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Darvish S, Mahoney SA, Venkatasubramanian R, Rossman MJ, Clayton ZS, Murray KO. Socioeconomic status as a potential mediator of arterial aging in marginalized ethnic and racial groups: current understandings and future directions. J Appl Physiol (1985) 2024; 137:194-222. [PMID: 38813611 DOI: 10.1152/japplphysiol.00188.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 05/28/2024] [Accepted: 05/28/2024] [Indexed: 05/31/2024] Open
Abstract
Cardiovascular diseases (CVDs) are the leading cause of death in the United States. However, disparities in CVD-related morbidity and mortality exist as marginalized racial and ethnic groups are generally at higher risk for CVDs (Black Americans, Indigenous People, South and Southeast Asians, Native Hawaiians, and Pacific Islanders) and/or development of traditional CVD risk factors (groups above plus Hispanics/Latinos) relative to non-Hispanic Whites (NHW). In this comprehensive review, we outline emerging evidence suggesting these groups experience accelerated arterial dysfunction, including vascular endothelial dysfunction and large elastic artery stiffening, a nontraditional CVD risk factor that may predict risk of CVDs in these groups with advancing age. Adverse exposures to social determinants of health (SDOH), specifically lower socioeconomic status (SES), are exacerbated in most of these groups (except South Asians-higher SES) and may be a potential mediator of accelerated arterial aging. SES negatively influences the ability of marginalized racial and ethnic groups to meet aerobic exercise guidelines, the first-line strategy to improve arterial function, due to increased barriers, such as time and financial constraints, lack of motivation, facility access, and health education, to performing conventional aerobic exercise. Thus, identifying alternative interventions to conventional aerobic exercise that 1) overcome these common barriers and 2) target the biological mechanisms of aging to improve arterial function may be an effective, alternative method to aerobic exercise to ameliorate accelerated arterial aging and reduce CVD risk. Importantly, dedicated efforts are needed to assess these strategies in randomized-controlled clinical trials in these marginalized racial and ethnic groups.
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Affiliation(s)
- Sanna Darvish
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States
| | - Sophia A Mahoney
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States
| | | | - Matthew J Rossman
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States
| | - Zachary S Clayton
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States
| | - Kevin O Murray
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States
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Cordeiro FP, Marchiori LLM, Teixeira DC, Andraus RAC, Poli-Frederico RC. Plasma Levels of Interleukin 2 (IL-2) Associated with Hearing Loss Evaluation in the Elderly. Noise Health 2024; 26:165-173. [PMID: 38904818 DOI: 10.4103/nah.nah_3_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 04/01/2024] [Indexed: 06/22/2024] Open
Abstract
CONTEXT Presbycusis can be mediated by the effects of inflammatory processes on the auditory system, and these aging biological mechanisms remain poorly studied. AIMS The aim of this study was to determine whether plasma biomarkers are associated with hearing disorders caused by aging in the elderly. SETTINGS AND DESIGN Cross-sectional study with 106 participants in the Active Aging Project, 93 (88%) females and 13 (12%) males, with an average age of 70 years. METHODS AND MATERIAL Audiological evaluation was performed with pure tone audiometry and collection of peripheral blood for the measurement of plasma levels of interleukins 2, 4, 6, and 10, tumor necrosis factor-α, and interferon-γ by means of flow cytometry. STATISTICAL ANALYSIS USED The SPSS (v.0, SPSS Inc., Chicago, USA) was used for the analysis of the data obtained. For all data analyzed, the significance level adopted was P < 0.05 and 95% confidence interval. RESULTS There were statistically significant correlations between male and IL-2 (P = 0.031; rs = 0.210), mean II of the right ear (P = 0.004; rs = 0.279), longer in years (P = 0.002; rs = 0.307) and in hours (P = 0.004; rs = 0.281) of noise exposure also in males. CONCLUSIONS In the present study, there was an association between the male gender and higher plasma levels of IL-2, an increase in the average hearing in the right ear, and greater time in years and hours of exposure to noise. There was a predominance of mild sensorineural hearing loss and worsening of hearing related to age, characteristics of presbycusis.
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Affiliation(s)
- Fernanda P Cordeiro
- Student of theMaster's and Doctor's Degree in Rehabilitation Sciences, UEL-UNOPAR. https://orcid.org/0000-0003-4489-2568
| | - Luciana L M Marchiori
- Interdisciplinary Laboratory for Intervention in Health Promotion LIIPS/UNICESUMAR-Maringá, Paraná, Brazil https://orcid.org/0000-0002-9026-0468
| | - Denilson C Teixeira
- Research Center in Health Science, State University of Londrina, Paraná, Brazil https://orcid.org/0000-0002-6299-0252
| | - Rodrigo A C Andraus
- Professor of the Master's and Doctor's Degree Associated in Rehabilitation Sciences UEL-UNOPAR https://orcid.org/0000-0002-3849-0872
| | - Regina Célia Poli-Frederico
- Professor of the Master's and Doctor's Degree Associated in Rehabilitation Sciences UEL-UNOPAR. https://orcid.org/0000-0003-4631-4606
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Paing PY, Littman AJ, Reese JA, Sitlani CM, Umans JG, Cole SA, Zhang Y, Ali T, Fretts AM. Association of Achievement of the American Heart Association's Life's Essential 8 Goals With Incident Cardiovascular Diseases in the SHFS. J Am Heart Assoc 2024; 13:e032918. [PMID: 38456410 PMCID: PMC11010036 DOI: 10.1161/jaha.123.032918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 02/02/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Cardiovascular disease (CVD) is a leading cause of morbidity and mortality in American Indian people. In 2022, the American Heart Association developed the Life's Essential 8 goals to promote cardiovascular health (CVH) for Americans, composed of diet, physical activity, nicotine exposure, sleep, body mass index, blood lipids, blood pressure, and blood glucose. We examined whether achievement of Life's Essential 8 goals was associated with incident CVD among SHFS (Strong Heart Family Study) participants. METHODS AND RESULTS A total of 2139 SHFS participants without CVD at baseline were included in analyses. We created a composite CVH score based on achievement of Life's Essential 8 goals, excluding sleep. Scores of 0 to 49 represented low CVH, 50 to 69 represented moderate CVH, and 70 to 100 represented high CVH. Incident CVD was defined as incident myocardial infarction, coronary heart disease, congestive heart failure, or stroke. Cox proportional hazard models were used to examine the relationship of CVH and incident CVD. The incidence rate of CVD at the 20-year follow-up was 7.43 per 1000 person-years. Compared with participants with low CVH, participants with moderate and high CVH had a lower risk of incident CVD; the hazard ratios and 95% CIs for incident CVD for moderate and high CVH were 0.52 (95% CI, 0.40-0.68) and 0.25 (95% CI, 0.14-0.44), respectively, after adjustment for age, sex, education, and study site. CONCLUSIONS Better CVH was associated with lower CVD risk which highlights the need for comprehensive public health interventions targeting CVH promotion to reduce CVD risk in American Indian communities.
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Affiliation(s)
| | | | | | | | | | | | - Ying Zhang
- University of Oklahoma Health Sciences CenterOklahoma CityOK
| | - Tauqeer Ali
- University of Oklahoma Health Sciences CenterOklahoma CityOK
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Savin KL, Carlson JA, Patel SR, Jankowska MM, Allison MA, Sotres-Alvarez D, Sallis JF, Talavera GA, Roesch SC, Malcarne VL, Larsen B, Rutledge T, Gallo LC. Social and built neighborhood environments and sleep health: The Hispanic Community Health Study/Study of Latinos Community and Surrounding Areas and Sueño Ancillary Studies. Sleep 2024; 47:zsad260. [PMID: 37788570 PMCID: PMC10851842 DOI: 10.1093/sleep/zsad260] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 09/15/2023] [Indexed: 10/05/2023] Open
Abstract
STUDY OBJECTIVES To test associations between neighborhood social, built, and ambient environment characteristics and multidimensional sleep health in Hispanic/Latino adults. METHODS Data were from San Diego-based Hispanic/Latino adults mostly of Mexican heritage enrolled in the Hispanic Community Health Study/Study of Latinos (N = 342). Home addresses were geocoded to ascertain neighborhood characteristics of greenness, walkability (density of intersections, retail spaces, and residences), socioeconomic deprivation (e.g. lower income, lower education), social disorder (e.g. vacant buildings, crime), traffic density, and air pollution (PM 2.5) in the Study of Latinos Communities and Surrounding Areas Study. Sleep dimensions of regularity, satisfaction, alertness, timing, efficiency, and duration were measured by self-report or actigraphy approximately 2 years later. Multivariable regression models accounting for study design (stratification and clustering) were used to examine associations of neighborhood variables with individual sleep dimensions and a multidimensional sleep health composite score. RESULTS Neighborhood characteristics were not significantly associated with the multidimensional sleep health composite, and there were few significant associations with individual sleep dimensions. Greater levels of air pollution (B = 9.03, 95% CI: 1.16, 16.91) were associated with later sleep midpoint, while greater social disorder (B = -6.90, 95% CI: -13.12, -0.67) was associated with earlier sleep midpoint. Lower walkability was associated with more wake after sleep onset (B = -3.58, 95% CI: -7.07, -0.09). CONCLUSIONS Living in neighborhoods with lower walkability and greater air pollution was associated with worse sleep health, but otherwise findings were largely null. Future research should test these hypotheses in settings with greater variability and investigate mechanisms of these associations.
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Affiliation(s)
- Kimberly L Savin
- San Diego State University/University of California San Diego, Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Jordan A Carlson
- Center for Children’s Health Lifestyles and Nutrition, Children’s Mercy Kansas City, Kansas City, MO, USA
- Department of Pediatrics, Children’s Mercy Kansas City and University of Missouri Kansas City, Kansas City, MO, USA
| | - Sanjay R Patel
- Center for Sleep and Cardiovascular Outcomes Research, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Matthew A Allison
- Department of Family Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Daniela Sotres-Alvarez
- Collaborative Studies Coordinating Center, Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - James F Sallis
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - Gregory A Talavera
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Scott C Roesch
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Vanessa L Malcarne
- Department of Psychology, San Diego State University, San Diego, CA, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Britta Larsen
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
| | - Thomas Rutledge
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Department of Mental Health, VA San Diego Healthcare System, San Diego, CA, USA
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA, USA
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Mossavar-Rahmani Y, Lin J, Pan S, Song RJ, Xue X, Spartano NL, Xanthakis V, Sotres-Alvarez D, Marquez DX, Daviglus M, Carlson JA, Parada H, Evenson KR, Talavera AC, Gellman M, Perreira KM, Gallo LC, Vasan RS, Kaplan RC. Characterizing longitudinal change in accelerometry-based moderate-to-vigorous physical activity in the Hispanic Community Health Study/Study of Latinos and the Framingham Heart Study. BMC Public Health 2023; 23:1614. [PMID: 37620824 PMCID: PMC10464120 DOI: 10.1186/s12889-023-16442-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 08/02/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND Physical activity promotes health and is particularly important during middle and older age for decreasing morbidity and mortality. We assessed the correlates of changes over time in moderate-to-vigorous physical activity (MVPA) in Hispanic/Latino adults from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL: mean [SD] age 49.2 y [11.5]) and compared them to a cohort of primarily White adults from the Framingham Heart Study (FHS: mean [SD] 46.9 y [9.2]). METHODS Between 2008 and 2019, we assessed accelerometry-based MVPA at two time points with an average follow-up of: 7.6 y, SD 1.3 for HCHS/SOL, and 7.8 y, SD 0.7 for FHS. We used multinomial logistic regression to relate socio-demographic and health behaviors with changes in compliance with 2018 US recommendations for MVPA from time 1 to time 2 (remained active or inactive; became active or inactive) across the two cohorts. RESULTS In HCHS/SOL mean MVPA was 22.6 (SD, 23.8) minutes at time 1 and dropped to 16.7 (19.0) minutes at time 2. In FHS Mean MVPA was 21.7 min (SD, 17.7) at time 1 and dropped to 21.3 min (SD, 19.2) at time 2. Across both cohorts, odds of meeting MVPA guidelines over time were about 6% lower in individuals who had lower quality diets vs. higher, about half in older vs. younger adults, about three times lower in women vs. men, and 9% lower in individuals who had a higher vs. lower BMI at baseline. Cohorts differed in how age, gender, income, education, depressive symptoms, marital status and perception of general health and pain associated with changes in physical activity. High income older Hispanics/Latino adults were more likely to become inactive at the follow-up visit as were HCHS/SOL women who were retired and FHS participants who had lower levels of education and income. Higher depressive symptomology was associated with becoming active only in HCHS/SOL women. Being male and married was associated with becoming inactive in both cohorts. Higher perception of general health and lower perception of pain were associated with remaining active only in FHS adults. CONCLUSIONS These findings highlight potentially high-risk groups for targeted MVPA intervention.
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Affiliation(s)
- Yasmin Mossavar-Rahmani
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Belfer Bldg, 1312C, Bronx, NY, 10461, USA.
| | - Juan Lin
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Belfer Bldg, 1312C, Bronx, NY, 10461, USA
| | - Stephanie Pan
- Section of Preventive Medicine and Epidemiology, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
| | - Rebecca J Song
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, 02118, USA
| | - Xiaonan Xue
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Belfer Bldg, 1312C, Bronx, NY, 10461, USA
| | - Nicole L Spartano
- Department of Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
| | - Vanessa Xanthakis
- Section of Preventive Medicine and Epidemiology, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
- Framingham Heart Study, Framingham, MA, 01701, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, 02118, USA
| | - Daniela Sotres-Alvarez
- Department of Biostatistics, Gillings School of Global Public Health, Collaborative Studies Coordinating Center, University of North Carolina, Chapel Hill, NC, 27516, USA
| | - David X Marquez
- Department of Kinesiology & Nutrition, University of Illinois Chicago, Chicago, IL, 60612, USA
| | - Martha Daviglus
- Institute for Minority Health Research, University of Illinois Chicago, Chicago, IL, 60612, USA
| | - Jordan A Carlson
- Department of Pediatrics, Children's Mercy Hospital and University of Missouri-Kansas City School of Medicine, Kansas City, MO, 64108, USA
| | - Humberto Parada
- Division of Epidemiology & Biostatistics, San Diego State University School of Public Health, San Diego, CA, 92182, USA
| | - Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Ana C Talavera
- South Bay Latino Research Center, College of Sciences, San Diego State University, San Diego, CA, 92182, USA
| | - Marc Gellman
- Department of Psychology, University of Miami, Coral Gables, Florida, 33136, USA
| | - Krista M Perreira
- Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, 27599, USA
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA, 91910, USA
| | - Ramachandran S Vasan
- Section of Preventive Medicine and Epidemiology, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, 02118, USA
- Framingham Heart Study, Framingham, MA, 01701, USA
- University of Texas School of Public Health, San Antonio and University of Texas Health Science Center, San Antonio, TX, 78229, USA
- Section of Cardiovascular Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
| | - Robert C Kaplan
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Belfer Bldg, 1312C, Bronx, NY, 10461, USA
- Fred Hutchinson Cancer Research Center, Division of Public Health Sciences, Seattle, WA, 98109, USA
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Sucich J, Breitbart V, Williams S, Sanichar N, Candelaria-Arce E, Frankle WG, Davison-Duffy S. Prevalence of Childhood Trauma in a Community-Based Mental Health Clinic. Community Ment Health J 2023; 59:1136-1149. [PMID: 36752932 DOI: 10.1007/s10597-023-01094-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 11/12/2022] [Accepted: 01/24/2023] [Indexed: 02/09/2023]
Abstract
A large number of individuals in the US have experienced childhood trauma. However, little is known about the prevalence of trauma in a diverse patient population entering treatment in a community mental health center. To assess early trauma in this population, the Adverse Childhood Experience (ACEs) questionnaire was administered to 856 participants over a nine-month period. 40% reported four or more ACEs. Among high scorers, emotional abuse, physical abuse and emotional neglect were the most prevalent ACE experiences. High mean ACE sum scores were observed among patients with PTSD, depression, impulse disorder and substance use disorder. Having a higher ACE sum score was associated with a greater number of co-occurring psychiatric disorders. Characterizing ACEs by patient sociodemographic attributes and psychiatric diagnoses extracted from the electronic medical records (EMR) can benefit therapeutic interventions. These findings indicate a need for creating more trauma-informed settings with knowledgeable, trained staff.
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Affiliation(s)
- James Sucich
- The Family Health Centers at NYU Langone, Brooklyn, NY, USA.
- NYU Lagone Health, Sunset Terrace Family Health Center, 514 49th St. Brooklyn, 11220, New York, NY, USA.
| | | | - Sharifa Williams
- The Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Navin Sanichar
- The Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | | | - W Gordon Frankle
- NYU Lagone Health, Sunset Terrace Family Health Center, 514 49th St. Brooklyn, 11220, New York, NY, USA
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Evenson KR, Scherer E, Peter KM, Cuthbertson CC, Eckman S. Historical development of accelerometry measures and methods for physical activity and sedentary behavior research worldwide: A scoping review of observational studies of adults. PLoS One 2022; 17:e0276890. [PMID: 36409738 PMCID: PMC9678297 DOI: 10.1371/journal.pone.0276890] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 10/15/2022] [Indexed: 11/22/2022] Open
Abstract
This scoping review identified observational studies of adults that utilized accelerometry to assess physical activity and sedentary behavior. Key elements on accelerometry data collection were abstracted to describe current practices and completeness of reporting. We searched three databases (PubMed, Web of Science, and SPORTDiscus) on June 1, 2021 for articles published up to that date. We included studies of non-institutionalized adults with an analytic sample size of at least 500. The search returned 5686 unique records. After reviewing 1027 full-text publications, we identified and abstracted accelerometry characteristics on 155 unique observational studies (154 cross-sectional/cohort studies and 1 case control study). The countries with the highest number of studies included the United States, the United Kingdom, and Japan. Fewer studies were identified from the continent of Africa. Five of these studies were distributed donor studies, where participants connected their devices to an application and voluntarily shared data with researchers. Data collection occurred between 1999 to 2019. Most studies used one accelerometer (94.2%), but 8 studies (5.2%) used 2 accelerometers and 1 study (0.6%) used 4 accelerometers. Accelerometers were more commonly worn on the hip (48.4%) as compared to the wrist (22.3%), thigh (5.4%), other locations (14.9%), or not reported (9.0%). Overall, 12.7% of the accelerometers collected raw accelerations and 44.6% were worn for 24 hours/day throughout the collection period. The review identified 155 observational studies of adults that collected accelerometry, utilizing a wide range of accelerometer data processing methods. Researchers inconsistently reported key aspects of the process from collection to analysis, which needs addressing to support accurate comparisons across studies.
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Affiliation(s)
- Kelly R. Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina–Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Elissa Scherer
- RTI International, Research Triangle Park, North Carolina, United States of America
| | - Kennedy M. Peter
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina–Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Carmen C. Cuthbertson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina–Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Stephanie Eckman
- RTI International, Research Triangle Park, North Carolina, United States of America
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Sallis JF, Carlson JA, Ortega A, Allison MA, Geremia CM, Sotres-Alvarez D, Jankowska MM, Mooney SJ, Chambers EC, Hanna DB, Perreira KM, Daviglus ML, Gallo LC. Micro-scale pedestrian streetscapes and physical activity in Hispanic/Latino adults: Results from HCHS/SOL. Health Place 2022; 77:102857. [PMID: 36027739 DOI: 10.1016/j.healthplace.2022.102857] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 06/23/2022] [Accepted: 06/30/2022] [Indexed: 11/29/2022]
Abstract
We examined associations of micro-scale environment attributes (e.g., sidewalks, street crossings) with three physical activity (PA) measures among Hispanic/Latino adults (n = 1776) living in San Diego County, CA. Systematic observation was used to quantify micro-scale environment attributes near each participant's home. Total PA was assessed with accelerometers, and PA for transportation and recreation were assessed by validated self-report. Although several statistically significant interactions between individual and neighborhood characteristics were identified, there was little evidence micro-scale attributes were related to PA. An important limitation was restricted environmental variability for this sample which lived in a small area of a single county.
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Affiliation(s)
- James F Sallis
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, MC 0631, La Jolla, CA, USA.
| | - Jordan A Carlson
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy, Kansas City, MO, USA
| | - Adrian Ortega
- Clinical Child Psychology Program, University of Kansas, Lawrence, KS, USA
| | - Matthew A Allison
- Department of Family Medicine, University of California, La Jolla, CA, USA
| | - Carrie M Geremia
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, MC 0631, La Jolla, CA, USA
| | - Daniela Sotres-Alvarez
- Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Marta M Jankowska
- Population Sciences, Beckman Research Institute, City of Hope, Duarte, CA, USA
| | - Stephen J Mooney
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Earle C Chambers
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
| | - David B Hanna
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Krista M Perreira
- Department of Social Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, USA
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA, USA
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Gallo LC, Savin KL, Jankowska MM, Roesch SC, Sallis JF, Sotres-Alvarez D, Talavera GA, Perreira KM, Isasi CR, Penedo FJ, Llabre MM, Estrella ML, Chambers EC, Daviglus ML, Brown SC, Carlson JA. Neighborhood Environment and Metabolic Risk in Hispanics/Latinos From the Hispanic Community Health Study/Study of Latinos. Am J Prev Med 2022; 63:195-203. [PMID: 35365395 PMCID: PMC9308627 DOI: 10.1016/j.amepre.2022.01.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 12/21/2021] [Accepted: 01/23/2022] [Indexed: 01/05/2023]
Abstract
INTRODUCTION This study examines the associations of neighborhood environments with BMI, HbA1c, and diabetes across 6 years in Hispanic/Latino adults. METHODS Participants from the Hispanic Community Health Study/Study of Latinos San Diego site (n=3,851, mean age=39.4 years, 53.3% women, 94.0% Mexican heritage) underwent assessment of metabolic risk factors and diabetes status (categorized as normoglycemia, prediabetes, and diabetes) at baseline (2008-2011) and approximately 6 years later (2014-2017). In the Study of Latinos Community and Surrounding Areas Study ancillary study (2015-2020), participant baseline addresses were geocoded, and neighborhoods were defined using 800-meter circular buffers. Neighborhood variables representing socioeconomic deprivation, residential stability, social disorder, walkability, and greenness were created using Census and other public databases. Analyses were conducted in 2020-2021. RESULTS Complex survey regression analyses revealed that greater neighborhood socioeconomic deprivation was associated with higher BMI (β=0.14, p<0.001) and HbA1c (β=0.08, p<0.01) levels and a higher odds of worse diabetes status (i.e., having prediabetes versus normoglycemia and having diabetes versus prediabetes; OR=1.25, 95% CI=1.06, 1.47) at baseline. Greater baseline neighborhood deprivation also was related to increasing BMI (β=0.05, p<0.01) and worsening diabetes (OR=1.27, 95% CI=1.10, 1.46) statuses, whereas social disorder was related to increasing BMI levels (β=0.05, p<0.05) at Visit 2. There were no associations of expected protective factors of walkability, greenness, or residential stability. CONCLUSIONS Neighborhood deprivation and disorder were related to worse metabolic health in San Diego Hispanic/Latino adults of mostly Mexican heritage. Multilevel interventions emphasizing individual and structural determinants may be most effective in improving metabolic health among Hispanic/Latino individuals.
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Affiliation(s)
- Linda C Gallo
- San Diego State University/Universtiy of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California.
| | - Kimberly L Savin
- San Diego State University/Universtiy of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California
| | - Marta M Jankowska
- Department of Population Sciences, Beckman Research Institute, City of Hope, Duarte, California
| | - Scott C Roesch
- San Diego State University/Universtiy of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California
| | - James F Sallis
- The Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, San Diego, California; Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Daniela Sotres-Alvarez
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Gregory A Talavera
- San Diego State University/Universtiy of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California
| | - Krista M Perreira
- Department of Social Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Carmen R Isasi
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Frank J Penedo
- Department of Psychology, College of Arts and Sciences, University of Miami, Miami, Florida
| | - Maria M Llabre
- Department of Psychology, College of Arts and Sciences, University of Miami, Miami, Florida
| | - Mayra L Estrella
- Institute for Minority Health Research, The University of Illinois College of Medicine, Chicago, Illinois
| | - Earle C Chambers
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York; Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, New York
| | - Martha L Daviglus
- Department of Psychology, College of Arts and Sciences, University of Miami, Miami, Florida
| | - Scott C Brown
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, Florida
| | - Jordan A Carlson
- Department of Pediatrics, Children's Mercy Hospital and University of Missouri, Kansas City, Kansas City, Missouri
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10
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Carlson JA, Sallis JF, Jankowska MM, Allison MA, Sotres-Alvarez D, Roesch SC, Steel C, Savin KL, Talavera GA, Castañeda SF, Llabre MM, Penedo FJ, Kaplan R, Mossavar-Rahmani Y, Daviglus M, Perreira KM, Gallo LC. Neighborhood built environments and Hispanic/Latino adults' physical activity in the U.S.: The Hispanic community health study/study of Latinos community and surrounding areas study. Prev Med 2022; 160:107073. [PMID: 35513129 PMCID: PMC9756587 DOI: 10.1016/j.ypmed.2022.107073] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 04/07/2022] [Accepted: 04/27/2022] [Indexed: 10/18/2022]
Abstract
Despite experiencing health inequities, less is known about neighborhood environments and physical activity among Hispanic/Latino adults compared to other populations. We investigated this topic in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Hispanic/Latino adults in the San Diego, California area of the U.S. completed measures of overall moderate-to-vigorous physical activity (MVPA) via accelerometry and domain-specific MVPA via questionnaire at Visits 1 (2008-2011; n = 4086) and 2 (2014-2017; n = 1776), ~6 years apart. 800-m home neighborhood buffers were used to create objective measures of residential, intersection, and retail density, bus/trolley stops, greenness, parks, and recreation area at Visit 1. Regression models tested the association of each neighborhood feature with MVPA at Visit 1 and over 6 years, adjusting for individual characteristics and neighborhood socioeconomic deprivation. At Visit 1, those in neighborhoods with higher vs. lower retail density or recreation area (+1 vs. -1 standard deviation from the mean) engaged in 10% more overall MVPA and 12-22% more active transportation. Those in neighborhoods with higher vs. lower residential density engaged in 22% more active transportation. Those in neighborhoods with higher vs. lower greenness and park count engaged in 14-16% more recreational MVPA. Neighborhood features were unassociated with changes in MVPA over 6 years. Although changes in MVPA over time were similar across neighborhoods, Hispanic/Latino adults living in neighborhoods with design features supportive of walking and recreational activity (e.g., greater residential and retail density, more parks and recreation facilities) were consistently more active. Improving neighborhood environments appears important for supporting physical activity among Hispanic/Latino adults.
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Affiliation(s)
- Jordan A Carlson
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, Kansas City, MO, USA; Department of Pediatrics, Children's Mercy Kansas City, University of Missouri Kansas City, Kansas City, MO, USA.
| | - James F Sallis
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA; Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Marta M Jankowska
- Population Sciences, Beckman Research Institute, City of Hope, Duarte, CA, USA
| | - Matthew A Allison
- Department of Family Medicine, University of California San Diego, La Jolla, CA, USA
| | - Daniela Sotres-Alvarez
- Collaborative Studies Coordinating Center, Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Scott C Roesch
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Chelsea Steel
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, Kansas City, MO, USA
| | - Kimberly L Savin
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California San Diego, San Diego, CA, USA
| | - Gregory A Talavera
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Sheila F Castañeda
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Maria M Llabre
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Frank J Penedo
- Department of Psychology, University of Miami, Coral Gables, FL, USA; Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
| | - Robert Kaplan
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA; Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Yasmin Mossavar-Rahmani
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Martha Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, USA
| | - Krista M Perreira
- Department of Social Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA, USA
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Xiaojin L, Licong C, Fei W, Schulz PE, Zhang GQ. Identifying Sleep-Related Factors Associated with Cognitive Function in a Hispanics/Latinos Cohort: A Dual Random Forest Approach. AMIA ... ANNUAL SYMPOSIUM PROCEEDINGS. AMIA SYMPOSIUM 2022; 2021:744-753. [PMID: 35308908 PMCID: PMC8861662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Disordered sleep is associated with poor cognitive function and cognitive decline. However, little is known regarding the association of sleep-related factors with cognitive function in underrepresented cohorts such as the Hispanic/Latino population. Leveraging the National Sleep Research Resource, one of the most comprehensive collections of sleep studies, we identified a Hispanic/Latino cohort of 1,031 lower cognitive function cases and 2,062 normal controls. We developed a novel dual random forest (DRF) approach to discriminate cases against controls for estimating the potential impact of sleep-related variables related to the decline of cognitive function. Several important sleep-related factors were identified which may be associated with cognitive function in the Hispanics/Latinos cohort, such as heart rate, sleep duration, trouble falling asleep, and apnea/hypopnea index, which are consistent with existing research findings. Our DRF approach is effective in validating the association between disordered sleep and cognitive decline in this unique minority population.
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Affiliation(s)
- Li Xiaojin
- The University of Texas Health Science Center at Houston, Houston, TX 77030
| | - Cui Licong
- The University of Texas Health Science Center at Houston, Houston, TX 77030
| | - Wang Fei
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY 10065
| | - Paul E Schulz
- The University of Texas Health Science Center at Houston, Houston, TX 77030
| | - Guo-Qiang Zhang
- The University of Texas Health Science Center at Houston, Houston, TX 77030
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12
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Savin KL, Roesch SC, Oren E, Carlson JA, Allison MA, Sotres-Alvarez D, Sallis JF, Jankowska MM, Talavera GA, Rodriguez TM, Chambers EC, Daviglus M, Perreira KM, Llabre MM, Gallo LC. Social and built neighborhood environments and blood pressure 6 years later: Results from the Hispanic Community Health Study/Study of Latinos and the SOL CASAS ancillary study. Soc Sci Med 2022; 292:114496. [PMID: 34774366 PMCID: PMC8748411 DOI: 10.1016/j.socscimed.2021.114496] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 10/12/2021] [Accepted: 10/16/2021] [Indexed: 01/03/2023]
Abstract
Neighborhood-level socioeconomic deprivation can increase risk for higher blood pressure or hypertension, while greater neighborhood safety and walkability may protect against hypertension. Large-scale prospective research, particularly among Hispanics/Latinos, is lacking. We examined cross-sectional and prospective associations between neighborhood environments and blood pressure and hypertension among 3851 Hispanic/Latinos enrolled in the Hispanic Community Health Study/Study of Latinos San Diego, CA cohort. Addresses from Visit 1 (2008-2011) were geocoded and neighborhood characteristics were determined as part of the SOL CASAS ancillary study. Home addresses were geocoded and home areas created using 800 m circular radial buffers. Neighborhood indices socioeconomic deprivation, residential stability, and social disorder were created using Census and other publicly available data. Walkability was computed as density of intersections, retail spaces, and residences. Greenness was measured via satellite imagery using the Normalized Difference Vegetation Index. Visit 1 and Visit 2 (2014-2017) clinical outcomes included systolic (SBP) and diastolic (DBP) blood pressure, as well as prevalent and 6-year incident hypertension, defined as SBP/DBP ≥140/90 mmHg or antihypertensive medication use. Complex survey regression models adjusted for covariates revealed cross-sectional associations between greater walkability and lower SBP (B = -0.05; 95% CI: -0.09, -0.003). In prospective analyses, greater neighborhood social disorder was related to increasing SBP (B = 0.05; 95% CI: 0.01, 0.09) and DBP (B = 0.07; 95% CI: 0.02, 0.12) over time. Greater socioeconomic deprivation (OR = 1.47; 95% CI: 1.06, 2.04) and greater social disorder (OR = 1.25; 95% CI: 1.02, 1.54) were associated with higher odds of incident hypertension. All other associations were not significant. Beyond individual-level characteristics, greater neighborhood social disorder and socioeconomic deprivation were related to adverse changes in blood pressure over 6 years among Hispanics/Latinos. Neighborhood social environment may help identify, or be an area for future intervention for, cardiovascular risk among Hispanics/Latinos.
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Affiliation(s)
- Kimberly L Savin
- San Diego State University/University of California San Diego, Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Court, San Diego, CA, 92120, USA.
| | - Scott C Roesch
- Department of Psychology, San Diego State University, 6363 Alvarado Court, San Diego, CA, 92120, USA.
| | - Eyal Oren
- School of Public Health, San Diego State University, 5500 Campanile Dr, San Diego, CA, 92182, USA.
| | - Jordan A Carlson
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City Postal Address: 2401 Gillham Rd, Kansas City, MO, 64108, USA; Department of Pediatrics, Children's Mercy Kansas City and University of Missouri Kansas City, 2401 Gillham Rd, Kansas City, MO, 64108, USA.
| | - Matthew A Allison
- Department of Family Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA.
| | - Daniela Sotres-Alvarez
- Collaborative Studies Coordinating Center, Department of Biostatistics, University of North Carolina at Chapel Hill, 123 W. Franklin Street, Suite 450, CB #8030, Chapel Hill, NC, 27516, USA.
| | - James F Sallis
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego 9500 Gilman Drive, La Jolla, CA, 92093, USA; Mary MacKillop Institute for Health Research, Australian Catholic University, 5/215 Spring St, Melbourne VIC, 3000, Australia.
| | - Marta M Jankowska
- Population Sciences, Beckman Research Institute, City of Hope, 1500 E Duarte Rd, Duarte, CA, 91010, USA.
| | - Gregory A Talavera
- Department of Psychology, San Diego State University, 6363 Alvarado Court, San Diego, CA, 92120, USA.
| | - Tasi M Rodriguez
- South Bay Latino Research Center, San Diego State University, 780 Bay Boulevard, Suite 200, Chula Vista, CA, 91910, USA.
| | - Earle C Chambers
- Department of Family and Social Medicine, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA.
| | - Martha Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, 835 S Wolcott Ave (Bldg 935), Mailbox #23 (M/C 769), Chicago, IL, 60612, USA.
| | - Krista M Perreira
- Department of Social Medicine, University of North Carolina, 333 South Columbia Street, MacNider Hall, Room #348 / CB #7240, Chapel Hill, NC, 27599-7240, USA.
| | - Maria M Llabre
- Department of Psychology, University of Miami, P.O. Box 248185, Coral Gables, FL, 33124, USA.
| | - Linda C Gallo
- Department of Psychology, San Diego State University, 6363 Alvarado Court, San Diego, CA, 92120, USA.
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13
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Holmgren JL, Carlson JA, Gallo LC, Doede AL, Jankowska MM, Sallis JF, Perreira KM, Andersson LM, Talavera GA, Castaneda SF, Garcia ML, Allison MA. Neighborhood Socioeconomic Deprivation and Depression Symptoms in Adults From the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2021; 68:427-439. [PMID: 34170007 PMCID: PMC8688277 DOI: 10.1002/ajcp.12525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Socioeconomic factors appear to impact mental health conditions such as depression, but little is known about the relative and combined role of neighborhood and personal socioeconomic deprivation among Hispanics/Latinos. This study examined cross-sectional associations of neighborhood and personal socioeconomic deprivation with depression symptoms in a US Hispanic/Latino population from the San Diego Field Center of the Hispanic Community Health Study/Study of Latinos (n = 3,851). Depression symptoms were assessed with the ten-item Centers for Epidemiological Studies in Depression Scale. Neighborhood socioeconomic deprivation was a composite of eleven variables (e.g., neighborhood income, education, employment, household crowding). Greater personal socioeconomic deprivation based on education, income, and employment was generally associated with higher depression symptoms, including after adjusting for neighborhood socioeconomic deprivation. Greater neighborhood socioeconomic deprivation was associated with higher depression symptoms in females but not males, but the association in females became non-significant when adjusting for personal socioeconomic deprivation. Neighborhood socioeconomic deprivation did not significantly interact with personal socioeconomic deprivation in relation to depression symptoms. The present findings support the association of personal socioeconomic status with mental health (indicated by depression symptoms) among Hispanic/Latino populations, whereas neighborhood socioeconomic deprivation did not relate to depression beyond the impact of personal indicators.
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Affiliation(s)
| | - Jordan A. Carlson
- Center for Children’s Healthy Lifestyles & Nutrition, Children’s Mercy Kansas City, MO, USA
- Department of Pediatrics, University of Missouri Kansas City, Kansas City, MO, USA
| | | | | | | | - James F. Sallis
- University of California San Diego, La Jolla, CA, USA
- Mary MacKillop Institute of Health Research, Australian, Catholic University, Melbourne, Vic., Australia
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Hispanic ethnicity and in-hospital morbidity and mortality outcomes in Alzheimer's Disease: A U.S. National Study 2005-2015. Clin Neurol Neurosurg 2021; 207:106753. [PMID: 34126451 DOI: 10.1016/j.clineuro.2021.106753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 04/17/2021] [Accepted: 06/04/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Hispanics are one of the largest and fastest-growing population in the United States. Having been reported as one of the high-risk ethnicities to develop Alzheimer's Disease (AD) makes elder Hispanics one of the significant groups of AD in the country, indicating a need to study the disparities in Hispanics vs. non-Hispanics patients. We aimed to determine the prevalence, morbidity, and mortality outcomes of AD in Hispanics. METHODS We surveyed Healthcare Cost and Utilization Project (HCUP) from 2005 to 2015 to identify patients older than 50 years who were admitted for any reason and had AD diagnosis. Prevalence, demographics, age brackets, in-hospital deaths, disease severity, and hospital length of stay (LOS) were compared between the Hispanics and Non-Hispanics. RESULTS Among 14,135,560 Hispanic discharges, 2.76% had AD, compared with 207,515,260 discharges in Non-Hispanic with 2.61% AD, p < 0.001. Hispanics had significantly more AD in all age brackets, especially over 90 years of age, p < 0.001. A significantly higher prevalence of AD in both Hispanic Females (3.27% vs. 3.10%) and Males (2.17% vs. 2.04%) was noticed, p < 0.001. In northeast and south regions of the country and urban hospitals, AD was more among Hispanics (p < 0.001). Hispanic patients were younger (81.8 ± 7.77 vs. 82.6 ± 7.50, p < 0.001), had longer LOS (6.41 ± 7.72 vs. 6.08 ± 7.05, p < 0.001), had higher hospital charges ($45,989 vs. $37,688, p < 0.001). Hispanic AD patients had higher disease severity and mortality risk (p < 0.001). However, the inpatient mortality was not different between the Hispanic and non-Hispanics. Multivariate analysis showed that Hispanics had the highest AD prevalence in the inpatient setting (OR, 1.38; 95% CI, 1.37-1.39, p < 0.001). CONCLUSION The prevalence of AD was significantly higher in inpatient Hispanics than non-Hispanics. Hispanic AD patients had a younger age compared with non-Hispanic AD. Disease severity and mortality risks were higher in Hispanics with AD than non-Hispanics with AD. However, no difference was seen in mortality rate during admission in Hispanics vs. non-Hispanics.
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