Skip to main content

Advertisement

SpringerLink
Log in

Immigration Disparities in Cardiovascular Disease Risk Factor Awareness

  • Original Paper
  • Published:
Journal of Immigrant and Minority Health Aims and scope Submit manuscript

Abstract

The association between immigration status and cardiovascular disease (CVD) risk factor awareness is unknown. Using physical examination-based data and participants’ self-report of prior diagnosis, we assessed immigration-based disparities in awareness of diabetes, hypertension, hypercholesterolemia, and overweight among 12,124 participants in the 2003–2008 National Health and Nutrition Examination Survey. Unawareness of CVD risk factors is high among all groups, but tends to be higher among foreign-born English and non-English speaking participants than among US-born participants. After adjusting for demographic factors and access to health care, foreign-born participants appear more likely to be unaware of their hypertension and overweight than US-born participants. Immigrants are more likely than those born in the US to be unaware of their CVD risk factors, and therefore may be less motivated to seek treatment and modify their behavior to prevent negative CVD outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Kannel WB, McGee DL. Diabetes and cardiovascular disease. JAMA. 1979;241(19):2035–8.

    Article  PubMed  CAS  Google Scholar 

  2. Wilson PWF, D’Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. Prediction of coronary heart disease using risk factor categories. Circulation. 1998;97(18):1837–47.

    Article  PubMed  CAS  Google Scholar 

  3. Flegal KM, Graubard BI, Williamson DF, Gail MH. Cause-specific excess deaths associated with underweight, overweight, and obesity. JAMA. 2007;298(17):2028–37.

    Article  PubMed  CAS  Google Scholar 

  4. American Heart Association. Heart disease and stroke statistics: 2010 update. Dallas, TX: American Heart Association; 2010.

    Google Scholar 

  5. Franz MJ, Bantle JP, Beebe CA, et al. Evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes and related complications. Diabetes Care. 2002;25(1):148–98.

    Article  PubMed  Google Scholar 

  6. Chobanian AV, Bakris GL, Black HR, et al. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure—the JNC 7 report. JAMA. 2003;289(19):2560–72.

    Article  PubMed  CAS  Google Scholar 

  7. Grundy SM, Cleeman JI, Merz CNB, et al. Implications of recent clinical trials for the national cholesterol education program adult treatment panel III guidelines. Circulation. 2004;110(2):227–39.

    Article  PubMed  Google Scholar 

  8. Post RE, Mainous AG III, Gregorie SH, Knoll ME, Diaz VA, Saxena SK. The influence of physician acknowledgment of patients’ weight status on patient perceptions of overweight and obesity in the United States. Arch Intern Med. 2011;171(4):316–21.

    Article  PubMed  Google Scholar 

  9. Farquhar J, Wood P, Breitrose H, et al. Community education for cardiovascular health. Lancet. 1977;309(8023):1192–5.

    Article  Google Scholar 

  10. Cleeman JI, Lenfant C. The national cholesterol education program. JAMA. 1998;280(24):2099–104.

    Article  PubMed  CAS  Google Scholar 

  11. US Department of Health and Human Services, National Heart Lung and Blood Institute, National Institutes of Health. Obesity education initiative. 2011. http://www.nhlbi.nih.gov/about/oei/index.htm. Accessed 14 Mar 2011.

  12. US Department of Health and Human Services. National diabetes education program. 2011. http://ndep.nih.gov/index.aspx. Accessed 14 Mar 2011.

  13. US Department of Health and Human Services, National Heart Lung and Blood Institute, National Institute of Health. National cholesterol education program. 2011. http://www.nhlbi.nih.gov/about/ncep/. Accessed 14 Mar 2011.

  14. Burt VL, Whelton P, Roccella EJ, et al. Prevalence of hypertension in the US adult population—results from the 3rd National Health and Nutrition Examination Survey, 1988–1991. Hypertension. 1995;25(3):305–13.

    Article  PubMed  CAS  Google Scholar 

  15. Hajjar I, Kotchen TA. Trends in prevalence, awareness, treatment, and control of hypertension in the United States, 1988–2000. JAMA. 2003;290(2):199–206.

    Article  PubMed  Google Scholar 

  16. Muntner P, DeSalvo KB, Wildman RP, Raggi P, He J, Whelton PK. Trends in the prevalence, awareness, treatment, and control of cardiovascular disease risk factors among noninstitutionalized patients with a history of myocardial infarction and stroke. Am J Epidemiol. 2006;163(10):913–20.

    Article  PubMed  Google Scholar 

  17. Hyre AD, Muntner P, Menke A, Raggi P, He J. Trends in ATP-III-defined high blood cholesterol prevalence, awareness, treatment and control among US adults. Ann Epidemiol. 2007;17(7):548–55.

    Article  PubMed  Google Scholar 

  18. Al Ghatrif M, Kuo Y-F, Al Snih S, Raji MA, Ray LA, Markides KS. Trends in hypertension prevalence, awareness, treatment and control in older Mexican Americans, 1993–2005. Ann Epidemiol. 2011;21(1):15–25.

    Article  PubMed  Google Scholar 

  19. Dark CK, Ezenkwele UA. Access to care as a predictor of patients’ knowledge of cardiovascular diseases. J Natl Med Assoc. 2007;99(12):1338–46.

    PubMed  Google Scholar 

  20. Hertz RP, Unger AN, Ferrario CM. Diabetes, hypertension, and dyslipidemia in Mexican Americans and non-hispanic whites. Am J Prev Med. 2006;30(2):103–10.

    Article  PubMed  Google Scholar 

  21. Cutler JA, Sorlie PD, Wolz M, Thom T, Fields LE, Roccella EJ. Trends in hypertension prevalence, awareness, treatment, and control rates in United States adults between 1988–1994 and 1999–2004. Hypertension. 2008;52(5):818–27.

    Article  PubMed  CAS  Google Scholar 

  22. Bersamin A, Stafford RS, Winkleby MA. Predictors of hypertension awareness, treatment, and control among Mexican American women and men. J Gen Intern Med. 2009;24:521–7.

    Article  PubMed  Google Scholar 

  23. Okosun IS, Dever GEA. Abdominal obesity and ethnic differences in diabetes awareness, treatment, and glycemic control. Obes Res. 2002;10(12):1241–50.

    Article  PubMed  Google Scholar 

  24. Lasser KE, Himmelstein DU, Woolhandler S. Access to care, health status, and health disparities in the United States and Canada: results of a cross-national population-based survey. Am J Public Health. 2006;96(7):1300–7.

    Article  PubMed  Google Scholar 

  25. Rodriguez MA, Bustamante AV, Ang A. Perceived quality of care, receipt of preventive care, and usual source of health care among undocumented and other Latinos. J Gen Intern Med. 2009;24:508–13.

    Article  PubMed  Google Scholar 

  26. Schenker Y, Karter AJ, Schillinger D, et al. The impact of limited English proficiency and physician language concordance on reports of clinical interactions among patients with diabetes: the DISTANCE study. Patient Educ Couns. 2010;81(2):222–8.

    Article  PubMed  Google Scholar 

  27. Traylor AH, Schmittdiel JA, Uratsu CS, Mangione CM, Subramanian U. Adherence to cardiovascular disease medications: does patient-provider race/ethnicity and language concordance matter? J Gen Intern Med. 2010;25(11):1172–7.

    Article  PubMed  Google Scholar 

  28. US Department of Health and Human Services Centers for Disease Control and Prevention and National Center for Health Statistics. National Health and Nutrition Examination Survey, 2007–2008: overview. Hyattsville, MD: US Department of Health and Human Services; 2007.

    Google Scholar 

  29. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2004;27(suppl 1):s5–10.

    Google Scholar 

  30. National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Third Report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III): final report. Circulation. 2002;106(25):3143–421.

    Google Scholar 

  31. Flegal KM, Carroll MD, Ogden CL, Curtin LR. Prevalence and trends in obesity among US adults, 1999–2008. JAMA. 2010;303(3):235–41.

    Article  PubMed  CAS  Google Scholar 

  32. DuBard CA, Gizlice Z. Language spoken and differences in health status, access to care, and receipt of preventive services among US hispanics. Am J Public Health. 2008;98(11):2021–8.

    Article  PubMed  Google Scholar 

  33. Wallace S, Gutierrez V, Castaneda X. Access to preventive services for adults of Mexican origin. J Immigr Minor Health. 2008;10(4):363–71.

    Article  PubMed  Google Scholar 

  34. American Diabetes Association. Standards of medical care in diabetes–2011. Diabetes Care. 2011;34(Suppl 1):S11–61.

    Article  Google Scholar 

  35. Stamler J, Vaccaro O, Neaton JD, Wentworth D. Diabetes, other risk factors, and 12-year cardiovascular mortality for men screened in the multiple risk factor intervention trial. Diabetes Care. 1993;16(2):434–44.

    Article  PubMed  CAS  Google Scholar 

  36. Neaton JD, Wentworth D. Serum cholesterol, blood pressure, cigarette smoking and death from coronary heart disease-overall findings and differences by age for 316, 099 White men. Arch Intern Med. 1992;152(1):56–64.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

This study was funded by grant number 1-P50 HL105188-01 of the National Heart, Lung and Blood Institute (NHLBI).

Author information

Authors and Affiliations

  1. Department of Community Health Sciences, UCLA School of Public Health, P.O. Box 951772, Los Angeles, CA, 90095-1772, USA

    Brent A. Langellier, Deborah Glik & Michael L. Prelip

  2. Department of Health Services, UCLA School of Public Health, Los Angeles, CA, USA

    Jeremiah R. Garza

  3. Department of Biostatistics, UCLA School of Public Health, Los Angeles, CA, USA

    Ron Brookmeyer

  4. Translational Sciences Section, UCLA School of Nursing, Los Angeles, CA, USA

    Christian K. Roberts

  5. USC Keck School of Medicine, Los Angeles, CA, USA

    Anne Peters

  6. Institute for Survey Research, Temple University, Philadelphia, PA, USA

    Alexander N. Ortega

Authors
  1. Brent A. Langellier
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jeremiah R. Garza
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Deborah Glik
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Michael L. Prelip
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ron Brookmeyer
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Christian K. Roberts
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Anne Peters
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Alexander N. Ortega
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Brent A. Langellier.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Langellier, B.A., Garza, J.R., Glik, D. et al. Immigration Disparities in Cardiovascular Disease Risk Factor Awareness. J Immigrant Minority Health 14, 918–925 (2012). https://doi.org/10.1007/s10903-011-9566-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10903-011-9566-2

Keywords

Search

Navigation