May 01, 2003 -- Older Hispanics Have Far More Diabetes and Uninsurance

Fresno Bee, 04/30/03

Diabetes plagues state's Hispanics By Beth Fouhy Associated Press

SAN FRANCISCO -- California's large and rapidly growing Hispanic population
is developing diabetes at an alarming rate, a problem that poses new threats
to a strained public health system, according to a report made public today.

The report by University of California at Los Angeles researchers analyzed
state data to conclude that nearly a quarter of retirement-age Hispanics
have been diagnosed with the incurable disease -- twice the percentage of
whites and significantly more than Asians.

While the report said diabetes is prevalent among the state's
African-American and American Indian populations, their numbers do not rival
the Hispanic presence in California. About one in three state residents is
Hispanic -- that was 11 million people in 2000, a number projected to double
by 2025, according to the U.S. Census Bureau.

"It's a significant public health problem, and it's growing," said Ann
Albright, who runs the diabetes program for the California Department of
Health Services. "And we know that the populations at highest risk of the
disease are the populations that are growing at a significant number."

The report by UCLA's Center for Health Policy Research was based on data
from a telephone survey of more than 55,000 state residents done in 2001.
Respondents self-identified their races.

Overall, about 6% of Californians have been diagnosed with diabetes, the
report said.

While younger Hispanics have a rate of diabetes comparable to other groups,
the report said, the numbers begin to rise as the population ages. By age
65, 24% of Hispanics are diagnosed with the disease -- compared with 12% of
whites and 15% of Asians.

Diabetes is an incurable condition characterized by the body's inability to
break down sugars in the blood.

It is the nation's seventh leading cause of death and the leading cause of
adult blindness, kidney failure and amputation of lower limbs. Diabetes
frequently leads to heart disease, stroke and kidney failure.

The most common form of the disease was once called "adult onset"
diabetes -- but recently it began showing up among more children and
adolescents. While genetic factors increase the chances of developing
diabetes, researchers agree that the nation's growing obesity problem has
become the leading risk factor.

The report found that obesity -- and, by extension, diabetes -- is most
common among Californians in low-income, rural, undereducated and
non-English-speaking communities. Almost 60% of Hispanic adults in
California are obese, according to the study, compared with 51% of white
adults.

"The issue is finding culturally appropriate interventions to reduce the
rates of obesity," said report co-author Dr. Allison Diamant.

Public health advocates pointed to research showing that Hispanic
assimilation in the United States often leads to behavioral changes that can
promote obesity.

"Living in the United States, we really decrease our exercise, change our
diet, and eat a lot of fast food," said Carlos Londano, a Union City health
educator who helps Hispanics with lifestyle changes such as quitting
smoking and improving dietary choices.

The UCLA study also found that Hispanics are more likely than other
populations to be uninsured, making treatment of the disease that much more
challenging. Just under one-third of Hispanics with diabetes take no
medication for their condition, compared with about 21% of whites. Only
about 35% of Hispanics monitor their blood sugar, the study found.

"You're talking about people who may or may not be in the health-care
system," said Lisa Navarrete, spokeswoman for the National Council of La
Raza. "And for diabetes, that's deadly. Literally deadly."

The study recommends a community-based, "culturally competent" effort to
prevent the development of diabetes, including asking local governments to
increase the availability of fresh fruits and vegetables and urging schools
to promote physical education and provide healthier food choices.

But some advocates say efforts must go much further.

"Sheerly based on numbers," said Dr. Jose Arevalo, co-founder of the
Diabetes Coalition of California, "we are seeing a public health crisis
emerging."