title: Association of Acculturation and Health Literacy with Prevalent Dysglycemia and Diabetes Control Among Latinos in the Boston Area Community Health (BACH) Survey.
abstract: This study assessed the effect of acculturation on type 2 diabetes and whether health literacy may mediate this association. The Boston Area Community Health cohort is a multi-stage stratified random sample of adults from Boston including 744 Latinos. We defined dysglycemia as a HbA1c ≥5.7 %. Multivariable analyses examined the associations between acculturation and health literacy adjusting for demographic and clinical variables. Similar analyses were performed among participants with HbA1c ≥7.0 % to assess the association between acculturation and diabetes control. Among an insured primarily foreign born Spanish speaking Latino population, with a long residence period in the US and good healthcare utilization, higher levels of acculturation were not associated with dysglycemia. Lower levels of acculturation were associated with worse diabetes control. Health literacy level did not modify these associations. Elucidating the components of heterogeneity among Latinos will be essential for understanding the influence of acculturation on diabetes.
authors.affiliation: Division of Hospital Medicine, University of California San Francisco, San Francisco, CA, USA. lopezlenny77@gmail.com.
authors.forename: Lenny
authors.initials: L
authors.lastname: López
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
authors.forename: Richard W
authors.initials: RW
authors.lastname: Grant
authors.affiliation: New England Research Institutes, Boston, MA, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Marceau
authors.affiliation: New England Research Institutes, Boston, MA, USA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Piccolo
authors.affiliation: New England Research Institutes, Boston, MA, USA.
authors.forename: John B
authors.initials: JB
authors.lastname: McKinlay
authors.affiliation: Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: James B
authors.initials: JB
authors.lastname: Meigs
mesh_terms: D000069:Acculturation; D000328:Adult; D000368:Aged; D001900:Boston / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology*; D005260:Female; D006442:Glycated Hemoglobin; D057220:Health Literacy; D006296:Health Services / Q000706:statistics & numerical data; D006306:Health Surveys; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000208:ethnology*; D015995:Prevalence; D012959:Socioeconomic Factors
chemical_list: D006442:Glycated Hemoglobin
keywords: Acculturation; Health literacy; Latinos; Type 2 diabetes