Morbidity

Disease States

Among elders from the populations studied other than non-Hispanic white, data indicate that in many cases disease states tend to be more advanced by the time they are discovered clinically.

Cancer and Cardiovascular Disease Rates

In some immigrant populations, rates of certain cancers and cardiovascular disease increased with the time in the U.S.

Disparities in Chronic Conditions

Examples of disparities in chronic conditions by ethnic population other than those reported in Table 2-1 on mortality:

Among persons aged 70 and over, non Hispanic black and Mexican Americans had significantly higher levels of diabetes than non-Hispanic white elders. Elders from some American Indian tribes have the highest rates of diabetes among any populations. Some studies have also found higher rates of diabetes among Japanese American, Chinese American, and Filipino American elders than among U.S. elders as a whole (Hazuda & Espino, 1997; Kramer, 1997; Kramerow et al., 1999; McCabe & Cuellar, (1994); McBride et al., 1996).
Non-Hispanic black elders were 1.5 times more likely to report hypertension than non-Hispanic whites (Kramerow et al., 1999).
Osteoporosis and hip fracture are more common in non-Hispanic white women than in non-Hispanic black or Hispanic women. Studies of post-menopausal Asian women in the U.S. have found lower rates of hip fracture but similar bone density as non-Hispanic white women (Kagawa-Singer, Hikoyeda, & Tanjasiri, 1997; Richardson, 1996; Villa et al., 1993).

Table 2-4

Populations	More Prevalent	Less Prevalent
African American	Heart Disease Hypertension Cerebrovascular Disease Diabetes Most Cancers (especially prostate) Glaucoma Vascular Dementia Fair or Poor SRH Activity Limitation Untreated Dental Caries	Osteoporosis Respiratory Disease
American Indian/ Alaska Native*	Diabetes Fair or Poor SRH Activity Limitation Accidents (m) Alcoholism Cervical Cancer (f) Kidney Disease Liver Disease Tuberculosis Rheumatoid Arthritis Hearing Problems Vision Problems	Cancer (most kinds) Cerebrovascular Disease
Southwestern & Oklahoma Tribes	Gallbladder Cancer
Alaska Natives	Esophageal Cancer Liver Cancer
Asian American	Tuberculosis	Heart Disease Hypertension Cerebrovascular Disease Cancer (most kinds) Respiratory Disease Hip Fracture
Asian Indian	Depression Insulin Resistance
Cambodian	Severe Headache & Dizziness Post Traumatic Stress Disorder
Chinese	Diabetes (f) Depression Suicide (f) Vascular Dementia Esophageal Cancer Nasopharyngeal Cancer (M) Liver Cancer Pancreatic Cancer (f) Colorectal Cancer Hepatitis B	Breast Cancer (f) Ovarian Cancer (f) Prostate Cancer (m) Colon Cancer (f)
Filipino	Diabetes Hypertension Gout Liver Cancer Lung Cancer (m) Thyroid Cancer (f)	Breast Cancer (f)
Hmong	Diabetes Hepatitis B Post Traumatic Stress Disorder
Japanese	Depression Suicide Diabetes Hemorrhagic Stroke Vascular Dementia Esophageal Cancer Stomach Cancer Colorectal Cancer Liver Cancer Osteoporosis (f)
Korean	Fair or Poor SRH Liver Cancer (m) Diabetes
Vietnamese	Depression Cervical Cancer (f) Hepatitis B Liver Cancer Thyroid Cancer (f)
Native Hawaiian and Pacific Islanders Americans	Heart Disease Hypertension Diabetes
Guamanian	Parkinson’s Disease
Hispanic/ Latino Americans	Fair or Poor SRH Activity/functional Limitations	Heart Disease Cancer (most types) Cerebrovascular Disease Respiratory Disease Accidents
Dominican	Dementia Diabetes Arthritis Hypertension
Mexican	Diabetes Depression (f) Cervical Cancer (f) Liver Cancer Lung Cancer (m) Untreated Dental Caries	Hip Fracture or Osteoporosis Hypertension Arthritis
Puerto Rican	Diabetes Liver Cancer Heart Disease (f) Dementia Arthritis Cataracts Depression Hypertension

Note
SRH= Self Rated Health; Diabetes=Type II Diabetes
(f)=females; (m)=males
*Rates vary greatly between tribes and geographic areas, especially in the rates of diabetes

Sources: USDHHS (2006) Hummer et al.(2003); Richardson (1996); McCabe et al. (1994); McBride et al.(1996); Villa et al.(1993); Mui et al. (2003); Kagawa-Singer et al. (1997); Kramer (1997); Howe et al.(2001); Gomez et al.(2005); Markides et al. (1999); Tucker et al.(2000); Gurland et al.(1999); Yeo, 2004); Yeo & Gallagher-Thompson (2006)

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