Recent evidence suggests that the health of the population in the United States continues to improve. However, over the past decades, the United Stated has seen a widespread disparity in the society, wealth, education, race and gender. Income and wealth are unevenly distributed and this distribution leads to widespread health disparities across racial, ethnic, and socioeconomic status groups. In addition, a multitude of economic, social, and political factors combined cause a health disparity between those groups
1. The United States is known for its diversity and unfortunately is an outstanding example of inequality in health. One of the most dramatic and important demographic trends affecting the United States is the rapid growth of the Hispanic (Latino) population that represents an increasing diversity of national-origin groups
2. Socioeconomic status is one of the most important determinants of health and the link between SES and health is widely accepted. A study using pooled National Health Interview Surveys from 1999 to 2001 discovered that Puerto Ricans, Mexican Americans, and other Hispanics demonstrated significantly less access to health care as compared to non-Hispanic whites with an immigrant status. According to the study, socioeconomic status was an important factor in greater access to regular and high-quality health care for Hispanics. For example, approximately 72 percent of Hispanics reported having a regular source of care compared to 84 percent of non-Hispanic whites with an immigrant status. However, racial and ethnic differences diminished as income increased. In families with a yearly income of less than $20,000, about 63 percent of Hispanics had a regular source of care compared with approximately 75 percent of non-Hispanic whites with an immigrant status
3. This indicates larger issues of disparities in access to care due to socioeconomic status. Relationships between socioeconomic status, ethnicity, and chronic disease undoubtedly have complex explanations. The socioeconomic status has been used to explain the higher prevalence and higher mortality rates among Hispanics of common conditions such as diabetes, heart disease, hypertension, asthma, arthritis, and cancer. According to the Centers for Disease Control and Prevention (CDC), diabetes is the fifth leading cause of death among Hispanics and is a leading cause of heart disease, stroke, kidney disease, blindness, and amputations
4. Mexico is the largest contributor of immigrants to the United States and has recently experienced rapid increases in diabetes rate. Based on analysis of data from 2007 California Health Interview Survey, Baby-Boom cohort of Californians documents a health and socioeconomic disparities between U.S.-born non-Hispanic whites and Mexican-origin populations. The results show that poverty and low education are associated with worse health and have the strongest effects on developing diabetes among Mexican-origin populations
5. A study that used the database from the Hispanic Established Population for the Epidemiologic Study of the Elderly (HEPESE) of 3,050 non-institutionalized Mexican Americans aged 65 years from 1993 to 1994 to determine the number of individuals who were diagnosed with diabetes showed that English-speaking respondents with high socioeconomic status have a lower risk of developing diabetes than Spanish-speaking with low socioeconomic status from 1st to 3rd generation. The study demonstrated that high socioeconomic status of individuals and increased exposure to the U.S. culture led to decreased risk of developing diabetes. Thus, increased cultural assimilation, which was measured by language preference was a protective factor for developing diabetes among high socioeconomic status of Mexican Americans
6. Another study showed that higher percentages of Spanish-speaking and Bilingual Hispanics had a low education, income, and occupation and therefore have been similar in the prevalence of hypertension, diabetes, and high cholesterol compared with English-speaking Hispanics. In conclusion, there are important differences among the Hispanic population of different English language proficiency with regard to education, income, occupation, and health status
7. Another chronic disease that affects the Hispanic population is asthma. According to the Centers for Disease Control and Prevention (CDC), Hispanics are 60 percent more likely to visit the hospital for asthma, as compared to non-Hispanic whites
8. Poverty, a common condition in Hispanics, has been associated with increased risks of acute asthma among children and adults, particularly in urban areas. A study that interviewed 1,847 patients at sixty-four North American emergency departments during the period 1996 to 1998 showed that about 63% of Hispanics had a history of hospitalizations due to acute asthma compared with approximately 54% of non-Hispanic whites. The study also revealed that Hispanics visit emergency room three times per year compared with only one visit per year of their white counterparts. This proves that Hispanic asthma patients had a history of more hospitalizations and more frequent emergency department use than non-Hispanic whites. After adjusting socioeconomic status, it appears that this explains most of the differences in acute asthma however, the impact of race and ethnicity in the development of acute asthma were significantly reduced
9. In conclusion, the socioeconomic status is a risk factor for the acute asthma and inadequate access to health care. Arthritis is one of the leading cause of chronic disability in the United States
10. Surgical procedures of replacement arthritic hips and knees reduce the pain and increase mobility. These procedures revolutionized the treatment of arthritis, providing a cost-effective alternative to analgesics, canes, and wheelchairs. According to data from the Hispanic Health and Nutrition Examination Survey and the National Health Interview Survey, self-reported arthritis is less frequent among Hispanics compared with their white counterparts
11. However, recipients of hip replacement, less likely to be Hispanics due to inequalities in access to care, linked to the generally lower socioeconomic conditions of Hispanics in the United States. The study that used a data from medical records of the twelve out of the seventeen accredited hospitals in Bexar County, Texas revealed that Hispanics less likely received a hip replacement. The researchers emphasized that low socioeconomic status was a risk factor of not getting a replacement. According to the study, Hispanics had lower socioeconomic status and their jobs were more physically demanding than non-Hispanic whites
12. Cancer is the leading cause of death among the Hispanic population, accounting for 22 percent of deaths
13. A large number of cancer cases and deaths could be prevented by screening. Regular screening can detect cancer at an early stage and improve the chances of a cure for some types of cancer. However, according to American Cancer Society, Hispanics are less likely to have a screening test for cancer than non-Hispanic whites
13. A study that used a data from the survey of low-income Hispanics, mostly immigrant, at community-based organizations and health clinics in New York City revealed that that the colonoscopy rates among Hispanics are low and lower than those for non-Hispanic whites
14. Another study that investigated the influences of acculturation, socioeconomic status, and cultural health beliefs on Mexican-descent women’s preventive health behaviors showed that Mexican-descent women who were less U.S. acculturated and had lower socioeconomic status were less likely to seek breast cancer screening, less likely to know the danger signs of breast cancer, and less likely to seek immediate care for health-related problems. The researchers emphasized that Mexican-descent women have a high risk of developing late-stage cancer, even when free health services are offered. Many of those women are hesitant to participate in regular screening. They, therefore, concluded that low SES Mexicandescent women could learn frugal habits as part of their cultural tradition that impacts their health care decisions. In addition, low socioeconomic status leads to structural limitations on health care access
15. The study that used data from a community sample of 963 women also emphasized that socioeconomic status was correlated significantly with mammography use in the sampled group. Moreover, the study conducted a separate analysis by ethnicity, which identified a substantial relationship between mammography use and fear of pain among Hispanic women. The researchers also run a pooled regression analysis controlling for ethnicity and socioeconomic status, which showed that concerns about cost were significant independent predictors of mammography use
16. Communities with high rates of poverty suffer from poor health and social outcomes such as mental illness. In general, Hispanic communities show similar susceptibility to mental illness as the general population, unfortunately, they experience disparities in access and quality of treatment they receive
17. The study that collected data from the 1990–1992 National Comorbidity Survey of 8,098 English-speaking respondents aged 15 to 54 years who self-identified their race or ethnicity showed that Latinos with low socioeconomic status have lower access to specialty care than non-Latino whites with the same socioeconomic status. The study also revealed that significant differences between Latinos and their white counterparts were found in demographic characteristics, a zone of residence, geographical location, insurance status, and use of mental health services. In conclusion, the results of this study underlined the urgent need for action to augment access to mental health care for Latinos with low socioeconomic status
