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Border inhabitants are 2–3 times
more likely to have diabetes, but many are unaware of the condition, according
to a special issue of the Pan American Journal of Public Health
Washington, D.C.,
October 22, 2010 (PAHO) — For every three people diagnosed with
diabetes along the U.S.–Mexico border, a fourth person has the condition
but doesn’t know it, putting them at increased risk of heart disease and
stroke as well as blindness, kidney failure, and amputations, according to
studies published in the latest issue of the Pan
American Journal of Public Health.
Type 2 diabetes is about 2–3
times more prevalent in the border area than in the rest of the United States or Mexico. Some 15.7 percent of adults
living along the border—about 1.2 million people—have diabetes,
compared with 8.2 percent nationally in Mexico
and 5.2 percent in the United
States.
An additional 14 percent of adults
living on the border—about 1 million people—are in a pre-diabetic
stage. Some 300,000 in the area are unaware they have the disease.
The findings are reported in a
special issue of the Pan American Journal of
Public Health, PAHO’s peer-reviewed scientific journal. The
issue reports the results of the U.S.–Mexico Border Diabetes Prevention
and Control Project, a binational research effort coordinated by the Pan
American Health Organization/World Health Organization (PAHO/WHO) in collaboration
with the U.S. Centers for Disease Control and Prevention (CDC), the ministry of
health of Mexico,
the Paso del Norte Health Foundation, and the California Endowment.
“DM2 [type 2 diabetes] is
one of the most important and challenging public health problems in both Mexico
and the United States,” writes Dr. Maria Teresa Cerqueira, chief of
PAHO’s U.S. –Mexico Border Office and one of the lead researchers
for the project. “In this sense, it might be considered as the tip of the
iceberg when it comes to chronic disease patterns along the entire U.S.-Mexico
border.”
The findings are based on data
collected between 2001 and 2002 in 16 U.S. counties and 28 Mexican
municipalities. They show that 70 percent of border inhabitants who suffer from
diabetes are overweight or obese, and only 30 percent engage in regular
physical activity. Acculturation appears to decrease people’s consumption
of fruits and vegetables but increases their awareness of the importance of
healthy lifestyle habits, particularly physical activity.
The studies also found that people
of Mexican descent—on both sides of the border—are more likely to
have diabetes but be unaware of it, as are people who lack health insurance or
access to routine health care.
“The implication from our
study is that public health policymakers should make efforts to increase access
to diabetes-related preventive care,” said Dr. Xuanping Zhang, a diabetes
expert at the CDC and lead author of one of the studies. “We also should
improve preventive care practice…. Individuals, communities, public
health providers and healthcare systems should work together to find a way to
prevent diabetes, for example, making preventive care more accessible,
affordable, sustainable and attractive.”
Among other key findings of the
project are:
- Diabetes
is inversely related to education and socioeconomic levels.
- Nearly
48 percent of diabetes sufferers have high blood pressure, but only one in
four is receiving treatment for it.
- About
61 percent of diagnosed diabetes sufferers in the border area have at
least one other family member with the disease, confirming family history
as an important risk factor.
- Obesity
appears to be a key factor in high rates of diabetes in the border area;
more than one-third of border
inhabitants are obese, and obese people are, in general, 2.5 times more
likely to have diabetes than those of normal weight.
The project also found that the
prevalence of undiagnosed diabetes among U.S.
inhabitants along the border was lower than rates in the general U.S. population
with diabetes—15 percent versus 30 percent, respectively. The researchers
conclude that this may be due to greater awareness on the part of U.S. healthcare
providers of the higher diabetes risk in the U.S. Hispanic versus non-Hispanic
white populations.
The border diabetes project is the
first research effort to treat the border as a single epidemiological unit.
Researchers note that counties and municipalities on both sides of the border share
more environmental, cultural and behavioral similarities with one another than
they do with their own respective countries.
“Cultural myths are deeply
ingrained among the border population, where expressions such as
‘diabetes is inevitable; my parents and/or grandparents had DM2 [diabetes
type 2] and now I have it’ are frequently heard,” notes Dr.
Cerqueira. “This attitude is a consequence of inadequate knowledge about
what causes DM2, how it can be prevented and what its risk factors are.”
The U.S.–Mexico border
diabetes project involved the efforts of more than 130 institutions in the United States and Mexico. It provides “a
shining example of how the cohesive, on-the-ground efforts of a binational
partnership led to a determination of the prevalence of diabetes,
identification of the risk factors, and development of a diabetes prevention
and control program capable of responding to the specific needs of the border
population,” writes PAHO Director
Dr. Mirta Roses in an editorial for the special issue of the PAHO Journal.
“The study results confirm
the urgent need to strengthen binational and trans-border efforts to control
chronic noncommunicable diseases and especially their risk factors,
particularly physical inactivity, unhealthy diet, overweight and
obesity,” writes Dr. Cerqueira.
For more information about the Pan American Journal of Public Health: http://new.paho.org/journal
For more information about the United States-Mexico Border
Diabetes Prevention and Control Project: http://www.paho.org/fep/diabetes
SPECIAL
NOTE:
Pan
American Journal of Public Health launches new website
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Health (RPSP/PAJPH) is being showcased on a redesigned website (http://new.paho.org/journal)
that uses new tools for interaction and dialogue with readers through participative
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