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Geriatrics

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Ethnogeriatrics

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Disease-Specific Mortality Rates

Coronary Heart Disease

In the Current Population Surveys conducted by the Census Bureau, Hispanics also had a lower mortality from cardiovascular diseases (SRR = 0.65 for men, and 0.80 for women) (Sorlie, et al., 1993).

Results from the National Health Interview Survey indicated that Hispanics had lower mortality for coronary heart disease (CHD), with the Hispanic/ NHW mortality rate ratio (or odds ratio) for men was 0.77 (95% CI 0.64-0.93), and for women was 0.82 (95% CI 0.66-1.01) (Liao, Cooper, Cao, Kaufman, Long, & McGee, 1997). However, the proportion of total deaths due to CHD was similar for the two ethnicities (28.1% in Hispanic men vs. 29.7% in NHW men; 24.1% in Hispanic women vs. 24.9% in NHW women). Another study from the National Center for Health Statistics showed that mortality rates from sudden cardiac death (dying outside of hospital or emergency room) were also lower in Hispanics than non-Hispanic whites (Gillum, 1997). The age-adjusted rates per 100,000 were 75 deaths for Hispanic men vs.166 for NHW men and 35 for Hispanic women vs. 74 for NHW women.

These comparisons of CHD mortality between Hispanics and non-Hispanic whites appear to give paradoxical results. Despite their adverse risk profiles, especially the greater risk of diabetes, Mexican Americans (MA), the largest Hispanic ethnic group, have been reported to have lower mortality rates from CHD. However, the Corpus Christi Heart Project performed a community-based surveillance of all death certificates from a county in Texas potentially relating to CHD, and used standardized methods blinded to ethnicity to validate the diagnoses (Pandey, Labarthe Goff, Chan, & Nichaman, 2001). CHD mortality was found to be 40% higher in MA women (RR=1.43, 95% CI 1.12 – 1.82); in men, the risk ratio (RR) was not significant

Cerebrovascular Disease

In 2004, cerebrovascular disease was the 3rd leading cause of death in Hispanics over the age of 65 in the U.S (Centers for Disease Control and Prevention). Hispanics had mortality rates from stroke substantially lower than NHW according to data from the National Center for Health Statistics (Gillum, 1995). Data from national surveys suggest this difference in stroke mortality may be due to lower blood pressures in Hispanics compared to NHW.  Between 1985 and 1991 stroke rates in California declined significantly in all ethnic/gender groups except Hispanic men (Karter, Gazzaniga, Cohen, Casper, Davis, & Kaplan, 1998).

Hispanics had excess mortality at earlier ages, and NHW’s rates were higher after the age 65 Comparisons of stroke mortality also were made in the National Longitudinal Mortality Study showing that stroke mortality was comparable in younger Hispanics, but marginally lower in older Hispanics (Howard, Anderson, Sorlie, Andrews, Backlund, & Burke, 1994).

Malignancies

In the Current Population Surveys by the US Census Bureau, Hispanics had a lower mortality from cancer than NHW (SSR=0.69 for men, and 0.61 for women) (Sorlie, Backlund, Johnson, & Rogot, 1993).

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Hispanic/Latino American

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