Differences in diabetes mellitus onset for older Black, White, and Mexican Americans.

OBJECTIVES: Our research examines the differences in estimated odds of developing diabetes mellitus for White, Black, and Mexican Americans age 51 and over for a period of 11 years. DESIGN, SETTING, AND PARTICIPANTS: Longitudinal data came from 14,783 respondents of the Health and Retirement Study (1995-2006) who reported being diabetes-free at the first time period. Discrete-time survival models were used to analyze ethnic variations in the probability of developing diabetes. MAIN OUTCOME MEASURE: Estimated odds of developing diabetes mellitus. RESULTS: The odds of newly diagnosed diabetes increased between 1995 and 2006, with 11% cumulative incidence for all study participants. The probability of incident diabetes among Black Americans was .01 during the period of 1995/96-1998, which increased to .03 during 1998-2000 and remained at .03 throughout subsequent periods, with cumulative incidence over the 11 years at 12%. In contrast, for Mexican Americans the probability more than doubled from .02 in 1995/ 96-1998 to .05 in 2004-2006, with cumulative incidence at 19%. White Americans had 11% cumulative incidence during the 11 year period. CONCLUSIONS: Relative to White Americans, Mexican Americans had significantly elevated odds of developing diabetes throughout the 11-year period of observation even after controlling for differences in demographic, socioeconomic, and time-varying health characteristics.

How does the trajectory of multimorbidity vary across Black, White, and Mexican Americans in middle and old age?

OBJECTIVES: This research examines intra- and interpersonal differences in multiple chronic conditions reported by Americans aged 51 and older for a period up to 11 years. It focuses on how changes in multimorbidity vary across White, Black, and Mexican Americans. METHODS: Data came from 17,517 respondents of the Health and Retirement Study (1995-2006) with up to 5 repeated observations. Hierarchical linear models were employed to analyze ethnic variations in temporal changes of reported comorbidities. FINDINGS: Middle-aged and older Americans have on average nearly 2 chronic diseases at the baseline, which increased to almost 3 conditions in 11 years. White Americans differ from Black and Mexican Americans in terms of level and rate of change of multimorbidity. Mexican Americans demonstrate lower initial levels and slower accumulation of comorbidities relative to Whites. In contrast, Blacks showed an elevated level of multimorbidity throughout the 11-year period of observation, although their rate of change slowed relative to Whites. DISCUSSION: These results suggest that health differences between Black Americans and other ethnic groups including White and Mexican Americans persist in the trajectory of multimorbidity even when population heterogeneity is adjusted. Further research is needed concerning the impact of health disadvantages and differential mortality that may have occurred before middle age as well as exploring the role of nativity, the nature of self-reported diseases, and heterogeneity underlying the average trajectory of multimorbidity for ethnic elders.