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Fernández-Rhodes L, Ward JB, Martin CL, Zeki Al Hazzouri A, Torres J, Gordon-Larsen P, Haan MN, Aiello AE. Intergenerational educational mobility and type 2 diabetes in the Sacramento Area Latino Study on Aging. Ann Epidemiol 2022; 65:93-100. [PMID: 34303766 PMCID: PMC8748283 DOI: 10.1016/j.annepidem.2021.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 07/11/2021] [Accepted: 07/13/2021] [Indexed: 01/03/2023]
Abstract
PURPOSE United States (US) Latinos have the lowest educational attainment of any US racial/ethnic group, which may contribute to their disparate burden of Type 2 Diabetes. Herein, we aimed to examine the association between intergenerational educational mobility and Type 2 Diabetes among US Latino adults. METHODS We used data from the Niños Lifestyle and Diabetes Study (2013-2014) and the Sacramento Area Latino Study on Aging (1998-1999) to link 616 adult Latino children to their parents. Model-based standardization and robust Poisson regression were used to estimate the prevalence of prediabetes, Type 2 Diabetes, treatment and glycemic control, and describe their associations with intergenerational educational mobility. RESULTS Adult children with stable high intergenerational educational attainment had a higher prevalence of prediabetes (Prevalence Ratio, PR=1.58; 95% Confidence Interval, CI=1.08, 2.34) and lower prevalence of Type 2 Diabetes (PR=0.64, CI=0.41, 0.99), as compared to those who experienced low educational attainment across generations. Downward mobility was associated with a higher prevalence of prediabetes (PR=1.54, CI=1.06, 2.23) and worse glycemic control (PR=2.20, CI=1.13, 4.30), and upward mobility was associated with a lower prevalence of Type 2 Diabetes (PR=0.39, CI=0.22, 0.70). CONCLUSIONS Our findings from a predominantly Mexican-heritage community suggest that higher education across generations may buffer individuals from glycemic dysregulation. As such, higher education may be a promising public health target to address the rising burden of Type 2 Diabetes in the US.
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Affiliation(s)
- Lindsay Fernández-Rhodes
- Department of Biobehavioral Health, College of Health and Human Development, Pennsylvania State University, University Park, PA; Carolina Population Center, University of North Carolina, Chapel Hill, NC.
| | - Julia B Ward
- Carolina Population Center, University of North Carolina, Chapel Hill, NC; Social & Scientific Systems, Inc., Durham, NC
| | - Chantel L Martin
- Carolina Population Center, University of North Carolina, Chapel Hill, NC; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| | - Adina Zeki Al Hazzouri
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, NY
| | - Jacqueline Torres
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA
| | - Penny Gordon-Larsen
- Carolina Population Center, University of North Carolina, Chapel Hill, NC; Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| | - Mary N Haan
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA
| | - Allison E Aiello
- Carolina Population Center, University of North Carolina, Chapel Hill, NC; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
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Crenshaw EG, Fernández-Rhodes L, Martin CL, Gordon-Larsen P, Haan MN, Aiello AE. Intergenerational Educational Attainment and Cardiometabolic Health in Latino Individuals Living in the United States. Obesity (Silver Spring) 2021; 29:1178-1185. [PMID: 34096684 PMCID: PMC8549077 DOI: 10.1002/oby.23156] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 02/14/2021] [Accepted: 02/16/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE This study aimed to estimate the association between cycles of poverty, measured by intergenerational educational attainment (IEA), and the burden of obesity and metabolic dysfunction among Hispanic/Latino individuals in the United States. METHODS This is a cross-sectional study utilizing data from 392 adults linked to 286 biologic parents from the Niños Lifestyle and Diabetes Study and the Sacramento Area Latino Study on Aging. The educational attainment of parents and offspring was dichotomized in order to categorize IEA. Outcomes included obesity and metabolic syndrome (MetS). Model-based standardization with population weights was used to compare obesity and MetS across generations, and Poisson regression was used to estimate prevalence ratios by IEA. RESULTS A higher prevalence of obesity and MetS was observed in offspring (54% and 69%, respectively) compared with their parents (48% and 42%, respectively). Compared with stable-low IEA, any category with high offspring education was associated with lower obesity and MetS prevalence. The upwardly mobile group saw the greatest benefit; they were 38% (95% CI: 10%-57%) and 46% (95% CI: 21%-63%) less likely to have obesity or MetS. CONCLUSIONS IEA strongly patterns cardiometabolic health among Hispanic/Latino individuals living in the United States, suggesting that promotion of higher education is associated with reductions in obesity and MetS, potentially benefitting future generations of this population.
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Affiliation(s)
- Emma G. Crenshaw
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| | - Lindsay Fernández-Rhodes
- Carolina Population Center, University of North Carolina, Chapel Hill, NC
- Department of Biobehavioral Health, College of Health and Human Development, Pennsylvania State University, University Park, PA
| | - Chantel L. Martin
- Carolina Population Center, University of North Carolina, Chapel Hill, NC
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| | - Penny Gordon-Larsen
- Carolina Population Center, University of North Carolina, Chapel Hill, NC
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill
| | - Mary N. Haan
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA
| | - Allison E. Aiello
- Carolina Population Center, University of North Carolina, Chapel Hill, NC
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
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Ahanchi NS, Hadaegh F, Azizi F, Khalili D. Sex- specific clustering of metabolic syndrome components and incidence of cardiovascular disease: A latent class analysis in a population-based cohort study. J Diabetes Complications 2021; 35:107942. [PMID: 33965337 DOI: 10.1016/j.jdiacomp.2021.107942] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 04/05/2021] [Accepted: 04/18/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND The prevalence of metabolic syndrome (MetS) is rapidly increasing in the world; also, the importance of management of MetS to decrease the risk of cardiovascular disease (CVD) has been recognized worldwide. This study aimed to explore the clusters of participants based on MetS components and its association with CVD outcomes. METHODS We included 2598 middle-aged participants (1545 women and 1053 men), 45-65 years old, at baseline and without prior CVD history. Participants were followed up for 10years. We conducted a latent class analysis based on MetS components. Subsequently, the relationship between latent classes and the incidence of CVD was investigated using Cox regression models adjusted for the main confounders. RESULTS During the study period, 393 (186 women and 207 men) new cases of CVD were identified among participants. In both genders, four distinct latent classes were identified: (1) Mets class (its prevalence rate in men: 19.6%, women: 27.7%), (2) Hypertension class (men: 12.1%, women: 13.7%), (3) Dyslipidemia class (men: 31.7%, women: 30.7%), (4) Low risk class (men: 39.3%, women: 30.5%). Compared with low-risk class, in both genders, Mets and hypertension classes were significant predictors of incident CVD. However, dyslipidemia class was a significant predictor just in women. CONCLUSION We found four subclasses in both genders indicating the same patterns of MetS latent classes in men and women. However, the relationship between subclasses of MetS and incident CVD varied by gender. These results suggest that the etiology of MetS involve more than one pathway and giving equal weight to each component or using the same cut-off values in both genders need to be reconsidered.
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Affiliation(s)
- Noushin Sadat Ahanchi
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Davood Khalili
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Biostatistics and Epidemiology, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Martinez-Miller EE, Robinson WR, Avery CL, Yang YC, Haan MN, Prather AA, Aiello AE. Longitudinal Associations of US Acculturation With Cognitive Performance, Cognitive Impairment, and Dementia. Am J Epidemiol 2020; 189:1292-1305. [PMID: 32440686 DOI: 10.1093/aje/kwaa088] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 05/08/2020] [Accepted: 05/13/2020] [Indexed: 12/17/2022] Open
Abstract
US Latinos, a growing, aging population, are disproportionately burdened by cognitive decline and dementia. Identification of modifiable risk factors is needed for interventions aimed at reducing risk. Broad sociocultural context may illuminate complex etiology among culturally diverse Latinos. Among 1,418 older (≥60 years), low-socioeconomic position (SEP) Latinos (predominantly of Mexican descent) in Sacramento, California, we examined whether US acculturation was associated with cognitive performance, cognitive decline, and dementia/ cognitive impairment without dementia over a 10-year period and whether education modified the associations (Sacramento Area Latino Study on Aging, 1998-2008). Analyses used linear mixed models, competing-risk regression, and inverse probability of censoring weights for attrition. Participants with high US acculturation had better cognitive performance (0.21 fewer cognitive errors at grand-mean-centered age 70 years) than those with low acculturation after adjustment for sociodemographic factors, practice effects, and survey language. Results may have been driven by cultural language use rather than identity factors (e.g., ethnic identity, interactions). Rate of cognitive decline and risk of dementia/cognitive impairment without dementia did not differ by acculturation, regardless of education (β = 0.00 (standard error, 0.00) and hazard ratio = 0.81 (95% confidence interval: 0.49, 1.35), respectively). High US acculturation was associated with better cognitive performance among these older, low-SEP Latinos. Acculturation may benefit cognition when SEP is low. Future studies should incorporate extended longitudinal assessments among more diverse groups.
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Ward JB, Feinstein L, Vines AI, Robinson WR, Haan MN, Aiello AE. Perceived discrimination and depressive symptoms among US Latinos: the modifying role of educational attainment. ETHNICITY & HEALTH 2019; 24:271-286. [PMID: 28399649 PMCID: PMC5683937 DOI: 10.1080/13557858.2017.1315378] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 03/29/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Despite growing evidence that discrimination may contribute to poor mental health, few studies have assessed this association among US Latinos. Furthermore, the interaction between discrimination and educational attainment in shaping Latino mental health is virtually unexplored. This study aims to examine the association between perceived discrimination and depressive symptoms and the modifying role of education among a population of Mexican-origin adults. DESIGN We utilized population-based data from 629 Mexican-origin adults (mean age = 52.8 years) participating the Niños Lifestyle and Diabetes Study (2013-2014). Perceived discrimination was defined as responding 'sometimes' or 'often' to at least one item on the 9-item Everyday Discrimination Scale. High depressive symptoms were defined as scoring ≥10 on the CESD-10. We used log-binomial and linear-binomial models to estimate prevalence ratios (PR) and prevalence differences (PD), respectively, of high depressive symptoms for levels of perceived discrimination. Final models were adjusted for age, sex, education, cultural orientation, and nativity. General estimating equations were employed to account for within-family clustering. RESULTS Prevalence of perceived discrimination and high depressive symptoms were 49.5% and 29.2%, respectively. Participants experiencing discrimination had higher depressive symptom prevalence than those never or rarely experiencing discrimination [PR = 1.94, 95% confidence interval (CI): 1.46-2.58; PD = 0.19, 95% CI: 0.12-0.27]. The strength of this association varied by education level. The association between discrimination and depressive symptoms was stronger among those with >12 years of education (PR = 2.69; PD = 0.24) compared to those with ≤12 years of education (PR = 1.36; PD = 0.09). CONCLUSION US Latinos suffer a high burden of depressive symptoms, and discrimination may be an important driver of this burden. Our results suggest that effortful coping strategies, such as achieving high education despite high perceived discrimination, may magnify discrimination's adverse effect on Latino mental health.
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Affiliation(s)
- Julia B Ward
- a Department of Epidemiology, Gillings School of Global Public Health , University of North Carolina , Chapel Hill , USA
- b Carolina Population Center , University of North Carolina , Chapel Hill , USA
| | - Lydia Feinstein
- a Department of Epidemiology, Gillings School of Global Public Health , University of North Carolina , Chapel Hill , USA
- c Social & Scientific Systems, Inc. , Durham , USA
| | - Anissa I Vines
- a Department of Epidemiology, Gillings School of Global Public Health , University of North Carolina , Chapel Hill , USA
| | - Whitney R Robinson
- a Department of Epidemiology, Gillings School of Global Public Health , University of North Carolina , Chapel Hill , USA
- b Carolina Population Center , University of North Carolina , Chapel Hill , USA
| | - Mary N Haan
- d Department of Epidemiology and Biostatistics , University of California , San Francisco , USA
| | - Allison E Aiello
- a Department of Epidemiology, Gillings School of Global Public Health , University of North Carolina , Chapel Hill , USA
- b Carolina Population Center , University of North Carolina , Chapel Hill , USA
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Martinez-Miller EE, Prather AA, Robinson WR, Avery CL, Yang YC, Haan MN, Aiello AE. US acculturation and poor sleep among an intergenerational cohort of adult Latinos in Sacramento, California. Sleep 2019; 42:zsy246. [PMID: 30544165 PMCID: PMC6424080 DOI: 10.1093/sleep/zsy246] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Revised: 10/26/2018] [Indexed: 11/13/2022] Open
Abstract
Acculturation may shape the disproportionate burden of poor sleep among Latinos in the United States. Existing studies are limited by unidimensional acculturation proxies that are incapable of capturing cultural complexities across generations. Understanding how acculturation relates to sleep may lead to the identification of modifiable intervention targets. We used multivariable regression and latent class methods to examine cross-sectional associations between a validated multidimensional scale of US acculturation and self-reported poor sleep measures. We analyzed an intergenerational cohort: first-generation (GEN1) older Latinos (Sacramento Area Latino Study on Aging; N = 1,716; median age: 69.5) and second-generation (GEN2) middle-aged offspring and relatives of GEN1 (Niños Lifestyle and Diabetes Study; N = 670; median age: 54.0) in Sacramento, California. GEN1 with high US acculturation, compared with high acculturation towards another origin/ancestral country, had less restless sleep (prevalence ratio [PR] [95% confidence interval (CI)]: 0.67 [0.54, 0.84]) and a higher likelihood of being in the best sleep class than the worst (OR [95% CI]: 1.62 [1.09, 2.40]), but among nonmanual occupations, high intergenerational US acculturation was associated with more general fatigue (PR [95% CI: 1.86 [1.11, 3.10]). GEN2 with high intergenerational US acculturation reported shorter sleep (PR [95% CI]: 2.86 [1.02, 7.99]). High US acculturation shaped sleep differentially by generation, socioeconomic context, and intergenerational acculturative status. High US acculturation was associated with better sleep among older, lower socioeconomic Latinos, but with shorter sleep duration among middle-aged, higher socioeconomic Latinos; results also differed by parental acculturation status. Upon replication, future studies should incorporate prospective and intergenerational designs to uncover sociobehavioral pathways by which acculturation may shape sleep to ultimately inform intervention efforts.
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Affiliation(s)
- Erline E Martinez-Miller
- Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Aric A Prather
- Department of Psychiatry, School of Medicine, University of California at San Francisco, San Francisco, CA
| | - Whitney R Robinson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Christy L Avery
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Yang C Yang
- Department of Sociology, College of Arts and Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Mary N Haan
- Department of Epidemiology and Biostatistics, School of Medicine, University of California at San Francisco, San Francisco, CA
| | - Allison E Aiello
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
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Lartey ST, Magnussen CG, Si L, de Graaff B, Biritwum RB, Mensah G, Yawson A, Minicuci N, Kowal P, Boateng GO, Palmer AJ. The role of intergenerational educational mobility and household wealth in adult obesity: Evidence from Wave 2 of the World Health Organization's Study on global AGEing and adult health. PLoS One 2019; 14:e0208491. [PMID: 30625141 PMCID: PMC6326547 DOI: 10.1371/journal.pone.0208491] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 11/19/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Obesity has emerged as a major risk factor for non-communicable diseases in low and middle-income countries but may not follow typical socioeconomic status (SES)-related gradients seen in higher income countries. This study examines the associations between current and lifetime markers of SES and BMI categories (underweight, normal weight, overweight, obese) and central adiposity in Ghanaian adults. METHODS Data from 4,464 adults (2,610 women) who participated in the World Health Organization's Study on global AGEing and adult health (SAGE) Wave 2 were examined. Multilevel multinomial and binomial logistic regression models were used to examine associations. SES markers included parental education, individual education, intergenerational educational mobility and household wealth. Intergenerational educational mobility was classified: stable-low (low parental and low individual education), stable-high (high parental and high individual education), upwardly (low parental and high individual education), or downwardly mobile (high parental and low individual education). RESULTS The prevalence of obesity (12.9%) exceeded the prevalence of underweight (7.2%) in the population. High parental and individual education were significantly associated with higher odds of obesity and central adiposity in women. Compared to the stable low pattern, stable high (obesity: OR = 3.15; 95% CI: 1.96, 5.05; central adiposity: OR = 1.75; 95% CI: 1.03, 2.98) and upwardly (obesity: OR = 1.71; 95% CI: 11.13, 2.60; central adiposity: OR = 1.60; 95% CI: 1.08, 2.37) mobile education patterns were associated with higher odds of obesity and central adiposity in women, while stable high pattern was associated with higher odds of overweight (OR = 1.88; 95% CI: 1.11, 3.19) in men. Additionally, high compared to the lowest household wealth was associated with high odds of obesity and central adiposity in both sexes. CONCLUSION Stable high and upwardly mobile education patterns are associated with higher odds of obesity and central adiposity in women while the stable high pattern was associated with higher odds of overweight in men.
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Affiliation(s)
- Stella T. Lartey
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Costan G. Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Lei Si
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
- The George Institute for Global Health, University of New South Wales, Kensington, NSW, Australia
| | - Barbara de Graaff
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | | | - George Mensah
- Department of Community Health, University of Ghana, Accra, Ghana
| | - Alfred Yawson
- Department of Community Health, University of Ghana, Accra, Ghana
| | - Nadia Minicuci
- National Research Council, Neuroscience Institute, Padova, Italy
| | - Paul Kowal
- World Health Organization (WHO), Geneva, Switzerland
- University of Newcastle Research Centre for Generational Health and Ageing, Newcastle, New South Wales, Australia
| | - Godfred O. Boateng
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Andrew J. Palmer
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
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Whitley JC, Peralta CA, Haan M, Aiello AE, Lee A, Ward J, Zeki Al Hazzouri A, Neuhaus J, Moyce S, López L. The association of parental and offspring educational attainment with systolic blood pressure, fasting blood glucose and waist circumference in Latino adults. Obes Sci Pract 2018; 4:582-590. [PMID: 30574351 PMCID: PMC6298209 DOI: 10.1002/osp4.307] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 09/14/2018] [Accepted: 09/22/2018] [Indexed: 12/29/2022] Open
Abstract
Objective The objective of the study is to evaluate the association of intergenerational educational attainment with cardiovascular disease (CVD) risk factors among US Latinos. Methods We used cross‐sectional data from the Niños Lifestyle and Diabetes Study, an offspring cohort of middle‐aged Mexican‐Americans whose parents participated in the Sacramento Latino Study on Aging. We collected educational attainment, demographic and health behaviours and measured systolic blood pressure (SBP), fasting glucose and waist circumference. We evaluated the association of parental, offspring and a combined parent–offspring education variable with each CVD risk factor using multivariable regression. Results Higher parental education was associated only with smaller offspring waist circumference. In contrast, higher offspring education was associated with lower SBP, fasting glucose and smaller waist circumference. Adjustment for parental health behaviours modestly attenuated these offspring associations, whereas adjustment for offspring health behaviours and income attenuated the associations of offspring education with offspring SBP and fasting glucose but not smaller waist circumference, even among offspring with low parental education. Conclusions Higher offspring education is associated with lower levels of CVD risk factors in adulthood, despite intergenerational exposure to low parental education.
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Affiliation(s)
- J C Whitley
- University of California, San Francisco San Francisco CA USA
| | - C A Peralta
- University of California, San Francisco San Francisco CA USA
| | - M Haan
- University of California, San Francisco San Francisco CA USA
| | - A E Aiello
- Gillings School of Public Health University of North Carolina Chapel Hill NC USA
| | - A Lee
- University of California, San Francisco San Francisco CA USA
| | - J Ward
- Gillings School of Public Health University of North Carolina Chapel Hill NC USA
| | | | - J Neuhaus
- University of California, San Francisco San Francisco CA USA
| | - S Moyce
- College of Nursing Montana State University MT USA
| | - L López
- University of California, San Francisco San Francisco CA USA
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Ward JB, Robinson WR, Pence BW, Maselko J, Albrecht SS, Haan MN, Aiello AE. Educational Mobility Across Generations and Depressive Symptoms Over 10 Years Among US Latinos. Am J Epidemiol 2018; 187:1686-1695. [PMID: 29762643 DOI: 10.1093/aje/kwy056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 03/09/2018] [Indexed: 01/19/2023] Open
Abstract
Few studies have collected intergenerational data to assess the association between educational mobility across multiple generations and offspring depression. Using data from the Sacramento Area Latino Study on Aging (1998-2008), we assessed the influence of intergenerational education on depressive symptoms over 10 years among 1,786 Latino individuals (mean age = 70.6 years). Educational mobility was classified as stable-low (low parental/low offspring education), upwardly mobile (low parental/high offspring education), stable-high (high parental/high offspring education), or downwardly mobile (high parental/low offspring education). Depressive symptoms were measured with the Center for Epidemiological Studies-Depression Scale (CES-D); higher scores indicated more depressive symptoms. To quantify the association between educational mobility and CES-D scores over follow-up, we used generalized estimating equations to account for repeated CES-D measurements and adjusted for identified confounders. Within individuals, depressive symptoms remained relatively stable over follow-up. Compared with stable-low education, stable-high education and upward mobility were associated with significantly lower CES-D scores (β = -2.75 and -2.18, respectively). Downwardly mobile participants had slightly lower CES-D scores than stable-low participants (β = -0.77). Our results suggest that sustained, low educational attainment across generations may have adverse mental health consequences, and improved educational opportunities in underresourced communities may counteract the adverse influence of low parental education on Latino depression.
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Affiliation(s)
- Julia B Ward
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
- Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina
| | - Whitney R Robinson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
- Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina
| | - Brian W Pence
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Joanna Maselko
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
- Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina
| | - Sandra S Albrecht
- Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Mary N Haan
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California
| | - Allison E Aiello
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
- Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina
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Ward JB, Haan MN, Garcia ME, Lee A, To TM, Aiello AE. Intergenerational education mobility and depressive symptoms in a population of Mexican origin. Ann Epidemiol 2016; 26:461-466. [PMID: 27346705 DOI: 10.1016/j.annepidem.2016.05.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 04/14/2016] [Accepted: 05/23/2016] [Indexed: 11/15/2022]
Abstract
PURPOSE Low educational attainment has been associated with depression among Latinos. However, few studies have collected intergenerational data to assess mental health effects of educational mobility across generations. METHODS Using data from the Niños Lifestyle and Diabetes Study, we assessed the influence of intergenerational education on depressive symptoms among 603 Mexican-origin individuals. Intergenerational educational mobility was classified: stable-low (low parent and/or low offspring education), upwardly mobile (low parent and/or high offspring education), stable-high (high parent and/or high offspring education), or downwardly mobile (high parent and/or low offspring education). High depressive symptoms were defined as scoring ≥10 on the Center for Epidemiological Studies Depression Scale-10 (CESD-10). We examined prevalence ratios (PRs) for depressive symptoms with levels of educational mobility. We used general estimating equations with log-binomial models to account for within-family clustering, adjusting for age, gender, and offspring and parent nativity. RESULTS Compared with stable-low participants, the lowest prevalence of CESD-10 score ≥10 occurred in upwardly mobile (PR = 0.55; 95% confidence interval [CI] = 0.39-0.78) and stable-high (PR = 0.62; 95% CI = 0.44-0.87) participants. Downwardly mobile participants were also less likely to have a CESD-10 score ≥10 compared with stable-low participants (PR = 0.65; 95% CI = 0.38-1.11), although the estimate was not statistically significant. CONCLUSIONS Sustained stress from low intergenerational education may adversely affect depression. Latinos with stable-low or downwardly mobile intergenerational educational attainment may need closer monitoring for depressive symptoms.
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Affiliation(s)
- Julia B Ward
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill
| | - Mary N Haan
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco
| | - Maria E Garcia
- UCSF Division of General Internal Medicine, San Francisco General Hospital, University of California, San Francisco, San Francisco
| | - Anne Lee
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco
| | - Tu My To
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco
| | - Allison E Aiello
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill.
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Abraído-Lanza AF, Echeverría SE, Flórez KR. Latino Immigrants, Acculturation, and Health: Promising New Directions in Research. Annu Rev Public Health 2016; 37:219-36. [PMID: 26735431 DOI: 10.1146/annurev-publhealth-032315-021545] [Citation(s) in RCA: 179] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This article provides an analysis of novel topics emerging in recent years in research on Latino immigrants, acculturation, and health. In the past ten years, the number of studies assessing new ways to conceptualize and understand how acculturation-related processes may influence health has grown. These new frameworks draw from integrative approaches testing new ground to acknowledge the fundamental role of context and policy. We classify the emerging body of evidence according to themes that we identify as promising directions--intrapersonal, interpersonal, social environmental, community, political, and global contexts, cross-cutting themes in life course and developmental approaches, and segmented assimilation--and discuss the challenges and opportunities each theme presents. This body of work, which considers acculturation in context, points to the emergence of a new wave of research that holds great promise in driving forward the study of Latino immigrants, acculturation, and health. We provide suggestions to further advance the ideologic and methodologic rigor of this new wave.
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Affiliation(s)
- Ana F Abraído-Lanza
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY 10032;
| | - Sandra E Echeverría
- Department of Community Health Education, School of Urban Public Health, City University of New York-Hunter College, New York, NY 10035;
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Zou Y, Zhang R, Zhou B, Huang L, Chen J, Gu F, Zhang H, Fang Y, Ding G. A comparison study on the prevalence of obesity and its associated factors among city, township and rural area adults in China. BMJ Open 2015; 5:e008417. [PMID: 26179650 PMCID: PMC4513451 DOI: 10.1136/bmjopen-2015-008417] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 06/09/2015] [Accepted: 06/22/2015] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES To explore the association of dietary behaviour factors on obesity among city, township and rural area adults. SETTING A stratified cluster sampling technique was employed in the present cross-sectional study. On the basis of socioeconomic characteristics, two cities, two townships and two residential villages were randomly selected where the investigation was conducted. PARTICIPANTS A total of 1770 city residents, 2071 town residents and 1736 rural area residents participated in this survey. PRIMARY AND SECONDARY OUTCOME MEASURES Dietary data were collected through interviews with each household member. Anthropometric values were measured. Participants with a body mass index (BMI) of ≥28.0 kg/m(2) were defined as obesity. RESULTS The prevalence of obesity was 10.1%, 7.3% and 6.5% among city, township and rural area adults, respectively. Correlation analysis showed that for adults living in cities, the daily intake of rice and its products, wheat flour and its products, light coloured vegetables, pickled vegetables, nut, pork and sauce was positively correlated with BMI (r=0.112, 0.084, 0.109, 0.129, 0.077, 0.078, 0.125, p<0.05), while the daily intake of tubers, dried beans, milk and dairy products was negatively correlated with BMI (r=-0.086, -0.078, -0.116, p<0.05). For township residents, the daily intake of vegetable oil, salt, chicken essence, monosodium glutamate and sauce was positively correlated with BMI (r=0.088, 0.091, 0.078, 0.087, 0.189, p<0.05). For rural area residents, the daily intake of pork, fish and shrimp, vegetable oil and salt was positively correlated with BMI (r=0.087, 0.122, 0.093, 0.112, p<0.05), while the daily intake of dark coloured vegetables was negatively correlated with BMI (r=-0.105, p<0.05). CONCLUSIONS The prevalence of obesity was higher among city residents than among township and rural area residents. The findings of this study indicate that demographic and dietary factors could be associated with obesity among adults. Healthy dietary behaviour should be promoted and the ongoing monitoring of population nutrition and health status remains crucially important.
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Affiliation(s)
- Yan Zou
- Nutrition and Food safety Department, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Ronghua Zhang
- Nutrition and Food safety Department, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Biao Zhou
- Nutrition and Food safety Department, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Lichun Huang
- Nutrition and Food safety Department, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Jiang Chen
- Nutrition and Food safety Department, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Fang Gu
- Nutrition and Food safety Department, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Hexiang Zhang
- Nutrition and Food safety Department, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Yueqiang Fang
- Nutrition and Food safety Department, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Gangqiang Ding
- National Institute for Nutrition and Health, Beijing, China
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