Diversity in Disease Risk

Comparing the leading causes of death in non-Hispanic whites vs. Hispanics

Since the Affordable Care Act’s implementation, all racial and ethnic groups have seen boosts in the number of insured, but none more so than Hispanics. For a better view of the nation’s largest racial-ethnic minority group, the Centers for Disease Control and Prevention (CDC) undertook its first national study on Hispanics’ leading causes of death, disease prevalence, risk factors, and access to health services in the United States. The results have important implications for doctors and other health professionals.

Hispanics are not a monolithic group, as the CDC’s Vital Signs monthly report clearly demonstrates. Using recent national census and health surveillance data from the National Health Interview Survey, 2009-2013, and the National Health and Nutrition Examination Survey, 2009-2012, the CDC report found key differences. Some highlights include:

• Similar to non-Hispanic whites, the two leading causes of death for Hispanics are heart disease and cancer, with four out of 10 dying from one of these diseases.
• Fewer Hispanics than whites die from the 10 leading causes of death.
• Mexicans and Puerto Ricans are about twice as likely to die from diabetes as are whites. Mexicans also are nearly twice as likely to die from chronic liver disease and cirrhosis as are whites.

Differences Among Hispanic Subgroups

Health risk can vary by Hispanic subgroup and by country of origin. For example, nearly 66% more Puerto Ricans smoke than Mexicans. Other findings include:

• Smoking overall among Hispanics (14%) is less common than among whites (24%), but is high among Puerto Rican males (26%) and Cuban males (22%).
• Colorectal cancer screening varies for Hispanics ages 50 to 75 years. About 40% of Cubans get screened (29% of men and 49% of women). About 58% of Puerto Ricans get screened (54% of men and 61% of women).
• Hispanics are as likely as whites to have high blood pressure. But Hispanic women with high blood pressure are twice as likely as Hispanic men to get it under control.
• Whites have higher suicide rates.

Barriers to Care

Despite lower overall death rates, the study stressed that socio-demographic gaps may interfere with Hispanics getting the care needed to protect their health. The study’s socio-demographic findings include:

• About one in three Hispanics has limited English proficiency.
• About one in four Hispanics lives below the poverty line, compared with whites.
• About one in three has not completed high school.

These gaps are even greater for foreign-born Hispanics, except that this group experiences better health and fewer health risks than U.S.-born Hispanics for key health indicators such as cancer, heart disease, obesity, hypertension, and smoking, the report said.

Hispanics in the United States are on average nearly 15 years younger than whites, and almost three times as likely to be uninsured as are white Americans. Currently, nearly one in six people living in the United States (almost 57 million) is Hispanic, and this number is projected to increase to nearly one in four (more than 85 million) by 2035.

Advice for Health Providers

The CDC’s Vital Signs urges doctors and other health care professionals to:

Work with interpreters to eliminate language barriers when patients prefer to speak Spanish.

Counsel patients at high risk for elevated blood pressure, diabetes, or cancer on weight control and diet.

Ask patients if they smoke and, if they do, help them quit.

Engage community health workers (promotores de salud) to educate and link people to free or low-cost services.