Persistent disparities in cholesterol screening among immigrants to the United States

Self-reported cholesterol screening for adults was calculated from multivariate logistic regression analysis of the 1988–2008 National Health and Nutrition Examination Surveys (N？=？17,118). Immigrant populations were classified by place of birth and length of residency.After adjusting for individual characteristics and access to health care, the multivariate adjusted probability of cholesterol screening is significantly lower for persons originating from Mexico (70.9%) compared to persons born in the US (80.1%) or compared to US born Hispanic persons (77.8%). Adjustment for access to care did significantly reduce the difference in screening rates between immigrants and natives because the rate for natives remained the same, but the rate for immigrants improved. For example, the difference in screening between US born persons and persons born in Mexico was reduced by nearly 10% after adjustment for access to care.There are persistent disparities in cholesterol screening for immigrants, particularly recent immigrants from Mexico, but improved access to health care may be a viable policy intervention to reduce disparities.Please see related article: http://www.biomedcentral.com/1741-7015/10/55 webciteAlthough trends in cholesterol have followed a downward trajectory over time, disparities in cholesterol levels persist [1-4]. Theory suggests that the persistence of disparities in cholesterol over time is expected and may be related to changes in prevention and treatment [5]. By studying how cholesterol prevention and treatment efforts vary over time across disadvantaged populations, it may provide insight into disparities for chronic diseases [6,7]. Most research on the disparities of cardiovascular disease risk factors such as cholesterol has been focused on socioeconomic status and race/ethnicity [1]. Nativity status has received less attention in the cholesterol literature despite evidence that it is an important factor differentiating health and limiting access to c