Understanding the Hispanic/Latino Patient

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Abstract

The Hispanic/Latino population is the largest minority group in the United States, representing approximately 16% of the population in 2010. The US Census Bureau defines Hispanic/Latino origin as ethnicity, which tends to be associated with culture and is distinct from race. Based on the US Census Bureau classifications, Hispanics/Latinos have at least 3 main racial backgrounds (white, black, and Native Indian), with the combination and proportion differing among Hispanic/Latino subgroups. The reflection of these racial differences in genetic ancestry partly explains why biological characteristics differ among Hispanic/Latino subgroups. Partly as a result of variations in biological characteristics, the risk of type 2 diabetes mellitus varies among Hispanic/Latino subgroups. According to data from the 1982 to 1984 Hispanic Health and Nutrition Examination Survey (HHANES), the prevalence of diagnosed and undiagnosed type 2 diabetes among adults aged 45 to 74 years was higher in Mexican Americans (23.9%) and Puerto Ricans (26.1%) compared with Cubans (15.8%). In addition to genetics, there are multiple social and cultural factors that affect the prevalence and course of type 2 diabetes in Hispanic/Latino individuals. Although certain aspects of Hispanic/Latino culture may become barriers in the management of type 2 diabetes in this population, these cultural characteristics may also represent an opportunity for prevention and/or improvement of care. It is important for healthcare providers to have an understanding and appreciation of Hispanic/Latino culture in order to provide their Hispanic/Latino patients with healthcare that is culturally and socially appropriate. Only by considering genetic, social, and cultural factors can type 2 diabetes be successfully prevented, treated, and managed in Hispanic/Latino patients.

Section snippets

The Hispanic/Latino Population in the United States

The Hispanic/Latino population is the largest minority group in the United States, representing 15.8% of the population in 2009.1 According to 2006 data from the US Census Bureau, the largest Hispanic subgroup comprised persons of Mexican descent (65.5%), followed by those of Puerto Rican (8.6%), Central American (8.2%), South American (6.0%), Cuban (3.7%), and other Hispanic (8.0%) descent.2 Although often used interchangeably, including by the US Census Bureau,3 the terms “Hispanic” and

Genetic Differences Among Hispanic/Latino Subgroups and Relation to Risk for Type 2 Diabetes Mellitus

A study investigating various genetic markers demonstrated that the genetic ancestry of Mexican Americans, Puerto Ricans, and Cubans is heterogeneous.9 The proportion of the contemporary gene pool derived from Spanish, Native American, and West African ancestry for Mexican Americans, Puerto Ricans, and Cubans is shown in Figure 1.9

Studies have shown that the risk of type 2 diabetes mellitus varies among Hispanic/Latino subgroups. According to data from the 1982 to 1984 Hispanic Health and

Challenges and Opportunities in Treating Hispanic/Latino Patients with Type 2 Diabetes Mellitus

Although genetics clearly contribute to the risk of type 2 diabetes in Hispanics/Latinos, a number of cultural factors may affect type 2 diabetes outcomes.4, 5, 18 A list of key challenges in the treatment and prevention of type 2 diabetes among Hispanic/Latino patients is presented in Table 1. While these cultural factors may affect the prevention and treatment of type 2 diabetes, they may also offer opportunities to increase awareness of the disease and improve its treatment.

Summary

The risk of type 2 diabetes is particularly high in Hispanics/Latinos in the United States and varies among subgroups. Although this increased risk is partly caused by genetic influences, a number of socioeconomic and cultural factors, including familismo, fatalismo, machismo, personalismo, and simpatia, may also affect healthcare outcomes in Hispanic/Latino patients. While these factors are not necessarily present in all individuals, an awareness of Hispanic/Latino culture is important in

Author Disclosures

The author of this article has disclosed the following industry relationships:

A. Enrique Caballero, MD, reports no relationships to disclose with any manufacturer of a product or device discussed in this supplement.

Acknowledgments

Medical writing services and editorial assistance provided by Karen Stauffer, PhD, and Lucy Whitehouse, of inScience Communications, a Wolters Kluwer business, were funded by Daiichi Sankyo, Inc.

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