An immigrant diabetes disadvantage in New York ethnic enclaves?

Background/Significance: For a variety of health conditions, immigrants to the US have better health than their U.S.-born counterparts. One potential exception is diabetes, which is high among both U.S. born and foreign born Latinos. Some of the highest rates of diabetes in the country have been detected in ethnic enclaves in New York City, but it is not clear whether these high rates are driven more by U.S. born or foreign born residents, or if rates are equal. Sample sizes of foreign-born individuals for groups other than Hispanics are frequently too small to draw inferences. Methods: This study draws on the REACH U.S. Risk Factor Survey- a survey that over-sampled Hispanic, Asian and black minority enclaves in New York over 3 years (2009-2011). Bivariate and multivariate analyses compared rates of self-reported diabetes between foreign-born Hispanic, Asian and black communities and their U.S.-born counterparts. Results: Results show that the odds of being diagnosed with diabetes is significantly higher for foreign-born Hispanics and Asians, but lower for foreign-born blacks. Adjusting for age, socio-economic status, gender and insurance, these significant differences disappear. Further analysis will explore behavioral differences and diabetes care between US and foreign-born as well as differences within ethnic subgroups (e.g., foreign-born vs US-born South Asians and East Asians; Puerto Ricans, Dominicans and Mexicans), and the impact of acculturation. Conclusions: In contrast with other health risks, self-reported diabetes rates among foreign-born Hispanics and Asians are significantly higher than their US counterparts, but these differences appear to be explained by demographic characteristics.-2013-->