Mortality disparities recorded within Hispanic/Latino groups pre-pandemic

1. In this cohort study, within the pre-pandemic period, persons of Puerto Rican and Cuban backgrounds were found to have significantly higher rates of mortality compared to those of South American backgrounds.

2. There were no significant differences in all-cause two-year mortality rates within Hispanic/Latino groups during the pandemic.

Evidence Rating Level: 2 (Good)

Study Rundown: Within the United States, there has been historical data showing that a variation in all-cause mortality exists within subgroups of those belonging to Hispanic/Latino groups, which has been hypothesized to differ by proxy measures of acculturation to the country. However, factors contributing to mortality rates within specific groups are complex and multifactorial. It is hypothesized that there are aspects of Hispanic/Latino culture, lifestyle factors, etc., which may alter mortality risk. This was a large prospective cohort study evaluating cumulative all-cause mortality and its possible causes where differences existed amongst Hispanic/Latino populations from four cities within the United States. Results of the study found that there did exist within-group variation in all-cause mortality in the 11 years before the coronavirus disease 2019 (COVID-19) pandemic, which was explained by lifestyle, chronic disease, and clinical factors. Subsequently, during the pandemic, the differences in all-cause mortality between South American and Central American-identifying Hispanic/Latino persons were not statistically significant. Although it’s challenging to directly extrapolate these findings to Hispanic/Latino populations beyond the pools from which participants were sampled, this study offers interesting insights into the heterogeneities within this population. Further, it offers greater insight into Hispanic/Latino culture and population characteristics that may affect overall mortality.

Click to read the study in AIM

In-Depth [prospective cohort study]: This prospective, multicenter cohort study evaluated cumulative all-cause mortality and its associated etiologies amongst persons belonging to Hispanic/Latino ethnicities within the United States with recruitment spanning 2008 to 2011. The primary outcome of interest was to describe all-cause mortality during the study’s inclusion period, with additional outcomes of interest including etiologies of differential mortality risks amongst various groups and chronic conditions. Adults self-identifying as Hispanic or Latino between the ages of 18 and 74 residing in the Bronx (New York), Chicago (Illinois), Miami (Florida), and San Diego (California) were invited to participate per a multistage probability sampling design. Overall, 16,415 participants were invited to participate, and 15,568 were included in the final analysis. The analysis found that the overall 11-year cumulative all-cause mortality risk after adjustment for age differed by ethnicity pre-pandemic. Specifically, persons of Puerto Rican (6.3%; 95% Confidence Interval [CI], 5.2%-7.5%) and Cuban backgrounds (5.9%; 95% CI, 5.1%-6.8%) were found to have significantly higher rates of age-adjusted all-cause mortality compared to patients of South American background (2.3%; 95% CI, 1.6%-3.4%). There were no significant differences in two-year cumulative all-cause mortality when adjusted by age and sex between persons of South American and Central American backgrounds during the pandemic. A key limitation of this study is the absence of comparator groups, such as non-Hispanic White populations, to offer direct comparisons in mortality risk. Overall, this was a large population-based cohort study, which strengthened the existing pool of literature’s understanding of the heterogeneities that contribute to all-cause mortality and the changes in in all-cause mortality before and for a duration within the pandemic for this population.

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