Feb. 25, 2014

A comprehensive health and lifestyle analysis of adults from a range of Hispanic and Latino origins shows that this segment of the U.S. population is diverse, not only in ancestry, culture and economic status, but also in the prevalence of several diseases, risk factors and lifestyle habits.

Data were derived from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a landmark seven-year research effort that enrolled 16,415 Hispanic/Latino adults living in San Diego, Chicago, Miami and the Bronx, N.Y., who self-identified as having Central American, Cuban, Dominican, Mexican, Puerto Rican or South American origins.

A comprehensive summary of findings to date was released Feb. 24 by the National Heart, Lung and Blood Institute, one of the National Institutes of Health, as the Hispanic Community Health Study Data Book: A Report to the Communities.

Dr. Jianwen Cai

Dr. Jianwen Cai

Jianwen Cai, PhD, professor and vice chair in the Department of Biostatistics of the Gillings School of Global Public Health, is the principal investigator for the HCHS/SOL Coordinating Center, within the Department of Biostatistics’ Collaborative Studies Coordinating Center (CSCC).

Research contributed by Cai and colleagues, published Nov. 7, 2012, in The Journal of the American Medical Association,  found that 80 percent of Hispanic/Latino men and 71 percent of the women had at least one cardiovascular disease risk factor. That study also showed that risk factor prevalence varies across Hispanic/Latino background. Individuals from Puerto Rico showed a less favorable profile of heart disease risk factors, compared to other groups.

Gerardo Heiss, MD, PhD, Kenan Distinguished Professor of epidemiology, serves as co-principal investigator for the HCHS/SOL Coordinating Center, and Marston Youngblood Jr., MA, MPH, serves as the project director.

A number of Gillings School researchers are project co-investigators, notably biostatistics professors Sonia Davis, DrPH, CSCC director; Daniela Sotres-Alvarez, DrPH; Shrikant Bangdiwala, PhD; and Donglin Zeng, PhD, along with epidemiology professor Wayne Rosamond, PhD; Krista Perreira, PhD, adjunct associate professor of maternal and child health and health behavior; Laura Loehr, PhD, research assistant professor of epidemiology; Anna Maria Siega-Riz, PhD, professor of epidemiology and nutrition; and Kari North, PhD, associate professor of epidemiology.

comms_hispanic_data_book“Although Hispanics represent 1 out of every 6 people in the U.S., our knowledge about Hispanic health has been limited,” said Larissa Avilés-Santa, MD, MPH, a medical officer in the Division of Cardiovascular Sciences at the National Heart, Lung, and Blood Institute (NHLBI) and project officer for the HCHS/SOL. “These detailed findings provide a foundation to address questions about the health of the U.S. Hispanic/Latino population and a critical understanding of risk factors that could lead to improved health in all communities.”

Aviles-Santa added that information contained in the HCHS/SOL data book will enable individuals, communities, scientists and health policy makers to tailor health intervention strategies to improve the health of all Hispanics/Latinos.
 
The numerous findings described by the HCHS/SOL researchers confirmed some existing knowledge and uncovered new health trends.

Among the items highlighting Hispanic/Latino diversity:

  • The percentage of adults who reported having asthma ranged from 7.4 (among those of Mexican ancestry) to 35.8 (among those of Puerto Rican ancestry).
  • The percentage of individuals with hypertension ranged from 20.3 (South American origin) to 32.2 (Cuban origin).
  • The percentage of people eating five servings or more fruits/vegetables daily ranged from 19.2 (Puerto Rican origin) to 55.0 (Cuban origin). Also, men reported consuming more fruit and vegetables than women.
  • Women reported a much lower consumption of salt than men among all Hispanic groups represented in the study.

 

The new data also found some areas of more general importance for Hispanic/Latino health.

  • The prevalence of sleep-disordered breathing is similar to the U.S. general population.
  • About 1 in 3 individuals had pre-diabetes, also fairly evenly distributed among Hispanic/Latino groups.
  • Only about half of individuals with diabetes among all Hispanic groups were controlling the disease successfully.

 

During the first phase of HCHS/SOL, which took place from 2008 to 2011, study participants underwent an extensive clinical evaluation to identify the prevalence of diseases and risk or protective factors, as well as lifestyle and sociocultural and economic factors. While cardiovascular and lung health were key components of the evaluation, HCHS/SOL also performed an oral health exam, hearing tests and a glucose tolerance test. Most of the information presented in this Data Book was collected through interviews. Analyses of clinical measurements performed during the baseline examination are underway and will be published in the future.

After the baseline examination, study participants have answered an annual interview. This is being done to explore the relationship between their baseline health profile and changes in health, particularly cardiovascular health. A new examination of the cohort is scheduled to start in October 2014 to reassess certain health measurements and understand the relationship between the identified risk factors during the first visit and future disease in Hispanic populations.

Cai says the HCHS/SOL study is the culmination of several years of work by researchers from a variety of areas.

“I’m very proud of the our team at UNC’s Gillings School of Global Public Health that contributed so much to this landmark and historic study,” Cai said. “Building from our core biostatistics department team, we’ve had a large contingent of investigators from the Gillings School of Global Public Health and beyond, including the School of Dentistry. A great number of CSCC research and administrative staff members, statisticians, graduate research assistants, and undergraduate interns are the unsung heroes who have made this project a success day in and out.”

Sonia Davis, DrPH, Professor of the Practice of biostatistics and director of the Collaborative Studies Coordinating Center, has high praise for the research team.

“The CSCC is proud to be an integral part of this important public health research,” Davis said. “We expect continued findings from HCHS/SOL to impact public health and medical practice for the U.S. Hispanic/Latino population for years to come. The complexities of this particular study design relied heavily on our faculty and staff’s extraordinary expertise in the design, implementation and analysis of community-based studies, continuing the CSCC’s more than 40-year history at the forefront of public health research projects.”


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Gillings School of Global Public Health contact: David Pesci, director of communications, (919) 962-2600 or dpesci@unc.edu.

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