An immigrant diabetes disadvantage? diabetes among US versus foreign born immigrants in east harlem, New York

Results across a variety of health conditions show an immigrant health advantage. One potential exception is diabetes, which is high among both U.S. born and foreign born Latinos. However, few studies have specifically examined differences in diabetes rates between U.S. and foreign born Latinos and studies that have use limited biomarker data. The present study draws on a unique cohort of overweight residents of East Harlem, New York, an epicenter of the Latino diabetes epidemic. Oral glucose tolerance test (OGTT) were administered to 646 overweight (BMI 25+) English and Spanish speaking adult (18+) residents of East Harlem to assess prevalence of diabetes and pre-diabetes. Biological data on height and weight were collected to measure BMI. Respondents were asked about whether they were born in the US, how long they had been in the US, their race, ethnicity and nationality, and a serious of questions about health related behaviors. This study compares rates of diabetes between foreign born and US born respondents controlling for race, gender, bmi, employment, education, income and insurance status and stratified by nationality (Puerto Rico, Mexico, Dominican Republican). Unadjusted and adjusted logistic regression results showed that foreign born Latinos were two times more likely be diabetic compared with individuals born in the U.S. Surprisingly, most of this immigrant health disadvantage was explained by being born in Puerto Rico whereas being born in Mexico and the Dominican Republic was protective. More research needs to explore the mechanisms that create a higher risk for diabetes among Puerto Rican immigrants.