Epidemiology and impact of rheumatic disorders in the United States Hispanic population

The emergence of a sizable Hispanic population in the US is a relatively recent historical phenomenon, and thus much is still unknown about this group of North Americans. Data from national surveys suggest small differences between Hispanic and non-Hispanic white populations in the age-adjusted prevalence of self-reported arthritic conditions. However, the rate of activity-limitation attributable to arthritis is higher among Hispanic patients. This likely reflects the poorer socioeconomic conditions and lack of health insurance that prevail among Hispanic populations, which may limit their access to rheumatologic care. Osteoporotic vertebral and hip fractures are less frequent, and proximal femoral mineral density is higher, in Hispanic individuals than in non-Hispanic white individuals. The mechanisms for these observations are currently under investigation. There have been no studies of the prevalence of osteoarthritis, rheumatoid arthritis, or systemic lupus erythematosus among Hispanic populations. However, important immunogenetic, clinical, and psychosocial differences between Hispanic and non-Hispanic patients in regard to rheumatoid arthritis and systemic lupus erythematosus have been reported. There is no published information on the prevalence or characteristics of other rheumatic diseases in the US Hispanic population. Emerging evidence suggests considerable underuse of certain health services for arthritis among Hispanic patients, likely due in part to socioeconomic factors. Further research is needed to determine whether biologic, cultural or psychosocial factors contribute to underuse as well. There is clearly a need for data on the prevalence and characteristics of arthritis and other rheumatic and musculoskeletal diseases in this emerging US population.