Health Disparities Among Hispanics/Latinos

Everyone should have the opportunity to be as healthy as possible, but health disparities continue to severely impact our nation’s health. Health disparities are differences in health outcomes and their causes among groups of people. Although life expectancy and overall health have improved in recent years for many Americans, not everyone is benefit­ing equally.

Many racial and ethnic minor­ity groups have persistently higher rates of illness and death than the U.S. population as a whole. Some chronic diseases and conditions disproportionately affect Hispanic and Latino communities:

• Hispanics/Latinos are about 50% more likely to die from diabetes or liver disease than non-Hispanic whites.
• Compared to non-Hispanic whites, Hispanics are 22% less likely to have controlled high blood pressure.
• Hispanic/Latinos have a colorectal cancer screening rate that is 28% lower than that of non-Hispanic whites.
• Hispanics/Latinos are almost 3 times as likely to be uninsured as non-Hispanic whites.
• The rate of diagnosed diabetespdf icon is 66% higher among Hispanics/Latinos than among non-Hispanic whites.
• Hispanic/Latino children and adolescents aged 2-19 years have a higher prevalence of obesity than their non-Hispanic white and non-Hispanic Asian peers.
• The proportion of Hispanic adults with obesity is about 20% higher than non-Hispanic whites.

Racial and Ethnic Approaches to Community Health

There are many ways to address differences in health outcomes. Community-driven strategies that fully engage community members and address social and economic circumstances as well as cultural practices are improving health outcomes and reducing health disparities.

What Can I Do to Improve My Health Now?

• Regular physical activity helps improve your overall health and fitness.
• Eat healthy! Try adding healthy fats, reducing sodium, and increasing fiber in your diet!
• Know your limits for added sugar in your diet. Too much added sugar in diets is associated with health problems such as weight gain and obesity, type 2 diabetes, and heart disease.
• Drink enough water every day. As plain drinking water has zero calories, it can also help with managing body weight and reducing caloric intake when substituted for drinks with calories, like regular soda.
• Stay active! Regular physical activity helps improve your overall health and fitness. Walking is a great way to be active.
• Mothers can breastfeed! Breast milk can lower a baby’s risk of common illnesses, including diarrhea, vomiting, ear infections, respiratory infections, stomach infections, and Sudden Infant Death Syndrome. Breastfed babies may also have less risk of health problems later in life, such as asthma, childhood leukemia, obesity, and type 2 diabetes. Breastfeeding can help lower the risk of future health problems for mothers as well, including type 2 diabetes, certain types of breast cancer, and ovarian cancer.

How Can Communities Help?

• Increase access to healthy food. Without access to healthier foods, a nutritious diet is out of reach. Making affordable, healthier foods more available to residents can improve residents’ health.
• Design walkable communities. Creating or modifying environments to make it easier for people to walk or bike not only helps increase physical activity, but it can also make communities better places to live.
• Support breastfeeding moms. Most mothers don’t breastfeed as long as recommended. The success rate among mothers who want to breastfeed can be improved through active support from their communities.

Hispanics are the largest and most rapidly growing ethnic group in the United States, making up about 17 percent of the population, or more than 50 million people. Research shows that drinking patterns among Hispanics are different from those of non-Hispanic Whites and other ethnic or racial groups. Understanding these differences can help prevention, intervention, and treatment programs better serve the Hispanic community.

How Much Do Hispanics Drink?

Overall, Hispanics are less likely to drink at all than are non-Hispanic Whites. In fact, Hispanics have high rates of abstinence from alcohol. But Hispanics who choose to drink are more likely to consume higher volumes of alcohol than non-Hispanic Whites.

What Is “Binge Drinking?”

The National Institute on Alcohol Abuse and Alcoholism defines binge drinking as a pattern of drinking alcohol that brings blood alcohol concentration (BAC) to 0.08 percent—or 0.08 grams of alcohol per deciliter—or higher. For a typical adult, this pattern of alcohol misuse corresponds to consuming 4 or more drinks (female), or 5 or more drinks (male) in about 2 hours.

What Factors Predict Drinking Behavior in the Hispanic Community?

Acculturation

Acculturation is the process of adapting to the beliefs, values, and behaviors of a new culture. A critical factor in predicting drinking patterns in the Hispanic community is level of acculturation.

Living and working in the United States, raising families here, speaking English, and above all, getting an American education all contribute to adapting to American culture. But as acculturation levels increase, so can alcohol consumption. The evidence is clear that as women become acculturated to American life, they tend to drink more alcohol. There is mixed evidence of the same effect for men.

Gender

In traditional Hispanic culture, women typically do not drink alcohol outside of small family gatherings or other private settings. For Hispanics in the United States, though, this cultural norm is changing. Recent evidence shows some young Hispanic women are drinking as much or even more than young Hispanic men.

Attitudes

Research shows that young, U.S.-born Hispanic men who are not Protestant tend to have relaxed attitudes toward drinking. Those who feel this way also are more likely to drink, to drink heavily, and to possibly have alcohol-related problems. Within the Hispanic community, Puerto Ricans and Mexican Americans tend to have more relaxed attitudes about drinking than Cuban Americans.

Drinking Trends by Country of National Origin

Trends in drinking among Hispanics vary by country of origin. Among men, Puerto Ricans tend to drink the most and Cubans the least. Among women, Puerto Ricans tend to drink the most and Mexicans the least. Across all Hispanic national groups, beer is the preferred beverage, followed by wine and then liquor.

How Much Is too Much?

In the United States, a “standard drink” (also known as an alcoholic drink-equivalent) is defined as any beverage containing 0.6 fluid ounces or 14 grams of pure alcohol, which is found in

• 12 ounces of beer with 5 percent alcohol content
• 5 ounces of wine with 12 percent alcohol content
• 1.5 ounces of distilled spirits with 40 percent alcohol content

Although the U.S. standard drink (alcoholic drink-equivalent) amounts are helpful for following health guidelines, they may not reflect customary serving sizes. In addition, while the alcohol concentrations listed above are “typical,” there is considerable variability in alcohol content within each type of beverage.

According to the Dietary Guidelines for Americans, 2020–2025, adults of legal drinking age can choose not to drink or to drink in moderation by limiting intake to 2 drinks or less in a day for men and 1 drink or less in a day for women, when alcohol is consumed. Drinking less is better for health than drinking more. Some individuals should avoid alcohol completely.

Consequences of Heavy Drinking

Alcohol Dependence

About 9.5 percent of Hispanics will have alcohol dependence at some point in their lives, as compared with about 13.8 percent of non-Hispanic Whites. But 33 percent of Hispanics who become alcohol dependent have recurrent or persistent problems compared with 22.8 percent of non-Hispanic Whites.

Drunk Driving

Among Hispanics who drink, Mexican American men and women and South/Central American men are most likely to receive a citation for driving under the influence of alcohol. Research shows that between 1992 and 2002, there was a decrease in the number of Hispanic men (ages 18–29) who received a DUI, but an increase in the number of Hispanic women (ages 18–29) who received this citation.

Liver Disease

In general, Hispanic men develop liver disease at high rates. In fact, White Hispanic men have the highest rates of alcohol-related cirrhosis, a serious liver disease, of all ethnic or racial groups. But Black Hispanic men (e.g., from the Caribbean, the Dominican Republic, or Cuba) have the lowest cirrhosis rates when compared with non-Hispanic Whites.

Do Hispanics Seek Treatment for Alcohol Problems?

About 9.9 percent of Hispanics in the United States needed treatment for alcohol problems in the past year (data collected between 2004 and 2011). Of those in need, about 9.3 percent received treatment in a special facility.¹

Limited research shows that treatment can help Hispanics who speak English and who are highly acculturated to American life. Nevertheless, Hispanics with severe alcohol problems are less likely than non-Hispanic Whites to seek the treatment they need. Hispanics also are less likely to join Alcoholics Anonymous (AA), even though AA groups are available for free and in Spanish.

Alzheimer’s disease is a progressive, irreversible brain disorder that affects memory, thinking, and language skills. Over time, people living with Alzheimer’s disease may become unable to carry out daily activities. African American and Hispanic/Latino populations are disproportionately affected.

What is Alzheimer's disease?

Alzheimer’s disease causes brain cells to stop functioning, lose connections with other brain cells, and die over the course of many years. Exactly why this happens is unknown. In advanced stages, a person living with Alzheimer’s disease will experience dementia: a decline in brain function severe enough to interfere with daily life.

Who is affected by Alzheimer's disease?

Age is the best known risk factor for Alzheimer's disease with symptoms usually appearing after age 60. Older African American and Hispanic/Latino adults are more likely to have Alzheimer’s disease than older white adults. You may also be at higher risk of developing Alzheimer’s disease if you:

• Are a woman.
• Have ever had a moderate or severe head injury.
• Have heart disease, stroke, high blood pressure, diabetes, or obesity.
• Have an immediate family member with Alzheimer’s disease.
• Engage in few physical, mental, or social activities.

How is Alzheimer's disease treated?

Although there is no cure, several FDA-approved medications are available to help people maintain mental function and slow or delay the symptoms of Alzheimer’s disease. Your health care provider may also recommend treatments to help manage behavioral symptoms such as anxiety and other health conditions like high blood pressure.

Asthma is a chronic inflammatory disease that affects the airways. The main goal for people living with asthma is control. Properly managing your asthma can reduce the number and severity of your asthma attacks. Left untreated, asthma can cause long-term lung damage, frequent visits to the emergency room, and hospitalizations.

What is asthma?

Asthma is a chronic (long-term) condition that causes the airways to become inflamed and narrow. Symptoms of an asthma attack include coughing, periods of wheezing, chest tightness, and shortness of breath. More than 24 million people in the United States have asthma, and nearly 6 million of them are children. African Americans and Hispanics/Latinos, especially Puerto Ricans, are at higher risk of asthma than people of other races or ethnicities. African American and Hispanic/Latino children are also more likely to die from asthma-related complications.

Common asthma triggers

Asthma symptoms can vary from person to person. The severity of symptoms can change over time. Some triggers that can worsen these symptoms include:

• Dust
• Mold
• Pollen
• Tobacco smoke
• Air pollution
• Perfumes or cologne
• Pet dander (animal skin or hair)
• Respiratory illness such as the cold or flu

Uncontrolled asthma can lead to:

• Shortness of breath
• Long-term damage to the lungs and airways
• Increased use of quick-relief medications
• Increased hospital stays and emergency room visits
• Decreased productivity, missed work or school days

Asthma treatments

There are two main types of FDA-approved medications used to treat asthma: quick-relief medications and medications intended for long-term control.

• Quick-relief medications work fast to treat sudden symptoms at the onset of an asthma attack or flare-up. They are inhaled to help relax the muscles of your airways and provide quick relief of symptoms during an asthma attack.
• Long-term control medications are used on a regular basis to reduce the inflammation and constriction of the airways that cause asthma symptoms. They can be taken orally, injected, or inhaled.

You should talk to your health care provider to create an Asthma Action Plan (AAP). An AAP outlines how and when to take your medications.

Cancer is the leading cause of death for Hispanic or Latino people in the United States. Compared to members of other races and ethnicities, Hispanic and Latino people have higher rates of getting and dying from some kinds of cancer.

• Hispanic women have the highest rate of getting cervical cancer. Hispanic women have the second highest rate of dying from cervical cancer, after non-Hispanic Black women.
• Hispanic people have the highest rate of dying from liver cancer.
• Hispanic people and non-Hispanic Black people have the highest rates of getting and dying from stomach cancer.

However, Hispanic people have the lowest rates of getting and dying from lung cancer.

Data source: United States Cancer Statistics: Data Visualizations.

Barriers to Health Care

Compared to non-Hispanic White people in the United States, Hispanic or Latino people generally find it harder to get medical care. They often face the following barriers—

• Language barriers. A recent study found that Hispanic adults who have limited comfort speaking English were less likely to use health care services than Hispanic adults who were comfortable speaking English.
• Lack of paid sick leave. A survey by the Agency for Healthcare Research and Quality found that 56.6% of Hispanic or Latino workers had paid sick leave—the lowest percentage of all US racial and ethnic groups. Workers who have paid sick leave are much more likely to go to a doctor or get a routine cancer screening test compared with workers without paid sick leave.
• Lack of health insurance. Hispanic people are more than twice as likely to be uninsured as non-Hispanic White people (20% and 8%, respectively, in 2019). Hispanic people who have health insurance are more likely to get a mammogram, Pap test, or colorectal cancer screening test than those with no insurance.
• Educational disparities. Cancer screening is associated with higher education levels. Hispanic people with higher education are more likely to be screened. Only 67% of Hispanic people had a high school education in 2015, compared to 93% of non-Hispanic White people, 89% of Asian people, and 87% of Black people, according to the US Census Bureau.

Despite these challenges, a recent CDC study found that Hispanic people are equally as likely to receive a colorectal cancer screening test, and more likely to receive a mammogram or Pap test, as non-Hispanic White people (after statistical adjustment).

Note: The comparisons above may be between race categories only or between race and ethnicity (non-Hispanic or Hispanic) categories.

What Can Be Done to Reduce Health Disparities?

To help reduce health disparities, the public health community can work to improve health literacy, address barriers to care, and provide language assistance to people who need it. These steps can help Hispanic or Latino people use preventive health services, including cancer screenings. Health literacy is the ability to find, understand, and use information and services to inform health-related decisions and actions. Two-thirds of Hispanic people in the United States have limited health literacy.

Health care organizations can also help by developing culturally relevant health messages that encourage Hispanic or Latino people to get cancer screenings. Community health workers can help people in minority communities get the health care they need. Trained interpreters and bilingual health care providers can improve the quality of care for people who speak Spanish.

Clinical trials are research studies involving human volunteers to evaluate medical products like medications, vaccines, or devices for safety and effectiveness. These studies may also show which medical products or therapies work best for people with certain illnesses or for certain groups of people. Ensuring people from diverse backgrounds join clinical trials is key to advancing health equity.

5 things you should know about clinical trials

1. Clinical trials are research studies conducted with people—they are designed to answer specific research questions about medical products or therapies.
2. Participation is always voluntary—you can leave a study whenever you want.
3. Clinical trials often need healthy volunteers to help answer research questions.
4. Your safety is a priority. Researchers must follow detailed protocols and the FDA’s safety requirements to make each trial as safe as possible.
5. The study will be explained to you in an informed consent process before you agree to join.

The importance of diverse participation in clinical trials

Participants in clinical trials should represent the patients that will use the medical products. This is often not the case—people from racial and ethnic minority and other diverse groups are underrepresented in clinical research. This is a concern because people of different ages, races, and ethnicities may react differently to medical products. To achieve health equity so all can benefit from clinical trials, we are committed to taking steps to change this.

Joining a clinical trial might be a good choice for you if:

• You and your health care provider believe a clinical trial may provide another option when standard treatments have failed.
• You want to help test new medical products or therapies in the diverse patients likely to use them.
• You want to help researchers find better ways to fight diseases.

People of certain racial and ethnic groups are more likely to develop prediabetes and type 2 diabetes, including African American, Hispanic or Latino, and Asian American people. Learn why risk for Hispanic or Latino people is higher, and some ways to prevent type 2 diabetes or manage diabetes if you already have it.

Hispanic or Latino people make up a diverse group that includes people of Cuban, Mexican, Puerto Rican, South and Central American, and other Spanish cultures, and all races. Each has its own history and traditions, but all are more likely to have type 2 diabetes (17%) than non-Hispanic White people (8%).

But that 17% is just an average for Hispanic or Latino groups. The chance of having type 2 diabetes is closely tied to background. For example, if your heritage is Puerto Rican, you’re about twice as likely to have type 2 diabetes as someone whose background is South American.

Diabetes Affects Hispanic or Latino People More

Over their lifetime, US adults overall have a 40% chance of developing type 2 diabetes. But if you’re a Hispanic or Latino adult, your chance is more than 50%, and you’re likely to develop it at a younger age. Diabetes complications also hit harder: Hispanic or Latino people have higher rates of kidney failure caused by diabetes as well as diabetes-related vision loss and blindness.

Managing Diabetes

If you have diabetes, you need to make choices and take action every day to manage your blood sugar levels. That includes eating healthy food, being physically active most days, taking medicine if needed, and getting regular checkups.

Diabetes is challenging for anyone to manage, but you may have additional barriers, including:

• Communication: If you can’t communicate fully with your doctors or they don’t understand your values and preferences, you’re less likely to follow treatment instructions and make lifestyle changes.
• Culture: You may put the needs of your family before your own health needs. You may want to use natural or traditional medicines instead of standard diabetes treatments. You may also have heard that taking insulin will cause diabetes complications (this isn’t true).

For help dealing with daily diabetes care, ask your doctor for a referral to diabetes self-management education and support (DSMES) services. DSMES has many benefits, from helping improve blood sugar, blood pressure, and cholesterol levels to enhancing quality of life.

Help could also be as close as the dinner table. Hispanic or Latino people are known for their strong family connections, and for sharing meals together at home. When a family member has to change what he or she eats to manage diabetes, it affects the whole family. This can be an opportunity for everyone to make healthy changes, which is especially important for kids. Hispanic or Latino children and teens are at higher risk for type 2 diabetes too, and learning healthy eating habits early gives them the best chance to prevent it.

Type 2 Diabetes is Common

More than half of Hispanic or Latino adults are expected to develop type 2 diabetes in their lifetime.

Prediabetes

Hispanic or Latino people are also more likely to have prediabetes. With prediabetes, blood sugar levels are higher than normal, but not high enough yet to be diagnosed as type 2 diabetes. If you have prediabetes, you’re at higher risk for getting type 2 diabetes and other serious health problems, including heart disease and stroke.

Prediabetes usually doesn’t have any symptoms, so finding out your risk by taking the 1-minute prediabetes risk test (available in Spanish and English) is an important first step, especially if you have other prediabetes risk factors. If you get a high score (5 or above), visit your doctor and get a simple blood sugar test to confirm your result.

If you have prediabetes, joining a lifestyle change program offered as part of CDC’s National Diabetes Prevention Program (National DPP) can help you prevent or delay type 2 diabetes and improve your overall health. You’ll learn the skills needed to lose a modest amount of weight through healthy eating and being more physically active. (Classes are available in Spanish and English.)

A modest amount of weight loss is about 10 to 14 pounds (4.5 to 6.3 kg) for a 200-pound (90.6 kg) person. Getting at least 150 minutes of physical activity a week, such as brisk walking, also is important. That’s just 30 minutes a day, 5 days a week.

In the lifestyle change program, you’ll work with a trained coach and share experiences with others who have the same goals and challenges. Some classes welcome other adult family members to attend along with you for support. Learn more about the National DPP lifestyle change program, and find a class near you (or online).

Risk factors include diabetes, obesity, and disability

Pain is one of the most common and expensive health problems in the U.S. In older adults, chronic pain can lead to frailty. This can mean anything from unintentional weight loss to slowness, weakness, and exhaustion. 

In the U.S., pain may be a bigger problem for older Hispanics, who make up the nation's fastest growing segment of older adults. They have a higher risk of diabetes, obesity, and disability—which are all risk factors for pain. They also tend to have less access to medical care and to health information or support. 

A study funded by the National Institutes of Health tracked 3,000 older Mexican American adults from 1995 to 2013. One important finding was that those who suffered from pain were 1.7 times more likely to become frail. In addition, people in the study who were older, were depressed, had hip fractures, and had difficulty with daily tasks were also more likely to become frail.

Researchers want to learn more about the link between pain and frailty in Mexican Americans. They hope that this information will help provide better health support earlier in life to this population and Hispanic Americans more generally.

Human immunodeficiency virus (HIV) is a chronic disease that attacks the body’s immune system, which can increase your chances of developing serious infections or cancer. If left untreated, HIV can lead to acquired immunodeficiency syndrome (AIDS), an advanced stage of HIV infection. There is no cure for HIV, but HIV prevention and treatment options are available.

Who is affected by HIV?

In the United States, an estimated 1.1 million people are living with HIV. African Americans and Hispanics/Latinos account for 2 out of 3 new diagnoses. Both men and women can become infected. Men who have sex with men, transgender women who have sex with men, and people who inject drugs have a higher risk of contracting HIV. Higher rates of HIV in certain communities may result from issues such as stigma and lack of awareness of someone’s HIV status.

How can I get tested for HIV?

Routine screening is the best way to reduce the spread of HIV. Screening is recommended for people ages 13 and over and for those with a higher risk of infection. There are three types of tests that may be used for screening and diagnosis:

• Antibody tests look for antibodies (proteins) in your blood or saliva that are made by the body in response to an HIV infection
• Combination (fourth-generation) tests look for both HIV antibodies and antigens, which are foreign substances that cause your immune system to activate
• Nucleic acid tests look for nucleic acids (genetic material) of HIV in the blood

How is HIV treated?

HIV medications, known as antiretroviral therapy (ART), slow the progression of the disease in your body by lowering the amount of HIV in your blood. This keeps the immune system strong enough to fight off other infections. ART involves taking a combination of HIV medications every day regardless of how long someone has had the virus or how healthy they are. 

Benefits of starting treatment early

• Significantly lower your chances of spreading HIV to HIV-negative people through sex, needle sharing, or from mother to child during childbirth and pregnancy
• Lower your chances of getting certain HIV-related cancers and infections
• Increase your chances of living a longer and healthier life

HIV prevention medications

PrEP (pre-exposure prophylaxis) is a method of preventing HIV infection that involves taking HIV medications every day, before possible exposure. Studies show that PrEP lowers the chances of getting HIV from sex by about 99% when taken daily. Among people who inject drugs, PrEP lowers the chances of getting HIV by at least 74% when taken daily.

Heart disease refers to several conditions that affect the heart. In the United States, it affects more than 1 in 10 adults (30 million) and is the leading cause of death for people of most racial and ethnic groups (responsible for about 1 in 4 deaths).

Heart disease may not be diagnosed until a person experiences signs or symptoms of a heart attack, heart failure, or an arrhythmia. These symptoms may include:

• Heart attack: Chest pain or discomfort, upper back or neck pain, indigestion, heartburn, nausea or vomiting, extreme fatigue, upper body discomfort, dizziness, and shortness of breath
• Heart failure: Shortness of breath, fatigue, or swelling of the feet, ankles, legs, abdomen, or neck veins
• Arrhythmia: Fluttering feelings in the chest (palpitations)

Who is at risk?

High blood pressure, high cholesterol, and smoking are key risk factors for heart disease. About half of all adults in the United States have at least one of these risk factors. Other medical conditions and health behaviors that put you at higher risk are:

• Diabetes
• Alcohol use
• Unhealthy diet
• Physical inactivity
• Overweight and obesity

Your risk for heart disease increases as you age and if you have a history of heart disease in your family.

How is heart disease treated?

Your health care provider may prescribe one or more FDA-approved medications to treat your heart disease or its risk factors. Some types of heart disease are also treated with medical devices such as pacemakers (implanted in the body to regulate the heart rate) or stents (metal tubes that are inserted in an artery to improve blood flow). Your health care provider will work with you to determine which treatment is the best option for your condition.

Participating in a cardiac rehabilitation (rehab) program after having a heart attack, heart failure, or some type of heart surgery is important for recovery. Supervised by a team of health care professionals, this program may include:

• Physical activity
• Counseling to find ways to relieve stress and improve your mental health
• Education about healthy living (such as healthy eating), taking medication as prescribed, and ways to help you quit smoking

Health disparities are differences in the incidence, prevalence, and mortality of a disease and the related adverse health conditions that exist among specific population groups. These groups may be characterized by gender, age, race or ethnicity, education, income, social class, disability, geographic location, or sexual orientation. These health disparities are one reason why HIV, viral hepatitis, STDs, and TB take a greater toll in one population group over another. Find information about how these diseases affect Hispanic/Latino populations.

HIV

In 2018, Hispanics/Latinos accounted for 27% of the 37,968 new diagnoses in the United States and dependent areas.

In 2018, among adult and adolescent Hispanic/Latino males in the United States and dependent areas, 85% of new HIV diagnoses were attributed to male-to-male sexual contact, 7% were attributed to heterosexual contact, and 4% were attributed to injection drug use. Four percent of the diagnoses were attributed to male-to-male sexual contact and injection drug use, and less than 1% were attributed to other transmission categories.

In 2018, among Hispanic/Latina adult and adolescent females in the United States and dependent areas, 87% of new HIV diagnoses were attributed to heterosexual contact and 12% were attributed to injection drug use.

An HIV care and treatment study published in JAMA Internal Medicine showed that Hispanics/Latinos diagnosed with HIV are less likely than Whites to be linked to care, retained in care, receive antiretroviral treatment, and achieve adequate viral suppression.

Sexually Transmitted Diseases (STD)

Chlamydia

In 2018, the rate of reported chlamydia cases among Hispanics was 392.6 cases per 100,000 population, which was 1.9 times the rate among Whites.

Gonorrhea

In 2018, the rate of reported gonorrhea cases among Hispanics was 115.9 cases per 100,000 population, which was 1.6 times the rate among Whites. This disparity was similar for Hispanic females (1.4 times the rate among White females) and Hispanic males (1.8 times the rate among White males). The disparity in gonorrhea rates for Hispanics in 2018 was higher in the Northeast than in the Midwest, South, and West.

Primary and Secondary Syphilis

In 2018, 23.3% of reported P&S syphilis cases with known race/Hispanic ethnicity information occurred among Hispanics. The rate of reported P&S syphilis cases among Hispanics was 2.2 times the rate among Whites (13.0 versus 6.0 cases per 100,000 population, respectively). This disparity was greater for Hispanic males (2.2 times the rate among White males) than Hispanic females (1.7 times the rate among White females).

Congenital Syphilis

From 2014 to 2018, the rate of reported congenital syphilis increased 263.4% among Hispanics (12.3 to 44.7 cases per 100,000 live births). In 2018, the rate of congenital syphilis for Hispanics was 3.3 times the rate among Whites (44.7 cases versus 13.5 cases per 100,000 live births).

Viral Hepatitis

In 2018, there were 1,649 death certificates among US residents that listed hepatitis B as the underlying or a contributing cause of death. In 2018, Hispanics/Latinos had the second lowest hepatitis B related death rate, 0.28 deaths per 100,000 population, among all race/ethnic groups.

In 2018, there were 15,713 death certificates among US residents that listed hepatitis C as the underlying or a contributing cause of death. In 2018 Hispanics/Latinoshad the third highest death rate for hepatitis C among all race/ethnic groups at 4.64 deaths per 100,000 population.

Tuberculosis

In 2018, 87% of all reported TB cases occurred in racial and ethnic minorities. TB disease was reported in 2,617 Hispanics/Latinos in the United States, accounting for 29% of all people reported with TB disease nationally. The rate of TB disease in Hispanic/Latinos was 4.4 cases per 100,000 population, which is over eight times higher than the rate of TB disease in non-Hispanic whites (0.5 cases per 100,000 population). Hispanics/Latinos born outside the United States represented 32% of the TB cases among non-U.S.-born persons in 2018. Overall, 9,025 TB cases were reported to CDC from the 50 states and the District of Columbia in 2018.

Hypertension (high blood pressure) happens when blood flows through your arteries at higher-than-normal pressures over time. This makes the heart and blood vessels work harder and less efficiently. Nearly half of all adults have hypertension, and it is more common among African American and Hispanic/Latino adults than other groups.

What is hypertension?

Hypertension (high blood pressure) develops when blood flows through your arteries at higher-than-normal pressures over time. Arteries that have narrowed because of a buildup of cholesterol make the heart and blood vessels work harder, increasing blood pressure.

Your blood pressure measurement is made up of two numbers: systolic and diastolic. Normal blood pressure is less than 120 (systolic)/80 (diastolic) mm Hg. High blood pressure is diagnosed when you have consistent systolic readings of 140 mm Hg or higher or diastolic readings of 90 mm Hg or higher.

Hypertension is known as the silent killer because most people do not have symptoms of hypertension, so it's important to have your blood pressure checked regularly. If not controlled, high blood pressure can lead to heart disease, stroke, heart attack, heart failure, and chronic kidney disease.

Who is affected by hypertension?

Nearly half of all adults in the United States have hypertension. High blood pressure is more common in African American and Hispanic/Latino adults than in other groups. Only 1 in 4 adults living with hypertension have their condition under control.

How is hypertension treated?

You may be prescribed FDA-approved medications to control or lower your blood pressure. Types of hypertension medications include:

• Angiotensin-converting enzyme (ACE) inhibitors: Keep blood vessels from narrowing.
• Angiotensin II receptor blockers (ARBs): Keep blood vessels from narrowing.
• Calcium channel blockers: Allow blood vessels to relax.
• Diuretics: Remove extra water and sodium (salt) from your body, reducing the amount of fluid in your blood.
• Beta blockers: Help your heart beat slower and with less force so that it pumps less blood through your blood vessels.

Your health care provider may also recommend that you adopt a heart-healthy lifestyle by:

• Choosing foods that are lower in sodium (salt) and those that are rich in potassium
• Avoiding or limiting alcohol
• Being physically active
• Aiming for a healthy weight
• Quitting smoking

Immunization happens when a person becomes protected against a disease through vaccination. Getting vaccinated is one of the safest and most effective ways of preventing infectious diseases.

What is immunization?

When disease-causing viruses or bacteria (germs) invade the body, our immune systems are activated to attack them. Vaccines work by mimicking these germs so that if you are exposed to the real germ, your immune system is prepared to respond quickly.

Vaccines contain dead and weakened forms of germs or small pieces of germs. Others contain genetic instructions for immune cells to identify germs. Since vaccines do not contain germs in disease-causing forms, they will not give you the disease they are designed to prevent.

Most vaccines are given as an injection (shot). Side effects are usually mild, such as redness or soreness where the shot was given or a low-grade fever.

Why is immunization important?

Getting vaccinated is one of the most effective ways of preventing infectious diseases, disabilities, and deaths. In the United States, routine childhood vaccines prevent many diseases, and immunization has reduced the occurrence of most vaccine-preventable diseases by over 95%.

Adults need vaccines too, even if you got all your childhood shots. The protection for some shots can wear off over time, and as you get older you may be at risk for diseases like shingles. All adults should get a yearly flu shot and other vaccines based on age, job, lifestyle, travel, or health conditions.

Getting vaccinated also helps decrease the spread of diseases to other people. When enough people are vaccinated against a disease, it is more difficult for that disease to spread and cause an outbreak. People with serious allergies or weakened immune systems who can’t get vaccinated will also gain some protection from getting sick (known as community or herd immunity).

Are vaccines safe?

Vaccines are one of the safest ways to protect against many infections. Every vaccine is safety tested before it’s approved by the FDA and recommended for use by the Centers for Disease Control and Prevention (CDC). Vaccine manufacturers test each vaccine lot for identity, purity, strength, and sterility before they are released for use. The FDA and the CDC also monitor the safety of vaccines in infants, children, and adults after they come to market.

In the event of a public health emergency, the FDA may issue an Emergency Use Authorization (EUA) to facilitate the availability and the use of a vaccine. An EUA requires an FDA review of data on the quality and consistency of the vaccine product and a review of data collected from studies with people who volunteer to take the vaccine.

African Americans, Hispanics, and American Indians are at high risk for developing kidney failure. This risk is due in part to high rates of diabetes and high blood pressure in these communities. Below is more information about kidney failure for each of these groups.

African Americans

African Americans are almost four times as likely as Whites to develop kidney failure.

While African Americans make up about 13 percent of the population, they account for 35 percent of the people with kidney failure in the United States. Diabetes and high blood pressure are the leading causes of kidney failure among African Americans.

Hispanics

A growing number of Hispanics are diagnosed with kidney disease each year. Since 2000, the number of Hispanics with kidney failure has increased by more than 70 percent.

Compared to non-Hispanics, Hispanics are almost 1.3 times more likely to be diagnosed with kidney failure.

American Indians and Alaska Natives

American Indians also are disproportionately affected by kidney failure. Compared to Whites, American Indians are about 1.2 times more likely to be diagnosed with kidney failure. Diabetes is the leading cause of kidney failure among American Indians. However, better diabetes care is reducing the risk for kidney failure in American Indians with diabetes.

Lupus is an autoimmune disease that triggers inflammation in different tissues of the body. The severity of lupus can range from mild to life threatening. According to studies supported by CDC, Hispanic women and Asian women are more likely to be affected by the disease compared with White women.

Signs and Symptoms of Lupus

Lupus can affect people of all ages. However, women of childbearing age — 15 to 44 —are at greatest risk of developing the disease. Men are at lower risk.

People with lupus can have many different symptoms. Some people with the disease may have fatigue, pain or swelling in joints, skin rashes, and fevers. Additional symptoms can include sun sensitivity, mouth ulcers, arthritis, lung problems, heart problems, kidney problems, seizures, psychosis, and blood cell and immunological problems.

People with the disease may have a period of lupus symptoms every so often (called flares), sometimes even years apart, that go away at other times (called remission). They may have these flares often throughout their life.

Estimating Who Has Lupus

To find out how common lupus is and how often it develops in different racial and ethnic groups, CDC supported five population-based lupus patient registries, which collected information on people who have been diagnosed with the disease. Researchers in Georgia, Michigan, and the Indian Health Service have published results on White, Black, and American Indian/Alaska Native people.

Researchers in New York City and San Francisco were funded later to estimate how many Hispanic and Asian women and men have lupus.

These studies found that non-Hispanic Asian women and Hispanic women (of any race) are more likely to be affected by lupus, compared with non-Hispanic White women.

Data from these registries also confirmed an increase in lupus diagnoses among Black women, as demonstrated through previous lupus studies.

The New York City and San Francisco studies also show that lupus-related kidney disease (lupus nephritis) — which can be fatal — appears to be more common among non-Hispanic Asian people and Hispanic people (of any race) compared with non-Hispanic White people.

These are the first population-based registries in the United States with enough Hispanic and Asian people to measure the number of people with diagnosed lupus.

Mental health matters! Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, act, handle stress, relate to others, and make choices. Mental health is just as important as physical health at all stages of life. Mental health issues are common – about 1 in 5 American adults experiences a mental illness each year. Mental health issues are treatable and often preventable. However, people in some racial and ethnic minority groups face obstacles to maintaining positive mental health.

Obstacles to Mental Health for Racial and Ethnic Minority Groups

The mental health of some racial and ethnic minority groups has worsened since the start of the COVID-19 pandemic relative to that of non-Hispanic white people.

The COVID-19 pandemic has been a challenge for everyone, and racial and ethnic minority groups have been placed at higher risk for COVID-19 infection, COVID-19 severe illness or death, and pandemic-related stressors. These stressors, such as unemployment, loss of a loved one, and COVID-19 stigma, can cause emotional distress and may lead to new or worsening mental health issues. Mental health issues may increase when people face additional stressors, on top of those related to COVID-19, and lack access to the resources and support needed to navigate these challenges.

Mental health care is important for mental wellbeing, yet many people from racial and ethnic minority groups face obstacles in accessing needed care. These obstacles may include lack of or insufficient health insurance, lack of racial and ethnic diversity among mental healthcare providers, lack of culturally competent providers, financial strain, and stigma.

Racism negatively impacts mental health. Racism contributes to unequal access to resources and services, including mental health care. First-hand experiences of racial discrimination, as well as witnessing or hearing about discrimination from others or in the media, can cause or intensify stress and racial trauma.

Working Together for Mental Health Equity

All of society benefits when people from racial and ethnic minority groups have access to mental health care, supportive social conditions, freedom from stressors that can compromise mental health, and access to other resources needed for health. We all have a role to play in promoting health equity.

Individuals can

• Learn about healthy ways to cope with stress and respond to loss. When possible, engage in these practices.
• Get help for mental health issues through free and confidential resources.
• Learn about mental health and take the mental health quiz.
• Share information on mental health, healthy coping skills, and resources with family, friends, neighbors, and other members of your community.
• Encourage open conversations about mental health and use non-stigmatizing language when talking about mental health issues.
• Learn about implicit bias, microaggressions, and other forms of discrimination and make efforts to avoid perpetuating them.

Mental health equity is the state in which everyone has a fair and just opportunity to reach their highest level of mental health and emotional well-being.

Public health organizations can

• Ensure mental health programming incorporates perspectives, ideas, and decision-making from appropriately representative people of racial and ethnic minority groups at all stages of programming – from planning to implementation to evaluation.
• Consider the data on mental health when developing organizational priorities and programs.
• Prioritize action on and/or meaningfully account for the potential influence of social determinants of health when designing mental health programs.
• Measure the impact of racism on mental health and develop best practices for reducing racism and its consequences.
• Ensure mental health educational materials are culturally and linguistically appropriate and follow health equity principles for communication such as using plain language.
• Take intentional steps to increase the reach of mental health information to racial and ethnic minority groups through culturally responsive communication outlets.
• Establish and foster partnerships with other organizations to fill gaps in reach and/or expertise.
• Verify and promote available free and low-cost mental health resources.
• Explore referrals to mental health services to ensure those served can be efficiently connected with needed resources.

Healthcare systems can

• Screen patients for depression and other mental health conditions and refer patients to accessible mental health care services.
• Make mental health educational materials available to all patients during their appointments, via patient portals, and in waiting rooms.
• Make efforts to recruit mental healthcare providers that reflect the race and ethnicity of the populations they serve.
• Provide cultural humility training to mental healthcare providers.
• Ensure mental healthcare services are culturally and linguistically appropriate.

States and communities can

• Expand community-based mental health care that provides culturally responsive mental health services at low or no cost for youth and adults.
• Evaluate policies for their differential impact on social determinants of health, and, when needed, modify these policies or create new policies that ensure equitable access to resources for people from all race and ethnicity groups.
• Evaluate policies for their potential to reinforce mental health stigma and revise or remove stigmatizing policies.
• Encourage community and faith-based leaders to have positive dialogues and discussions around mental health issues to help reduce stigma.
• Make efforts to ensure decision-makers reflect the races and ethnicities of the populations they serve.

CDC is collaborating with partners to improve mental health among racial and ethnic minority groups by

• Developing and sharing culturally responsive resources to promote and strengthen the emotional well-being of populations through How Right Now | Finding What Helps, also available in Spanish
• Gathering data on mental health, access to care, demographics, and more through the Household Pulse Survey, in collaboration with the US Census Bureau
• Analyzing data to better understand mental health disparities during COVID-19
• Recognizing the harm racism has on mental health and overall health, declaring racism a serious threat to the public’s health, and taking actions to address racism
• Implementing the CORE strategy, an agency-wide strategy that aims to integrate health equity into all work at CDC
• Ensuring equity principles guide planning around mental health programming
• Raising awareness of health workers’ mental health issues through the Health Worker Mental Health Initiative
• Identifying policies and practices that connect more children and families to mental health care and seeking to understand the impact of social determinants of health on mental health care – Improving Access to Children’s Mental Health Care
• Developing data systems and tools that appropriately identify, respond to, culturally tailor, and reach historically marginalized and/or racialized populations during crises through Project REFOCUS, in partnership with Howard University, Department of Communication, Culture and Media Studies UCLA Center for the Study of Racism Social Justice and Health Funding, and CDC Foundation

It is a common misconception that osteoporosis only affects white women. But, in the United States, the prevalence of osteoporosis in Hispanic women is similar to that in white women. Fortunately, osteoporosis can be prevented and treated. As a Hispanic woman, it is important that you understand your risk for osteoporosis, the steps you can take to protect your bones, and, if you have the disease, the options for treating it.

What is osteoporosis?

Osteoporosis is a condition in which the bones become less dense and more likely to fracture. If not prevented or if left untreated, bone loss can progress painlessly until a bone breaks, typically in the hip, spine, or wrist. A hip fracture can limit mobility and lead to a loss of independence, and vertebral fractures can result in a loss of height, stooped posture, and chronic pain.

What are the risk factors for osteoporosis?

Several risk factors increase your chances of developing osteoporosis, including:

• A thin, small-boned frame.
• Previous fracture or family history of osteoporotic fracture.
• Estrogen deficiency resulting from early menopause (before age 45), either naturally, from surgical removal of the ovaries, or as a result of prolonged amenorrhea (abnormal absence of menstruation) in younger women.
• Advanced age.
• A diet low in calcium.
• Cigarette smoking.
• Excessive use of alcohol.
• Prolonged use of certain medications, such as those used to treat lupus, asthma, thyroid deficiencies, and seizures.

Are there any special issues for Hispanic women regarding bone health?

Several studies highlight the risk that Hispanic women may face with regard to developing osteoporosis:

• Hispanics are more prone to lactose intolerance than are other groups. Lactose intolerance can hinder optimal calcium intake. People with lactose intolerance may often avoid milk and other dairy products that are excellent sources of calcium because they have trouble digesting lactose, the primary sugar in milk.
• Studies have shown that Hispanic women consume less calcium than the Recommended Dietary Allowance in all age groups.
• Hispanic women are more likely than white women to develop diabetes, which may increase their risk for osteoporosis.

How can osteoporosis be prevented?

Osteoporosis prevention begins in childhood. Building strong bones, especially before the age of 20, can help defend against bone loss. A healthy lifestyle can be critically important for keeping bones strong. The recommendations listed below should be followed throughout life to help lower your risk of osteoporosis.

• Eat a well-balanced diet rich in calcium and vitamin D.
• Exercise regularly, with an emphasis on weight-bearing and resistance activities. Examples of weight-bearing exercises include walking, jogging, and dancing. Resistance exercises – such as lifting weights – can also keep bones strong.
• Don’t smoke, and, if you drink alcohol, do so in moderation.

Talk to your doctor if you have a family history of osteoporosis or other factors that may put you at increased risk for the disease. Your doctor may suggest that you have your bone density measured through a safe and painless test that can determine your risk for fractures (broken bones), and measure your response to osteoporosis treatment. The most widely recognized bone mineral density (BMD) test is called a dual-energy x-ray absorptiometry, or DXA test. The BMD test is painless, a bit like having an x-ray, but with much less exposure to radiation. It can measure bone density at your hip and spine.

What treatments are available?

Although there is no cure for osteoporosis, several medications are available for the prevention and/or treatment of osteoporosis, including: bisphosphonates; calcitonin; estrogen (hormone) therapy; estrogen agonists/antagonists (also called selective estrogen receptor modulators or SERMs); parathyroid hormone (PTH analog); parathyroid hormone-related protein (PTHrp) analog; RANK ligand (RANKL) inhibitor; and tissue-selective estrogen complex (TSEC).

Nearly 1 in 5 people in the United States live in rural areas. Rural residents tend to be older and are at higher risk for poor health outcomes than urban residents.

What is rural health?

Rural health is the health of people living in rural areas, who generally are located farther from health care facilities and other services than people living in urban areas. More than 46 million people in the United States (15% of the population) live in rural areas. There are more older adults, people with disabilities, and veterans living in rural areas. Rural areas tend to have higher rates of people who do not have health insurance and who have limited access to health care services because many medical centers in rural areas are closing.

What are rural health disparities?

People living in rural areas are generally at higher risk of disease and death than people living in urban areas. These differences in risk are known as rural health disparities. Rural residents are at greater risk of death from:

• Heart disease
• Cancer
• Stroke
• Unintentional injury (for example: motor vehicle death, opioid overdose and other substance abuse)
• Chronic lower respiratory disease

Rural residents also are more likely to have multiple health conditions compared to people living in other areas.

Heart disease, stroke, hypertension, diabetes, and arthritis are examples of health conditions that are more common in rural areas.

Within rural areas, members of racial/ethnic minority, tribal, and other diverse groups are at higher risk for poor health outcomes. American Indian/Alaska Native, African American, and Hispanic/Latino adults living in rural areas reported higher rates of fair or poor health compared to non-Hispanic white adults. Rural African American and American Indian/Alaska Native adults are more likely to have multiple chronic health conditions than non-Hispanic white adults.

What causes rural health disparities?

Factors that put people living in rural areas at greater risk for poor health outcomes include:

• Less access to care because of fewer health care providers, medical facilities, and transportation options
• Exposures to specific environmental hazards, such as pollution and poor air and water quality
• Higher rates of cigarette smoking, high blood pressure, and obesity
• Less leisure-time physical activity
• Lower seatbelt use
• Food deserts, areas with fewer grocery options and lower availability of healthy foods
• Higher rates of poverty and less likelihood of having health insurance

Sickle cell disease is an inherited blood disorder that can cause anemia, severe pain, infections, organ damage, and stroke. It is a lifelong condition that primarily affects Black/African American and Hispanic/Latino populations.

What is sickle cell disease?

Healthy red blood cells are flexible and travel through your blood vessels to carry oxygen to your tissues. Sickle cell disease (SCD) is caused by a genetic mutation that changes the shape of red blood cells from round to C-shaped like a farm tool called a sickle. Sickled red blood cells are stiff and sticky and can get stuck in blood vessels and clog the blood flow, preventing oxygen from getting to parts of the body. This blockage can cause pain.

Who is affected by sickle cell disease?

Sickle cell disease is the most commonly inherited blood disorder in the United States. About 1 out of every 400 Black or African Americans and about 1 out of every 16,000 Hispanic/Latino Americans are born with SCD.

What are the symptoms of sickle cell disease?

The symptoms and complications of SCD vary in severity from person to person and may change over time. Early symptoms usually develop around 5 months of age and may include:

• Painful swelling of the hands and feet (dactylitis)
• Fatigue or fussiness from a shortage of oxygen in the blood (anemia)
• Yellowish color of the skin (jaundice) or in the white parts of the eye (icterus)

Adults and children living with SCD often experience pain crises, which are the most common cause of hospitalization. Sickle cell disease raises the risk of acute chest syndrome, infections, heart and kidney damage, and stroke.

How is sickle cell disease diagnosed?

Since 2006, all U.S. states require newborn screening for SCD using a blood test. Adults can get screened to identify sickle cell trait (SCT), which is when a person carries the gene for SCD. Your health care provider can estimate your chances of passing the gene to your children.

How is sickle cell disease treated?

Patients may use pain medications to manage pain crises. Blood transfusions (receiving healthy blood from a donor) can help prevent complications or treat severe anemia. Four FDA-approved medications may help prevent the common complications of SCD in children and adults:

• Hydroxyurea
• L-glutamine oral powder
• Voxelotor
• Crizanlizumab-tmca

Consult with your health care provider to find out if any of these medications are right for you or your child.

The only cure for SCD is a bone marrow or stem cell transplant. Younger patients with severe SCD can consider transplants, but they are expensive, require a matching donor, and have serious risks.

Is it true that only people with light skin get skin cancer?

No. Anyone can get skin cancer. It's more common among people with a light (fair) skin tone, but skin cancer can affect anyone. Skin cancer can affect both men and women. Even teenagers and, rarely, younger children can develop skin cancer.

How can people with dark skin get skin cancer?

Although dark skin does not burn in the sun as easily as fair skin, everyone is at risk for skin cancer. Even people who don't burn are at risk for skin cancer. It doesn't matter whether you consider your skin light, dark, or somewhere in between. You are at risk for skin cancer. Being in the sun can damage your skin. Sunlight causes damage through ultraviolet, or UV rays, (they make up just one part of sunlight). Two parts of UV, UVA and UVB, can both cause damage to skin. Also, the sun isn't the only cause of skin cancer. There are other causes. That's why skin cancer may be found in places on the body never exposed to the sun.

How can I find skin cancer early?

• Talk with your doctor if you see any changes on your skin that do not go away within one month.
• Check the skin on all surfaces of your body, even in your mouth.
• Watch for a new mole or other new growth on your skin.
• Check for changes in the appearance of an old growth on the skin or scar (especially a burn scar).
• Watch for a patch of skin that is a different color and becomes darker or changes color.
• Watch for a sore that does not heal – it may bleed or form a crust.
• Check your nails for a dark band. Check with your doctor if you see changes, such as if the dark band begins to spread.

When skin cancer is found early, it can be treated more easily.

What does skin cancer look like?

There are many different types of skin cancer (such as melanoma and basal cell skin cancer). Each type looks different. Also, skin cancer in people with dark skin often looks different from skin cancer in people with fair skin. A change on the skin is the most common sign of skin cancer. This may be any new growth on the skin, a sore that doesn't heal, or a change in an old growth.

If you notice a change on your skin, see your doctor. Don't wait until the change looks like the more advanced skin cancers in these photos.

How can I protect myself from skin cancer?

Have your doctor check your skin if you are concerned about a change.
Your doctor may take a sample of your skin to check for cancer cells.

Ask your doctor about your risk of skin cancer:

• Some skin conditions and certain medicines (such as some antibiotics or hormones) may make your skin more sensitive to damage from the sun.
• Medicines or medical conditions (such as HIV) that suppress the immune system may make you more likely to develop skin cancer.
• Having scars or skin ulcers increases your risk.
• Exposure to a high level of arsenic (a poison that is sometimes found in well water or pesticides) increases your risk.

Stay out of the sun as much as you can. Whenever possible, avoid exposure to the sun from
10 a.m. to 4 p.m. If you work or play outside, then…

• Try to wear long sleeves, long pants, and a hat that shades your face, ears, and neck with a brim all around.
• Use sunscreen with a label that says it is broad spectrum or is at least SPF 15 and can filter both UVA and UVB rays.
• Wear sunglasses that filter UV to protect your eyes and the skin around your eyes.
• If you are concerned about having a low level of vitamin D from not being in the sun, talk with your doctor about supplements.

Don't use tanning beds, tanning booths, or sunlamps.

Tuberculosis (TB) is a disease that is spread from person to person through the air. TB bacteria usually attack the lungs, but it can attack any part of the body such as the kidney, spine, and brain. TB symptoms can include a persistent cough, fever, night sweats, and unintentional weight loss. If not treated properly, TB disease can be fatal.

TB disease was once a leading cause of death in the United States, but since 1993 the rates of TB in the country have declined in almost all racial and ethnic groups. In 2015, a total of 9,557 TB cases were reported in the United States; however, Hispanics/Latinos continue to have a disproportionately higher burden of TB.

Several important factors contribute to the disproportionate burden of TB in racial/ethnic groups, including Hispanics/ Latinos. These factors include being born in countries with high rates of TB or traveling to their country of origin, living in overcrowded and poorly ventilated residences, and greater burden of co-morbidities associated with TB.

The Numbers

In 2015, TB disease was reported in 2,694 Hispanics/Latinos in the United States, accounting for 28% of all people reported with TB nationally.

• Among foreign-born people with TB, 32% were Hispanics/Latinos
• The rate of TB disease was 4.8 cases per 100,000 population, which is eight times higher than the rate of TB in white, non-Hispanic people (0.6 cases per 100,000 population).

Prevention Challenges

TB is a challenging disease to diagnose, treat, and control. Dwindling resources and loss of public health capacity, including access to care and maintaining clinical and public health expertise add to the challenge. It is critical to reach those at highest risk for TB, and to identify and implement innovative strategies to improve diagnosis and treatment.

TB rates are higher for some racial and ethnic groups. This relates to a greater proportion of people in these groups who have other risk factors for TB. Like other racial and ethnic groups, Hispanics/Latinos face a number of challenges that contribute to higher rates of TB. Challenges include:

• The duration of treatment for latent TB infection and TB disease is lengthy. Patients are often unable or reluctant to take medication for several months. For people with TB disease, inadequate treatment can lead to treatment failure, relapse, ongoing transmission, and development of drug resistance. For people with latent TB infection, medication for a condition with no symptoms of illness is often not a priority.
• Socioeconomic factors impact health outcomes and are associated with poverty, including limited access to quality health care, unemployment, housing, and transportation. These factors can directly or indirectly increase the risk for TB disease and present barriers to treatment of this disease.
• Language and cultural barriers, including health knowledge, stigma associated with the disease, values, and beliefs may also place certain populations at higher risk. Stigma may deter people from seeking medical care or follow up care.
• TB remains a serious threat, especially for people who are infected with human immunodeficiency virus (HIV). People infected with HIV are more likely than uninfected people to get sick with other infections and diseases, including TB.
  • Without treatment, as with other opportunistic infections, HIV and TB can work together to shorten the life of the person infected.
• In addition to HIV, other underlying medical conditions may increase the risk that latent TB infection will progress to TB disease. For example, the risk is higher in people with diabetes, substance abuse (including injection of illegal drugs), silicosis, or those undergoing medical treatments with corticosteroids.

• Delayed detection and diagnosis of TB disease, as well as delayed reporting of TB disease remains a challenge in TB prevention and treatment. Because the number of TB cases in the United States is declining, there is decreased awareness of TB signs and symptoms among health care providers and at-risk populations. Patients may be less likely to seek medical care and health care providers may be less likely to consider TB as the cause.

Some conditions that are common among Hispanics and Latinos put them at risk for vision loss. If you are Hispanic or Latino, know your risk and take steps to protect your eye health.

Some chronic conditions, such as diabetes and high blood pressure, can put you at higher risk for vision loss, and these conditions are more common among Hispanics and Latinos than non-Hispanic whites.

• Hispanics and Latinos are almost 2.5 times more likely to have diabetes, compared to non-Hispanic whites.
• 68% of Hispanics and Latinos have poorly controlled high blood pressure, compared to 54% of non-Hispanic whites.

Diabetes can lead to diabetic retinopathy, the leading cause of blindness in working-age adults in the United States. High blood pressure can cause glaucoma. Because Hispanics and Latinos are the largest and fastest-growing minority group in the United States, by 2050, half of people living with glaucoma will be Hispanic or Latino. Other eye conditions that lead to vision loss, if not treated, are cataracts and uncorrected refractive error.

Conditions Affecting the Health of Hispanics and Latinos

In addition to having higher rates of diabetes and high blood pressure, Hispanics and Latinos are less likely to:

• Have had an eye exam—which makes them less likely to get diagnosed and treated for eye conditions that lead to vision loss.
• Participate in daily physical activity—which increases your risk of being overweight or having obesity and can lead to diabetes and other chronic conditions.
• Be able to access health and eye care services—because of language barriers and/or health insurance coverage.

Social factors also play an important role in the health of Hispanics and Latinos. Social factors contributing to poorer health in this population are:

• Living in poverty, increases the chance of not being able to afford medical services and devices such as eye exams and eyeglasses.
• Lower levels of educational attainment. In fact, 1 in 3 Hispanics/Latinos do not complete high school.
• Feelings of discrimination from physicians if Hispanic/Latino patients do not speak English.

What Can You Do?

There is encouraging news: serious eye conditions such as diabetic retinopathy and glaucoma can be detected and treated early, before vision loss occurs. Make eye health a priority for yourself and your family. Follow these simple tips for healthy vision:

• Use protective eyewear. Protective eyewear should be used during high-risk activities such as working on the job, doing yardwork, or playing sports.
• Learn about your family’s history of eye disease. Some eye diseases can be hereditary, such as glaucoma, so it is important to share your family history with your eye doctor.
• Quit smoking or never start. It increases your risk of developing age-related macular degeneration and cataracts, and increases the severity of diabetic eye disease.
• Live a healthy lifestyle. Eating a healthy diet can help you maintain a healthy weight, which lowers the risk for type 2 diabetes.
• Manage your chronic conditions. If you have a chronic condition, such as diabetes or high blood pressure, it is important to take your medicines as prescribed to help manage your condition.

Data are for the U.S.

Live births

• Number of births: 866,713
• Births per 1,000 women aged 15-44: 63.1

Source: Births: Final Data for 2020 [PDF – 1 MB]

Health status

• Percent of adults aged 18 and over in fair or poor health: 15.4% (2021)

Source: Interactive Summary Health Statistics for Adults: National Health Interview Survey, 2019-2021

• Percent of children under age 18 years in fair or poor health: 3.0% (2021)

Source: Interactive Summary Health Statistics for Children: National Health Interview Survey, 2019-2021

Smoking

• Percent of adults aged 18 and over who currently smoke cigarettes: 7.7% (2021)

Source: Interactive Summary Health Statistics for Adults: National Health Interview Survey, 2019-2021

Obesity

• Percent of men aged 20 and over with obesity: 44.8% (2015-2018)
• Percent of women aged 20 and over with obesity: 46.8% (2015-2018)

Source: Health, United States, 2019, Table 26 [PDF – 9.8 MB]

Hypertension

• Percent of men aged 20 and over with hypertension (measured high blood pressure and/or taking antihypertensive medication): 46.0% (2015-2018)
• Percent of women aged 20 and over with hypertension (measured high blood pressure and/or taking antihypertensive medication): 35.4% (2015-2018)

Source: Health, United States, 2019, Table 22 [PDF – 9.8 MB]

Health insurance coverage

• Percent of adults aged 18–64 without health insurance coverage: 28.7% (2021)

Source: Interactive Summary Health Statistics for Adults: National Health Interview Survey, 2019-2021

• Percent of children under age 18 years without health insurance coverage: 7.7% (2021)

Source: Interactive Summary Health Statistics for Children: National Health Interview Survey, 2019-2021

Mortality

• Number of deaths: 305,708
• Deaths per 100,000 population: 498.6

Source: National Vital Statistics System – Mortality Data (2020) via CDC WONDER

Leading causes of death

• COVID-19
• Heart disease
• Cancer

Source: National Vital Statistics System – Mortality Data (2020) via CDC WONDER

Infant deaths

• Infant deaths per 1,000 live births: 4.69

Source: Infant Mortality in the United States, 2020: Data From the Period Linked Birth/Infant Death File [PDF – 1 MB]