Cardiometabolic Risk Disparities Associated with Health Insurance Status in a Latino Community in California

In the U.S., rates of type 2 diabetes (T2D) are higher in Latinos than in non-Latino whites. In 2015, we began a free community outreach program (Mobile Health Screenings, MHS) for the local Latino community to assess diabetes prevalence, cardiovascular risk and their relationships to insurance status. From July 2015 to November 2017, we measured HBA_1c (A1c Now+^®, PTS Diagnostics, Indianapolis, IN), body mass index (BMI), and blood pressure (BP) in 593 people at 24 MHS events. Health insurance status and current medications for diabetes and hypertension (HTN) were also recorded. More than half of those screened (55%) had HBA_1c values between 5.7-6.4% or ≥6.5%. Of the 589 participants who provided insurance information, 262 (44%) reported either having no insurance (n=212, 36%) or not knowing if they had insurance (n=50, 8%). Individuals with private insurance (n=101) had significantly lower HBA_1c levels than those with either government insurance (MediCal, Medicare, etc., (n=113), [5.7±0.7% vs. 6.0±1.0%, p=0.017] and no insurance (n=201), [5.7±0.7% vs. 6.0±1.2%, p=0.002]. The highest rates of prediabetes and diabetes (45% and 17%) were in the uninsured group and the lowest rates (30% and 12%) were in the privately insured group. Those without insurance also took fewer medications for HTN vs. those with insurance (11.3% vs. 20.0%, p=0.005). BMI was also significantly lower for insured participants [28.8±5.4 kg/m² (n=344) vs. uninsured participants 30.0±5.5 kg/m² (n=206, p=0.016].

In conclusion, there is an excess burden of cardio-metabolic disease on uninsured adult Latinos in Santa Barbara.