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ARS Home » Northeast Area » Boston, Massachusetts » Jean Mayer Human Nutrition Research Center On Aging » Research » Publications at this Location » Publication #201727
Title: Health disparities between island and mainland Puerto Ricans

Author
item HO, GLORIA - A. EINSTEIN COLL MED, NY
item QIAN, HONG - A. EINSTEIN COLL MED, NY
item KIM, MIMI - A. EINSTEIN COLL MED, NY
item MELNIK, THOMAS - NY ST DEPT OF HEALTH, NY
item Tucker, Katherine
item JIMENEZ-VELAZQUEZ, IVONNE - UNIV PUERTO RICO, PR
item KAPLAN, ROBERT - A. EINSTEIN COLL MED, NY
item LEE-REY, ELIZABETH - A. EINSTEIN COLL MED, NY
item STEIN, DANIEL - A. EINSTEIN COLL MED, NY
item RIVERA, WINNA - UNIV PUERTO RICO, PR
item ROHAN, THOMAS - A. EINSTEIN COLL MED, NY

Submitted to: Revista Panamericana de Salud Publica/Pan American Journal of Public Health
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 4/14/2006
Publication Date: 5/15/2006
Citation: Ho, G.Y., Qian, H., Kim, M.Y., Melnik, T.A., Tucker, K.L., Jimenez-Velazquez, I.Z., Kaplan, R.C., Lee-Rey, E.T., Stein, D.T., Rivera, W., Rohan, T.E. 2006. Health disparities between island and mainland Puerto Ricans. Review Article. 19(5):331-339.

Interpretive Summary: Puerto Ricans living on the United States mainland together with those who live in Puerto Rico make up 18% of the U.S. Hispanic population and comprise the second largest Hispanic subgroup in the country. The majority of Puerto Ricans moved to the U.S. mainland in the 1950s and 1960s for economic opportunities and may have experienced acculturative stress, a language barrier, and socio-economic disadvantages, and these factors could have affected their access to health care and their overall health status. Previous studies compared either mainland or island Puerto Ricans with non-Hispanic whites, but data comparing mainland and island Puerto Ricans are limited. In this study, we looked for health disparities between three populations—Puerto Ricans living in Puerto Rico, Puerto Ricans residing in New York City, and U.S. non-Hispanic whites—and compared various indicators of health status and health care utilization in these populations. Puerto Ricans living on the mainland and those living on the island had a similar prevalence of obesity (21% to 22%). Compared with islanders, mainland Puerto Ricans had a higher prevalence of diabetes, along with higher prevalences of smoking and physical illness. While mainland Puerto Ricans were similar to non-Hispanic whites in terms of their utilization of primary prevention and diabetes care, island Puerto Ricans trailed behind significantly. Puerto Ricans living on the U.S. mainland and those living in Puerto Rico both need to target lowering their prevalence of obesity and diabetes. For island Puerto Ricans, improved education about the significance of primary prevention and diabetes care is needed. For mainland Puerto Ricans, the accessibility of the primary health care system renders it a potentially effective venue for interventions, particularly for smoking cessation. More studies are warranted to identify factors associated with the poor health status observed in mainland Puerto Ricans.

Technical Abstract: The objective of this study was to detect health disparities among three populations—Puerto Ricans living in Puerto Rico as well as Puerto Ricans and non-Hispanic whites living on the United States (U.S.) mainland. Data from two similarly designed surveys conducted in 1999-2000 were analyzed. The Behavioral Risk Factor Surveillance System (BRFSS) provided data on Puerto Ricans living on the island and on non-Hispanic whites in the U.S. Another survey of Puerto Ricans living in New York City provided data on mainland Puerto Ricans. The age- and sex-standardized weighted prevalences of various health parameters (e.g., obesity, diabetes, smoking, and physical illness) and indicators of access to health care (e.g., frequencies of routine checkups and diabetes care) were compared between populations by means of standardized rate ratios (SRR). Puerto Ricans living on the mainland and those living on the island had a similar prevalence of obesity (21% to 22%). Compared with islanders, mainland Puerto Ricans had a higher prevalence of diabetes (SRR = 1.4; 95% confidence interval [95% CI] = 1.01 to 2.0); those with diabetes also showed higher prevalences of smoking (SRR = 4.2; 95% CI = 2.3 to 7.7) and physical illness (SRR = 1.5; 95% CI = 1.1 to 2.0) than Puerto Ricans living on the island. While mainland Puerto Ricans were similar to non-Hispanic whites in terms of their utilization of primary prevention and diabetes care, island Puerto Ricans trailed behind significantly. Puerto Ricans living on the U.S. mainland and those living in Puerto Rico both need to target lowering their prevalence of obesity and diabetes. For island Puerto Ricans, improved education about the significance of primary prevention and diabetes care is needed. For mainland Puerto Ricans, the accessibility of the primary health care system renders it a potentially effective venue for interventions, particularly for smoking cessation. More studies are warranted to identify factors associated with the poor health status observed in mainland Puerto Ricans.