Hispanics are a high risk population for diabetes and it complications which has presented a challenge for primary care physicians to address (Idrogo & Mazze 2004). Current literature indicates that genetic, environmental, and societal factors have a role in the development of diabetes (Idrogo & Mazze 2004). It is estimated that 10% of all Mexicans have diabetes and is the third largest cause of non obstetric hospital admissions and the leading cause of mortality in Mexico (Chrone-Navia & Chatterjee 2004). Hispanic Americans consist of approximately 13.
7% of the United States population but have 50% of all diagnosed diabetics (Idrogo & Mazze 2004). The estimated prevalence of newly diagnosed diabetes in Hispanic Americans is 200,000 to 400,000 annual new diagnoses (Idrogo & Mazze 2004). The cost of diabetes related healthcare expenditures in Mexico is 317 million US dollars (Chrone-Navia & Chatterjee 2004). Current literature indicates that United States born Mexican Americans have a higher mortality rate than those Mexican Americans born in Mexico (Hadwiger 2005).
Although compared to other ethnic groups diabetes prevalence is still abnormally high but recent studies indicates a slight decline in the overall incidence in those of Hispanic decent (Handwiger 2005). Those considered to be of Hispanic descent are those who ancestry can be connected to those to a mixture of European, native American, and African Roots (Idrogo & Mazze 2004). The Hispanic population globally originates from Puerto Rico, Mexico, Cuba and other Latin American countries (Idrogo & Mazze 2004).
Acculturation results from the combination of groups of individuals from different cultures who have continuous contact which results in the alteration of one or both cultures (Hadwiger 2005). Obesity which is a major factor in the development of diabetes is increasing at a rapid rate both in Mexico and among Mexican-Americans (Jimenez-Cruz & Bacardi-Gascon 2004). The overall prevalence of diabetes in Mexico increased from 55% to 62% from 1993-2000 and the increase was substantially higher among those between 35-64 years of age and those with low socioeconomic status (Jimenez-Cruz & Bacardi-Gascon 2004).
Compared to the United States general population Mexican-Americans have a high percentage diagnosed with metabolic syndrome which is defined as a combination of obesity, hypertension and dyslipidemia (Idrogo & Mazze 2004). Possible outcomes of acculturation include assimilation, integration, rejection, and deculturation (Hadwiger 2005). The United States-Mexico border region spans over 2,000 miles from San Isdro California to Brownsville Texas (Ramos, Davis, He, May & Ramos 2008).
The border region extends approximately 60 miles on both sides and has a population of approximately 12 million people (Ramos, Davis, He, May, & Ramos 2008). Eighty percent of this population is Mexican and the predominant language that is spoken is Spanish (Ramos, Davis, He May, & Ramos 2008). The absence of literacy and the lack of access to basic healthcare services impede achieving optimal health in this population (Ramos, Davis, He, May, & Ramos 2008). Optimal health by this population is also hampered by the unavailability of opportunities to buy healthy food and cultural barriers (Ramos, Davis, He, May, & Ramos 2008).
Culture is essential to the effectiveness of acculturation and is defined as a learned and shared beliefs held by a community and the behaviors are intergenerational predicting patterns of behavior (Hadwiger 2005). Communities that formed along the United States-Mexico border are called Colonia which is a Spanish term for these unincorporated settlements (Ramos, Davis, He, May, & Ramos 2008). Approximately 65% of the population and 85% of children within these colonias were born in the United States (Ramos, Davis, He, May, & Ramos 2008).
Promotores are lay healthcare providers who receive some training with the sole purpose promoting healthy behaviors to the members of this population (Ramos, Davis, He, May, & Ramos 2008). The leading three causes of death for Hispanic-Americans are cancer, heart disease and diabetes (Masel, Rudkin, & Peek 2006). These leading causes of death can be prevented through lifestyle modifications which includes the instillation of healthy behaviors (Masel, Rudkin, & Peek 2006).
It is important for healthcare providers to understand acculturation and use its principles to instill these healthy behaviors which can positively impact the incidence of diabetes in this population (Masel, Rudkin, & Peek 2006). Research has demonstrated that Mexican Americans who routinely speak English have adopted healthy behaviors through acculturation from the United States (Masel, Rudkin, & Peek 2006). Current literature demonstrates that those at risk for diabetes in Mexico without this influence continue to engage in unhealthy behaviors and sedentary lifestyles unabated (Chrone-Navia & Chatterjee 2008).
The incidence of type 2 diabetes in Hispanic Americans is increased and presents approximately 10 years earlier in Hispanic Americans than the typical American citizen (Idrogo & Mazze 2004). Diabetes is more prevalent in those with Hispanic descent regardless, of where one is born, but it does appear that some western acculturation from the United States making some positive influence on healthy behaviors which can impact the development and screening of type 2 diabetes (Idrogo & Mazze 2004). References: Chrone-Navia, R. , Chatterjee, N. (2008). Prevalence of Type 2 Diabetes Patients in Coahulia.
Mexico. Hispanic Healthcare International. 6 (1) 5-10. Retrieved on December 29, 2008 from the ProQuest database. Hadwiger, S. (2005). Acculturation and Diabetes in a New Hispanic Community. Hispanic Healthcare International. 3 (3) 133-143. Retrieved on December 29, 2008 from the ebscohost database. Idrogo, M. , Mazze, R. (2004). Diabetes in the Hispanic Population. Post graduate Medicine. 116 (6) 26-29. Retrieved on December 29, 2008 from the ProQuest database. Jimenez-Cruz, A. , Bacardi-Gascon, M. (2004). The Fattening Burden of Type 2 Diabetes on Mexicans. Diabetes Care. 27 (5) 1213-1216.
Retrieved on December 29, 2008 from the ProQuest database. Masel, M. C. , Rudkin, L. L. , Peek, M. K. (2006). Examining the Role of Acculturation in Health Behaviors of Older Mexican Americans. American Journal of Health Behavior 30 (6) 684-699. Retrieved on December 29, 2008 from the ebscohost database. Ramos, I. N. , Davis, L. B. , He, Q. , May, M. , Ramos, K. S. (2008). Environmental Risk Factors of Disease in the Cameron Park Colonia, A Hispanic Community Along the Texas-Mexico Border. Journal of Immigrant Minority Health. 10 345-351. Retrieved on December 29, 2008 from the ebscohost database.