Diabetes Study of Older Latinos Cites Poor Care

Misinformation and lack of access to health care contribute to elevated diabetes rates among elderly Latinos in Los Angeles County, according to a UCLA study released Tuesday.

“A lot of Latinos think that if [they] drink cactus juice, it can prevent diabetes,” said Dr. David Hayes-Bautista, director of the UCLA Center for the Study of Latino Health and Culture, which conducted the study. “We need to make sure they’re doing more.”

A random sample of 602 Latino and 577 non-Latino white residents of Los Angeles County ages 65 to 74 were surveyed by telephone in 1997. The study, with an overall margin of error of plus or minus 3 percentage points, included immigrant and U.S.-born Latinos. Reflecting socioeconomic disparities, most of the Latinos were Spanish-speaking, low-income immigrants.

Overall, about 11% of Mexican Americans suffer from adult onset diabetes, compared with 4% of the world’s population, experts say. In the UCLA study, 26% of Latinos surveyed and 15% of whites had been diagnosed with diabetes.

Experts say Latinos--particularly Mexican Americans--are more likely to develop diabetes for a variety of interrelated reasons. These include genetics, a higher propensity toward obesity and a more sedentary lifestyle. The UCLA study identifies additional social factors that its authors believe contribute to the rate disparity among the elderly:

* Only 71% of the Latino elderly immigrant population is enrolled in Medicare, compared with 95% of whites and 89% of U.S.-born Latinos.

* Of the immigrants surveyed, 42% mistakenly believed that citizenship is a prerequisite for Medicare eligibility. Any legal permanent resident is eligible for Medicare.

* Nearly one-quarter of Latino immigrants did not know that Medicare coverage is available. An additional 13% thought it was a welfare program and were therefore reluctant to enroll.

* More than one in 10 immigrants found the Medicare application process difficult and did not know how to complete it.

* Elderly Latinos, including those born in the United States, have a mortality rate from diabetes that is twice as high as that of elderly whites, based on information taken from death certificates.

Although Latinos often recognize diabetes risk factors--such as poor diet, heredity and lack of exercise--they are more likely to cite other factors that experts say are unrelated--emotional stress and anxiety--as causes of the disease, Hayes-Bautista said.

“Most of the general population would say this is ridiculous,” he said. “But the point is to work with the Latino service providers and try to make them aware that this issue will come up.”

Tenet HealthSystem, which owns the largest hospital network in Southern California, plans to use the findings to improve services for its Latino patients. With 32 hospitals in the region, more than 35% of its clients are Latino.

“We serve such a [large] Hispanic community at our hospitals that it is important for us to improve their access to health care,” said Gus Valdespino, Tenet’s senior vice president of operations for Southern California.

Tenet plans to provide bilingual counseling and information about Medicare benefits and Social Security at its hospitals and at community centers. It will provide diabetes lectures and screenings to Spanish-speaking residents through churches and community organizations. And it will develop a program for physicians, patients and family to help diagnose and treat diabetes among Latinos.

Hayes-Bautista said the lack of knowledge about diabetes and Medicare are related, because when people do not have financial assistance for medical services, they may not seek diabetes treatment.

They goal of the study is to encourage health care providers, like Tenet, to offer bilingual services, as well as information about health care and financial assistance, he said.