Ethnogeriatrics by Lenise Cummings-Vaughn & Dulce M. Cruz-Oliver

Ethnogeriatrics by Lenise Cummings-Vaughn & Dulce M. Cruz-Oliver

Author:Lenise Cummings-Vaughn & Dulce M. Cruz-Oliver
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham


8.3.6.1 Diabetes

According to the CDC’s Diabetes Public Health Resource [88], overall prevalence of diabetes mellitus in 2014 was 21.5 % of Americans aged 65–74 years and 19.2 % among those 75 and older. These rates have increased steadily by over 100 %, respectively, since the early 1990s, while rates among younger adults have stabilized from 2009 to 2014. Among men 65–74 years old in 2014, Latinos had the highest prevalence (37.2 %) followed by AAs (29.6 %), Asians (22.5 %), and Whites (including Hispanic and non-Hispanic, 22.3 %). Prevalence among men 75 and older was highest in AAs (35.1 %) and lowest in Whites (20.9 %). As for women aged 65–74 years, AAs ranked highest (38.2 %), followed by Latinos (27.2 %), Whites (17.1 %), and Asians (14.0 %). Among women 75 and older, Latinos had the highest prevalence (29.1 %) and Asians the lowest (14.0 %). Of note, prevalence among Asian and Hispanic populations varies greatly by nation of origin, with Asian Indians having much higher rates than Koreans and Japanese, and Cubans having lower rates than Mexican Americans and Puerto Ricans [89].

Prevalence rates of diabetes remain higher for AAs and Latinos as compared to Whites. While some of these differences are attributed to traditional risk factors such as obesity, differences in effect size of such risk factors by race/ethnicity, as well as the presence of nontraditional risk factors, are the matter of great research interest. For instance, Kulick and colleagues found obesity in Whites to convey a 64 % increased risk of developing diabetes versus no significant increased risk among AAs. And while smoking increased diabetes risk by 212 % in Whites, smoking status had a significantly smaller effect in both AAs (22 % decreased risk versus AA nonsmokers) and Hispanics (21 % increased risk versus Hispanic nonsmokers) compared to Whites. While elevated C-reactive protein heralded increased risk of diabetes among Whites (by 66 %) and Hispanics (by 32 %), there was no effect on diabetes risk in AAs. Kulick et al. posited that, considering other authors’ findings of increased prevalence of prediabetes among minority populations, the effects of the risk factors studied here might be greatly attenuated in populations with an already high risk for conversion to diabetes. Socioeconomic status is also a well-studied mediator of diabetes risk among minority populations, with Piccolo et al. finding that SES accounted for over 70 % of the difference in diabetes prevalence between AAs and Whites [90]. Additionally, Chatterjee and colleagues, in their interpretation of the ARIC Study data suggested that while 42 % of excess diabetes risk among AAs compared to Whites might be attributed to differences in traditional metabolic risk factors, newly identified risk factors might account for some 26 % of the remaining difference in risk: low forced vital capacity, low serum potassium, longest occupation held (a socioeconomic proxy), factor VIII: protein C ratio, and white blood cell count [91]. Potential mediators for the remaining, unexplained additional risk in AAs are being actively explored and include depression,



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