Health status of Hispanic elders.

Hispanic elders living in the United States compose a rapidly increasing population. They are underinsured and more likely to be living in poverty. Health care is hindered in this population by lower access to health services and less use of preventive services. Barriers to access are primarily socioeconomic. Acculturation exerts an effect, primarily through its association with language skills, employment, and education. Cardiovascular disease is the leading cause of mortality for Hispanics, who have a higher prevalence of risk factors for cardiovascular disease, such as diabetes mellitus, obesity, and hyperlipidemia. Although neoplasia is the second most frequent cause of death among Hispanics, as it is in whites who are not Hispanic, Hispanics have an overall lower cancer rate. Cancer rates are increasing, however. Non-insulin-dependent diabetes mellitus is a significant cause of morbidity and mortality in the Hispanic population, affecting nearly a quarter of adult Puerto Ricans and Mexican Americans. Although higher prevalence of obesity in the Hispanic population accounts for some of this difference, some data suggest the possibility of a genetic component as well. Assessment of psychological health in Hispanic elders is impeded by the lack of instruments designed for this population. Distress is often expressed as somatic symptoms. Values traditional to Hispanic culture, such as respeto, allocentrism, and familialism, are important to US Hispanic elders, many of whom were born in rural Mexico. Our knowledge of determinants of healthy aging in this population is still preliminary, but rapidly expanding, in part, because of increased attention to ethnicity in health reporting.