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Immigration Status and Disparities in the Treatment of Cardiovascular Disease Risk Factors in the Hispanic Community Health Study/Study of Latinos (Visit 2, 2014-2017).

TitleImmigration Status and Disparities in the Treatment of Cardiovascular Disease Risk Factors in the Hispanic Community Health Study/Study of Latinos (Visit 2, 2014-2017).
Publication TypePublication
Year2020
AuthorsGuadamuz JS, Durazo-Arvizu RA, Daviglus ML, Perreira KM, Calip GS, Nutescu EA, Gallo LC, Castañeda SF, Gonzalez F, Qato DM
JournalAm J Public Health
Volume110
Issue9
Pagination1397-1404
Date Published2020 09
ISSN1541-0048
KeywordsAdult, Aged, Antihypertensive Agents, Cardiovascular Diseases, Cross-Sectional Studies, Diabetes Mellitus, Emigrants and Immigrants, Female, Health Services Accessibility, Hispanic Americans, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Hypercholesterolemia, Hypertension, Hypoglycemic Agents, Male, Middle Aged, Risk Factors, Undocumented Immigrants
Abstract

To estimate treatment rates of high cholesterol, hypertension, and diabetes among Hispanic/Latino immigrants by immigration status (i.e., naturalized citizens, documented immigrants, or undocumented immigrants). We performed a cross-sectional analyses of the Hispanic Community Health Study/Study of Latinos (visit 2, 2014-2017). We restricted our analysis to Hispanic/Latino immigrants with high cholesterol (n = 3974), hypertension (n = 3353), or diabetes (n = 2406); treatment was defined as use of statins, antihypertensives, and antidiabetics, respectively. When compared with naturalized citizens, undocumented and documented immigrants were less likely to receive treatment for high cholesterol (38.4% vs 14.1%; prevalence ratio [PR] = 0.37 [95% confidence interval [CI] = 0.27, 0.51] and 25.7%; PR = 0.67 [95% CI = 0.58, 0.76]), hypertension (77.7% vs 57.7%; PR = 0.74 [95% CI = 0.62, 0.89] and 68.1%; PR = 0.88 [95% CI = 0.82, 0.94]), and diabetes (60.3% vs. 50.4%; PR = 0.84 [95% CI = 0.68, 1.02] and 55.8%; PR = 0.93 [95% CI = 0.83, 1.03]); the latter did not reach statistical significance. Undocumented and documented immigrants had less access to health care, including insurance coverage or a usual health care provider, than naturalized citizens. Therefore, adjusting for health care access largely explained treatment disparities across immigration status. Preventing cardiovascular disease among Hispanic/Latino immigrants should focus on undertreatment of high cholesterol, hypertension, and diabetes by increasing health care access, especially among undocumented immigrants.

DOI10.2105/AJPH.2020.305745
Alternate JournalAm J Public Health
PubMed ID32673107
PubMed Central IDPMC7427208
Grant ListP30 AG066615 / AG / NIA NIH HHS / United States
N01HC65236 / HL / NHLBI NIH HHS / United States
N01HC65235 / HL / NHLBI NIH HHS / United States
N01HC65234 / HL / NHLBI NIH HHS / United States
T32 HL125294 / HL / NHLBI NIH HHS / United States
N01HC65233 / HL / NHLBI NIH HHS / United States
N01HC65237 / HL / NHLBI NIH HHS / United States
P2C HD050924 / HD / NICHD NIH HHS / United States
MS#: 
0863
Manuscript Lead/Corresponding Author Affiliation: 
Field Center: Chicago (University of Illinois at Chicago)
ECI: 
Manuscript Affiliation: 
Field Center: Chicago (University of Illinois at Chicago)
Manuscript Status: 
Published