OLDER LATINOS AT HIGHER RISK FOR DIABETES.

Byline: Troy Anderson Staff Writer

Older Latinos die as a result of diabetes twice as often as non-Latino whites, and fewer elderly Latinos take advantage of Medicare than other elderly, according to two groundbreaking UCLA studies released Tuesday.

The findings underscore the need for education and other action on health needs of the growing Latino population, officials said.

The studies are based on surveys of 602 Latinos and 577 non-Latino whites in Los Angeles County, about half of whom live in the San Fernando Valley. The survey included immigrant Latinos, U.S.-born Latinos and non-Latino whites.

``In all populations, diabetes is increasing and it really is becoming an epidemic,'' said David Hayes-Bautista, lead researcher and director of the University of California, Los Angeles, Center of the Study of Latino Health and Culture.

``It's especially impacting elderly Latinos, whose mortality rates have gone up even faster in the last 10 or 15 years than the rest of the population,'' Hayes-Bautista said.

For those between the ages of 65 and 74, the mortality rates from diabetes in California in 1996 - the most recent figures available - were 57.8 deaths per 100,000 non-Latino whites and 135.7 per 100,000 for Latinos, the diabetes study found. Diabetes remains a leading threat to African-Americans, with a 194.7 per 100,000 mortality rate.

The second study found elderly Latinos lag behind other groups when it comes to accessing Medicare benefits.

Only 71 percent of the elderly Latino immigrant population in Los Angeles is enrolled in Medicare. By comparison, 95 percent of the non-Latino white population and 89 percent of U.S.-born Latinos have registered for Medicare benefits.

Legal permanent residents are eligible for Medicare coverage, but researchers found that a significant percentage said they were unaware of that.

``From our survey, we estimated that in 2002, there will be more than 53,000 Latino elderly not enrolled in Medicare,'' Hayes-Bautista said. ``That's a very significant number and that number will be growing as the number of elderly Latinos grows every year.''

Health officials said the statistics underline the need to educate older Latinos about the need to register for Medicare, and the importance of a healthy diet and exercise to avoid the potentially devastating consequences of diabetes, which can cause blindness and lead to the need to amputate limbs.

``The studies, among many key findings, suggest the urgent need for greater bilingual education on diabetes - termed the 'Latino disease' - and access to government-sponsored health care programs like Medicare,'' said Gustavo Valdespino, senior vice president for the Southern California Tenet HealthSystem, which sponsored the research.

One of the top 10 causes of death, diabetes is the only one in which the Latino rate is significantly higher than the non-Latino white rate, the diabetes study found.

The survey found that elderly Latinos were likely to mention the role of heredity and diet as the causes of diabetes, but the survey also found they are more likely than non-Latino whites to cite the role of emotional factors, such as ``susto,'' a Latino folk illness involving strong emotional shock, and ``nervios,'' or emotional upset, and stress as causative factors for diabetes.

``If your 16-year-old daughter said, 'By the way, I'm pregnant,' that would give you susto,'' Hayes-Bautista said. ``Yes, we'd like them to change their diets, lose weight and exercise. But if we can help them with their susto, we'll probably see their compliance go up.''

Dr. Art Gomez, a doctor of internal medicine at UCLA-Olive View Medical Center in Sylmar, said diabetes is a significant problem in the Valley.

``A lot of patients are undiagnosed,'' he said. ``In the Valley, with the growing Hispanic population, a lot more emphasis needs to be made to teach the public to get health checks and to diagnose it early. A lot can be done to prevent complications with good treatment.''

The primary reasons given by elderly immigrant Latinos for not enrolling in Medicare was a mistaken belief that naturalized citizenship is a prerequisite for eligibility. Legal permanent residents are eligible for Medicare coverage.

Information for Spanish speakers on eligibility requirements and how to register for Medicare benefits is available at [phone]. The official Medicare Web site, which also has information in Spanish, is at www.Medicare.gov.

The Medicare study was conducted in a joint project involving the UCLA Center for the Study of Latino Health & Culture and the Edward R. Roybal Institute for Applied Gerontology at California State University, Los Angeles.

The diabetes study was conducted for the Roybal Immunization Consortium for Older Adults in a joint project involving the UCLA Center for the Study of Latino Health & Culture, the Edward R. Roybal Institute for Applied Gerontology at California State University, Los Angeles, the California Department of Health, the federal Centers for Disease Control and Prevention and the National Immunization Program.

Funding was provided by the Tenet Healthcare Foundation. With 32 hospitals in Southern California, Tenet HealthSystem estimates that Latinos make up at least half the patients at 10 of its hospitals. The only Tenet hospital in the Valley is Encino-Tarzana Regional Medical Center, where 35 percent of its patients are Latino.

CAPTION(S):

2 charts

Chart:

(1) PERCENT ENROLLED IN MEDICARE

(2) DIABETES MORTALITY RATE

SOURCE: UCLA Center for the Study of Latino Health & Culture