Published online before print October 23, 2003, doi: 10.1161/01.STR.0000096459.62826.1F
(Stroke. 2003;34:2671.)
© 2003 American Heart Association, Inc.
Original Contributions |
Access to Care, Acculturation, and Risk Factors for Stroke in Mexican Americans
The Brain Attack Surveillance in Corpus Christi (BASIC) Project
From the Stroke Program, University of Michigan Health System, Ann Arbor (M.A.S., L.D.L., L.B.M.); Departments of Epidemiology (J.M.H.R.) and Biometry (L.A.M.), University of Texas School of Public Health at Houston; and Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor (L.B.M.)
Correspondence to Lewis B. Morgenstern, MD, University of Michigan Medical School, 1500 E Medical Center Dr, TC 1920/0316, Ann Arbor, MI 48109-0316. E-mail LMorgens{at}umich.edu
Background and Purpose— Mexican Americans are the largest subgroup of Hispanic Americans, now the most numerous US minority population. We compared access to care, acculturation, and biological risk factors among Mexican American and non-Hispanic white stroke patients and the general population.
Methods— The Brain Attack Surveillance in Corpus Christi project is a population-based stroke surveillance study conducted in southeast Texas. All stroke cases were ascertained through active and passive surveillance from January 2000 through April 2002 and compared with population estimates from a random-digit telephone survey.
Results— Compared with non-Hispanic white stroke patients (n=405), Mexican American stroke patients (n=403) were less likely to have graduated from high school (odds ratio [OR], 15.4; 95% confidence interval [CI], 10.6 to 22.4) and more likely to earn less than $20 000 per year (OR, 6.5; 95% CI, 4.5 to 9.4). Mexican American stroke patients were more likely to have diabetes (OR, 2.7; 95% CI, 2.0 to 3.7) and less likely to have atrial fibrillation (OR, 0.5; 95% CI, 0.4 to 0.8). Compared with population estimates (n=719), stroke was associated with diabetes (Mexican Americans: OR, 3.6; 95% CI, 2.2 to 5.8; non-Hispanic whites: OR, 3.0; 95% CI, 1.7 to 5.5), hypertension (Mexican Americans: OR, 2.8; 95% CI, 1.8 to 4.3; non-Hispanic whites: OR, 3.3; 95% CI, 2.2 to 5.0), lower incomes (Mexican Americans: OR, 3.4; 95% CI, 2.1 to 5.4; non-Hispanic whites: OR, 3.0; 95% CI, 1.7 to 5.2), and lower educational attainment (Mexican Americans: OR, 5.1; 95% CI, 3.2 to 8.1; non-Hispanic whites: OR, 4.5; 95% CI, 2.2 to 9.3).
Conclusions— Biological and social variables are associated with stroke to a similar extent in both Mexican Americans and non-Hispanic whites. Health behavior interventions for both populations may follow from this work. Stroke disparities between these populations may be explained only partially by differences in the prevalence of currently identified biological and social factors.
Key Words: epidemiology • Hispanic Americans • health services accessibility • stroke
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