1
|
Barajas CB, Rivera-González AC, Vargas Bustamante A, Langellier BA, Lopez Mercado D, Ponce NA, Roby DH, Stimpson JP, De Trinidad Young ME, Ortega AN. Health Care Access and Utilization and the Latino Health Paradox. Med Care 2024:00005650-990000000-00220. [PMID: 38598667 DOI: 10.1097/mlr.0000000000002004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
BACKGROUND The Latino health paradox is the phenomenon whereby recent Latino immigrants have, on average, better health outcomes on some indicators than Latino immigrants who have lived in the United States longer and US-born Latinos and non-Latino Whites. This study examined whether the paradox holds after accounting for health care access and utilization. METHODS The 2019-2020 National Health Interview Survey data were used. The main predictors included population groups of foreign-born and US-born Latinos (Mexican or non-Mexican) versus US-born non-Latino Whites. Predicted probabilities of health outcomes (self-reported poor/fair health, overweight/obesity, hypertension, coronary heart disease, diabetes, cancer, and depression) were calculated and stratified by length of residence in the United States (<15 or ≥15 years) among foreign-born Latinos and sex (female or male). Multivariable analyses adjusted for having a usual source of care other than the emergency department, health insurance, a doctor visit in the past 12 months, predisposing and enabling factors, and survey year. RESULTS After adjusting for health care access, utilization, and predisposing and enabling factors, foreign-born Latinos, including those living in the United States ≥15 years, had lower predicted probabilities for most health outcomes than US-born non-Latino Whites, except overweight/obesity and diabetes. US-born Latinos had higher predicted probabilities of overweight/obesity and diabetes and a lower predicted probability of depression than US-born non-Latino Whites. CONCLUSIONS In this national survey, the Latino health paradox was observed after adjusting for health care access and utilization and predisposing and enabling factors, suggesting that, although these are important factors for good health, they do not necessarily explain the paradox.
Collapse
Affiliation(s)
- Clara B Barajas
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, PA
| | - Alexandra C Rivera-González
- Department of Public Health, School of Social Sciences, Humanities, and Arts, University of California, Merced, Merced, CA
| | - Arturo Vargas Bustamante
- Department of Health Policy and Management and the Center for Health Policy Research, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA
| | - Brent A Langellier
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, PA
| | - Damaris Lopez Mercado
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, PA
| | - Ninez A Ponce
- Department of Health Policy and Management and the Center for Health Policy Research, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA
| | - Dylan H Roby
- Department of Health, Society, & Behavior, Program in Public Health, University of California, Irvine, Irvine, CA
| | - Jim P Stimpson
- Peter O'Donnell School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX
| | - Maria-Elena De Trinidad Young
- Department of Public Health, School of Social Sciences, Humanities, and Arts, University of California, Merced, Merced, CA
| | - Alexander N Ortega
- Thompson School of Social Work & Public Health, University of Hawai'i at Mānoa, Honolulu, HI
| |
Collapse
|
2
|
Moser B, Moore D, Khadka B, Lyons C, Foxall T, Andam CP, Parker CJ, Ochin C, Garelnabi M, Sevigny J, Thomas WK, Bigornia S, Dao MC. Association between inflammation, lipopolysaccharide binding protein, and gut microbiota composition in a New Hampshire Bhutanese refugee population with a high burden of type 2 diabetes. Front Nutr 2023; 9:1059163. [PMID: 36687728 PMCID: PMC9852993 DOI: 10.3389/fnut.2022.1059163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 12/12/2022] [Indexed: 01/07/2023] Open
Abstract
Introduction South Asian refugees experience a high risk of obesity and diabetes yet are often underrepresented in studies on chronic diseases and their risk factors. The gut microbiota and gut permeability, as assessed through circulating lipopolysaccharide binding protein (LBP), may underlie the link between chronic inflammation and type 2 diabetes (T2D). The composition of the gut microbiota varies according to multiple factors including demographics, migration, and dietary patterns, particularly fiber intake. However, there is no evidence on the composition of the gut microbiota and its relationship with metabolic health in refugee populations, including those migrating to the United States from Bhutan. The objective of this study was to examine glycemic status in relation to LBP, systemic inflammation fiber intake, and gut microbiota composition in Bhutanese refugee adults residing in New Hampshire (n = 50). Methods This cross-sectional study included a convenience sample of Bhutanese refugee adults (N = 50) in NH. Established bioinformatics pipelines for metagenomic analysis were used to determine relative genus abundance, species richness, and alpha diversity measures from shallow shotgun sequences. The relationships between inflammatory markers, gut microbiota composition, dietary fiber, and glycemic status were analyzed. Results We identified a substantial chronic disease burden in this study population, and observed a correlation between glycemic status, LBP, and inflammation, and a correlation between glycemic status and gut microbiome alpha diversity. Further, we identified a significant correlation between proinflammatory taxa and inflammatory cytokines. SCFA-producing taxa were found to be inversely correlated with age. Conclusion To date, this is the most comprehensive examination of metabolic health and the gut microbiome in a Bhutanese refugee population in NH. The findings highlight areas for future investigations of inflammation and glycemic impairment, in addition to informing potential interventions targeting this vulnerable population.
Collapse
Affiliation(s)
- Brandy Moser
- Department of Agriculture, Nutrition, and Food Systems, University of New Hampshire, Durham, NH, United States
| | - Dustin Moore
- Department of Agriculture, Nutrition, and Food Systems, University of New Hampshire, Durham, NH, United States
| | - Bishnu Khadka
- Building Community in New Hampshire, Manchester, NH, United States
| | - Carrie Lyons
- Department of Agriculture, Nutrition, and Food Systems, University of New Hampshire, Durham, NH, United States
| | - Tom Foxall
- Department of Biological Sciences, University of New Hampshire, Durham, NH, United States
| | - Cheryl P. Andam
- Department of Molecular, Cellular, and Biomedical Sciences, University of New Hampshire, Durham, NH, United States,Department of Biological Sciences, University at Albany, Albany, NY, United States
| | - Cooper J. Parker
- Department of Biological Sciences, University of New Hampshire, Durham, NH, United States
| | - Chinedu Ochin
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, United States
| | - Mahdi Garelnabi
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, United States
| | - Joseph Sevigny
- Department of Molecular, Cellular, and Biomedical Sciences, Hubbard Center for Genome Studies, University of New Hampshire, Durham, NH, United States
| | - W. Kelley Thomas
- Department of Molecular, Cellular, and Biomedical Sciences, Hubbard Center for Genome Studies, University of New Hampshire, Durham, NH, United States
| | - Sherman Bigornia
- Department of Agriculture, Nutrition, and Food Systems, University of New Hampshire, Durham, NH, United States
| | - Maria Carlota Dao
- Department of Agriculture, Nutrition, and Food Systems, University of New Hampshire, Durham, NH, United States,*Correspondence: Maria Carlota Dao,
| |
Collapse
|
3
|
Morey BN, Ryu S, Shi Y, Park HW, Lee S. Acculturation and Cardiometabolic Abnormalities Among Chinese and Korean Americans. J Racial Ethn Health Disparities 2022:10.1007/s40615-022-01347-x. [PMID: 35705844 PMCID: PMC9200372 DOI: 10.1007/s40615-022-01347-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 05/16/2022] [Accepted: 05/31/2022] [Indexed: 11/26/2022]
Abstract
Background Studies generally show that higher acculturation is associated with greater cardiovascular disease (CVD) risk among immigrants in the United States (US). However, few studies have compared how proxies of acculturation are differentially associated with metabolic abnormalities measured using objective biomarkers, self-reported diagnosis, and medication use, particularly among East Asian Americans. Methods Survey data and biomarker measurements collected from random (non-fasting) blood samples of Chinese and Korean immigrants in the US (n = 328) were used to examine the associations between two proxies for acculturation (years living in the US and English speaking proficiency) with three cardiometabolic abnormalities (high triglyceride levels, diabetes, and hypercholesterolemia). Poisson regression models estimated prevalence ratios adjusted for demographic characteristics, socioeconomic factors, and body mass index. Gender, Asian subgroup, and household income were tested as potential effect modifiers. Results Living longer in the US was associated with greater likelihood of having high triglycerides. In addition, living longer in the US was associated with greater likelihood of diabetes for people with lower household income and greater likelihood of hypercholesterolemia for people with higher household income. Higher level of English proficiency was less consistently associated with higher cardiometabolic risk, although there was a significant association with greater likelihood of hypercholesterolemia. Conclusions Longer time lived in the US is associated with higher risk of cardiometabolic abnormalities among Chinese and Korean Americans. Future studies of acculturation and cardiometabolic risk should carefully consider potential mechanisms and what proxy measures of acculturation capture. Trial Registration Number NCT03481296, date of registration: 3/29/2018.
Collapse
Affiliation(s)
- Brittany N Morey
- Program in Public Health, Department of Health, Society, & Behavior, University of California, Irvine, 653 E. Peltason Dr., Anteater Instruction and Research Building (AIRB) 2022, Irvine, CA, 92697-3957, USA.
| | - Soomin Ryu
- School of Public Policy, University of Maryland, College Park, MD, USA
| | - Yuxi Shi
- Department of Medicine, School of Medicine, University of California, Irvine, Irvine, CA, USA
| | - Hye Won Park
- Department of Medicine, School of Medicine, University of California, Irvine, Irvine, CA, USA
| | - Sunmin Lee
- Department of Medicine, School of Medicine, University of California, Irvine, Irvine, CA, USA
| |
Collapse
|
4
|
Andrews C, Oths KS, Dressler WW. Time in the United States and diabetes among Mexican immigrant women: The moderating role of culture. J Migr Health 2022; 6:100118. [PMID: 35668735 PMCID: PMC9166447 DOI: 10.1016/j.jmh.2022.100118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 05/16/2022] [Accepted: 05/25/2022] [Indexed: 11/26/2022] Open
Abstract
Mexican immigrants in the U.S. show high incidence of type 2 diabetes, and increased risk is associated with longer duration of residency. This study considers the impact of culture over time for Mexican immigrant women in a southern U.S. city. Using cultural consensus analysis to empirically derive the substance and structure of a cultural model for la buena vida (the good life) among Mexican immigrant women in Birmingham, Alabama, we assess the extent to which respondents are aligned with the model in their everyday lives. This measure of 'cultural consonance' is explored as a moderating variable between length of time living in the U.S. and level of Hemoglobin A1c. Results demonstrate that for those with more time in the U.S., those with lower consonance are more likely to have diabetes, while those who are more aligned with la buena vida are at lower risk.
Collapse
Affiliation(s)
- Courtney Andrews
- Department of Anthropology, The University of Alabama at Birmingham, University Hall – 3165, 1402 10th Avenue South, Birmingham, AL 35294, United States
| | - Kathryn S. Oths
- Department of Anthropology, The University of Alabama, Ten Hour Hall–19, 350 Marrs Spring Road, Tuscaloosa, AL 35487, United States
| | - William W. Dressler
- Department of Anthropology, The University of Alabama, Ten Hour Hall–19, 350 Marrs Spring Road, Tuscaloosa, AL 35487, United States
| |
Collapse
|
5
|
Lee S, Ryu S, Lee GE, Kawachi I, Morey BN, Slopen N. The association of acculturative stress with self-reported sleep disturbance and sleep duration among Asian Americans. Sleep 2022; 45:zsab298. [PMID: 34922392 PMCID: PMC8996032 DOI: 10.1093/sleep/zsab298] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 12/08/2021] [Indexed: 11/12/2022] Open
Abstract
STUDY OBJECTIVES This study aims to examine associations between acculturative stress-defined as the psychological impact, or stress reaction, of adapting to a new cultural context-and self-reported sleep outcomes among Chinese and Korean immigrants in the United States. METHODS In this cross-sectional study, acculturative stress was assessed using a 9-item scale, and sleep disturbance was measured using the 8-item scale. Sleep duration was self-reported. Poisson and linear regression analyses were conducted to examine the associations between acculturative stress, sleep disturbance, and sleep duration. RESULTS Our sample consists of 400 participants (females: 52%, Chinese: 50%, Koreans: 50%, the mean of age = 58.4). 81.8% of them were classified as having no sleep disturbance, whereas 18.2% were classified as having sleep disturbance. Poisson models revealed that greater acculturative stress was associated with a higher prevalence of sleep disturbance (Prevalence Ratio (PR): 1.18, 95% confidence interval (CI): 1.06% to 1.31%). In linear models, a one-unit increase in acculturative stress was associated with 0.08 hr less sleep (p < .05). Interaction tests indicated effect modification for sleep disturbance by sex and ethnic identity: only women had a significant association between acculturative stress and sleep disturbance (PR: 1.30; 95% CI: 1.13 to 1.49), while the association was significant for individuals identifying as "very Asian" (PR: 1.21; 95% CI: 1.08 to 1.35), but not for those identifying as "mostly Asian" or "bicultural/western". CONCLUSIONS If findings are replicated, we suggest developing intervention programs for Asian immigrants to minimize acculturative stress and bolster protective factors that decrease the risk for poor sleep outcomes.Information on Clinical Trial: Name: Screening To Prevent ColoRectal Cancer (STOP CRC) among At-Risk Asian American Primary Care Patients NCT Number: NCT03481296 URL: https://clinicaltrials.gov/ct2/show/NCT03481296?term=Sunmin+Lee&draw=2&rank=1.
Collapse
Affiliation(s)
- Sunmin Lee
- Department of Medicine, School of Medicine, University of California-Irvine, Irvine, CA, USA
| | - Soomin Ryu
- School of Public Policy, University of Maryland, College Park, MD, USA
| | - Grace E Lee
- Department of Medicine, School of Medicine, University of California-Irvine, Irvine, CA, USA
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Brittany N Morey
- Department of Health, Society, & Behavior, Program in Public Health, University of California-Irvine, Irvine, CA, USA
| | - Natalie Slopen
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| |
Collapse
|
6
|
Omer Gilon M, Balmakov Y, Gelman S, Twig G. Adolescent Immigration and Type-2 Diabetes. Curr Diab Rep 2021; 21:60. [PMID: 34902101 DOI: 10.1007/s11892-021-01420-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/03/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE OF REVIEW Type-2 diabetes (T2D) in children and adolescents has become an increasingly important public health concern, currently accounting for nearly half of all diabetes cases in this age group in some countries. With immigration growing worldwide, immigrants as a subpopulation warrant special attention. Although the association of immigration and T2D has been explored in older persons, few studies have examined it in adolescent immigrants. RECENT FINDINGS Of 64 studies, only 8 were relevant and elaborated on in this review. Our findings show that adolescent immigrants to Western countries seem to benefit an overall favorable metabolic profile that is associated with lower odds to dysmetabolism. However, this protective effect wanes over time with longer years of residency and plateaus at approximately a decade from arrival. As immigration becomes a global phenomenon, pediatric T2D in these special populations has major public health and socioeconomic implications. Improving immigrants' access to healthcare, healthcare education and utilization, and specific cultural programs for prevention and treatment of T2D are important to ensure the accessibility of preventive medical services to young immigrants. Further research should be considered to help identify at-risk youth.
Collapse
Affiliation(s)
- Ma'ayan Omer Gilon
- The Israel Defense Forces Medical Corps, Ramat Gan, Israel
- Department of Military Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Yulia Balmakov
- The Israel Defense Forces Medical Corps, Ramat Gan, Israel
- Department of Military Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Shira Gelman
- The Israel Defense Forces Medical Corps, Ramat Gan, Israel
- Department of Military Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Gilad Twig
- The Israel Defense Forces Medical Corps, Ramat Gan, Israel.
- Department of Military Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
- Institute of Endocrinology, Sheba Medical Center, Ramat Gan, Israel.
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.
| |
Collapse
|
7
|
Gujral UP, Kanaya AM. Epidemiology of diabetes among South Asians in the United States: lessons from the MASALA study. Ann N Y Acad Sci 2021; 1495:24-39. [PMID: 33216378 PMCID: PMC8134616 DOI: 10.1111/nyas.14530] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 10/19/2020] [Accepted: 10/21/2020] [Indexed: 02/06/2023]
Abstract
South Asian individuals in the United States are at an increased risk of type 2 diabetes (T2DM); however, the mechanisms behind this are not well understood. The Mediators of Atherosclerosis in South Asians Living in America (MASALA) study is the only longitudinal cohort of South Asians in the United States and provides key insights as to the epidemiology of T2DM in South Asians. Evidence from the MASALA study suggests that South Asians experience a disproportionately high burden of prevalent and incident T2DM compared with members of other race/ethnic groups. Higher insulin resistance in South Asians, even with low body mass index (BMI), more impairment in insulin secretion, and greater deposition of ectopic fat likely play a role in T2DM etiology. Furthermore, South Asian migrants to the United States experience a range of factors related to acculturation, social networks, and religious beliefs, which may impact physical activity and dietary practices. Interventions to prevent T2DM in South Asians should include a focus on cultural factors related to health and should consider the complete mechanistic pathway and the relative contributions of insulin resistance, β cell dysfunction, and ectopic fat deposition on T2DM development in South Asians, particularly in those with lower BMI.
Collapse
Affiliation(s)
- Unjali P. Gujral
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Alka M. Kanaya
- Division of General Internal Medicine, University of California, San Francisco, San Francisco, CA
| |
Collapse
|
8
|
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.
Collapse
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
| |
Collapse
|
9
|
Wang VA, Chu MT, Chie L, Gaston SA, Jackson CL, Newendorp N, Uretsky E, Dodson RE, Adamkiewicz G, James-Todd T. Acculturation and endocrine disrupting chemical-associated personal care product use among US-based foreign-born Chinese women of reproductive age. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2021; 31:224-232. [PMID: 33235331 PMCID: PMC7954893 DOI: 10.1038/s41370-020-00279-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 10/20/2020] [Accepted: 11/05/2020] [Indexed: 05/18/2023]
Abstract
BACKGROUND Personal care products (PCPs) are an important source of endocrine disrupting chemicals (EDCs) linked to adverse reproductive health outcomes. OBJECTIVE We evaluated EDC-associated PCP use and acculturation among Asian women. METHODS Our study included 227 foreign-born Chinese women ages 18-45 seeking obstetrics-gynecology care at community health centers (Boston, MA). Acculturation was measured by English-language use, length of US residence, and age at US entry. Self-reported use of PCPs (crème rinse/conditioner, shampoo, perfume/cologne, bar soap/body wash, liquid hand soap, moisturizer/lotion, colored cosmetics, sunscreen, and nail polish) in the last 48 h was collected. Latent class analysis was used to identify usage patterns. We also conducted multivariable logistic to determine the cross-sectional associations of acculturation measures and the use of individual PCP types. RESULTS Those who used more PCP types, overall and by each type, tended to be more acculturated. Women who could speak English had 2.77 (95% CI: 1.10-7.76) times the odds of being high PCP users compared to their non-English speaking counterparts. English-language use was associated with higher odds of using perfume/cologne and nail polish. SIGNIFICANCE Our findings give insight about EDC-associated PCP use based on acculturation status, which can contribute to changes in immigrant health and health disparities.
Collapse
Affiliation(s)
- Veronica A Wang
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - MyDzung T Chu
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Lucy Chie
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA
| | - Symielle A Gaston
- Department of Health and Human Services, Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, 27709, USA
| | - Chandra L Jackson
- Department of Health and Human Services, Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, 27709, USA
- Department of Health and Human Services, Intramural Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Nicole Newendorp
- Committee on Degrees in Social Studies, Harvard University, Cambridge, MA, 02138, USA
| | - Elanah Uretsky
- Department of Anthropology, Brandeis University, Waltham, MA, 02453, USA
| | | | - Gary Adamkiewicz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Tamarra James-Todd
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA.
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, 02114, USA.
| |
Collapse
|
10
|
Shah SM, Jaacks LM, Al-Maskari F, Al-Kaabi J, Aziz F, Soteriades E, Loney T, Farooqi H, Memon A, Ali R. Association between duration of residence and prevalence of type 2 diabetes among male South Asian expatriate workers in the United Arab Emirates: a cross-sectional study. BMJ Open 2020; 10:e040166. [PMID: 33334833 PMCID: PMC7747541 DOI: 10.1136/bmjopen-2020-040166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
UNLABELLED Expatriates account for about 80% of the total population in the United Arab Emirates (UAE). This study aimed to evaluate the hypothesis that prevalence of type 2 diabetes in male South Asian expatriates increases with increased length of residence in the UAE. DESIGN, SETTINGS AND PARTICIPANTS This cross-sectional study recruited a representative sample (n=1375) of male South Asian expatriates aged ≥18 years in Al Ain, UAE. Sociodemographic, anthropometric and lifestyle data were obtained using a pilot-tested adapted version of the WHO STEPS instrument. MAIN OUTCOME MEASURES Duration of residence was used as a marker for acculturation. Type 2 diabetes was defined as a self-reported physician diagnosis of diabetes or a glycosylated haemoglobin blood level ≥6.5%. RESULTS Mean (±SD) age of participants was 34.0±9.9 years. Overall, the prevalence of type 2 diabetes was 8.3% (95% CI 6.8% to 9.8%). Diabetes prevalence was positively associated with longer duration of residence in the UAE, 2.7%, <5 years; 8.2%, 5-10 years; and 18.8%, >10 years. After adjusting for age, nationality, and income and age, expatriates were more likely to develop diabetes if residing in the UAE for 5-10 years (OR=2.18; 95% CI 1.02 to 4.67) or >10 years (OR=3.23; 95% CI 1.52 to 6.85) compared with those residing for <5 years. CONCLUSIONS After controlling for potential confounding factors, longer duration of residence was significantly associated with a higher prevalence of type 2 diabetes in male South Asian expatriate workers in the UAE.
Collapse
Affiliation(s)
- Syed M Shah
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE
- Family Medicine, Aga Khan University, Karachi, Pakistan
- Zayed Centre for Health Sciences, United Arab Emirates University, Al Ain, UAE
| | - Lindsay M Jaacks
- Global Health and Population, Harvard T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Fatima Al-Maskari
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE
- Zayed Centre for Health Sciences, United Arab Emirates University, Al Ain, UAE
| | - Juma Al-Kaabi
- Zayed Centre for Health Sciences, United Arab Emirates University, Al Ain, UAE
- Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, Abu Dhabi, UAE
| | - Faisal Aziz
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE
| | - Elpidoforos Soteriades
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE
- Environmental and Occupational Medicine and Epidemiology (EOME), Department of Environmental Health, Harvard T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Tom Loney
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE
| | - Hamed Farooqi
- Dubai Diabetes Center, Dubai Health Authority, Dubai, UAE
| | - Anjum Memon
- Division of Primary Care and Public Health Medicine, Brighton and Sussex Medical School, Brighton, UK
| | - Raghib Ali
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE
- Public Health Research Center, New York University, Abu Dhabi, UAE
| |
Collapse
|
11
|
Shoup EM, Hormenu T, Osei-Tutu NH, Ishimwe MCS, Patterson AC, DuBose CW, Wentzel A, Horlyck-Romanovsky MF, Sumner AE. Africans Who Arrive in the United States before 20 Years of Age Maintain Both Cardiometabolic Health and Cultural Identity: Insight from the Africans in America Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249405. [PMID: 33333954 PMCID: PMC7765413 DOI: 10.3390/ijerph17249405] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/02/2020] [Accepted: 12/11/2020] [Indexed: 12/13/2022]
Abstract
The overall consensus is that foreign-born adults who come to America age < 20 y achieve economic success but develop adverse behaviors (smoking and drinking) that lead to worse cardiometabolic health than immigrants who arrive age ≥ 20 y. Whether age of immigration affects the health of African-born Blacks living in America is unknown. Our goals were to examine cultural identity, behavior, and socioeconomic factors and determine if differences exist in the cardiometabolic health of Africans who immigrated to America before and after age 20 y. Of the 482 enrollees (age: 38 ± 1 (mean ± SE), range: 20–65 y) in the Africans in America cohort, 23% (111/482) arrived age < 20 y, and 77% (371/482) arrived age ≥ 20 y. Independent of francophone status or African region of origin, Africans who immigrated age < 20 y had similar or better cardiometabolic health than Africans who immigrated age ≥ 20 y. The majority of Africans who immigrated age < 20 y identified as African, had African-born spouses, exercised, did not adopt adverse health behaviors, and actualized early life migration advantages, such as an American university education. Due to maintenance of cultural identity and actualization of opportunities in America, cardiometabolic health may be protected in Africans who immigrate before age 20. In short, immigrant health research must be cognizant of the diversity within the foreign-born community and age of immigration.
Collapse
Affiliation(s)
- Elyssa M. Shoup
- Section on Ethnicity and Health, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20892, USA; (E.M.S.); (T.H.); (N.H.O.-T.); (M.C.S.I.); (A.C.P.); (C.W.D.); (A.W.)
| | - Thomas Hormenu
- Section on Ethnicity and Health, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20892, USA; (E.M.S.); (T.H.); (N.H.O.-T.); (M.C.S.I.); (A.C.P.); (C.W.D.); (A.W.)
| | - Nana H. Osei-Tutu
- Section on Ethnicity and Health, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20892, USA; (E.M.S.); (T.H.); (N.H.O.-T.); (M.C.S.I.); (A.C.P.); (C.W.D.); (A.W.)
| | - M. C. Sage Ishimwe
- Section on Ethnicity and Health, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20892, USA; (E.M.S.); (T.H.); (N.H.O.-T.); (M.C.S.I.); (A.C.P.); (C.W.D.); (A.W.)
- National Institute of Minority Health and Health Disparities, Bethesda, MD 20892, USA
- Institute of Global Health Equity Research, University of Global Health Equity, Kigali 6955, Rwanda
| | - Arielle C. Patterson
- Section on Ethnicity and Health, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20892, USA; (E.M.S.); (T.H.); (N.H.O.-T.); (M.C.S.I.); (A.C.P.); (C.W.D.); (A.W.)
| | - Christopher W. DuBose
- Section on Ethnicity and Health, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20892, USA; (E.M.S.); (T.H.); (N.H.O.-T.); (M.C.S.I.); (A.C.P.); (C.W.D.); (A.W.)
| | - Annemarie Wentzel
- Section on Ethnicity and Health, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20892, USA; (E.M.S.); (T.H.); (N.H.O.-T.); (M.C.S.I.); (A.C.P.); (C.W.D.); (A.W.)
| | | | - Anne E. Sumner
- Section on Ethnicity and Health, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20892, USA; (E.M.S.); (T.H.); (N.H.O.-T.); (M.C.S.I.); (A.C.P.); (C.W.D.); (A.W.)
- National Institute of Minority Health and Health Disparities, Bethesda, MD 20892, USA
- Correspondence:
| |
Collapse
|
12
|
Payton C, Kimball S, Ahrenholz NC, Wieland ML. Preventive Care and Management of Chronic Diseases in Immigrant Adults. Prim Care 2020; 48:83-97. [PMID: 33516426 DOI: 10.1016/j.pop.2020.09.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Immigrants may have variable access to chronic disease screening and treatment in their countries of origin and host country, often limited by their immigration status. Immigrants face barriers to chronic disease management and preventive care, including health insurance access, linguistic challenges, lack of culturally sensitive care, limited records, and acculturation. Health care providers should prioritize chronic disease screening and follow up regularly to encourage preventive care and self-management of chronic disease.
Collapse
Affiliation(s)
- Colleen Payton
- School of Nursing and Public Health, Moravian College, 1200 Main Street, Bethlehem, PA 18018, USA.
| | - Sarah Kimball
- Immigrant & Refugee Health Center, Boston Medical Center, 725 Albany Street, 43 Suite 5b, Boston, MA 02118, USA; Boston University School of Medicine, 72 E Concord St, Boston, MA 02118, USA
| | - Nicole Chow Ahrenholz
- International Medicine Clinic, Harborview Medicine Center, 325 9th Avenue Box 359895, Seattle, WA 98104, USA; University of Washington School of Medicine, 1959 NE Pacific St, Seattle, WA 98195, USA
| | - Mark L Wieland
- Community Internal Medicine, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA
| |
Collapse
|
13
|
Hsueh L, Wu W, Hirsh AT, de Groot M, Mather KJ, Stewart JC. Undiagnosed diabetes among immigrant and racial/ethnic minority adults in the United States: National Health and Nutrition Examination Survey 2011-2018. Ann Epidemiol 2020; 51:14-19. [PMID: 32739530 PMCID: PMC11129874 DOI: 10.1016/j.annepidem.2020.07.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 07/11/2020] [Accepted: 07/16/2020] [Indexed: 01/02/2023]
Abstract
PURPOSE Undiagnosed diabetes disproportionately affects medically underserved groups. It is unknown whether being an immigrant confers additional risk for undiagnosed diabetes. The purpose of this study was to examine independent associations of immigrant status and race/ethnicity with the prevalence of diagnosed and undiagnosed diabetes in a U.S.-based population sample. METHODS Respondents were 21,306 adults from the 2011-2018 National Health and Nutrition Examination Survey. Immigrant status was coded as foreign-born or U.S.-born. Six racial/ethnic categories were white, Black, Mexican American, other Hispanic, Asian, and other/multiracial. Self-report and laboratory data yielded a three-level diabetes status outcome: no diabetes (88%), diagnosed diabetes (10%), and undiagnosed diabetes (2%). RESULTS Adjusted multinomial logistic regression models evaluating immigrant status and race/ethnicity as simultaneous predictors revealed that foreign-born (vs. U.S.-born) adults had a similar prevalence of diagnosed diabetes (OR = 0.98, 95% CI: 0.79-1.22, P = .84) but a higher prevalence of undiagnosed diabetes (OR = 1.54, 95% CI: 1.21-1.97, P = .004). Models showed that all racial/ethnic minority groups except the other/multiracial group (vs. whites) had a higher prevalence of diagnosed and undiagnosed diabetes (Ps < .04). CONCLUSIONS Immigrants and racial/ethnic minority adults have increased odds of undiagnosed diabetes, even after accounting for health insurance. These groups are likely at increased risk for diabetes complications because of prolonged periods of undetected diabetes.
Collapse
Affiliation(s)
- Loretta Hsueh
- Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), Indianapolis
| | - Wei Wu
- Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), Indianapolis
| | - Adam T Hirsh
- Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), Indianapolis
| | - Mary de Groot
- Department of Medicine, Indiana University School of Medicine, Indianapolis
| | - Kieren J Mather
- Department of Medicine, Indiana University School of Medicine, Indianapolis
| | - Jesse C Stewart
- Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), Indianapolis.
| |
Collapse
|
14
|
Bonilla-Escobar BA, Borrell LN, Del Cura-González I, Sánchez-Perruca L, Escortell-Mayor E, Franco M. Type 2 diabetes prevalence among Andean immigrants and natives in a Southern European City. Acta Diabetol 2020; 57:1065-1072. [PMID: 32253608 DOI: 10.1007/s00592-020-01515-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 03/07/2020] [Indexed: 11/24/2022]
Abstract
AIMS Inequalities in diabetes prevalence among immigrants from Andean countries remain unknown. Andean populations are one of the largest groups of immigrants in Madrid city. We examined the association between country of birth and type 2 diabetes mellitus (T2DM) prevalence in Andean immigrant population relative to Spanish-natives; and whether this association varied by age, sex and length of residence. METHODS We analyzed 1,258,931 electronic medical records from Spanish native and Andean immigrant adults aged 40-75 years of Madrid city. We used logistic regression and test interaction terms to address our aims. RESULTS Andean immigrants showed 1.13 (95% CI 1.10-1.17) greater adjusted odds for T2DM than Spanish natives. This association was positive in Ecuadorians and Bolivians but protective in Peruvians and Colombians. There was heterogeneity of this association according to age and sex. Relative to Spanish natives, odds of T2DM in Andeans of all ages and women were higher but lower in men. CONCLUSION Andean adults showed greater odds of T2DM compared with Spanish native adults in Madrid, with variation observed by age and sex. These findings emphasize the need for studying immigrant populations in a disaggregated manner to implement specific clinical and preventive approaches.
Collapse
Affiliation(s)
- Bertha Angelica Bonilla-Escobar
- Social and Cardiovascular Epidemiology Research Group, School of Medicine, University of Alcala, Alcala de Henares, Madrid, Spain
| | - Luisa N Borrell
- Social and Cardiovascular Epidemiology Research Group, School of Medicine, University of Alcala, Alcala de Henares, Madrid, Spain.
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, 55 West 125th Street, 530, New York, NY, 10027, USA.
| | - Isabel Del Cura-González
- Research Unit, Assistance Office for Primary Care, Health Services of Madrid, Madrid, Spain
- Department of Preventive Medicine and Public Health, University Rey Juan Carlos, Madrid, Spain
- Health Services Research on Chronic Patients Network (REDISSEC), Institute of Health Carlos III, ISCIII, Madrid, Spain
| | - Luis Sánchez-Perruca
- Health Services Research on Chronic Patients Network (REDISSEC), Institute of Health Carlos III, ISCIII, Madrid, Spain
- Information Technology Systems, Assistance Office for Primary Care, Health Services of Madrid, Madrid, Spain
| | - Esperanza Escortell-Mayor
- Research Unit, Assistance Office for Primary Care, Health Services of Madrid, Madrid, Spain
- Health Services Research on Chronic Patients Network (REDISSEC), Institute of Health Carlos III, ISCIII, Madrid, Spain
| | - Manuel Franco
- Social and Cardiovascular Epidemiology Research Group, School of Medicine, University of Alcala, Alcala de Henares, Madrid, Spain
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, 55 West 125th Street, 530, New York, NY, 10027, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| |
Collapse
|
15
|
Martinez-Cardoso A, Jang W, Baig AA. Moving Diabetes Upstream: the Social Determinants of Diabetes Management and Control Among Immigrants in the US. Curr Diab Rep 2020; 20:48. [PMID: 32857197 PMCID: PMC9328159 DOI: 10.1007/s11892-020-01332-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW Relative to the US-born population, immigrants are less likely to successfully manage and control their diabetes, leading to a host of diabetes-related complications. This review draws on the social determinants of health framework (SDoH) to summarize the multilevel factors that shape diabetes care and management among immigrants in the USA. RECENT FINDINGS While the diabetes literature is replete with research on individual-level risk factors and health behaviors, empirical literature linking the SDoH to diabetes management among immigrants is limited. However, housing precarity, food insecurity, poverty, uninsurance and underinsurance, and limited support for immigrants in healthcare systems are consistently shown to deter diabetes management and care. Immigrants with diabetes face a multitude of structural constraints to managing their diabetes. More research that theorizes the role of SDoH in diabetes management along with empirical qualitative and quantitative studies are needed. Interventions to address diabetes also require a more upstream approach in order to mitigate the drivers of diabetes disparities among immigrants.
Collapse
Affiliation(s)
- Aresha Martinez-Cardoso
- Department of Public Health Sciences, University of Chicago, 5841 South Maryland Ave, MC 2000, Chicago, IL, 60637, USA.
| | - Woorin Jang
- The College, University of Chicago, Chicago, IL, USA
| | - Arshiya A Baig
- Department of Medicine, University of Chicago, Chicago, IL, USA
| |
Collapse
|
16
|
Ayub S, Marsh V, Reed S. An Exploration of Chronic Disease Perception, Management, and Barriers to Care in Liberian Refugees Resettled in Charlottesville, Virginia. J Natl Med Assoc 2020; 112:654-667. [PMID: 32693979 DOI: 10.1016/j.jnma.2020.06.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 05/29/2020] [Accepted: 06/22/2020] [Indexed: 10/23/2022]
Abstract
Charlottesville is a resettlement site for Liberian refugees. Many receive care at the International Family Medicine Clinic (IFMC). IFMC physicians note reduced adherence to chronic disease medications among refugee patients. This study aims to understand the Liberian refugee populations' model of chronic disease. In 2014, twelve one-on-one interviews were conducted. Topics included concept of disease, health care access, disease burden, acculturation, and socioeconomic factors. Transcripts were analyzed according to the explanatory model of disease and Krueger's framework analysis. This study can assist providers in tailoring their practices to meet the needs of refugee patients and inform future public health interventions.
Collapse
Affiliation(s)
- Suniah Ayub
- University of Florida, College of Medicine, Department of Surgery, Gainesville, FL, USA.
| | - Vickie Marsh
- University of Virginia, School of Medicine, Department of Family Medicine, Charlottesville, VA, USA
| | - Sean Reed
- University of Virginia, School of Medicine, Department of Family Medicine, Charlottesville, VA, USA
| |
Collapse
|
17
|
|
18
|
Buchthal O, Nelson-Hurwitz D, Hsu L, Byers M, Banna J. Identifying Urban Immigrant Food-Cultivation Practices for Culturally-Tailored Garden-Based Nutrition Programs. J Immigr Minor Health 2019; 22:778-785. [PMID: 31838620 DOI: 10.1007/s10903-019-00952-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Garden-based nutrition programs are used to address food access and nutrition in low-income communities. In urban immigrant communities, food-growing practices may be shaped by environmental and cultural factors, and may not reflect the assumptions behind these curricula. Built-environment research was adapted to develop a protocol for assessing a community's gardening practices. A random sample of census blocks was generated and mapped, observational protocols developed, iteratively tested and refined, then fieldworkers trained and deployed. Daily debriefings were conducted to identify challenges in field implementation. Nearly all (93%) sampled blocks contained evidence of food cultivation. Garden structures, land-use patterns, and plant choices reflected cultural preferences, differing substantively from USDA home gardening curricula. This tool successfully identified food-growing practices within an urban immigrant Asian and Pacific Islander community, and provides a replicable methodology for community assessment. Results support the need to culturally-tailor garden-based nutrition programs for urban immigrant populations.
Collapse
Affiliation(s)
- Opal Buchthal
- Department of Public Health, University of Hawai'i at Mānoa, 1960 East-West Rd., Biomed D-201, Honolulu, HI, 96813, USA.
| | - Denise Nelson-Hurwitz
- Department of Public Health, University of Hawai'i at Mānoa, 1960 East-West Rd., Biomed D-201, Honolulu, HI, 96813, USA
| | - Laura Hsu
- Department of Public Health, University of Hawai'i at Mānoa, 1960 East-West Rd., Biomed D-201, Honolulu, HI, 96813, USA
| | - Melissa Byers
- Department of Public Health, University of Hawai'i at Mānoa, 1960 East-West Rd., Biomed D-201, Honolulu, HI, 96813, USA
| | - Jinan Banna
- Department of Human Nutrition, Food and Animal Sciences, University of Hawai'i at Mānoa, Honolulu, USA
| |
Collapse
|
19
|
Piwowarczyk LA, Ona F. BeWell: quality assurance health promotion pilot. Int J Health Care Qual Assur 2019; 32:321-331. [PMID: 31017063 DOI: 10.1108/ijhcqa-08-2017-0152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this paper is to determine the experience participating in a health promotion program for refugee and asylum seekers and torture survivors in a safety net clinical setting. DESIGN/METHODOLOGY/APPROACH Refugee and asylum seeker torture survivors participated in a seven-week health promotion program at a safety-net clinic. Participants interviewed before, during and after the program was designed to improve and maintain health promotion program quality. FINDINGS Six major themes emerged: social networks; tools/techniques/skills; wellness planning; spiritualism; health maintenance; and social/group interaction. Preliminary results suggest that this multi-pronged approach is feasible and acceptable to foreign-born torture survivors. RESEARCH LIMITATIONS/IMPLICATIONS Torture impacts many facets of one's life. A program which addresses health from a multidisciplinary perspective has promise to facilitate healing. PRACTICAL IMPLICATIONS The impact of torture and human rights violations significantly affects many facets of peoples' lives including emotional, social, physical and spiritual dimensions. Therefore a program which utilizes a multidisciplinary integrated bio-psychosocial and spiritual approach has the potential to simultaneously address many domains facilitating healing. ORIGINALITY/VALUE BeWell, a bio-psychosocio-spiritual health promotion strategy aimed at improving health service quality and increasing patient satisfaction to support positive health outcomes by implementing in-classroom/person modules for patients, to the authors' knowledge is unique in its efforts to encompass multiple domains simultaneously and fully integrate an approach to wellbeing.
Collapse
Affiliation(s)
- Linda A Piwowarczyk
- Boston Center for Refugee Health and Human Rights, Boston Medical Center, Boston, Massachusetts, USA
| | - Fernando Ona
- Tufts University School of Medicine , Boston, Massachusetts, USA
| |
Collapse
|
20
|
Sørbye IK, Vangen S, Juarez SP, Bolumar F, Morisaki N, Gissler M, Andersen AMN, Racape J, Small R, Wood R, Urquia ML. Birthweight of babies born to migrant mothers - What role do integration policies play? SSM Popul Health 2019; 9:100503. [PMID: 31993489 PMCID: PMC6978482 DOI: 10.1016/j.ssmph.2019.100503] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 10/16/2019] [Accepted: 10/16/2019] [Indexed: 11/18/2022] Open
Abstract
Birthweights of babies born to migrant women are generally lower than those of babies born to native-born women. Favourable integration policies may improve migrants’ living conditions and contribute to higher birthweights. We aimed to explore associations between integration policies, captured by the Migrant Integration Policy Index (MIPEX), with offspring birthweight among migrants from various world regions. In this cross-country study we pooled 31 million term birth records between 1998 and 2014 from ten high-income countries: Australia, Belgium, Canada, Denmark, Finland, Japan, Norway, Spain, Sweden and United Kingdom (Scotland). Birthweight differences in grams (g) were analysed with regression analysis for aggregate data and random effects models. Proportion of births to migrant women varied from 2% in Japan to 28% in Australia. The MIPEX score was not associated with birthweight in most migrant groups, but was positively associated among native-born (mean birthweight difference associated with a 10-unit increase in MIPEX: 105 g; 95% CI: 24, 186). Birthweight among migrants was highest in the Nordic countries and lowest in Japan and Belgium. Migrants from a given origin had heavier newborns in countries where the mean birthweight of native-born was higher and vice versa. Mean birthweight differences between migrants from the same origin and the native-born varied substantially across destinations (70 g–285 g). Birthweight among migrants does not correlate with MIPEX scores. However, birthweight of migrant groups aligned better with that of the native-born in destination counties. Further studies may clarify which broader social policies support migrant women and have impacts on perinatal outcomes. Favourable migrant integration policies, as measured by the MIPEX, did not correlate with offspring birthweight among migrants. However, the MIPEX correlated with birthweight among the offspring of native-born women. Migrants' birthweights were higher in countries with high birthweights in the local population and vice versa. Birthweight among native-born seems to have a pull-effect on the birthweight of migrant groups.
Collapse
Affiliation(s)
- Ingvil K. Sørbye
- Norwegian Advisory Unit for Women's Health, Department of Obstetrics, Oslo University Hospital, Norway
- Corresponding author. Norwegian Advisory Unit for Women's health, Department of Obstetrics, Oslo University Hospital, 0027, Oslo, Norway.
| | - Siri Vangen
- Norwegian Advisory Unit for Women's Health, Department of Obstetrics, Oslo University Hospital, Norway
| | - Sol P. Juarez
- Department of Public Health Sciences, Stockholm University, Sweden
| | - Francisco Bolumar
- Unit of Public Health, School of Medicine, University of Alcalá, Madrid, Spain
- City University of New York School of Public Health, New York, United States
| | - Naho Morisaki
- Department of Social Medicine, National Center for Child Health and Development, Japan
| | - Mika Gissler
- THL National Institute for Health and Welfare, Information Services Department, Helsinki, Finland
- Karolinska Institute, Department of Neurobiology, Care Sciences and Society, Stockholm, Sweden
| | | | - Judith Racape
- École de Santé Publique, Faculté de Médecine, Université Libre de Bruxelles, Belgium
| | - Rhonda Small
- Judith Lumley Centre, La Trobe University, Melbourne, Australia
- Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - Rachael Wood
- NHS National Services Scotland, Information Services Division, Edinburgh, Scotland, UK
| | - Marcelo L. Urquia
- Manitoba Centre for Health Policy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
- Dalla Lana School of Public Health, Faculty of Medicine, University of Toronto, Ontario, Canada
| |
Collapse
|
21
|
Tatara N, Hammer HL, Mirkovic J, Kjøllesdal MKR, Andreassen HK. Associations Between Immigration-Related User Factors and eHealth Activities for Self-Care: Case of First-Generation Immigrants From Pakistan in the Oslo Area, Norway. JMIR Public Health Surveill 2019; 5:e11998. [PMID: 31420957 PMCID: PMC6716338 DOI: 10.2196/11998] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 07/11/2019] [Accepted: 07/28/2019] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Immigrant populations are often disproportionally affected by chronic diseases, such as type 2 diabetes mellitus (T2DM). Use of information and communication technology (ICT) is one promising approach for better self-care of T2DM to mitigate the social health inequalities, if designed for a wider population. However, knowledge is scarce about immigrant populations' diverse electronic health (eHealth) activities for self-care, especially in European countries. OBJECTIVE With a target group of first-generation immigrants from Pakistan in the Oslo area, Norway, we aimed to understand their diverse eHealth activities for T2DM self-care in relation to immigration-related user factors specific to this target group: proficiency in relevant languages (Urdu, Norwegian, English), length of residence in Norway, and diagnosis of T2DM compared with general user factors (age, gender, education and digital skills, and self-rated health status). METHODS Data were from a survey among the target population (N=176) conducted in 2015-2016. Using logistic regression, we analyzed associations between user factors and experiences of each of the following eHealth activities for T2DM self-care in the last 12 months: first, information seeking by (1) search engines and (2) Web portals or email subscriptions; second, communication and consultation (1) by closed conversation with a few acquaintances using ICT and (2) on social network services; and third, active decision making by using apps for (1) tracking health information and (2) self-assessment of health status. Using Poisson regression, we also assessed the relationship between user factors and variety of eHealth activities experienced. The Bonferroni correction was used to address the multiple testing problem. RESULTS Regression analyses yielded the following significantly positive associations: between Urdu literacy and (1) information seeking by Web portals or email subscriptions (odds ratio [OR] 2.155, 95% CI 1.388-3.344), (2) communication and consultation on social network services (OR 5.697, 95% CI 2.487-13.053), and (3) variety (estimate=0.350, 95% CI 0.148-0.552); between length of residence in Norway and (1) communication and consultation by closed conversation with a few acquaintances using ICT (OR 1.728, 95% CI 1.193-2.503), (2) communication and consultation on social network services (OR 2.098, 95% CI 1.265-3.480), and (3) variety (estimate=0.270, 95% CI 0.117-0.424); between Norwegian language proficiency and active decision making by using apps for self-assessment of health status (OR 2.285, 95% CI 1.294-4.036); between education and digital skills and active decision making by using apps for tracking health information (OR 3.930, 95% CI 1.627-9.492); and between being a female and communication and consultation by closed conversation with a few acquaintances using ICT (OR 2.883, 95% CI 1.335-6.227). CONCLUSIONS This study implies immigration-related factors may confound associations between general user factors and eHealth activities. Further studies are needed to explore the influence of immigration-related user factors for eHealth activities in other immigrant groups and countries. INTERNATIONAL REGISTERED REPORT RR2-DOI 10.2196/resprot.5468.
Collapse
Affiliation(s)
- Naoe Tatara
- Department of Computer Science, Faculty of Technology, Art and Design, Oslo Metropolitan University, Oslo, Norway
| | - Hugo Lewi Hammer
- Department of Computer Science, Faculty of Technology, Art and Design, Oslo Metropolitan University, Oslo, Norway
| | - Jelena Mirkovic
- Center for Shared Decision Making and Collaborative Care Research, Oslo University Hospital, Oslo, Norway
| | - Marte Karoline Råberg Kjøllesdal
- Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.,Health Services Research, Norwegian Institute of Public Health, Oslo, Norway
| | - Hege Kristin Andreassen
- Centre for Women's and Gender Research, UiT The Arctic University of Norway, Tromsø, Norway.,Centre for Care Research, Norwegian University of Science and Technology, Gjøvik, Norway
| |
Collapse
|
22
|
Abuelezam NN, El-Sayed AM, Galea S. Differences in health behaviors and health outcomes among non-Hispanic Whites and Arab Americans in a population-based survey in California. BMC Public Health 2019; 19:892. [PMID: 31286920 PMCID: PMC6613261 DOI: 10.1186/s12889-019-7233-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 06/24/2019] [Indexed: 01/09/2023] Open
Abstract
Background Few population-based studies of Arab American health behaviors and outcomes exist outside of Michigan. We aimed to provide prevalence estimates of health behaviors and outcomes for Arab Americans and compare them to non-Hispanic Whites in California. Methods We used data from the 2003–2016 California Health Interview Surveys. We determined Arab American ethnicity using an algorithm that considered place of birth of the respondent or parent and use of Arabic language at home. Survey-weighted frequencies, chi-squared statistics, and logistic regression analyses were used to compare Arab Americans and non-Hispanic Whites on socioeconomic indicators, health behaviors and health outcomes. Multivariable models were adjusted for age, education level, and insurance status. Results Arab Americans had higher prevalence of no insurance, living below the federal poverty level, and home ownership than non-Hispanic Whites despite high levels of education and low unemployment prevalence. Arab Americans had reduced odds of alcohol consumption (OR: 0.33, 95% CI: 0.24, 0.45), binge drinking (OR: 0.28, 95% CI: 0.19, 0.40), and suicidal ideation (OR: 0.41, 0.25, 0.66) when compared to non-Hispanic Whites in multivariable models. Arab Americans had decreased odds of hypertension (OR: 0.64, 95% CI: 0.50, 0.83) and increased odds of diabetes (OR: 2.03, 95% CI: 1.23, 3.34) when compared to non-Hispanic Whites in multivariable models. Conclusions Arab Americans in California participate in less risky health behaviors and have better health outcomes than non-Hispanic Whites, except with regards to diabetes. Future work aiming to understand the health of Arab Americans should allow for self-identification and less reliance on country of origin and language use at home for sample selection.
Collapse
Affiliation(s)
- Nadia N Abuelezam
- Boston College, William F. Connell School of Nursing, 140 Commonwealth Avenue, Maloney Hall 352, Chestnut Hill, MA, 02467, USA.
| | | | - Sandro Galea
- School of Public Health, Boston University, Boston, MA, USA
| |
Collapse
|
23
|
Srivastava R, Bishu KG, Walker RJ, Williams JS, Egede LE. Quality of Diabetes Care Among Recent Immigrants to the USA. J Racial Ethn Health Disparities 2019; 6:457-462. [PMID: 30430462 PMCID: PMC6500477 DOI: 10.1007/s40615-018-00542-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 10/11/2018] [Accepted: 10/29/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND This study investigated the relationship between immigration status and quality of care for patients with diabetes. METHODS We used the Medical Expenditure Panel (MEPS) dataset between 2002 and 2011 to examine the association between quality of care and immigration status. Quality of care was measured by report of dilated eye exam, foot exam, A1C test, an annual doctor's visit, and having blood pressure checked. Immigration status was defined as US born, non-US born but living in the USA for less than 15 years, and non-US born but living in the USA for more than 15 years. Bivariate analyses were used to compare receiving quality of care and immigration status. Multiple logistic regression was used to examine the association of immigration status with quality of care, adjusting for demographic and medical variables. RESULTS Bivariate analyses showed significant differences for all quality of care measures compared to immigration status. However, after adjusting for sociodemographic factors and comorbidities, the only quality of care measures that were significantly associated with immigration status was having blood pressure checked (OR = 0.37 for < 15 years and 0.90 for > 15 years compared to US born, p < 0.001) and having dilated eye exam (OR = 0.77 for < 15 years and 0.89 for > 15 years compared to US born, p = 0.046). CONCLUSIONS After adjustment for socioeconomic and comorbidity factors, blood pressure testing and dilated eye exams were the only measures significantly associated with immigration status. The highest risk was in the first 15 years after entering the USA and should be a target for interventions.
Collapse
Affiliation(s)
- Romik Srivastava
- College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Kinfe G Bishu
- Center for Health Disparities Research, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA
- Department of Medicine, Division of General Internal Medicine and Geriatrics, Medical University of South Carolina, Charleston, SC, USA
| | - Rebekah J Walker
- Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, 9200 W. Wisconsin Ave, Milwaukee, WI, 53226, USA
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Joni Strom Williams
- Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, 9200 W. Wisconsin Ave, Milwaukee, WI, 53226, USA
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Leonard E Egede
- Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, 9200 W. Wisconsin Ave, Milwaukee, WI, 53226, USA.
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI, USA.
| |
Collapse
|
24
|
Impact of Length of Residence in the United States on Risk of Diabetes and Hypertension in Resettled Refugees. J Immigr Minor Health 2019; 20:296-306. [PMID: 28852919 DOI: 10.1007/s10903-017-0636-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The relationship between resettlement and development of chronic disease has yet to be elucidated in refugees. We aimed to assess the relationship between length of residence in the US and development of diabetes and hypertension utilizing multivariable logistic regression models in a sample of former refugee patients seeking primary care services. Multivariable logistic regression models adjusting for age, gender, and country of origin showed significantly increasing odds of type 2 diabetes (OR 1.12, 95% CI 1.03-1.22, p < 0.01) and hypertension (OR 1.07, 95% CI 1.00-1.14) with increasing length of stay in the US for resettled refugee adults. A significant proportion of diabetes (26.7%) and hypertension (36.9%) diagnoses were made within one year of arrival, highlighting the critical role of focusing diagnosis and prevention of chronic disease in newly resettled refugees, and continuing this focus throughout follow-up as these patients acculturate to their new homeland.
Collapse
|
25
|
Perera MJ, Reina SA, Elfassy T, Potter JE, Sotres Alvarez D, Simon MA, Isasi CR, Stuebe AM, Schneiderman N, Llabre MM. Gestational diabetes and cardiovascular risk factors and disease in U.S. Hispanics/Latinas in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Women Health 2018; 59:481-495. [PMID: 30040600 DOI: 10.1080/03630242.2018.1500415] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
To compare cardiovascular risk and disease prevalence in U.S. Hispanics/Latinas with and without a history of gestational diabetes mellitus (GDM). Cross-sectional data from 2008 to 2011 were analyzed for 8,262 (305 with GDM history) parous women, aged 20-73 years, from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Women with and without a history of GDM were compared on sociodemographic, cardiovascular risk factor, and disease data from standardized interviews and fasting blood tests, using chi-square tests, t-tests, and logistic regressions to determine odds ratios (ORs) and 95 percent confidence intervals (CIs). Adjusting for covariates, compared to those without a history of GDM, women with a history of GDM were younger (M = 39.1 years [95 percent CI = 37.8, 41.6] vs. 45.5 years [95 percent CI = 44.9, 46.1]) and more likely to have health insurance (68.1 percent [95 percent CI = 60.3 percent, 76.0 percent] vs. 54.9 percent [95 percent CI = 52.8 percent, 57.1 percent]), had greater waist circumference (M = 102.3 cm, [95 percent CI = 100.2, 104.3] vs. 98.1 cm [95 percent CI = 97.4, 98.5]) and higher fasting glucose (116.0 mg/dL [95 percent CI = 107.8, 124.3] vs. 104.2 mg/dL [95 percent CI = 103.4, 105.1]), and had higher odds of having metabolic syndrome (OR = 1.7 [95 percent CI = 1.2, 2.6]) or diabetes (OR = 3.3 [95 percent CI = 2.2, 4.8]). Prevalences of heart and cerebrovascular disease were similar. GDM history was positively associated with diabetes but not with cardiovascular disease.
Collapse
Affiliation(s)
- Marisa J Perera
- a Department of Psychology , University of Miami , Coral Gables , Florida , USA
| | - Samantha A Reina
- a Department of Psychology , University of Miami , Coral Gables , Florida , USA
| | - Tali Elfassy
- b Miller School of Medicine , University of Miami , Coral Gables , Florida , USA
| | - JoNell E Potter
- b Miller School of Medicine , University of Miami , Coral Gables , Florida , USA
| | - Daniela Sotres Alvarez
- c Department of Biostatistics , University of North Carolina , Chapel Hill , North Carolina , USA
| | - Melissa A Simon
- d Feinberg School of Medicine , Northwestern University , Chicago , Illinois , USA
| | - Carmen R Isasi
- e Department of Epidemiology & Population Health , Albert Einstein College of Medicine , Bronx , New York , USA
| | - Alison M Stuebe
- f Department of Obstetrics & Gynecology , University of North Carolina , Chapel Hill , North Carolina , USA
| | - Neil Schneiderman
- a Department of Psychology , University of Miami , Coral Gables , Florida , USA
| | - Maria M Llabre
- a Department of Psychology , University of Miami , Coral Gables , Florida , USA
| |
Collapse
|
26
|
Oladele CR, Pathak EB, Yang J, Nembhard WN, Sharma S, Himmelgreen D, Dagne G, Mason T. Acculturation and dietary intake pattern among Jamaican immigrants in the US. Prev Med Rep 2018; 9:80-85. [PMID: 29348996 PMCID: PMC5767562 DOI: 10.1016/j.pmedr.2017.12.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 12/04/2017] [Accepted: 12/18/2017] [Indexed: 11/30/2022] Open
Abstract
Information on dietary intakes of Jamaican immigrants in the United States is sparse. Understanding factors that influence diet is important since diet is associated with chronic diseases. This study examined the association between acculturation, socio-cultural factors, and dietary pattern among Jamaican immigrants in Florida. Jamaican persons 25–64 years who resided in two South Florida counties were recruited for participation. A health questionnaire that assessed acculturation, dietary pattern, and risk factors for cardiovascular disease was administered to participants. Generalized Estimating Equations were used to determine associations. Acculturation score was not significantly associated with dietary intake pattern (β = − 0.02 p = 0.07). Age at migration was positively associated with traditional dietary pattern (β = 0.02 p < 0.01). Persons with 12 or fewer years of education (β = − 0.55 p < 0.001), divorced (β = − 0.26 p = 0.001), or engaged in less physical activity (β = − 0.07 p = 0.01) were more likely to adhere to a traditional diet. Although acculturation was not a statistically significant predictor of dietary intake, findings show the role of demographic and lifestyle characteristics in understanding factors associated with dietary patterns among Jamaicans. Findings point to the need to measure traditional dietary intakes among Jamaicans and other immigrant groups. Accurate assessment of disease risk among immigrant groups will lead to more accurate diet-disease risk assessment and development of effective intervention programs. Age at migration was associated with traditional diet among Jamaican immigrants. Persons with lower educational attainment were more likely to eat traditional foods. Residing in an ethnic enclave was not associated with having a traditional diet.
Collapse
Affiliation(s)
- Carol R Oladele
- Equity Research and Innovation Center, Yale School of Medicine, P.O. Box 208093, New Haven, CT, United States
| | - Elizabeth B Pathak
- University of South Florida, Morsani College of Medicine, Tampa, FL, United States
| | - Jimin Yang
- University of South Florida, Health Informatics Institute, Tampa, FL, United States
| | - Wendy N Nembhard
- University of Arkansas for Medical Sciences, Department of Pediatrics and Arkansas Children's Hospital Research Institute, Little Rock, AR, United States
| | - Sangita Sharma
- University of Alberta, Department of Medicine, Edmonton, Alberta, Canada
| | - David Himmelgreen
- University of South Florida, Department of Anthropology, Tampa, FL, United States
| | - Getachew Dagne
- University of South Florida, Department of Epidemiology and Biostatistics, Tampa, FL, United States
| | - Thomas Mason
- University of South Florida, Department of Environmental and Occupational Health, Tampa, FL, United States
| |
Collapse
|
27
|
López L, Grant RW, Marceau L, Piccolo R, McKinlay JB, Meigs JB. Association of Acculturation and Health Literacy with Prevalent Dysglycemia and Diabetes Control Among Latinos in the Boston Area Community Health (BACH) Survey. J Immigr Minor Health 2018; 18:1266-1273. [PMID: 26898955 DOI: 10.1007/s10903-016-0362-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
This study assessed the effect of acculturation on type 2 diabetes and whether health literacy may mediate this association. The Boston Area Community Health cohort is a multi-stage stratified random sample of adults from Boston including 744 Latinos. We defined dysglycemia as a HbA1c ≥5.7 %. Multivariable analyses examined the associations between acculturation and health literacy adjusting for demographic and clinical variables. Similar analyses were performed among participants with HbA1c ≥7.0 % to assess the association between acculturation and diabetes control. Among an insured primarily foreign born Spanish speaking Latino population, with a long residence period in the US and good healthcare utilization, higher levels of acculturation were not associated with dysglycemia. Lower levels of acculturation were associated with worse diabetes control. Health literacy level did not modify these associations. Elucidating the components of heterogeneity among Latinos will be essential for understanding the influence of acculturation on diabetes.
Collapse
Affiliation(s)
- Lenny López
- Division of Hospital Medicine, University of California San Francisco, San Francisco, CA, USA.
| | - Richard W Grant
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Lisa Marceau
- New England Research Institutes, Boston, MA, USA
| | | | | | - James B Meigs
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA
| |
Collapse
|
28
|
Ando E, Sin MK. Waist measurement as an aid to type II diabetes screening among Asian Americans. Perspect Public Health 2017; 137:36-37. [PMID: 28074685 DOI: 10.1177/1757913916676771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
29
|
Li K, Wen M. Substance use, age at migration, and length of residence among adult immigrants in the United States. J Immigr Minor Health 2016; 17:156-64. [PMID: 23925520 DOI: 10.1007/s10903-013-9887-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
In this study we scrutinize prevalence of current smoking and binge drinking among adult US immigrants, and examine whether age at migration predicts these two behaviors and moderates the effect of length of residence. Immigrant groups include those from Latin America/Caribbean, East and South Asia, Sub-Saharan Africa, Europe/Central Asia, and Middle East/North Africa. Multivariate logistic regressions are estimated using cross-sectional data from the New Immigrant Survey (N = 7,397). Results show that patterns of smoking and binge drinking vary by gender and by region of origins. In addition, arriving at age 0-9 are directly associated with higher odds of binge drinking among adult women. Among adult men, age at migration moderates the association between length of residence and substance use. Specifically, length of residence has more detrimental effects for adolescent immigrants (arriving at age 10-18) on smoking, while its detrimental effects are more pronounced for childhood immigrants (arriving at age 0-9) on binge drinking. We interpret our findings within the critical period model in epidemiological research, concluding that adolescence and childhood are critical life stages that are associated with differential effects of length of residence when looking at smoking and binge drinking among immigrant men.
Collapse
Affiliation(s)
- Kelin Li
- Department of Sociology, University of Utah, 380 S 1530 E, RM 301, Salt Lake City, UT, 84112, USA,
| | | |
Collapse
|
30
|
The association of duration of residence in the United States with cardiovascular disease risk factors among South Asian immigrants. J Immigr Minor Health 2016; 17:781-90. [PMID: 24380928 DOI: 10.1007/s10903-013-9973-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
South Asians are disproportionately impacted by cardiovascular disease (CVD). Our objective was to examine the association between duration of residence in the US and CVD risk factors among South Asian adult immigrants. Multivariate logistic regression analyses using pooled data from the 2005, 2007, 2009 California Health Interview Surveys. Duration of residence in the US < 15 years was significantly associated with overweight/obese BMI (OR 0.59; 95% CI 0.35, 0.98 for 5 to < 10 years), daily consumption of 5+ servings of fruits/vegetables (OR 0.37; 95% CI 0.15, 0.94 for 10 to < 15 years), and sedentary lifestyle (OR 2.11; 95% CI 1.17, 3.81 for 10 to < 15 years) compared with duration of residence ≥ 15 years after adjusting for illness burden, healthcare access, and socio-demographic characteristics. Duration of residence was not significantly associated with other CVD risk factors. Duration of residence is an important correlate of overweight/obesity and other risk factors among South Asian immigrants.
Collapse
|
31
|
Ambulatory disability among immigrants from China, India, and Mexico: Exploration of heterogeneity in ‘immigrant advantage’. MIGRATION STUDIES 2016. [DOI: 10.1093/migration/mnw021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
|
32
|
Mehta NK, Elo IT, Engelman M, Lauderdale DS, Kestenbaum BM. Life Expectancy Among U.S.-born and Foreign-born Older Adults in the United States: Estimates From Linked Social Security and Medicare Data. Demography 2016; 53:1109-34. [PMID: 27383845 PMCID: PMC5026916 DOI: 10.1007/s13524-016-0488-4] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
In recent decades, the geographic origins of America's foreign-born population have become increasingly diverse. The sending countries of the U.S. foreign-born vary substantially in levels of health and economic development, and immigrants have arrived with distinct distributions of socioeconomic status, visa type, year of immigration, and age at immigration. We use high-quality linked Social Security and Medicare records to estimate life tables for the older U.S. population over the full range of birth regions. In 2000-2009, the foreign-born had a 2.4-year advantage in life expectancy at age 65 relative to the U.S.-born, with Asian-born subgroups displaying exceptionally high longevity. Foreign-born individuals who migrated more recently had lower mortality compared with those who migrated earlier. Nonetheless, we also find remarkable similarities in life expectancy among many foreign-born subgroups that were born in very different geographic and socioeconomic contexts (e.g., Central America, western/eastern Europe, and Africa).
Collapse
Affiliation(s)
- Neil K Mehta
- Department of Global Health, Emory University, Claudia Nance Rollins Building, 1518 Clifton Road, Room 7035, Atlanta, GA, 30322, USA.
| | - Irma T Elo
- Population Aging Research Center and Population Studies Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Michal Engelman
- Department of Sociology, University of Wisconsin-Madison, Madison, WI, USA
| | - Diane S Lauderdale
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - Bert M Kestenbaum
- Office of the Chief Actuary, Social Security Administration, Baltimore, MD, USA
| |
Collapse
|
33
|
Afable A, Yeh MC, Trivedi T, Andrews E, Wylie-Rosett J. Duration of US Residence and Obesity Risk in NYC Chinese Immigrants. J Immigr Minor Health 2016; 18:624-635. [PMID: 25963049 PMCID: PMC4658303 DOI: 10.1007/s10903-015-0216-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
We evaluated whether duration of time in the US is associated with obesity risk in NYC Chinese immigrants. We analyzed cross-sectional survey data on 2072 men and women. Duration of US residence was categorized into ≤5, 6-15, and 15 years and over. Obesity was defined using WHO Asian standards: BMI of 27.5 kg/m(2) or greater. Diet and physical activity (PA) were assessed as potential explanatory variables. After adjusting for covariates, increased time in the US was associated with an increased obesity risk (OR 1.49; 95 % CI 1.06, 2.08 for 15 years or more vs. ≤5 years); and in separate analysis, with having reported no work related PA (OR 0.76; 95 % CI 0.59, 0.99). Findings suggest that increased time living in the US is associated with an increased obesity risk, a finding possibly explained by a shift to more sedentary lifestyle characteristic of the transition of immigrants to the US.
Collapse
Affiliation(s)
- Aimee Afable
- Department of Community Health Sciences, SUNY Downstate School of Public Health, 450 Clarkson Avenue, Mail Stop Code 43, Brooklyn, NY, 11203, USA.
| | - Ming-Chin Yeh
- Department of Community Health Sciences, SUNY Downstate School of Public Health, 450 Clarkson Avenue, Mail Stop Code 43, Brooklyn, NY, 11203, USA
| | - Tushar Trivedi
- Department of Community Health Sciences, SUNY Downstate School of Public Health, 450 Clarkson Avenue, Mail Stop Code 43, Brooklyn, NY, 11203, USA
| | - Erin Andrews
- Department of Community Health Sciences, SUNY Downstate School of Public Health, 450 Clarkson Avenue, Mail Stop Code 43, Brooklyn, NY, 11203, USA
| | - Judith Wylie-Rosett
- Department of Community Health Sciences, SUNY Downstate School of Public Health, 450 Clarkson Avenue, Mail Stop Code 43, Brooklyn, NY, 11203, USA
| |
Collapse
|
34
|
Variations in gestational length and preterm delivery by race, ethnicity and migration. Best Pract Res Clin Obstet Gynaecol 2016; 32:60-8. [DOI: 10.1016/j.bpobgyn.2015.08.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 08/14/2015] [Accepted: 08/15/2015] [Indexed: 11/24/2022]
|
35
|
Terasaki D, Ornelas I, Saelens B. Length of Residence and Vehicle Ownership in Relation to Physical Activity Among U.S. Immigrants. J Immigr Minor Health 2016; 19:484-488. [PMID: 26868494 DOI: 10.1007/s10903-016-0361-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Physical activity among U.S. immigrants over time is not well understood. Transportation may affect this trajectory. Using a survey of documented immigrants (N = 7240), we performed simple, then multivariable logistic regression to calculate ORs and 95 % CIs between length of residence (LOR) and both light-to-moderate (LPA) and vigorous (VPA) activity. We adjusted for demographic variables, then vehicle ownership to assess changes in ORs. Compared to new arrivals, all four LOR time-intervals were associated with lower odds of LPA and higher odds of VPA in simple analysis. All ORs for LPA remained significant after including demographics, but only one remained significant after adding vehicle ownership. Two ORs for VPA remained significant after including demographics and after adding vehicle ownership. Immigrants lower their light-to-moderate activity the longer they reside in the U.S., partly from substituting driving for walking. Efforts to maintain walking for transportation among immigrants are warranted.
Collapse
Affiliation(s)
- Dale Terasaki
- Department of Health Services, University of Washington School of Public Health, 1959 NE Pacific St, Box 359455, Seattle, WA, 98195, USA.
| | - India Ornelas
- Department of Health Services, University of Washington School of Public Health, 1959 NE Pacific St, Box 359455, Seattle, WA, 98195, USA
| | - Brian Saelens
- Department of Health Services, University of Washington School of Public Health, 1959 NE Pacific St, Box 359455, Seattle, WA, 98195, USA
| |
Collapse
|
36
|
Improvements in Cultural Competence Through Classroom and Local Cross-Cultural Service-Learning Activities. ACTA ACUST UNITED AC 2016. [DOI: 10.1097/00001416-201630020-00004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
37
|
Maneze D, Everett B, Astorga C, Yogendran D, Salamonson Y. The Influence of Health Literacy and Depression on Diabetes Self-Management: A Cross-Sectional Study. J Diabetes Res 2016; 2016:3458969. [PMID: 27595113 PMCID: PMC4995333 DOI: 10.1155/2016/3458969] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 07/15/2016] [Accepted: 07/19/2016] [Indexed: 11/18/2022] Open
Abstract
Despite an increasing focus on health literacy in the clinical setting and in the literature, there is still ongoing debate about its influence on diabetes self-management. The aim of the study was to examine the relationships of sociodemographic, clinical, and psychological factors on health literacy and diabetes self-management. A cross-sectional survey was undertaken on 224 patients with type 2 diabetes at two diabetes centres in Sydney, Australia. Findings showed that people with low health literacy were more likely to (a) have lower educational attainment; (b) be migrants; and (c) have depressed mood. Unexpectedly, those who met HbA1c threshold of good glucose control were more likely to have low health literacy. Predictors of low diabetes self-management included (a) younger age group (AOR: 2.58, 95% CI: 1.24-4.64); (b) having postsecondary education (AOR: 2.30, 95% CI: 1.05-5.01); (c) low knowledge of diabetes management (AOR: 2.29, 95% CI: 1.25-4.20); and (d) having depressed mood (AOR: 2.30, 95% CI: 1.30-4.06). The finding that depressed mood predicted both low health literacy and low diabetes self-management stresses the importance of screening for depression. Increasing people's understanding of diabetes self-management and supporting those with depression are crucial to enhance participation in diabetes self-management.
Collapse
Affiliation(s)
- D. Maneze
- South Western Sydney Local Health District, 59a Cumberland Road, Ingleburn, NSW 2565, Australia
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
- Centre for Applied Nursing Research, Locked Bag 7103, Liverpool, NSW 1871, Australia
- Ingham Institute for Applied Medical Research, P.O. Box 3151, Liverpool, NSW 2170, Australia
- *D. Maneze:
| | - B. Everett
- South Western Sydney Local Health District, 59a Cumberland Road, Ingleburn, NSW 2565, Australia
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
- Centre for Applied Nursing Research, Locked Bag 7103, Liverpool, NSW 1871, Australia
- Ingham Institute for Applied Medical Research, P.O. Box 3151, Liverpool, NSW 2170, Australia
| | - C. Astorga
- South Western Sydney Local Health District, 59a Cumberland Road, Ingleburn, NSW 2565, Australia
| | - D. Yogendran
- South Western Sydney Local Health District, 59a Cumberland Road, Ingleburn, NSW 2565, Australia
| | - Y. Salamonson
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
- Centre for Applied Nursing Research, Locked Bag 7103, Liverpool, NSW 1871, Australia
- Ingham Institute for Applied Medical Research, P.O. Box 3151, Liverpool, NSW 2170, Australia
| |
Collapse
|
38
|
Afable A, Ursua R, Wyatt LC, Aguilar D, Kwon SC, Islam NS, Trinh-Shevrin C. Duration of US Residence Is Associated With Overweight Risk in Filipino Immigrants Living in New York Metro Area. FAMILY & COMMUNITY HEALTH 2016; 39:13-23. [PMID: 26605951 PMCID: PMC4662079 DOI: 10.1097/fch.0000000000000086] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
We examined the association between years living in the United States and overweight risk among a community sample of Filipino adult immigrants living in the New York metropolitan area. We found a significant and adverse association between years living in the United States and overweight risk. Compared with Filipinos who lived in the United States less than 5 years, those who lived in the United States 10 years or longer had a higher overweight risk; this association was present only among Filipinos who migrated to New York metropolitan area at 30 years of age or younger. Studies on causal mechanisms explaining this pattern are needed.
Collapse
Affiliation(s)
- Aimee Afable
- SUNY Downstate School of Public Health, Brooklyn, NY,
| | - Rhodora Ursua
- Asian Pacific Partners for Empowerment, Advocacy, and Leadership, Oakland, CA,
| | - Laura C. Wyatt
- Department of Population Health, NYU School of Medicine, New York, NY,
| | | | - Simona C. Kwon
- Department of Population Health, NYU School of Medicine, New York, NY,
| | - Nadia S. Islam
- Department of Population Health, NYU School of Medicine, New York, NY,
| | | |
Collapse
|
39
|
González G, Wilson-Frederick Wilson SM, Thorpe RJ. Examining Place As a Social Determinant of Health: Association Between Diabetes and US Geographic Region Among Non-Hispanic Whites and a Diverse Group of Hispanic/Latino Men. FAMILY & COMMUNITY HEALTH 2015; 38:319-331. [PMID: 26291192 DOI: 10.1097/fch.0000000000000081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Place (geographic location), birthplace, the number of years in the United States, and gender are important social determinants of health essential to our understanding of health disparities. In this study, we examined the association between place and diabetes in white and Hispanic/Latino men and found that place and the number of years in the United States are important social determinants of health. Our findings provide implications for a nuanced perspective by highlighting the importance of examining social determinants of health to identify tailored interventions to address disparities in diabetes for diverse groups of Hispanic/Latino men.
Collapse
Affiliation(s)
- Gloria González
- Hopkins Center for Health Disparities Solutions (Dr González), Department of Epidemiology (Dr Wilson-Frederick Wilson), and Program for Men's Health Research, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | | |
Collapse
|
40
|
Holmes JS, Driscoll AK, Heron M. Mortality among US-born and immigrant Hispanics in the US: effects of nativity, duration of residence, and age at immigration. Int J Public Health 2015; 60:609-17. [DOI: 10.1007/s00038-015-0686-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 04/29/2015] [Indexed: 10/23/2022] Open
|
41
|
Abstract
OBJECTIVE Little is known about diabetes status among US blacks by nativity. This study aims to measure differences in diabetes among US blacks by region of birth and examines potential explanations for subgroup differences. DESIGN Data from 47,751 blacks aged 25-74 pooled from the 2000-2013 waves of the National Health Interview Survey were analyzed. Logistic regression models predicted self-reported diabetes. The roles of education, income, body mass index (BMI), smoking, and duration of US residence were explored. RESULTS Compared to the US-born, foreign-born blacks had significantly lower reported diabetes prevalence (8.94% vs. 11.84%) and diabetes odds ratio [OR: 0.75; 95% confidence interval (CI): 0.62, 0.89], adjusting for socio-demographic characteristics. Further inclusion of education, income, household size, and smoking did not appreciably change the OR (0.77; 95% CI: 0.61, 0.86). Including an adjustment for BMI entirely eliminated the foreign-born advantage (OR 0.93; 95% CI: 0.78, 1.11). The foreign-born from the Caribbean/Americas had similar diabetes odds compared to the African-born. Among the foreign-born, an increased duration of US residence was associated with a higher diabetes odds, but these associations did not reach statistical significance (p > 0.05). CONCLUSION The healthy immigrant advantage extended to diabetes among US blacks, a finding that is explained by lower levels of overweight/obesity among the foreign-born compared to the US-born. Nonetheless, more than 71.4% of the foreign-born were overweight or obese. Understanding the mechanisms through which exposure to the US environment leads to higher obesity and diabetes risk may aid prevention efforts for the rapidly growing foreign-born black subpopulation.
Collapse
Affiliation(s)
- Nicole D. Ford
- Division of Biological and Biomedical Sciences,Emory University, 1518 Clifton Road, CNR 7000C, Atlanta, GA, USA 30033; ; phone: 404-395-4363; fax: 404-727-4590
| | - K.M. Venkat Narayan
- Division of Biological and Biomedical Sciences, Emory University, 1518 Clifton Road, CNR 7040, Atlanta, GA, USA 30033; ; phone: 404-727-8402
| | - Neil K. Mehta
- Hubert Department of Global Health, Emory University, 1518 Clifton Road, CNR 7035, Atlanta, GA, USA 30033; ; phone: 404-712-8812
| |
Collapse
|
42
|
Goosen S, Middelkoop B, Stronks K, Agyemang C, Kunst AE. High diabetes risk among asylum seekers in The Netherlands. Diabet Med 2014; 31:1532-41. [PMID: 24860962 DOI: 10.1111/dme.12510] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 03/05/2014] [Accepted: 05/21/2014] [Indexed: 02/03/2023]
Abstract
AIMS To map the prevalence and incidence of recorded diabetes among asylum seekers according to demographic factors and length of stay in the host country. METHODS We used a nationwide database from the Community Health Services for Asylum Seekers. The study population included all asylum seekers aged 20-79 years who arrived in the Netherlands between 2000 and 2008. Case allocation was based on International Classification of Primary Care codes. A general practice registry was used to obtain reference data. Standardized prevalence and incidence ratios were calculated and their association with length of stay was explored with Cox regression. RESULTS The study included 59 380 asylum seekers among whom there were 1227 recorded cases of diabetes. The prevalence of recorded diabetes was higher among asylum seekers compared with the reference population for both men (standardized prevalence ratio=1.85, 95% CI 1.71-1.91) and women (standardized prevalence ratio=2.26, 95% CI 2.08-2.45). The highest standardized prevalence ratios were found for asylum seekers from Somalia, Sudan and Sri Lanka. The standardized prevalence ratio was higher in asylum seekers aged ≥ 30 years. Incidence rates were higher compared with the reference population for all length-of-stay intervals. CONCLUSIONS Asylum seekers from the majority of countries of origin were at higher risk of diabetes compared with the general population in the Netherlands. Asylum seekers from Somalia were particularly at risk. This emerging public health issue requires attention from policy-makers and care providers.
Collapse
Affiliation(s)
- S Goosen
- Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam; Netherlands Association for Community Health Services, Utrecht
| | | | | | | | | |
Collapse
|
43
|
Schneiderman N, Chirinos DA, Avilés-Santa ML, Heiss G. Challenges in preventing heart disease in hispanics: early lessons learned from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Prog Cardiovasc Dis 2014; 57:253-61. [PMID: 25212986 PMCID: PMC4252509 DOI: 10.1016/j.pcad.2014.08.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
The challenge of preventing cardiovascular disease (CVD) in US Hispanics depends upon being able to understand and communicate about the diversity within this population in terms of environmental exposures, health behaviors, socio-cultural experiences and genetic background to CVD risk factor profiles and disease burdens. Recent publications from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) launched by the National Institutes of Health (NIH) have begun to accomplish this task. In this article we review some of the HCHS/SOL findings concerning cardiometabolic and other CVD risk factors and relate them to the need for increased access to health care and attention to lifestyle variables including nutrition. A major challenge that needs to be accomplished is to alert our lawmakers, public health officials, health care providers and the Hispanic population at large about how to lighten the CVD risk factor and disease burdens now carried by our Hispanic population.
Collapse
Affiliation(s)
- Neil Schneiderman
- Department of Psychology and Behavioral Medicine Research Center, University of Miami, Miami, FL.
| | - Diana A Chirinos
- Department of Psychology and Behavioral Medicine Research Center, University of Miami, Miami, FL
| | - M Larissa Avilés-Santa
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Gerardo Heiss
- Department of Epidemiology, UNC at Chapel Hill, Chapel Hill, NC
| |
Collapse
|
44
|
Guo S, Gies P, King K, Lucas RM. Sun Exposure and Vitamin D Status as Northeast Asian Migrants Become Acculturated to Life in Australia. Photochem Photobiol 2014; 90:1455-61. [DOI: 10.1111/php.12349] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 09/13/2014] [Indexed: 12/11/2022]
Affiliation(s)
- Shuyu Guo
- National Centre for Epidemiology and Population Health; Research School of Population Health; The Australian National University; Canberra ACT Australia
| | - Peter Gies
- Australian Radiation Protection and Nuclear Safety Agency; Melbourne VIC Australia
| | - Kerryn King
- Australian Radiation Protection and Nuclear Safety Agency; Melbourne VIC Australia
| | - Robyn M Lucas
- National Centre for Epidemiology and Population Health; Research School of Population Health; The Australian National University; Canberra ACT Australia
- Telethon Kids Institute; University of Western Australia; Perth WA Australia
| |
Collapse
|
45
|
O'Brien MJ, Alos VA, Davey A, Bueno A, Whitaker RC. Acculturation and the prevalence of diabetes in US Latino Adults, National Health and Nutrition Examination Survey 2007-2010. Prev Chronic Dis 2014; 11:E176. [PMID: 25299982 PMCID: PMC4193061 DOI: 10.5888/pcd11.140142] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Introduction US Latinos are growing at the fastest rate of any racial/ethnic group in the United States and have the highest lifetime risk of diabetes. Acculturation may increase the risk of diabetes among all Latinos, but this hypothesis has not been studied in a nationally representative sample. The objective of this study was to test the hypothesis that acculturation was associated with an increased risk of diabetes in such a sample. Methods We conducted a cross-sectional analysis including 3,165 Latino participants in the 2007–2010 National Health and Nutrition Examination Survey. Participants with doctor-diagnosed diabetes and participants without diagnosed diabetes who had glycated hemoglobin (HbA1C) values of 6.5% or higher were classified as having diabetes. An acculturation score, ranging from 0 (lowest) to 3 (highest), was calculated by giving 1 point for each of 3 characteristics: being born in the United States, speaking predominantly English, and living in the United States for 20 years or more. Logistic regression was used to determine the association between acculturation and diabetes. Results The prevalence of diabetes among Latinos in our sample was 12.4%. After adjusting for sociodemographic factors, the likelihood of diabetes (95% confidence interval [CI]) increased with level of acculturation— 1.71 (95% CI, 1.31–2.23), 1.63 (95% CI, 1.11–2.39), and 2.05 (95% CI, 1.27–3.29) for scores of 1, 2, and 3, respectively. This association persisted after further adjustment for body mass index (BMI), total dietary calories, and physical inactivity. Conclusion Acculturation was associated with a higher risk of diabetes among US Latinos, and this risk was only partly explained by BMI and weight-related behaviors. Future research should examine the bio-behavioral mechanisms that underlie the relationship between acculturation and diabetes in Latinos.
Collapse
Affiliation(s)
- Matthew J O'Brien
- Northwestern Feinberg School of Medicine, Center for Community Health, 750 N. Lake Shore Drive, 6th Floor, Chicago, IL 60611. E-mail: . At the time of this study, Dr. O'Brien was affiliated with the Temple University Center for Obesity Research and Education and with Puentes de Salud Health Center, Philadelphia, Pennsylvania
| | - Victor A Alos
- Temple University and Puentes de Salud Health Center, Philadelphia, Pennsylvania
| | - Adam Davey
- Temple University, Philadelphia, Pennsylvania
| | | | | |
Collapse
|
46
|
Huffman FG, Vaccaro JA, Zarini GG, Dixon Z. Comparison of two indices of diet quality with acculturation factors and demographics in Haitian Americans. Ecol Food Nutr 2014; 53:42-57. [PMID: 24437543 DOI: 10.1080/03670244.2013.774674] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This study examined associations of language preference and length of stay in the United States and diet among 132 Haitian Americans aged ≥35, born in Haiti. Two dietary indices, Healthy Eating Index (HEI) and Alternative Healthy Eating Index (AHEI), were used to assess dietary quality. Years in the United States (>15 years; B = 0.063, p = .012) and female gender (B = 5.63, p = .028) were positively associated with AHEI. Lower HEI scores were associated with speaking no English (B = -6.11, p = .026). Participants reporting an income under 20,000/yr had lower AHEI scores (B = -7.63, p = .014). Concurrent use of these indices would provide a screening tool for nutrition intervention. Public health programs targeting low-cost resources, such as community gardening, are recommended to reduce health disparities among this population.
Collapse
Affiliation(s)
- Fatma G Huffman
- a Department of Dietetics and Nutrition, Robert Stempel College of Public Health and Social Work , Florida International University , Miami , Florida , USA
| | | | | | | |
Collapse
|
47
|
Schneiderman N, Llabre M, Cowie CC, Barnhart J, Carnethon M, Gallo LC, Giachello AL, Heiss G, Kaplan RC, LaVange LM, Teng Y, Villa-Caballero L, Avilés-Santa ML. Prevalence of diabetes among Hispanics/Latinos from diverse backgrounds: the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Diabetes Care 2014; 37:2233-9. [PMID: 25061138 PMCID: PMC4113173 DOI: 10.2337/dc13-2939] [Citation(s) in RCA: 286] [Impact Index Per Article: 28.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Accepted: 03/06/2014] [Indexed: 02/03/2023]
Abstract
OBJECTIVE We examine differences in prevalence of diabetes and rates of awareness and control among adults from diverse Hispanic/Latino backgrounds in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). RESEARCH DESIGN AND METHODS The HCHS/SOL, a prospective, multicenter, population-based study, enrolled from four U.S. metropolitan areas from 2008 to 2011 16,415 18-74-year-old people of Hispanic/Latino descent. Diabetes was defined by either fasting plasma glucose, impaired glucose tolerance 2 h after a glucose load, glycosylated hemoglobin (A1C), or documented use of hypoglycemic agents (scanned medications). RESULTS Diabetes prevalence varied from 10.2% in South Americans and 13.4% in Cubans to 17.7% in Central Americans, 18.0% in Dominicans and Puerto Ricans, and 18.3% in Mexicans (P < 0.0001). Prevalence related positively to age (P < 0.0001), BMI (P < 0.0001), and years living in the U.S. (P = 0.0010) but was negatively related to education (P = 0.0005) and household income (P = 0.0043). Rate of diabetes awareness was 58.7%, adequate glycemic control (A1C <7%, 53 mmol/mol) was 48.0%, and having health insurance among those with diabetes was 52.4%. CONCLUSIONS Present findings indicate a high prevalence of diabetes but considerable diversity as a function of Hispanic background. The low rates of diabetes awareness, diabetes control, and health insurance in conjunction with the negative associations between diabetes prevalence and both household income and education among Hispanics/Latinos in the U.S. have important implications for public health policies.
Collapse
Affiliation(s)
- Neil Schneiderman
- Department of Psychology and Behavioral Medicine Research Center, University of Miami, Miami, FL
| | - Maria Llabre
- Department of Psychology and Behavioral Medicine Research Center, University of Miami, Miami, FL
| | - Catherine C Cowie
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD
| | - Janice Barnhart
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Mercedes Carnethon
- Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA
| | - Aida L Giachello
- Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Gerardo Heiss
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Robert C Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Lisa M LaVange
- Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Yanping Teng
- Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Leonel Villa-Caballero
- Certificate Program in Clinical Trials Administration for Latin America, University of California, San Diego, La Jolla, CA
| | - M Larissa Avilés-Santa
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| |
Collapse
|
48
|
Goldman N, Pebley AR, Creighton MJ, Teruel GM, Rubalcava LN, Chung C. The consequences of migration to the United States for short-term changes in the health of Mexican immigrants. Demography 2014; 51:1159-73. [PMID: 24788391 PMCID: PMC4165490 DOI: 10.1007/s13524-014-0304-y] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Although many studies have attempted to examine the consequences of Mexico-U.S. migration for Mexican immigrants' health, few have had adequate data to generate the appropriate comparisons. In this article, we use data from two waves of the Mexican Family Life Survey (MxFLS) to compare the health of current migrants from Mexico with those of earlier migrants and nonmigrants. Because the longitudinal data permit us to examine short-term changes in health status subsequent to the baseline survey for current migrants and for Mexican residents, as well as to control for the potential health selectivity of migrants, the results provide a clearer picture of the consequences of immigration for Mexican migrant health than have previous studies. Our findings demonstrate that current migrants are more likely to experience recent changes in health status-both improvements and declines-than either earlier migrants or nonmigrants. The net effect, however, is a decline in health for current migrants: compared with never migrants, the health of current migrants is much more likely to have declined in the year or two since migration and not significantly more likely to have improved. Thus, it appears that the migration process itself and/or the experiences of the immediate post-migration period detrimentally affect Mexican immigrants' health.
Collapse
Affiliation(s)
- Noreen Goldman
- Office of Population Research, Princeton University, Wallace Hall, Princeton, NJ, 08544, USA,
| | | | | | | | | | | |
Collapse
|
49
|
Sørbye IK, Daltveit AK, Sundby J, Vangen S. Preterm subtypes by immigrants' length of residence in Norway: a population-based study. BMC Pregnancy Childbirth 2014; 14:239. [PMID: 25048200 PMCID: PMC4223612 DOI: 10.1186/1471-2393-14-239] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 07/18/2014] [Indexed: 11/25/2022] Open
Abstract
Background The reduction of the preterm delivery (PTD) rate is a maternal and child health target. Elevated rates have been found among several immigrant groups, but few studies have distinguished between PTD according to the mode of birth start. In addition, migrants’ birth outcomes have further been shown to be affected by the time in residence; however, the association to PTD subtypes has not previously been assessed. In this study we examined if the risk of spontaneous and non-spontaneous, or iatrogenic, PTD among immigrants in Norway varied according to the length of residence and the country of birth, and compared with the risks among the majority population. Methods We linked population-based birth and immigration data for 40 709 singletons born to immigrant women from Iraq, Pakistan, the Philippines, Somalia, Sri Lanka and Vietnam and 868 832 singletons born to non-immigrant women from 1990–2009. Associations between the length of residence and subtypes of PTD were estimated as relative risks (RRs) with 95% confidence intervals (CIs) from multivariable models. Results In total, 48 191 preterm births occurred. Both spontaneous and non-spontaneous PTD rates were higher among immigrants (4.8% and 2.0%) than among non-immigrants (3.6% and 1.6%). Only non-spontaneous PTD was associated with longer lengths of residence (p trend <0.001). Recent immigrants (<5 years of residence) and non-immigrants had a similar risk of non-spontaneous PTD, whereas immigrants with lengths of residence of 5–9 years, 10–14 years and ≥15 years had adjusted RRs of 1.18 [95% CI 1.03,1.35], 1.43 [95% CI 1.20,1.71] and 1.66 [95% CI 1.41,1.96]. The association was reduced after further adjustments for maternal and infant morbidity. Conversely, the risk of spontaneous PTD among immigrants was not mitigated by length of residence, but varied with country of birth according to the duration of pregnancy in term births. Conclusions Non-spontaneous PTD increased with the length of residence whereas spontaneous PTD remained elevated regardless of the length of residence. Policies to improve birth outcomes in ethnically mixed populations should address the modifiable causes of PTD rather than aiming to reduce absolute PTD rates.
Collapse
Affiliation(s)
- Ingvil K Sørbye
- Norwegian Resource Centre for Women's Health, Women and Children's Division, Oslo University Hospital, P,O, Box 4950 Nydalen, Oslo 0424, Norway.
| | | | | | | |
Collapse
|
50
|
Cruz Y, Hernandez-Lane ME, Cohello JI, Bautista CT. The effectiveness of a community health program in improving diabetes knowledge in the Hispanic population: Salud y Bienestar (Health and Wellness). J Community Health 2014; 38:1124-31. [PMID: 23913103 DOI: 10.1007/s10900-013-9722-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
We evaluated the effectiveness of the Salud y Bienestar program to deliver diabetes education in the Hispanic population in the United States. This program uses a community outreach model where community health promoters are trained and then they deliver education to other community members regarding diabetes disease, risk factors, and ways to prevent and control disease. This intervention applies a one-group pre- and post-test design to improve diabetes knowledge. The intervention carried out in the states of California, Texas, and Washington DC. A total of 1,413 participants were enrolled. Of these, 73% were females, 46% were 65 years or older, 59% were Mexican, 64% had at least elementary education, 56% had lived in the US for more than 20 years, and 38% participants were self-reported diabetic. Among diabetic participants, a significant improvement was observed on diabetes knowledge when comparing pre- and post-test scores (13.7 vs. 18.6, P < 0.001; Cohen's d = 1.2). Among non-diabetic participants, diabetes knowledge also increased significantly after one-single training session (12.9 vs. 18.2, P < 0.001; Cohen's d = 1.2). The Salud y Bienestar program conducted by community health workers was effective approach to improving diabetes knowledge in the Hispanic population.
Collapse
Affiliation(s)
- Yanira Cruz
- National Hispanic Council on Aging, 734 15th Street NW Suite 1050, Washington, DC, 20005, USA
| | | | | | | |
Collapse
|