ABSTRACT
Literature on depression in rural and Hispanic elderly adults is sparse. This report describes the prevalence of depressive symptoms in 1,151 community-dwelling, Hispanic and non-Hispanic White participants in the San Luis Valley Health and Aging Study, conducted in rural Colorado during 1993-1995. The prevalence and odds ratios of high depressive symptoms, defined as a Center for Epidemiologic Studies Depression Scale score of > or = 16, were calculated. The crude prevalence of high depressive symptoms was 11.4% (95% confidence interval: 9.6, 13.6). Female gender, chronic diseases, dissatisfaction with social support, living alone, and lower income and education were associated with depressive symptoms. There were no ethnic differences in the men. The age-adjusted odds ratio of depressive symptoms in Hispanic women compared with that of non-Hispanic White women was 2.11 (95% confidence interval: 1.32, 3.38). After adjustment for multiple sociodemographic and health risk factors, the odds ratio in Hispanic women was 2.12 (95% confidence interval: 1.19, 3.80). Higher depressive symptoms in Hispanic women varied by acculturation level. The odds ratio in the high acculturation stratum was 1.56 (95% confidence interval: 0.75, 3.27) and in the low acculturation stratum was 2.51 (95% confidence interval: 1.11, 5.70). A lower acculturation level may increase the risk for depression in older Hispanic women.
Subject(s)
Aged, 80 and over/psychology , Aged/psychology , Depression/ethnology , Hispanic or Latino/psychology , Rural Health , Case-Control Studies , Colorado/epidemiology , Female , Hispanic or Latino/statistics & numerical data , Humans , Male , Middle Aged/psychology , Odds Ratio , Prevalence , Risk Factors , Socioeconomic Factors , White People/statistics & numerical dataABSTRACT
Non-insulin-dependent diabetes mellitus is between two and five times more prevalent among Hispanic Americans than among non-Hispanic whites (NHW). Incidence data for Hispanic populations will help to determine whether this excess prevalence is due to increased incidence, survivorship, or other factors. Incident cases were identified through concurrent surveillance of all local medical practices from 1983 to 1988 in two southern Colorado counties in which the population was 46% Hispanic. All identified subjects were invited for an oral glucose tolerance test. Among the subjects who attended clinic, 83% were confirmed as having diabetes, using WHO criteria. The standardized average annual incidence rates per 1000 for confirmed non-insulin-dependent diabetes, accounting for nonresponse, were 3.7 and 1.6 for Hispanic and NHW males, and 4.5 and 1.2 for Hispanic and NHW females, respectively. The age and nonresponse adjusted rate ratio comparing Hispanics to NHWs was 3.1 (95% CI: 2.3-4.2), indicating a significant excess risk of diabetes incidence for the Hispanic population in southern Colorado. Peak age-specific incidence among Hispanics occurred in persons 50 to 59 years old, a decade earlier than among NHWs. These results are consistent with data from the Mexican-American population in Texas and suggest that the previously observed excess in diabetes prevalence is due to higher incidence rates. The earlier age-specific peak in incidence has also been observed in Mexican-American and American Indian populations, suggesting that risk factors may operate at earlier ages.
