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BACKGROUND: Hispanics are the fastest growing ethnic minority in Texas (40.8%), almost reaching equal proportions as non-Hispanic whites (42.8%) in 2013. Hispanic Paradox has been examined extensively for mortality and life expectancy but little is known in relation to prevalence of chronic medical conditions. The aim of this study is to explore the burden of chronic diseases, risk factors and healthcare access among Hispanics in Texas and further compare Mexican-origin vs. non-Mexican-origin Hispanics.
METHODS: Texas 2013 Behavioral Risk Factor Surveillance System data were analyzed. Descriptive analysis including chi-square statistics was run by ethnicity, income and education estimating prevalence of chronic diseases such as heart disease, stroke, asthma, Chronic Obstructive Pulmonary Disease (COPD), cancer, arthritis and diabetes; risk factors such as obesity, smoking, binge drinking, high blood pressure, high cholesterol and activity limitation. Healthcare access variables like lack of insurance and cost as barrier to seek medical care were analyzed. Binary logistic regression models were run to estimate Odds Ratios (OR) for having the above listed outcomes for Mexican-origin Hispanics and non-Mexican-origin Hispanics compared to non-Hispanics. The analysis was stratified by age groups 18-44, 45-64 and 65+ years old. The differences between Mexican-origin and non-Mexican-origin Hispanics were estimated. Weighted data analysis was conducted using SAS 9.3 controlling for education and income.
RESULTS: Descriptive analysis showed the prevalence of most chronic diseases were significantly associated with Hispanic ethnicity, lower education and income. Logistic regression models showed that Mexican-origin Hispanics had significantly lower odds of having heart disease (OR: 0.46), stroke (OR: 0.40) and asthma (OR: 0.34) among 45-64 years old than non-Hispanics. Odds of having COPD, arthritis and activity limitations among Mexican-origin Hispanics increased with increasing age but they were still significantly lower than non-Hispanics. However the odds of having diabetes among 45-64 years old (OR: 1.6) and obesity among 18-44 years old (OR: 1.4) and binge drinking among 65 years and older (OR: 2.7) were significantly higher among Mexican-origin Hispanics. Compared to Mexican-origin Hispanics, non-Mexican-origin Hispanics were more likely to have cancer, heart disease, and activity limitations but less likely to have COPD or diabetes.
CONCLUSIONS: Aging Mexican-origin Hispanics looked more similar to non-Hispanics than younger Mexican-origin Hispanics but they still had lower burden of diseases than non-Hispanics. Mexican-origin and non-Mexican-origin Hispanics showed differences for having some chronic diseases and they varied by age groups. Our study provides some support to Hispanic Paradox but further investigation is warranted to confirm it.