Ethnic divide for diabetes
City's Puerto Ricans far more likely to die of illness, study says
Judith Graham, Chicago Tribune
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Puerto Ricans in Chicago are three times more likely to die of diabetes than white residents and almost twice as likely as black residents, according to a study that is spurring calls for action among community leaders.
The research, published Wednesday in the Journal of Community Health, is the first to use state death records to document enormous variation in the diabetes death rate among Chicago's ethnic groups.
Its focus is the enormous toll diabetes is taking in the Humboldt Park-West Town area, the center of Chicago's Puerto Rican community, although citywide numbers are also included.
Steve Whitman, director of the Sinai Urban Health Institute and lead author of the paper, said the diabetes death rates documented in the study for the city's Puerto Ricans were the highest recorded in the U.S., to his knowledge.
Asked why, he acknowledged that "we don't know."
The report suggests a larger-than-average number of Puerto Ricans in Humboldt Park-West Town develop diabetes in the first place, though those results are based on a relatively small group of people responding to a door-to-door survey.
Twenty-one percent of Puerto Ricans surveyed in Humboldt Park-West Town said they have been diagnosed with the disease--a far higher figure than has been found in other studies nationally.
Nationwide, about 9.5 percent of Hispanics have diabetes. A 2000 study found 11.3 percent of Puerto Ricans in New York City had been diagnosed with the disease, while two studies conducted in Puerto Rico found that more than 9 percent of residents were diabetic.
There is no good evidence to explain diabetes' disproportionate impact on Puerto Ricans in Chicago, several medical experts said. A variety of factors--including genetic heritage, diet, social and economic circumstances, health insurance status, access to medical care and willingness to seek help--likely are involved.
The local study found that the death rate for Mexican-Americans from diabetes is about 40 percent less than that for Puerto Ricans.
That's in line with other research that has found Puerto Ricans are generally less healthy than Mexican-Americans, said Dr. Elena Rios, president of the National Hispanic Medical Association. She said Mexican-Americans tend to eat more fruits, nuts and vegetables and have stronger social networks. Puerto Ricans also smoke more, she said.
`Staggering rates'
The Sinai study found the death rate from diabetes for Puerto Ricans in Chicago from 1999 to 2001 was 70.9 deaths per 100,000 people; in Humboldt Park-West Town, it was 67.6. For whites in the city, the rate was 23.8; for blacks, it was 37.9.
In 2002, the diabetes death rate for Puerto Ricans nationally was 45.4; in Puerto Rico, it was 69.5, nearly the same as in Chicago.
"These are staggering rates ... and this is a problem that must be dealt with," Whitman said. "We know how to prevent diabetes; we know how to treat it. What is needed now is the political will and the resources to do something about it."
Community leaders agreed, calling the findings "shocking" and "unconscionable."
"This is truly an epidemic," said Ald. Billy Ocasio (26th).
On Wednesday a new organization called the Humboldt Park Diabetes Task Force presented a 19-point action plan that calls for screening all residents in a 20-block area of the neighborhood for diabetes or pre-diabetes, improving medical services, promoting prevention, helping people better manage the disease and providing more public education. The five-year plan also calls for creating a diabetes care center.
"Often, you get the sense people are fatalistic about diabetes: Their sister has it, their mother, their cousin, their neighbor, and they think it's only a matter of time until they get it too," said Dr. Steve Rothschild, task force chair and an associate professor at Rush University Medical Center.
"What we need to communicate is: Diabetes isn't inevitable, and the sooner you act to prevent it or detect it, the better off you'll be."
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