Ethnic heterogeneity in self-reported diabetes prevalence trends across Hispanic subgroups: National Health Interview Survey, 1997-2012

Though many ethnicities exist within the Hispanic population, Hispanics in the US are often placed into pan-ethnic groupings in health research. Studies have shown that there are ethnic variations in diabetes morbidity and mortality among Hispanics. While studies typically pool several years of data for sample size, we examined heterogeneity in self-reported diabetes over time for Hispanic subgroups. Methods: Data is taken from 452,845 adults over the age of 18 from the National Health Interview Survey from 1997-2012. Annual age-adjusted diabetes prevalence was estimated by race/ethnicity and analyses of time trends in annual age-adjusted prevalence were conducted by education and race/ethnicity. Results: Over 15 years, Hispanics had higher diabetes prevalence than non-Hispanic Whites yet lower than non-Hispanic Blacks. There were significant differences in diabetes prevalence across race/ethnicity (P < .001) and Hispanic subgroup (P < .001).  The annual age-adjusted diabetes prevalence per 5 years was highest among Cuban/Cuban Americans (b_5YR = 4.3, P_TIME = 0.0032) and Puerto Ricans (b_5YR = 2.3, P_TIME = 0.0543), non-Hispanic Blacks (b_5YR = 2.1, P_TIME < 0.0001), and non-Hispanic Whites (b_5YR = 2.1, P_TIME < 0.0001) with less than a high school education. Conclusions: In this representative sample of US adults, results demonstrate ethnic variations in diabetes prevalence. The burden of diabetes is greater among Hispanics compared to non-Hispanic whites, unevenly distributed across Hispanic subgroups, and more pronounced by education. Findings support targeted, culturally appropriate interventions to prevent diabetes, and disaggregation of data for racial/ethnic populations in the US for monitoring trends in diabetes disparities.