Preventing Chronic Disease | Acculturation and the Prevalence of Diabetes in US Latino Adults, National Health and Nutrition Examination Survey 2007–2010 - CDC
Acculturation and the Prevalence of Diabetes in US Latino Adults, National Health and Nutrition Examination Survey 2007–2010
Matthew J. O’Brien, MD, MSc; Victor A. Alos, DMD, MPH; Adam Davey, PhD; Angeli Bueno, BS; Robert C. Whitaker, MD, MPH
Suggested citation for this article: O’Brien MJ, Alos VA, Davey A, Bueno A, Whitaker RC. Acculturation and the Prevalence of Diabetes in US Latino Adults, National Health and Nutrition Examination Survey 2007–2010. Prev Chronic Dis 2014;11:140142. DOI:http://dx.doi.org/10.5888/pcd11.140142
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PEER REVIEWED
Abstract
Introduction
US Latinos are growing at the fastest rate of any racial/ethnic group in the United States and have the highest lifetime risk of diabetes. Acculturation may increase the risk of diabetes among all Latinos, but this hypothesis has not been studied in a nationally representative sample. The objective of this study was to test the hypothesis that acculturation was associated with an increased risk of diabetes in such a sample.
US Latinos are growing at the fastest rate of any racial/ethnic group in the United States and have the highest lifetime risk of diabetes. Acculturation may increase the risk of diabetes among all Latinos, but this hypothesis has not been studied in a nationally representative sample. The objective of this study was to test the hypothesis that acculturation was associated with an increased risk of diabetes in such a sample.
Methods
We conducted a cross-sectional analysis including 3,165 Latino participants in the 2007–2010 National Health and Nutrition Examination Survey. Participants with doctor-diagnosed diabetes and participants without diagnosed diabetes who had glycated hemoglobin (HbA1C) values of 6.5% or higher were classified as having diabetes. An acculturation score, ranging from 0 (lowest) to 3 (highest), was calculated by giving 1 point for each of 3 characteristics: being born in the United States, speaking predominantly English, and living in the United States for 20 years or more. Logistic regression was used to determine the association between acculturation and diabetes.
We conducted a cross-sectional analysis including 3,165 Latino participants in the 2007–2010 National Health and Nutrition Examination Survey. Participants with doctor-diagnosed diabetes and participants without diagnosed diabetes who had glycated hemoglobin (HbA1C) values of 6.5% or higher were classified as having diabetes. An acculturation score, ranging from 0 (lowest) to 3 (highest), was calculated by giving 1 point for each of 3 characteristics: being born in the United States, speaking predominantly English, and living in the United States for 20 years or more. Logistic regression was used to determine the association between acculturation and diabetes.
Results
The prevalence of diabetes among Latinos in our sample was 12.4%. After adjusting for sociodemographic factors, the likelihood of diabetes (95% confidence interval [CI]) increased with level of acculturation— 1.71 (95% CI, 1.31–2.23), 1.63 (95% CI, 1.11–2.39), and 2.05 (95% CI, 1.27–3.29) for scores of 1, 2, and 3, respectively. This association persisted after further adjustment for body mass index (BMI), total dietary calories, and physical inactivity.
The prevalence of diabetes among Latinos in our sample was 12.4%. After adjusting for sociodemographic factors, the likelihood of diabetes (95% confidence interval [CI]) increased with level of acculturation— 1.71 (95% CI, 1.31–2.23), 1.63 (95% CI, 1.11–2.39), and 2.05 (95% CI, 1.27–3.29) for scores of 1, 2, and 3, respectively. This association persisted after further adjustment for body mass index (BMI), total dietary calories, and physical inactivity.
Conclusion
Acculturation was associated with a higher risk of diabetes among US Latinos, and this risk was only partly explained by BMI and weight-related behaviors. Future research should examine the bio-behavioral mechanisms that underlie the relationship between acculturation and diabetes in Latinos.
Acculturation was associated with a higher risk of diabetes among US Latinos, and this risk was only partly explained by BMI and weight-related behaviors. Future research should examine the bio-behavioral mechanisms that underlie the relationship between acculturation and diabetes in Latinos.
Acknowledgments
The authors thank Ronald T. Ackerman, MD, MPH, of Northwestern Feinberg School of Medicine, and Cynthia L. Ogden, PhD, of the National Center for Health Statistics, for their review of previous versions of this manuscript. We also thank Brandon Becker, MSc, of Temple University Department of Public Health, for his contribution to the statistical analyses presented here, and Dulce Barrios, MS, of Temple University Center for Obesity Research and Education, for her assistance in preparing the manuscript for submission. This study was funded by K23-DK095981 (O’Brien). The views expressed in this article do not necessarily reflect the official policies of the National Institutes of Health. No financial disclosures were reported by the authors of this article.
Author Information
Corresponding Author: Matthew O’Brien, MD, MSc, Assistant Professor of Medicine, Northwestern Feinberg School of Medicine, Center for Community Health, 750 N. Lake Shore Drive, 6th Floor, Chicago, IL 60611. Telephone: 312-503-5046. E-mail: matthew.obrien1@northwestern.edu. At the time of this study, Dr. O’Brien was affiliated with the Temple University Center for Obesity Research and Education and with Puentes de Salud Health Center, Philadelphia, Pennsylvania.
Author Affiliations: Victor A. Alos, Temple University and Puentes de Salud Health Center, Philadelphia, Pennsylvania; Adam Davey, Angeli Bueno, Robert C. Whitaker, Temple University, Philadelphia, Pennsylvania.
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