Background: We set out to describe the risk of hospitalization from heart disease, stroke, and diabetes among persons born in India, all foreign-born persons, and U.S.-born persons residing in New York City. Methods: We examined billing records of 1,083,817 persons hospitalized in New York City during the year 2000. The zip code of each patient's residence was linked to corresponding data from the 2000 U.S. Census to obtain covariates not present in the billing records. Using logistic models, we evaluated the risk of hospitalization for heart disease, stroke and diabetes by country of origin. Results: After controlling for covariates, Indian-born persons are at similar risk of hospitalization for heart disease (RR = 1.02, 95% confidence interval 1.02, 1.03), stroke (RR = 1.00, 95% confidence interval, 0.99, 1.01), and diabetes mellitus (RR = 0.96 95% confidence interval 0.94, 0.97) as native-born persons. However, Indian-born persons are more likely to be hospitalized for these diseases than other foreign-born persons. For instance, the risk of hospitalization for heart disease among foreign-born persons is 0.70 (95% confidence interval 0.67, 0.72) and the risk of hospitalization for diabetes is 0.39 (95% confidence interval 0.37, 0.42) relative to native-born persons. Conclusions: South Asians have considerably lower rates of hospitalization in New York than reported in countries with national health systems. Access may play a role. Clinicians working in immigrant settings should nonetheless maintain a higher vigilance for these conditions among Indian-born persons than among other foreign-born populations. © 2004 Muennig et al; licensee BioMed Central Ltd.

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hospitalization India Stroke cerebrovascular accident demography Diabetes Complications Indian human epidemiology risk assessment middle aged statistics diabetes mellitus controlled study priority journal Aged Logistic Models Epidemiologic Studies ethnology national health service Small-Area Analysis Confidence interval cluster analysis United States South Asia Humans Adolescent Infant, Newborn male preschool child Socioeconomic Factors Infant Child, Preschool newborn female socioeconomics heart disease population research Heart Diseases Article adult migration health care access New York City coronary artery atherosclerosis Emigration and Immigration statistical model hospital billing alertness Child