Differences in overall health of Latino-American subgroups revealed in new studies

The authors, led by College of Social Work Professor and Associate Dean Amy L. Ai, evaluated the physical and behavioral health, as well as the health care service usage, of all three major Latino subgroups in the United States. Collectively, these have been the fastest-growing ethnic minority in recent decades and are today the nation's largest ethnic minority, comprising more than 15 percent of the nation's population, according to the 2010 U.S. Census. The source of the studies' data was the National Latino and Asian-American Study, the first nationally representative study of Latino-Americans.

"Within Latino groups, cross-subcultural differences may contribute to the different patterns in both physical and mental health," Ai said. "There are interesting pattern differences between men and women. The patterns for Latino men are rather uniform, with Puerto Rican-Americans dominating most chronic conditions and behavorial health issues. The patterns for Latino women are more diverse in terms of overall health."

Factors such as education, occupation and geography can come into play to explain similarities or differences, although more analyses are needed, according to the researchers. For instance, Cuban-Americans, who are the most affluent among the three subgroups, and Puerto Rican-Americans, a less affluent subgroup, both tend to reside in cities and therefore face similar environmental stresses. They both have the highest rates of cardiovascular disease, despite primary differences in their racial heritages. Mexican-Americans, the least affluent subgroup, have significantly lower rates of cardiovascular disease but the highest rates for diabetes, especially in the female group.

"It is critical to further examine factors associated with the gender- and ethnicity-specific health issues and with their underuse of health services in order to inform culturally appropriate intervention for Latino-Americans," Ai said.

The first study, "Overall Health and Health Care Utilization Among Latino-American Women in the United States," was published in August in the Journal of Women's Health, the official journal of the American Medical Women's Association. It was conducted by Ai; Florida State College of Medicine Assistant Professor Kathy Lee; Hoa B. Appel of the Minority Achievers Program, Marysville, Wash.; and Bu Huang of Bastyr University, Kenmore, Wash.

The researchers found that patterns of overall health issues varied widely among the subgroups of Latino-American women:

• Puerto Rican-American women reported the highest rate of asthma, followed by a slightly lower rate for Cuban-American women and a considerably lower rate for Mexican-American women.
• Mexican-American women reported the highest rate of diabetes.
• Cuban-American women reported the highest rates of hypertension and heart disease.
• Two-thirds of Mexican-American women and Puerto Rican-American women and more than half of Cuban-American women reported being overweight or obese.
• Puerto Rican-American women have the highest rates of smoking and marijuana use.

Though all three women's subgroups reported using health care services at low rates, Puerto Rican-American women seek mental-health services most frequently and Cuban-American women see medical specialists most frequently.

The second study, "Overall Health and Health Care Utilization Among Latino-American Men in the United States," was published in September in the American Journal of Men's Health. It was conducted by Ai; Florida State College of Social Work Assistant Professor LaTonya Noel; Appel; Huang; and William E. Hefley of the University of Pittsburgh.

The researchers found that Puerto Rican-American men have the highest rates of eight physical ailments, including life-altering conditions such as cardiovascular disease. One in five among them have asthma, a rate nearly double or quadruple those of other male subgroups. In addition, Cuban-American men share similar rates of heart disease and cancer with Puerto Rican-American men. Puerto Rican-American men also reported the highest rates of major depression, smoking and all forms of substance abuse.

All three men's subgroups reported low usage of either general practitioners or specialists.