By Dr. Yanira Cruz, President and CEO of NHCOA.
Hispanics and Latinos make up the fastest-growing demographic of the US population. In 2015, the Hispanic population reached 56.6 million, making Hispanics the nation’s largest ethnic/racial minority, constituting 17.6% of the US population. It is projected that by 2060, the Hispanic population will reach 119 million, or 28.6% of the US population.
In addition to rapid population growth, Hispanics and Latinos are also facing the fastest increase in the rates of type 2 diabetes. Hispanics are at a greater risk than non-Hispanics for having prediabetes, a treatable condition categorized by somewhat elevated blood glucose levels, suggestive that a person is at risk of developing type 2 diabetes, stroke and heart-disease.
Many with prediabetes are unaware that they have it. A study published in 2013, found that prediabetes among Latinos in the 18-44 age group was 33% for men and 23.7% for women but rose significantly in the 45-64 age group for men and women (46.9% and 44.7% respectively). In both age groups, men had a higher percentage of pre-diabetes.
If prediabetes goes undetected or if lifestyle changes are not made, prediabetes progresses to type 2 diabetes. One study found that more than half of Hispanic men and women face the highest lifetime risk of being diagnosed with diabetes. Albeit, Latinos have a lower death rate than non-Latinos, they face roughly a 50% higher death rate from diabetes.
When looking at the ten leading causes of death for Hispanics in 2014, diabetes was the fifth (4.6% of deaths), but seventh for non-Hispanic whites (2.5% of deaths). Among the top health concerns among Latino/Hispanic Americans were health care costs and diabetes.
It is important to note, the considerable diversity that exists within subgroups of Hispanics/Latinos, resulting in greater variability in prevalence of diabetes. Diabetes prevalence varies from 18.3% among Mexican descendants to a low of 10.2% among South American descendants.
A study by the National Health, Lung and Blood Institute found that roughly 18% of Dominican and Puerto Rican descendants, 18% of Central American descendants and 13% of Cuban descendants living in the US had type 2 diabetes. This study also found that diabetes prevalence increased significantly with age, affecting more than 50% for Hispanic women and 44.3% for men by the time they reached 70.
The US Hispanic older adult population is the fastest-growing segment of the aging demographic. In 2014, 46.2 million Americans were aged 65 and older; this number is expected to double by 2060. Hispanics made up 8%, or 3.6 million, of the Medicare beneficiary population in 2014. By 2060, Hispanics are expected to constitute 22% of the older population in the US.
Hispanic older adults and their families are often first generation immigrants and are individuals who have faced discrimination throughout their lifetime. They tend to be Spanish monolingual, have low levels of formal education, low health literacy and have different cultural mores than the larger population.
Access to healthcare, services, and nutrition continue to be challenging due to cultural barriers not often understood by service providers. The Hispanic population throughout America is highly diverse. Factors such as geographic area, time in the U.S., level of acculturation, and the country of origin all contribute to this diversity. This is especially important because length of residency in the US is correlated with likelihood of prediabetes and the development of type 2 diabetes.
Hispanic older adults are an especially vulnerable population. They carry a greater burden of chronic disease, experiencing the onset of type 2 diabetes up to seven years earlier in life than non-Hispanic whites. They are also more likely to suffer complications and mortality from chronic diseases like type 2 diabetes. Even though Hispanic older adults live up to five years longer than the general population, they often live those years in poor health.
Despite the eligibility of most Hispanic older adults for federal, state and local programs, such as SNAP, Medicare part D, and programs that provide assistance with meals and housing, many of the nation’s Hispanic seniors are not accessing these programs. Furthermore, many Hispanic older adults are facing severe situations that are detrimental to their overall wellbeing, such as poor health and economic insecurity.
There are many complex underlying reasons for the lack of access to programs. Few organizations focus on serving Hispanic older adults across the nation. However, NHCOA has found that this is a gap that goes much deeper than a lack of Spanish speaking personnel on agency staff. NHCOA has discovered that there is a great disconnect between programs available and Hispanic older adults and caregivers.