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Flórez KR, Hwang NS, Hernandez M, Verdaguer-Johe S, Rahnama Rad K. "No sufro, estoy bien/I am not suffering, so I am doing OK": A mixed method exploration of individual and network-level factors and Type 2 Diabetes Mellitus (T2DM) among Mexican American adults in New York City. PLoS One 2024; 19:e0295499. [PMID: 38241426 PMCID: PMC10798639 DOI: 10.1371/journal.pone.0295499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 11/24/2023] [Indexed: 01/21/2024] Open
Abstract
INTRODUCTION The prevalence of type 2 Diabetes Mellitus (T2DM) is 2-3 times greater among Mexican Americans than non-Latino whites, and Mexican Americans are more likely to develop T2DM at younger ages and experience higher rates of complications. Social networks might play a crucial role in both T2DM etiology and management through social support, access to resources, social engagement, and health behavioral norms. OBJECTIVE To quantitatively identify the social network features associated with glycated hemoglobin (HbA1c) in a community sample of Mexican immigrants residing in New York City, and to explore the extent to which these quantitative findings converge with qualitative narratives of their lived experiences. METHODS This study used a convergent mixed methods design. To collect personal network data, we used EgoWeb, and obtained 1,400 personal network ties from 81 participants. HbA1c readings were collected using dried blood spots and categorized according to the laboratory criteria of the American Diabetes Association. Additional survey data were collected using Qualtrics software. To investigate the significance of the network-level factors after accounting for the socioeconomic and demographic individual-level factors that the literature indicates to be associated with T2DM, we used a multiple regression model on quantitative data sources. For the qualitative portion of the study, we selected a subset of individuals who participated in the quantitative portion, which represented 500 personal network ties from 25 participants. We conducted in-depth interviews guided by the visualization of these ties to explore who was helpful or difficult in managing their health and health behaviors. RESULTS Individual-level indicators associated with lower HbA1c scores were body mass index (β = -0.07, p<0.05), and healthy eating index scores (β = -0.03, p<0.02). The network-level predictor associated with higher HbA1c levels was the percentage of diabetic alters in the network (β = 0.08, p <0.001, with a 25% increase in the percentages associated 2.0 change in HbA1c levels. The qualitative data highlighted that most of the diabetes-related information diffused through the social networks of our participants was related to dietary practices, such as reducing sugar and red meat consumption, eating out less, and reducing portion sizes. Notably, even among those with elevated levels and diabetes-related health complications, HbA1c was not considered a part of the lay descriptions of good health since they were not "suffering." Participants regarded doctors as the ultimate authority in diabetes care, even if they had supportive members in their personal networks. CONCLUSION Our study provides quantitative evidence for the significant role of diabetic network members in the etiology and management of T2DM among Mexican Americans. Our qualitative findings suggest important ley terms for T2DM management and the importance of physicians, which could be included in in future social networks studies seeking to diffuse diabetes-related health information for T2DM prevention and management efforts in this population.
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Affiliation(s)
- Karen R. Flórez
- Environmental, Occupational and Geospatial Sciences Department, City University of New York (CUNY), CUNY Graduate School of Public Health and Heath Policy, New York, NY, United States of America
- Center for Systems and Community Design, City University of New York (CUNY), CUNY Graduate School of Public Health and Heath Policy, New York, NY, United States of America
| | - Neil S. Hwang
- Business and Information Systems Department, City University of New York, Bronx Community College, Bronx, NY, United States of America
| | - Maria Hernandez
- El Instituto: Institute of Latina/o, Caribbean and Latin America Studies of College of Liberal Arts and Science, University of Connecticut, Storrs, CT, United States of America
| | - Sandra Verdaguer-Johe
- Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, New York, NY, United States of America
| | - Kamiar Rahnama Rad
- Paul H. Chook Department of Information Systems and Statistics, City University of New York, Zicklin School of Business Baruch College, New York, NY, United States of America
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Paixão TM, Teixeira LR, de Andrade CAF, Sepulvida D, Martinez-Silveira M, Nunes C, Siqueira CEG. Systematic Review and Meta-Analysis of Metabolic Syndrome and Its Components in Latino Immigrants to the USA. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1307. [PMID: 36674066 PMCID: PMC9858988 DOI: 10.3390/ijerph20021307] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 01/04/2023] [Accepted: 01/05/2023] [Indexed: 06/17/2023]
Abstract
The Metabolic Syndrome (MetS) is an increasingly prevalent condition globally. Latino populations in the USA have shown an alarming increase in factors associated with MetS in recent years. The objective of the present systematic review was to determine the prevalence of MetS and its risk factors in immigrant Latinos in the USA and perform a meta-analysis of those prevalence. The review included cross-sectional, cohort, or case−control studies involving adult immigrant Latinos in the USA, published during the period 1980−2020 in any language. Studies involving individuals who were pregnant, aged <18 years, immigrant non-Latinos, published outside the 1980−2020 period, or with other design types were excluded. The Pubmed, Web of Science, Embase, Lilacs, Scielo, and Google Scholar databases were searched. The risk of bias was assessed using the checklists of the Joanna Briggs Institute. The review included 60 studies, and the meta-analysis encompassed 52 studies. The pooled prevalence found for hypertension, diabetes, general obesity, and abdominal obesity were 28% (95% Confidence Interval (CI): 23−33%), 17% (95% CI: 14−20%), 37% (95% CI: 33−40%), and 54% (95% CI: 48−59%), respectively. The quality of the evidence of the primary studies was classified as low or very low. Few studies including immigrants from South America were identified. Further studies of those immigrants are needed due to the cultural, dietary, and language disparities among Latin American countries. The research protocol was registered with the Open Science Framework (OSF).
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Affiliation(s)
- Talita Monsores Paixão
- Center of Studies of Worker Health and Human Ecology, National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro 21041-210, Brazil
| | - Liliane Reis Teixeira
- Center of Studies of Worker Health and Human Ecology, National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro 21041-210, Brazil
| | - Carlos Augusto Ferreira de Andrade
- Department of Epidemiology and Quantitative Methods in Health, National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro 21041-210, Brazil
| | | | | | - Camila Nunes
- Fluminense Federal Institute of Education Science and Technology, Campos dos Goytacazes 28030-130, Brazil
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Joseph RP, Vega-López S, Han S. Physical Activity Patterns and Neighborhood Characteristics of First-Generation Latina Immigrants Living in Arizona: Cross-sectional Study. JMIR Form Res 2021; 5:e25663. [PMID: 33999003 PMCID: PMC8167607 DOI: 10.2196/25663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 03/30/2021] [Accepted: 04/04/2021] [Indexed: 11/29/2022] Open
Abstract
Background Metabolic diseases, including obesity and type 2 diabetes, are a major health concern for Latina immigrants. Performing regular aerobic physical activity (PA) is a lifestyle behavior associated with the prevention and control of these conditions. However, PA levels of most Latina immigrants are below national guidelines. Neighborhood environmental factors may influence the PA levels of adults, but limited research has explored associations between the neighborhood environment and PA levels among Latina immigrants. Objective The objective of this study was to explore the PA patterns of first-generation US Latina immigrants and how neighborhood environmental factors are related to those PA patterns. Methods Using a cross-sectional study design, 50 first-generation Latina immigrants completed the International Physical Activity Questionnaire (IPAQ) and the Neighborhood Scales Questionnaire, which assessed 6 perceived neighborhood factors: (1) walking environment, (2) aesthetic quality, (3) safety, (4) violence, (5) social cohesion, and (6) activities with neighbors. Median self-reported metabolic equivalent (MET)-minutes/week of PA were used to summarize domain-specific (ie, work, domestic/household, leisure, and transportation) and intensity-specific (ie, walking, moderate, vigorous, moderate to vigorous) PA patterns. Logistic regression examined associations between neighborhood factors and engaging in leisure-time PA (ie, dichotomous outcome of some versus no leisure-time PA), transportation PA (ie, dichotomous outcome of some versus no transportation PA), and meeting national PA guidelines (ie, dichotomous outcome of meeting versus not meeting guidelines). Results Preliminary analyses showed that 10 participants reported excessively high PA levels and 1 participant had incomplete PA data; these women were excluded from analyses based on IPAQ scoring guidelines. The remaining 39 participants (mean age 40.5 years; mean length of US residency 4.6 years) reported a median of 4512 MET-minutes/week of total PA. The majority of PA was acquired through domestic activities (median 2160 MET-minutes/week), followed by leisure-time PA (median 396 MET-minutes/week), transportation PA (median 198 MET-minutes/week), and work PA (0 MET-minutes/week). Intensity-specific PA patterns showed a median of 594 MET-minutes/week of walking activity and 3500 MET-minutes/week of moderate-to-vigorous PA. Logistic regression models indicated that the neighborhood factors of walking environment, aesthetic quality, and safety were positively associated with engaging in leisure-time PA (odds ratios of 5.95, 95% CI 1.49-23.74; 2.45, 95% CI 1.01-5.93; and 3.30, 95% CI 1.26-8.67, respectively) and meeting national PA guidelines (odds ratios of 4.15, 95% CI 1.13-15.18; 6.43, 95% CI 1.45-28.39; and 2.53, 95% CI 1.00-6.36, respectively). The neighborhood factors of violence, social cohesion, and activities with neighbors were not significantly associated with PA outcomes. Conclusions Although most participants met national PA guidelines (ie, ≥500 MET-minutes/week of moderate-to-vigorous PA), the majority of their PA was achieved through domestic activities, with limited leisure, transportation, and work PA. Given that leisure-time PA in particular plays a significant role in improving health outcomes, findings suggest that many Latina immigrants could benefit from a leisure-time PA intervention. Such interventions should consider neighborhood environmental influences, as these factors may serve as determinants of PA.
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Affiliation(s)
- Rodney P Joseph
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, United States
| | - Sonia Vega-López
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States.,Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, AZ, United States
| | - SeungYong Han
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, United States
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Yoshida Y, Broyles S, Scribner R, Chen L, Phillippi S, Jackson-Thompson J, Simoes EJ, Tseng TS. Social support modifies the negative effects of acculturation on obesity and central obesity in Mexican men. ETHNICITY & HEALTH 2020; 25:1103-1114. [PMID: 29944431 PMCID: PMC9044708 DOI: 10.1080/13557858.2018.1492708] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 06/11/2018] [Indexed: 06/08/2023]
Abstract
Background: This study examined the moderating role of social support in the acculturation-obesity/central obesity relationship in Mexican American (MA) men and women. Methods: Data from NHANES 1999-2008 were used. Acculturation derived from language use, country of birth and length of residence in the U.S. Social support assessed emotional and financial support. BMI (≥30) and waist circumference (≥88 cm for women; ≥102 cm for men) measured obesity and central obesity, respectively. Weighted multivariate logistic regression models were used to describe associations. Results: Compared to less acculturation, more acculturation was associated with higher odds of obesity (ORs 2.48; 95% CI 1.06-5.83) and central obesity (2.90; 1.39-6.08) among MA men with low/no social support, but not among MA men reporting high social support. The modifying effects was not observed among women. Conclusion: Higher amounts of social support appeared to attenuate the risk of obesity/central obesity associated with acculturation. Interventions enhancing social support maybe effective among acculturated MAs, particularly among men.
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Affiliation(s)
- Yilin Yoshida
- Department of Health Management and Informatics, School of Medicine, University of Missouri, CE707 CS&E Bldg., One Hospital Drive, Columbia, Missouri 65212
- Missouri Cancer Registry & Research Center, 401 Clark Hall, Columbia, Missouri 65211
| | - Stephanie Broyles
- Behavioral and Community Health Sciences program, School of Public Health, Louisiana State University Health Sciences Center, 3FL, 2020 Gravier St., New Orleans, Louisiana 70112
- Pennington Biomedical Research Center, Baton Rouge, Louisiana
| | - Richard Scribner
- Epidemiology program, School of Public Health, Louisiana State University Health Sciences Center, 3FL, 2020 Gravier St., New Orleans, Louisiana 70112
| | - Liwei Chen
- Department of Public Health Sciences, Clemson University, 503 Edwards Hall, Clemson, SC 29634-0745
| | - Stephen Phillippi
- Behavioral and Community Health Sciences program, School of Public Health, Louisiana State University Health Sciences Center, 3FL, 2020 Gravier St., New Orleans, Louisiana 70112
| | - Jeanette Jackson-Thompson
- Department of Health Management and Informatics, School of Medicine, University of Missouri, CE707 CS&E Bldg., One Hospital Drive, Columbia, Missouri 65212
- Missouri Cancer Registry & Research Center, 401 Clark Hall, Columbia, Missouri 65211
| | - Eduardo J. Simoes
- Department of Health Management and Informatics, School of Medicine, University of Missouri, CE707 CS&E Bldg., One Hospital Drive, Columbia, Missouri 65212
| | - Tung-Sung Tseng
- Behavioral and Community Health Sciences program, School of Public Health, Louisiana State University Health Sciences Center, 3FL, 2020 Gravier St., New Orleans, Louisiana 70112
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Lindsay AC, Greaney ML, Wallington SF, Wright JA, Hunt AT. Depressive Symptoms and Length of U.S. Residency Are Associated with Obesity among Low-Income Latina Mothers: A Cross-Sectional Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14080869. [PMID: 28767094 PMCID: PMC5580573 DOI: 10.3390/ijerph14080869] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 07/24/2017] [Accepted: 07/27/2017] [Indexed: 11/25/2022]
Abstract
Latinos are the largest minority population group in the United States (U.S.), and low-income Latina women are at elevated risk of depression and obesity. Thus, the prevention of these two problems is a pressing public health concern in this population. Both depressive symptoms and obesity are modifiable factors that can be addressed by culturally relevant interventions. However, the association between depressive symptoms and obesity in Latina immigrant women is not well understood. Therefore, this cross-sectional study examined the association between depressive symptoms and obesity among Latina women of childbearing age (15–44). Participants (n = 147) were low-income, predominantly immigrant Latina mothers enrolled in the Latina Mothers′ Child Feeding Practices and Style Study. Women were eligible to participate if they self-identified as Latina; were enrolled in or eligible for the Special Supplemental Nutrition Program for Women, Infants and Children program; had a child between ages two and five years; and were living in the U.S. for at least one year, and residing in Rhode Island. Enrolled participants completed a survey in their language of preference (English or Spanish) administered by bilingual interviewers. About one-third (34%) of participants were classified as having obesity (BMI ≥ 30 kg/m2), 28.3% had elevated depressive symptoms (CES-D ≥ 16), and 70.1% were immigrants. Women with elevated depressive symptoms had increased odds of having obesity (odds ratio (OR) = 2.80, 95% confidence interval (CI): 1.24–6.33). Additionally, among immigrants, length of U.S. residency was associated with increased odds of obesity (OR = 1.05, 95% CI: 1.02–1.09). Findings underscore the need for screening and culturally relevant interventions designed to address both depressive symptoms and obesity among low-income Latina women of childbearing age. Furthermore, findings highlight the importance of taking into account the length of residency in the U.S. when designing interventions targeting Latina immigrants.
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Affiliation(s)
- Ana Cristina Lindsay
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts, Boston, MA 02125, USA.
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
| | - Mary L Greaney
- Health Studies and Department of Kinesiology, University of Rhode Island, Kingston, RI 02881, USA.
| | - Sherrie F Wallington
- Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20057, USA.
| | - Julie A Wright
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts, Boston, MA 02125, USA.
| | - Anne T Hunt
- Hunt Consultants Associates; Chapel Hill, NC 27517 USA.
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Holguin F, Moughrabieh MA, Ojeda V, Patel SR, Peyrani P, Pinedo M, Celedón JC, Douglas IS, Upson DJ, Roman J. Respiratory Health in Migrant Populations: A Crisis Overlooked. Ann Am Thorac Soc 2017; 14:153-159. [PMID: 28146384 PMCID: PMC5427732 DOI: 10.1513/annalsats.201608-592ps] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Accepted: 11/02/2016] [Indexed: 01/04/2023] Open
Abstract
The crisis in the Middle East has raised awareness about the challenges encountered by migrant populations, in particular, health-care access and delivery. Similar challenges are encountered by migrant populations around the world, including those entering the United States as refugees and/or survivors of torture as well as Mexicans and other Latin Americans crossing the border. During the 2016 International American Thoracic Society Meeting held in San Francisco, California, a group of researchers and health-care providers discussed these challenges at a minisymposium devoted to the respiratory health of migrants. The discussion focused on the increased incidence of airway diseases among individuals migrating to more developed countries, the problems created by sleep disorders and their implications for cardiovascular and mental health, the challenges inherent in the control of infections in refugee populations, and the problems resulting from deportation. The group also discussed the potential impact of novel strategies made available by Internet-based technologies and how these strategies could be deployed to support worldwide efforts in assisting migrants and refugees, even in countries that find themselves in the direst circumstances. These presentations are summarized in this document, which is not meant to be exhaustive, but to improve awareness about the challenges confronted by migrants and their host nations regarding respiratory health-care access and delivery, and about the need for adequate investment of resources to better define these challenges through research and for the development of efficient strategies for intervention.
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Affiliation(s)
- Fernando Holguin
- Pulmonary Sciences, Department of Medicine, University of Colorado, Denver, Colorado
| | - M. Anas Moughrabieh
- Division of Pulmonary and Critical Care, Department of Medicine, Wayne State University, Detroit, Michigan
| | - Victoria Ojeda
- Division of Global Public Health, Department of Medicine, University of California, San Diego, San Diego, California
| | - Sanjay R. Patel
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Paula Peyrani
- Division of Infectious Diseases, Department of Medicine, University of Louisville Health Sciences Center, Louisville, Kentucky
| | - Miguel Pinedo
- Alcohol Research Group, University of California, Berkeley, Berkeley, California
| | - Juan C. Celedón
- Division of Pulmonary Medicine, Allergy and Immunology, Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Ivor S. Douglas
- Division of Pulmonary and Critical Care, Department of Medicine, Denver Health Medical Center, University of Colorado, and Anschutz Medical Center, Denver, Colorado
| | - Dona J. Upson
- Division of Pulmonary and Critical Care, Department of Medicine, New Mexico Veterans Affairs Health Care Services, Albuquerque, New Mexico; and
| | - Jesse Roman
- Division of Pulmonary, Critical Care, and Sleep Disorders, Department of Medicine and Department of Pharmacology, University of Louisville Health Sciences Center and Robley Rex Veterans Affairs Medical Center, Louisville, Kentucky
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Perez LG, Chavez A, Marquez DX, Soto SC, Haughton J, Arredondo EM. Associations of Acculturation With Self-Report and Objective Physical Activity and Sedentary Behaviors Among Latinas. HEALTH EDUCATION & BEHAVIOR 2016; 44:431-438. [PMID: 27679665 DOI: 10.1177/1090198116669802] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Less than 50% of Latinas meet physical activity (PA) recommendations. Acculturation is a complex cultural phenomenon that may influence health behaviors, but associations between acculturation and Latinas' activity and sedentary levels are unclear. AIM To examine associations of acculturation with Latinas' domain-specific and total PA as well as sedentary time. METHOD We analyzed baseline data collected between 2011 and 2013 among 410 Latinas (18-65 years) from a PA promotion intervention in San Diego, CA ( Fe en Acción/ Faith in Action). Participants wore an accelerometer to assess moderate-to-vigorous PA (MVPA) and sedentary time and completed a survey assessing domain-specific PA, sociodemographics, and acculturation as measured by length of residence in the United States and the Bidimensional Acculturation Scale (BAS) for Hispanics. Higher acculturation was defined as longer residence in the United States or being either assimilated or bicultural as per scores on the Hispanic and Anglo domains of the BAS. RESULTS Based on weekly averages from the accelerometer, Latinas spent 103 minutes in MVPA and 76% of total activity in sedentary time. Only 32% met MVPA recommendations via self-reported leisure-time and transportation PA. Longer residence in the United States was inversely associated with reporting any transportation or occupational PA and meeting MVPA recommendations. Assimilated/bicultural Latinas had significantly less accelerometer-based total MVPA and higher sedentary time than their lower acculturated counterparts. CONCLUSIONS Overall, higher acculturation, based on either measure, was related to less activity. Our findings suggest interventions tailored to the acculturation levels of Latinas are needed to help reduce disparities in Latinas' PA and sedentary behaviors.
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Affiliation(s)
- Lilian G Perez
- 1 University of California, San Diego, CA, USA.,2 San Diego State University, San Diego, CA, USA.,3 Institute for Behavioral and Community Health, San Diego, CA, USA
| | - Adrian Chavez
- 3 Institute for Behavioral and Community Health, San Diego, CA, USA
| | | | - Sandra C Soto
- 1 University of California, San Diego, CA, USA.,2 San Diego State University, San Diego, CA, USA.,3 Institute for Behavioral and Community Health, San Diego, CA, USA
| | - Jessica Haughton
- 3 Institute for Behavioral and Community Health, San Diego, CA, USA
| | - Elva M Arredondo
- 2 San Diego State University, San Diego, CA, USA.,3 Institute for Behavioral and Community Health, San Diego, CA, USA
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Goulão B, Santos O, Carmo ID. The impact of migration on body weight: a review. CAD SAUDE PUBLICA 2015; 31:229-45. [PMID: 25760158 DOI: 10.1590/0102-311x00211913] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2013] [Accepted: 10/31/2014] [Indexed: 12/16/2022] Open
Abstract
Immigrants may be more vulnerable to obesity as a result of the immigration process. The aim of this article is to summarize current knowledge about the impact of immigration on body mass index (BMI). A systematic review was performed in accordance with PRISMA guidelines through a database search of scientific articles (last updated in August 2014). Thirty-nine articles were included and assessed. Results varied according to ethnic background, country of origin and host country. A consistent positive association between BMI and time since immigration was found among Hispanic, European and African immigrants. Less than half of the studies observed a positive association among Asian immigrants. The quality of the majority of the studies assessed was poor, reflecting a need to improve methodology and concept definition. Immigration appears to have a deteriorative effect on BMI. Underlying causes may include changes in nutrition and physical activity, psychological and social factors, and genetic susceptibility and these aspects should be included as moderator variables in future studies.
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Rodriguez CJ, Allison M, Daviglus ML, Isasi CR, Keller C, Leira EC, Palaniappan L, Piña IL, Ramirez SM, Rodriguez B, Sims M. Status of cardiovascular disease and stroke in Hispanics/Latinos in the United States: a science advisory from the American Heart Association. Circulation 2014; 130:593-625. [PMID: 25098323 PMCID: PMC4577282 DOI: 10.1161/cir.0000000000000071] [Citation(s) in RCA: 277] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND PURPOSE This American Heart Association (AHA) scientific statement provides a comprehensive overview of current evidence on the burden cardiovascular disease (CVD) among Hispanics in the United States. Hispanics are the largest minority ethnic group in the United States, and their health is vital to the public health of the nation and to achieving the AHA's 2020 goals. This statement describes the CVD epidemiology and related personal beliefs and the social and health issues of US Hispanics, and it identifies potential prevention and treatment opportunities. The intended audience for this statement includes healthcare professionals, researchers, and policy makers. METHODS Writing group members were nominated by the AHA's Manuscript Oversight Committee and represent a broad range of expertise in relation to Hispanic individuals and CVD. The writers used a general framework outlined by the committee chair to produce a comprehensive literature review that summarizes existing evidence, indicate gaps in current knowledge, and formulate recommendations. Only English-language studies were reviewed, with PubMed/MEDLINE as our primary resource, as well as the Cochrane Library Reviews, Centers for Disease Control and Prevention, and the US Census data as secondary resources. Inductive methods and descriptive studies that focused on CVD outcomes incidence, prevalence, treatment response, and risks were included. Because of the wide scope of these topics, members of the writing committee were responsible for drafting individual sections selected by the chair of the writing committee, and the group chair assembled the complete statement. The conclusions of this statement are the views of the authors and do not necessarily represent the official view of the AHA. All members of the writing group had the opportunity to comment on the initial drafts and approved the final version of this document. The manuscript underwent extensive AHA internal peer review before consideration and approval by the AHA Science Advisory and Coordinating Committee. RESULTS This statement documents the status of knowledge regarding CVD among Hispanics and the sociocultural issues that impact all subgroups of Hispanics with regard to cardiovascular health. In this review, whenever possible, we identify the specific Hispanic subgroups examined to avoid generalizations. We identify specific areas for which current evidence was less robust, as well as inconsistencies and evidence gaps that inform the need for further rigorous and interdisciplinary approaches to increase our understanding of the US Hispanic population and its potential impact on the public health and cardiovascular health of the total US population. We provide recommendations specific to the 9 domains outlined by the chair to support the development of these culturally tailored and targeted approaches. CONCLUSIONS Healthcare professionals and researchers need to consider the impact of culture and ethnicity on health behavior and ultimately health outcomes. There is a need to tailor and develop culturally relevant strategies to engage Hispanics in cardiovascular health promotion and cultivate a larger workforce of healthcare providers, researchers, and allies with the focused goal of improving cardiovascular health and reducing CVD among the US Hispanic population.
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Salinas JJ, Abdelbary B, Rentfro A, Fisher-Hoch S, McCormick J. Cardiovascular disease risk among the Mexican American population in the Texas-Mexico border region, by age and length of residence in United States. Prev Chronic Dis 2014; 11:E58. [PMID: 24721218 PMCID: PMC3984943 DOI: 10.5888/pcd11.130253] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Introduction Although the relationship between health behaviors and outcomes such as smoking and obesity with longer residence in the United States among Mexican American immigrants is established, the relationship between length of residency in the United States and risk for cardiovascular disease (CVD) is not fully understood. The objective of this study was to determine the relationship between immigrant status, length of residence in the United States, age, and CVD markers in a sample of Mexican American adults living in Brownsville, Texas. Methods We categorized participants in the Cameron County Hispanic Cohort study as immigrants in the United States for 10 years or less, immigrants in the United States for more than 10 years, or born in the United States. We conducted logistic and ordinary least squares regression for self-reported chronic conditions and CVD biomarkers. Results We found bivariate differences in the prevalence of self-reported conditions and 1 CVD biomarker (low-density lipoprotein cholesterol) by length of residence in the middle (41–64 y) and younger (18–40 y) age groups. After adjusting for covariates, the following varied significantly by immigrant status: stroke and high cholesterol (self-reported conditions) and diastolic blood pressure, systolic blood pressure, total cholesterol, and low-density lipoprotein cholesterol (CVD biomarkers). Conclusion The association between immigrant status, length of residence in the United States, and CVD markers varied. The effect of length of residence in the United States or immigrant status may depend on age and may be most influential in middle or older age.
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Affiliation(s)
- Jennifer J Salinas
- University of Texas Health Science Center, School of Public Health, Brownsville Campus, 80 Fort Brown, Brownsville, TX 78520. E-mail:
| | - Bassent Abdelbary
- University of Texas Health Science Center, School of Public Health, Brownsville Campus, Brownsville, Texas
| | - Anne Rentfro
- University of Texas at Brownsville, Brownsville, Texas
| | - Susan Fisher-Hoch
- University of Texas Health Science Center, School of Public Health, Brownsville Campus, Brownsville, Texas
| | - Joseph McCormick
- University of Texas Health Science Center, School of Public Health, Brownsville Campus, Brownsville, Texas
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Ainsworth BE, Keller C, Herrmann S, Belyea M, Records K, Nagle-Williams A, Vega-López S, Permana P, Coonrod DV. Physical activity and sedentary behaviors in postpartum Latinas: Madres para la Salud. Med Sci Sports Exerc 2014; 45:1298-306. [PMID: 23439416 DOI: 10.1249/mss.0b013e3182863de5] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE To describe the physical activity (PA) and sedentary behaviors of postpartum Latinas who are overweight or obese before initiating Madres para la Salud, a social support-mediated walking intervention to promote postpartum weight loss. METHODS One hundred thirty-nine postpartum women (13.6 ± 7.7 wk since childbirth, age = 28.3 ± 5.6 yr, BMI = 29.7 ± 3.5 kg · m(-2); mean ± SD), recruited from organizations serving Latino residents in the Phoenix, Arizona, area completed the Stanford Brief Activity Survey and concurrently wore an accelerometer (ActiGraph) and a pedometer for 7 d and kept a PA record. RESULTS Most were classified as inactive and lightly active on the Stanford Brief Activity Survey (51% inactive, 37% light, 11% moderate). Most time was spent in sedentary (512.0 ± 169.9 min · d(-1)) and light-intensity PA (242.4 ± 51.4 min · d(-1)) with less time in moderate-intensity lifestyle (78.3 ± 39.9 min · d(-1)), moderate-intensity walking (16.6 ± 14.4 min · d(-1)), and vigorous-intensity PA (0.34 ± 1.5 min · d(-1)). Pedometer steps per day were low (total = 4973 ± 2202 steps, aerobic = 412 ± 774 steps), with most participants rated as sedentary (61%) or low active (28.1%). Consistent with objective PA measures, PA records showed more time spent in light-intensity PA such as home care, cooking, child care and self-care tasks, occupation, religious events, and watching television. CONCLUSION By and large, the postpartum Latinas enrolled spent most of their day in low-intensity activity levels with little time spent in health-enhancing PA levels/behaviors. This demographic should be the focus of PA interventions to increase PA to health-enhancing levels.
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New C, Xiao L, Ma J. Acculturation and overweight-related attitudes and behavior among obese Hispanic adults in the United States. Obesity (Silver Spring) 2013; 21:2396-404. [PMID: 23687100 DOI: 10.1002/oby.20146] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2012] [Accepted: 10/23/2012] [Indexed: 12/25/2022]
Abstract
OBJECTIVE US Hispanics bear a disproportionate burden of excess body weight and associated morbidity, making obesity prevention and control in this population a public health priority. Development of culturally appropriate weight loss interventions requires understanding the influence of acculturation on attitudes and behavior related to obesity and weight loss. DESIGN AND METHODS Using data from the National Health and Nutrition Examination Survey (2001-2004), we analyzed the associations of country of birth and language usage with weight perception, weight dissatisfaction, intention to lose weight, and intended weight loss of clinical significance among obese Hispanic adults (>20 years of age; unweighted n = 675) in multivariable logistic regression analyses. RESULTS US birth was significantly associated with correct weight perception (odds ratio [OR], 4.45; 95% confidence interval [CI], 2.16-9.17) and weight dissatisfaction (OR = 2.95; 95% CI = 1.63-5.35). Compared with Spanish-speaking only, obese Hispanics, bilingual, obese Hispanics were more likely to attempt weight loss (OR = 2.78; 95% CI = 1.43-5.40) and achieve clinically significant weight loss (OR = 3.94; 95% CI = 1.51-10.3). CONCLUSIONS The findings suggest that lack of acculturation as measured by foreign birth and limited English proficiency may contribute to within-ethnicity health inequality among obese Hispanics, even after controlling for a variety of sociodemographic characteristics, including education and income, differential healthcare access and use, and health status. Further studies should examine the underlying mechanisms, thereby informing culturally competent intervention strategies targeted at obese US Hispanics.
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Affiliation(s)
- Christin New
- Department of Health Services Research, Palo Alto Medical Foundation Research Institute, Palo Alto, California, USA; Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, California, USA
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Ramirez AG, Gallion KJ, Despres CE, Adeigbe RT. SaludAmerica!: a national research network to build the field and evidence to prevent Latino childhood obesity. Am J Prev Med 2013; 44:S178-85. [PMID: 23415181 DOI: 10.1016/j.amepre.2012.12.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 12/13/2012] [Accepted: 12/13/2012] [Indexed: 11/25/2022]
Affiliation(s)
- Amelie G Ramirez
- Institute for Health Promotion Research, The University of Texas Health Science Center, San Antonio, Texas 78229, USA.
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Keller C, Todd M, Ainsworth B, Records K, Vega-Lopez S, Permana P, Coonrod D, Nagle Williams A. Overweight, obesity, and neighborhood characteristics among postpartum Latinas. J Obes 2013; 2013:916468. [PMID: 23476752 PMCID: PMC3580903 DOI: 10.1155/2013/916468] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Accepted: 01/09/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Weight gain during the childbearing years and failure to lose pregnancy weight after birth contribute to the development of obesity in Latinas. DESIGN AND METHODS Madres para la Salud (Mothers for Health) is a 12-month prospective, randomized controlled trial exploring a social support intervention with moderate-intensity physical activity to effect changes in body fat, systemic and fat tissue inflammation, and depression symptoms in sedentary postpartum Latinas. This paper describes the initial body composition of the sample, social support, and neighborhood contextual correlations of overweight and obese Latina mothers within the first 6 months after birth. RESULTS The mean body mass index was 29.68 with 38.56% bioelectrical impedence analysis for body fat. Elements of the environment (e.g., opportunities to walk) received middle or high scores. Access to healthy food was positively related to favorability of the walking environment. Waist-to-hip ratio was uncorrelated with other obesity-related indices. CONCLUSIONS The body adiposity of these Latina mothers was coupled with low levels of social support from family and friends and neighborhood characteristics that were unfavorable to walking.
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Affiliation(s)
- Colleen Keller
- College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ 85004, USA.
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Abstract
The objective of this study is to examine the association between acculturation and BMI among Asian Americans using multiple measures of acculturation. Data of 847 Chinese, Korean and Vietnamese recruited for a health education program in Maryland during 2009 to 2010 were used. Acculturation was measured by the short version of Suinn-Lew Asian Self-Identity Acculturation Scale (SL-ASIA) and its individual components. Height and weight were measured by trained staff. Multiple linear regressions were used to estimate the association between acculturation and BMI. After adjusting for age, gender, education, income, marital status, and ethnicity, SL-ASIA (β = 0.71, SE = 0.28), having education in the US (β = 0.56, SE = 0.28), younger age of arrival (0-5 years: β = 3.32, SE = 0.76, 6-10 years: β = 1.55, SE = 0.78), self identified as Americans (β = 1.51, SE = 0.77) and equal preference of Asian/American food in restaurants (β = 0.92, SE = 0.28) were significantly associated with increased BMI. The association between acculturation and BMI was stronger among men than women, strongest among Chinese and weakest among Vietnamese. Acculturation was moderately associated with increased BMI among Asian Americans and this association varied by measures of acculturation. The association of acculturation and BMI was moderated by sex and ethnicity groups.
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Abstract
PURPOSE To verify and explicate the impact of marianismo beliefs on the physical activity behaviors of immigrant Latinas. DESIGN Twenty-eight immigrant Latinas, aged 18 to 40 years, were recruited to participate in two focus group interviews. Data collection and analysis were driven by Spradley's Developmental Research Sequence. RESULTS Two domain terms were identified: "Life is too fast here" and "The woman is the center of the family." Six included terms and five cultural themes were specified. DISCUSSION A combination of marianismo beliefs, acculturation stress, loss of social support, and conflicts between collectivist and individualist values combine to adversely influence physical activity behaviors of immigrant Latinas. IMPLICATIONS Physical activity interventions for Hispanic women should capitalize on the strengths of the marianista, address factors leading to acculturation stress among women and their families, and establish bridges of social support among new groups of immigrants.
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Affiliation(s)
- Karen T D'Alonzo
- Rutgers, The State University of New Jersey, 180 University Avenue, Newark, NJ 07102, USA.
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Ward RK, Jilcott SB, Bethel JW. Acculturation, Food Insecurity, Diet Quality, and Body Mass Index Among Pre-Conception-Aged Latino Women in Eastern North Carolina. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2011. [DOI: 10.1080/19320248.2011.627300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Abstract
BACKGROUND Latinos have become the largest minority group in the United States and will represent 25% of the US population by 2050. Latinos experience a disproportionate burden of poverty and poor health outcomes. OBJECTIVES We critically examined the evidence for a link between acculturation and health disparities in Latinos with a focus on type 2 diabetes (T2D) and nutrition-related risk factors and illustrated how acculturation principles can help design a culturally appropriate T2D self-management intervention in Latinos. DESIGN Evidence presented in this article was drawn from 1) systematic reviews identified through PubMed searches, 2) backward searches that were based on articles cited, 3) experts in the field, and 4) the author's personal files. RESULTS The preponderance of the evidence supported an association of acculturation with poor dietary quality and obesity. These associations appeared to be modified by several socioeconomic and demographic factors and were not always linear. The association between acculturation and T2D is unclear. CONCLUSIONS Longitudinal studies and more sophisticated analytic approaches are needed to better understand if and how acculturation affects health-disparity outcomes in Latinos. Tailoring interventions to the acculturation level of individuals is likely to help reduce health disparities in Latinos.
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Abstract
AbstractObjectiveVarious studies in the USA and Canada have consistently shown a positive association between length of residence of immigrants and obesity. Studies in European countries have obtained less consistent results. The present work assesses the influence of length of residence on the frequency of obesity in immigrants in the city of Madrid, Spain.DesignWe studied a sample of 7155 persons aged 18 years and over residing in the city of Madrid, who were was surveyed between November 2004 and May 2005. Information was collected on immigrant status (country of birth), length of residence in Spain, obesity, sociodemographic characteristics and lifestyle.ResultsCompared with the Spanish population, the odds for obesity in the immigrant population by length of residence was less than one in all groups, becoming closer to one with increasing time of residence (OR = 0·67, 0·73 and 0·81 for immigrants with less than 2, 2–4 and 5–9 years of residence in Spain, respectively), up to 10 or more years of residence, when it declined (OR = 0·69). The magnitude of this association was considerably reduced after adjusting for sociodemographic variables and for perceived health, but was not further modified after adjusting for lifestyle variables.ConclusionsLength of residence of immigrants in the city of Madrid is not associated with the frequency of obesity. It is possible that the circumstances immigrants encounter after arriving in Spain do not involve an overexposure to factors favouring obesity, relative to those they bring with them.
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Ahmed AT, Quinn VP, Caan B, Sternfeld B, Haque R, Van Den Eeden SK. Generational status and duration of residence predict diabetes prevalence among Latinos: the California Men's Health Study. BMC Public Health 2009; 9:392. [PMID: 19840393 PMCID: PMC2770491 DOI: 10.1186/1471-2458-9-392] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2009] [Accepted: 10/19/2009] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Diabetes disproportionately affects Latinos. However, examining Latinos as one group obscures important intra-group differences. This study examined how generational status, duration of US residence, and language preference are associated with diabetes prevalence and to what extent these explain the higher prevalence among Latinos. METHODS We determined nativity, duration of US residence, language preference, and diabetes prevalence among 11 817 Latino, 6109 black, and 52 184 white participants in the California Men's Health Study. We combined generational status and residence duration into a single migration status variable with levels: > or = third generation; second generation; and immigrant living in the US for > 25, 16-25, 11-15, or < or = 10 years. Language preference was defined as language in which the participant took the survey. Logistic regression models were specified to assess the associations of dependent variables with prevalent diabetes. RESULTS Diabetes prevalence was 22%, 23%, and 11% among Latinos, blacks, and whites, respectively. In age-adjusted models, we observed a gradient of risk of diabetes by migration status among Latinos. Further adjustment for socioeconomic status, obesity and health behaviors only partially attenuated this gradient. Language preference was a weak predictor of prevalent diabetes in some models and not significant in others. In multivariate models, we found that odds of diabetes were higher among US-born Latinos than US-born blacks. CONCLUSION Generational status and residence duration were associated with diabetes prevalence among middle-aged Latino men in California. As the Latino population grows, the burden of diabetes-associated disease is likely to increase and demands public health attention.
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Affiliation(s)
| | - Virginia P Quinn
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, USA
| | - Bette Caan
- Division of Research, Kaiser Permanente, Oakland, USA
| | | | - Reina Haque
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, USA
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