Diabetes Monitoring in Foreign-Born and US-Born Latino Adults in US Community Health Centers

Introduction: The Latino population is the largest ethnic group in the United States and has a higher prevalence of diabetes mellitus than non-Latino Whites. The objective of this article is to assess if glycohemoglobin (HbA1c) monitoring rates vary across Latino patients by subgroup and nativity compared with their non-Latino White counterparts. Methods: Our sample included 43,593 adults (18 to 79 years) with Type-2 diabetes extracted from electronic health record (EHR) data from Community Health Centers (CHCs) across 16 US states, linked with neighborhood-level Latino subgroup data within the study period 2012 to 2020. The outcome was number of HbA1c monitoring tests per year. The main independent variable was self-reported ethnicity/nativity (eg, Mexican-born, US-born Latino, etc.) or for those with no EHR-recorded country of birth. Results: Compared with non-Latino White people with diabetes, US-born Latinos with diabetes had an 11% higher rate of receiving HbA1c monitoring; no foreign-born Latinos had monitoring rates that differed significantly from non-Latino Whites. Latinos with no country of birth recorded and living in high percent Mexican neighborhood had 22% higher rates of receiving HbA1c monitoring. Those living in high percent Dominican, Guatemalan and Honduran neighborhoods also had greater rates of HbA1c monitoring compared with non-Latino White patients. Conclusions: It could be beneficial for clinics to inquire about nativity and subgroup information of their Latino patients, so as to customize the treatment plan and better understand utilization patterns common in their communities.