Atherosclerotic cardiovascular disease measures in foreign-born Latino patients by country of birth compared with U.S.-born Latinos

Abstract

Objective: The burden of atherosclerotic cardiovascular disease (ASCVD) may differ based on the country of birth in Latinos, therefore, we aimed to examine differences in the utilization of ASCVD screening services, which have not been studied using large healthcare datasets.

Methods: Data included electronic health record (EHR) data from a multistate network of United States (U.S.) community health centers from 2014 to 2020. The study population (N = 49,177) was foreign-born Latinos (from ten different Latin countries) and U.S.-born Latino patients aged 40-83 years seeking care at 149 U.S. community health centers across 14 states. To compare the prevalence of documented medical record data necessary for ASCVD risk calculation, we performed a cross-sectional anlaysis, using logistic regression, adjusted for demographic and health services utilization factors.

Results: The adjusted odds ratio (aOR) comparing foreign-born to U.S.-born Latinos was 1.17 (95 % CI = 1.01, 1.35). When stratifying by country of birth, patients from specific countries had higher odds of documented data when compared to their U.S.-born counterparts (Dominican Republic: aOR = 1.13, 95 % CI = 1.03, 1.24; El Salvador: aOR = 1.26, 95 % CI = 1.08, 1.47; Guatemala: aOR = 1.17, 95 % CI = 1.02, 1.34; Mexico: aOR = 1.19, 95 % CI = 1.01, 1.41).

Conclusions: Foreign-born Latinos from El Salvador, Guatemala, the Dominican Republic, and Mexico are more likely to have documented information in their EHR necessary to assess cardiovascular risk. These findings underscore the clinical importance of data disaggregation in Latino patients as specific national birthplace may be associated with the adequacy of cardiovascular screening.

Keywords: Cardiovascular disease; Cholesterol screening; Hispanic; Immigrant.