Prevalence of undiagnosed chronic disease among self-described healthy latinos

Background: The UCLA/USC Center for Population Health and Health Disparities (CPHHD) seeks to reduce cardiovascular disease risk in East Los Angeles, a predominantly low-income, immigrant Latino community with high rates of obesity-related chronic diseases such as heart disease, diabetes, hypertension and stroke. The eligibility requirements of two CPHHD research projects include that subjects be free of chronic diseases, be able to eat a healthy diet, and be able to walk one mile unassisted. Methods: Principal recruitment strategies were community based advertising, and staff presentations in the community. Recruitment messages made clear that to be eligible, subjects had to be free of diabetes, cardiovascular disease, or invasive cancer and be in good physical health. Candidates were queried about health status by questionnaire and then if eligible underwent biometric screening. Key Results: Preliminary data show that over 45% of self-described “healthy” subjects were ineligible because of undiagnosed existing disease, as determined by paper and/or biometric screening. Questionnaire responses identified 38% of candidates as ineligible, primarily because of elevated cardiovascular risk factors, diabetes and physical health limitations. Biometric data identified 7% of candidates as ineligible based on BMI, blood pressure, pulse wave velocity, and elevated HbA1C measures. Discussion: A large proportion of seemingly “healthy” Latino adults in East L.A. in fact harbor undiagnosed existing disease. Community screening for major chronic disease risk factors in East L.A. would likely help reduce health disparities by early identification and treatment of chronic disease risk factors before medical complications arise, requiring more intensive medical intervention.