Heterogeneity of Latina/os' acculturative experiences in the National Latino and Asian American Study: a latent profile analysis

Association of Epigenetic Age and Everyday Discrimination With Longitudinal Trajectories of Chronic Health Conditions in Older Adults

We investigated the strength of the association between baseline epigenetic age, everyday discrimination, and trajectories of chronic health conditions (CHCs) across 3 study waves, among adults 50 years of age and older. We used 2016-2020 data from the Health and Retirement Study (HRS). Data for the PhenoAge and DNAm GrimAge second-generation epigenetic clocks were from the 2016 HRS Venous Blood Study. CHC trajectories were constructed using latent class growth curve models. Multinomial logistic regression models assessed the strength of the association between accelerated epigenetic age, everyday discrimination, and the newly constructed CHC trajectories for participants with complete data (n = 2 893). In the fully adjusted model, accelerated PhenoAge (relative risk ratios [RRR] = 2.53, 95% confidence interval [95% CI] = 1.81, 3.55) and DNAm GrimAge (RRR = 2.79, 95% CI = 1.95, 4.00) were associated with classification into the high CHC trajectory class. Racial disparities were evident, with increased risk of classification into the high trajectory class for Black (PhenoAge: RRR = 1.69, 95% CI = 1.07, 2.68) and reduced risk for Hispanic (PhenoAge: RRR = 0.32, 95% CI = 0.16, 0.64; DNAm GrimAge: RRR = 0.34, 95% CI = 0.17, 0.68), relative to White participants. Everyday discrimination was associated with classification into the medium-high (RRR = 1.28, 95% CI = 1.00, 1.64) and high (RRR = 1.52, 95% CI = 1.07, 2.16) trajectory classes in models assessing DNAm GrimAge. More research is needed to better understand the longitudinal health outcomes of accelerated aging and adverse social exposures. Such research may provide insights into vulnerable adults who may need varied welfare supports earlier than the mandated chronological age for access to federal and state resources.

The Relationship Between Latinxs' Acculturative Experiences and Mental and Behavioral Disorder in the National Latino and Asian American Study

Mental and behavioral disorders are among the leading contributors to disability among US-residing Latinxs. When treated as a homogeneous group, important disparities in the prevalence of such disorders among Latinx subgroups (e.g., by ethnic heritage) are obscured. However, Latinxs may also be characterized by their acculturative experiences while living in the USA, such as discrimination, neighborhood context and family conflict. Latent Profile Analysis with distal outcomes was used to estimate differences in psychiatric disorder prevalence across acculturative subgroups. Data from 2,541 Latinx participants (age 18 +) in the National Latino and Asian American Study (NLAAS) were used to estimate differences in the proportion of three categories of DSM-IV disorder: depressive, anxiety and substance use by four latent subgroups of Latinxs based on their acculturative experiences. Latinxs reporting more positive acculturative experiences had the lowest prevalence of all three disorders (14.8%, 13.6% and 7.1%, respectively). Those whose lives were characterized by high levels of family conflict and discrimination combined with low levels of social cohesion and neighborhood safety had the highest disorder prevalence (34.0%, 26.6% and 22.5%; all p < 0.01 compared to positive experiences subgroup). Latinxs with moderate levels of discrimination and conflict, along with those with high conflict and cohesion, were better off as compared to those with high negative experiences and low cohesion. These latent subgroups of Latinxs according to their acculturative experiences hold important implications for identifying high-risk groups for developing a psychiatric disorder. Findings also point to the protective role of family and neighborhood cohesion when facing high levels of adversity, which may inform prevention and intervention efforts.

The differential relationship of common health comorbidities with acculturative experiences in United States Latinxs

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A novel conceptualization of acculturation and related experiences is related to comorbidity.

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Different patterns emerge in the relationship between acculturative experiences and health.

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Toxic stress and social support may play differential roles in the risk for health comorbidities.

Effectiveness of a culturally competent care intervention in reducing disparities in Hispanic live donor kidney transplantation: A hybrid trial

Hispanic patients receive disproportionately fewer living donor kidney transplants (LDKTs) than non-Hispanic Whites (NHWs). The Northwestern Medicine Hispanic Kidney Transplant Program (HKTP), designed to increase Hispanic LDKTs, was evaluated as a nonrandomized, implementation-effectiveness hybrid trial of patients initiating transplant evaluation at two intervention and two similar control sites. Using a mixed method, observational design, we evaluated the fidelity of the HKTP implementation at the two intervention sites. We tested the impact of the HKTP intervention by evaluating the likelihood of receiving LDKT comparing pre-intervention (January 2011-December 2016) and postintervention (January 2017-March 2020), across ethnicity and centers. The HKTP study included 2063 recipients. Intervention Site A exhibited greater implementation fidelity than intervention Site B. For Hispanic recipients at Site A, the likelihood of receiving LDKTs was significantly higher at postintervention compared with pre-intervention (odds ratio [OR] = 3.17 95% confidence interval [1.04, 9.63]), but not at the paired control Site C (OR = 1.02 [0.61, 1.71]). For Hispanic recipients at Site B, the likelihood of receiving an LDKT did not differ between pre- and postintervention (OR = 0.88 [0.40, 1.94]). The LDKT rate was significantly lower for Hispanics at paired control Site D (OR = 0.45 [0.28, 0.90]). The intervention significantly improved LDKT rates for Hispanic patients at the intervention site that implemented the intervention with greater fidelity. Registration: ClinicalTrials.gov registered (retrospectively) on September 7, 2017 (NCT03276390).