title: Lack of Lipid Screening Disparities in Obese Latino Adults at Health Centers.
abstract: BACKGROUND
  In cross-sectional survey studies, obese Latinos are less likely to be screened for elevated serum cholesterol, despite their higher risk for hyperlipidemia and coronary artery disease. This study evaluated insurance and racial/ethnic disparities in lipid screening receipt between obese Latino and non-Hispanic white patients in Oregon community health centers (CHCs) over 5 years, using electronic health record data.
  
  
  METHODS
  This retrospective cohort study evaluated obese (BMI ≥30), low-income, adult patients (aged 21-79 years) with at least one visit at an Oregon CHC during 2009-2013 (n=11,095). Odds of lipid screening in the study period (clinical data collected in 2009-2013) were measured, adjusting for age, sex, primary clinic, and comorbidities, stratified by utilization in the study period. Analysis was done in 2016.
  
  
  RESULTS
  Sixty percent of the study population received at least one lipid screening in 2009-2013. There were no significant differences in screening between insured Latinos and insured non-Hispanic whites, except those with more than five visits over 5 years (OR=0.75, 95% CI=0.60, 0.94). Uninsured Latinos had higher odds of screening versus insured non-Hispanic whites among the low visit strata (OR=1.65, 95% CI=1.18, 2.30). Among Latinos, Spanish preference resulted in higher screening odds versus English preference in the two- to five-visit stratum (OR=1.63, 95% CI=1.12, 2.35).
  
  
  CONCLUSIONS
  Obese, low-income patients at CHCs underutilize cholesterol screening. However, screening differences by race/ethnicity and preferred language are minimal. Further research is necessary to understand how care delivered by CHCs may mitigate previously reported disparities in lipid screening.
authors.affiliation: Department of Family Medicine, Oregon Health & Science University, Portland, Oregon. Electronic address: heintzma@ohsu.edu.
authors.forename: John D
authors.initials: JD
authors.lastname: Heintzman
authors.affiliation: Department of Family Medicine, Oregon Health & Science University, Portland, Oregon.
authors.forename: Steffani R
authors.initials: SR
authors.lastname: Bailey
authors.affiliation: Department of Family Medicine, Oregon Health & Science University, Portland, Oregon.
authors.forename: John
authors.initials: J
authors.lastname: Muench
authors.affiliation: Department of Family Medicine, Oregon Health & Science University, Portland, Oregon.
authors.forename: Marie
authors.initials: M
authors.lastname: Killerby
authors.affiliation: OCHIN, Inc., Portland, Oregon.
authors.forename: Stuart
authors.initials: S
authors.lastname: Cowburn
authors.affiliation: Department of Family Medicine, Oregon Health & Science University, Portland, Oregon.
authors.forename: Miguel
authors.initials: M
authors.lastname: Marino
mesh_terms: D000328:Adult; D002784:Cholesterol / Q000032:analysis* / Q000097:blood; D003151:Community Health Centers; D005006:Ethnicity; D005260:Female; D054625:Healthcare Disparities / Q000208:ethnology*; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D009765:Obesity; D009922:Oregon; D011203:Poverty; D012189:Retrospective Studies; D044465:White People / Q000706:statistics & numerical data
chemical_list: D002784:Cholesterol