in the US.  To fill the gap, this study aims to demonstrate ethnically differential patterns of itemized chronic conditions and service seeking of Latino American men and women. We hypothesized significant differences in these patterns across ethic subgroup Latinos within each gender.

Methods: The NLAAS consists of primary sampling units selected with probabilities proportional to size.  The total sample size of the NLAAS is 4,649, including 2,554 Latinos(ages>18) in the US.  The total Latino-American men’s sample size was 1,127(276 Cubans, 213 Puerto Ricans, 398 Mexicans, and 240 “Others”). The total Latino-American women’s sample was 1,427(301 Cubans, 470 Mexicans, 282 Puerto Ricans, and 374 Others). The list of conditions included 15 health conditions and Body Mass Index(BMI), consistent with World Health Organization(WHO) standards. Smoking, other drug use, self-reported mental health, and major depression were based on the Diagnostic and Statistical Manual of Mental Disorders(DSM-IV). Service seeking frequency included participants’ self-reported mental health service use and visits to physicians and mental health professionals. Descriptive analyses were performed for all variables of interest.  Their representative percentage in the population was computed and reported using weights to correct potential sampling bias. Chi-square tests were used to compare differences in categorical variables among subgroups. 

Results: Average age of men was 39.0(SD=41.3; range:18—95), and that of women was 41.19(SD=14.5; range:18—88). Regarding physical health of men, Puerto Ricans toped 8 of the diseases out of 15. Cubans shared similar rates of heart diseases and cancer with Puerto Ricans; and both were higher than those of Mexicans. As for Latino American women, Puerto-Ricans reported highest rates of 7 conditions, whereas Mexicans had the highest rates of back and neck pain, diabetes, and arthritis(similar to as that of Puerto Ricans).  Cubans had the highest rate of heart disease and hypertension. Among men, Cuban had the highest overweight rates(50.4%); and Mexicans had highest obese rates. Among women, Mexicans had the highest BMIs. Puerto-Rican American men reported the highest incidence of substance abuse, while their women counterparts reported the highest incidence of only current smokers and marijuana use.

Conclusions and Implications: Patterns in chronic conditions vary among subgroup Latino Americans. The different patterns between genders in Latino Americans suggest the influences of factors in living environment, socioeconomic status, and lifestyles on their physical and behavioral health, in addition to racial heritage. Health providers and policy makers need to take this into account in order to addressing their health care disparities.