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Adzrago D, Williams DR, Williams F. Multiple chronic diseases and psychological distress among adults in the United States: the intersectionality of chronic diseases, race/ethnicity, immigration, sex, and insurance coverage. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02730-1. [PMID: 39017703 DOI: 10.1007/s00127-024-02730-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 07/05/2024] [Indexed: 07/18/2024]
Abstract
PURPOSE Psychological distress significantly contributes to the burdens of morbidity and mortality in the United States (U.S.), but our understanding is limited with regards to the risk factors associated with psychological distress. We used nationally representative data to examine (1) the comorbidities of chronic diseases and their risks for psychological distress and (2) the ways in which chronic diseases combine with demographic factors such as sex, race/ethnicity, immigration status, and health insurance coverage to affect the patterning of psychological distress. METHODS We analyzed the 2005-2018 National Health Survey Interview cross-sectional data on U.S. adults aged ≥ 18 years (n = 351,457). We fitted sequential multivariable logistic regression models. RESULTS There was a dose-response relationship between the number of chronic diseases and psychological distress, with increased number of chronic diseases associated with increased psychological distress risk. Females (vs. males) and those without health insurance (vs. insured) were more likely to experience psychological distress. Immigrants (vs. non-immigrants) and racial/ethnic minorities (vs. White individuals) were less likely to experience psychological distress. There were significant interactions between chronic diseases and insurance coverage, immigration status, and race/ethnicity, but the three-way interactions were not statistically significant with psychological distress: chronic disease status vs. immigration status vs. health insurance coverage, and chronic disease vs. race/ethnicity vs. immigration status. CONCLUSION The findings suggest a critical need to consider the complex ways in which chronic diseases and psychosocial factors combine to affect psychological distress and their implications for tailoring mental health screening, initiatives to reduce distress, and prevention strategies for effectively addressing health-related disparities in the general population.
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Affiliation(s)
- David Adzrago
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA.
| | - David R Williams
- Department of Social and Behavioral Sciences, Department of African and African American Studies, Harvard T.H. Chan School of Public Health, Harvard University, Cambridge, MA, USA
| | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA.
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Stimpson JP, Park S, Rivera-González AC, Wilson FA, Ortega AN. Prevalence of Chronic Pain by Immigration Status and Latino Ethnicity. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02056-3. [PMID: 38888880 DOI: 10.1007/s40615-024-02056-3] [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: 03/14/2024] [Revised: 06/12/2024] [Accepted: 06/13/2024] [Indexed: 06/20/2024]
Abstract
OBJECTIVE The goal of this study was to evaluate the Latino paradox and healthy migrant hypotheses by estimating the association between the prevalence of chronic pain, immigration status, and Latino ethnicity. METHODS This cross-sectional study analyzed pooled data from 85,395 adult participants of the 2019-2021 National Health Interview Survey. The dependent variables were any pain and chronic pain in the past 3 months. The independent variables were immigration status (US born, naturalized citizen, non-citizen) and Latino ethnicity. RESULTS Chronic pain was prevalent for nearly a quarter of US born non-Latino adults (24%) and non-citizen non-Latino adults had the lowest prevalence at 8%. In multivariable adjusted models, US born non-Latino immigration status and ethnicity was associated with a higher probability of reporting chronic pain in the last 3 months compared to US born Latino adults (-3.0%; 95% CI = -4.4%, -1.6%), naturalized citizen non-Latino adults (-4.7%; 95% CI = -5.9%, -3.4%), naturalized citizen Latino adults (-6.7%; 95% CI = -8.5%, -4.9%), non-citizen non-Latino adults (-3.1%; 95% CI = -4.7%, -1.5%), and non-citizen Latino adults (-8.9%; 95% CI = -10.8%, -7.0%). CONCLUSION US Born non-Latino adults reported the highest prevalence of chronic pain and non-citizen Latino adults reported the lowest prevalence of chronic pain providing support for the Latino paradox and healthy migrant effect hypotheses.
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Affiliation(s)
- Jim P Stimpson
- Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, USA.
| | - Sungchul Park
- Department of Health Policy and Management, Korea University, Seoul, Republic of Korea
| | - Alexandra C Rivera-González
- Department of Public Health, School of Social Sciences, Humanities and Arts, University of California, Merced, Merced, CA, USA
| | - Fernando A Wilson
- Matheson Center for Health Care Studies, University of Utah, Salt Lake City, UT, USA
| | - Alexander N Ortega
- Thompson School of Social Work and Public Health, University of Hawai'i at Mānoa, Honolulu, HI, USA
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Rada I, Cabieses B. Challenges for the prevention of hypertension among international migrants in Latin America: prioritizing the health of migrants in healthcare systems. Front Public Health 2024; 11:1125090. [PMID: 38274523 PMCID: PMC10809178 DOI: 10.3389/fpubh.2023.1125090] [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] [Received: 12/15/2022] [Accepted: 12/29/2023] [Indexed: 01/27/2024] Open
Abstract
Among the health priorities of international migrants, non-communicable diseases such as hypertension are of major interest due to their increasing prevalence, mainly in low- and middle-income countries. Previous evidence has reported a significant risk of hypertension in international migrants derived from multiple exposures during the migration process and at the destination, such as living conditions, health literacy and access to preventive services. Also, poorer disease control has been found compared to the local population. Considering existing deficiencies in access and use of healthcare services related to hypertension prevention and continuity of care of migrants globally, we aimed to offer a Latin American perspective of the challenges faced by international migrants residing in Latin America in accessing hypertension preventive care from a human rights, equity, and universal primary healthcare approaches. From a health systems perspective, we conducted a scoping review of scientific literature on hypertension prevention and control among international migrants in Latin America and the Caribbean. Based on the findings, we discuss the potential influence of migration and health policies on healthcare systems and individual and structural barriers to healthcare access, including lack of insurance, linguistic barriers, limited intercultural competence, and geographical and financial barriers. From existing evidence related to hypertension, we highlight the particular healthcare needs of migrants and their implications for regional public health goals. This aligns with promoting culturally tailored interventions considering the migration process, lifestyle patterns, structural vulnerabilities, and gender particularities in hypertension prevention, diagnosis, and treatment. We advocate for developing universal, voluntary, and systemic regional screening and disease control initiatives in Latin America for hypertension and other chronic conditions.
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Affiliation(s)
- Isabel Rada
- Centro de Salud Global Intercultural (CeSGI), Facultad de Medicina Clínica Alemana, Facultad de Psicología, Universidad del Desarrollo, Santiago, Chile
- Programa de Doctorado en Ciencias e Innovación en Medicina, Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Baltica Cabieses
- Centro de Salud Global Intercultural (CeSGI), Facultad de Medicina Clínica Alemana, Facultad de Psicología, Universidad del Desarrollo, Santiago, Chile
- Department of Health Sciences, University of York, York, United Kingdom
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Datta BK, Coughlin SS, Majeed B. Inequities in routine preventive care utilization among persons with overweight/obesity in the United States: An analysis of nativity, racial and ethnic identity, and socioeconomic status. DIALOGUES IN HEALTH 2023; 2:100125. [PMID: 37377782 PMCID: PMC10292657 DOI: 10.1016/j.dialog.2023.100125] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 03/06/2023] [Accepted: 03/10/2023] [Indexed: 06/29/2023]
Abstract
Extant literature documented various health disparities among immigrants and racial and ethnically marginalized individuals in the United States. However, health disparities in the intersection of nativity and race are generally less visited. This cross-sectional study assessed utilization of routine preventive care among adults with overweight/obesity at the junction of their nativity, racial/ethnic identity, and socioeconomic status (i.e., income and education). Pooling data on 120,184 adults with overweight/obesity from the 2013-2018 waves of the National Health Interview Survey (NHIS), we estimated modified Poisson regressions with robust standard errors to obtain adjusted prevalence rates of preventive care visit, receiving flu shot, and having blood pressure, cholesterol and blood glucose screened. We found that immigrant adults with overweight/obesity had lower rates of utilization of all five preventive care services. However, these patterns varied by racial and ethnic sub-populations. While White immigrants had comparable rates of cholesterol and blood glucose screening, they had 2.7%, 2.9%, and 14.5% lower rates of preventive care visit, blood pressure screening, and getting a flu shot respectively, compared to native-born Whites. These patterns were similar for Asian immigrants as well. Black immigrants, on the other hand, had comparable rates of getting a flu shot and blood glucose screening, and had 5.2%, 4.9%, and 4.9% lower rates of preventive care visit, blood pressure screening, and cholesterol screening respectively. Lastly, the rates of utilization among Hispanic immigrants were significantly lower (ranging from 9.2% to 20%) than those of their native-born counterparts for all five preventive care services. These rates further varied by education, income, and length of stay in the US, within the racial and ethnic subgroups. Our findings thus suggest a complex relationship between nativity and racial/ethnic identity in relation to preventive care utilization among adults with overweight/obesity.
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Affiliation(s)
- Biplab Kumar Datta
- Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA
- Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Steven S. Coughlin
- Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA
- Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Ban Majeed
- Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA
- Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA
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LeCroy MN, Suss R, Russo RG, Sifuentes S, Beasley JM, Barajas-Gonzalez RG, Chebli P, Foster V, Kwon SC, Trinh-Shevrin C, Yi SS. Looking Across and Within: Immigration as a Unifying Structural Factor Impacting Cardiometabolic Health and Diet. Ethn Dis 2023; 33:130-139. [PMID: 38845741 PMCID: PMC11145733 DOI: 10.18865/ed.33.2-3.130] [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: 06/09/2024] Open
Abstract
Introduction Immigration has been identified as an important social determinant of health (SDH), embodying structures and policies that reinforce positions of poverty, stress, and limited social and economic mobility. In the public health literature with regard to diet, immigration is often characterized as an individual-level process (dietary acculturation) and is largely examined in one racial/ethnic subgroup at a time. For this narrative review, we aim to broaden the research discussion by describing SDH common to the immigrant experience and that may serve as barriers to healthy diets. Methods A narrative review of peer-reviewed quantitative, qualitative, and mixed methods studies on cardiometabolic health disparities, diet, and immigration was conducted. Results Cardiometabolic disease disparities were frequently described by racial/ethnic subgroups instead of country of origin. While cardiovascular disease and obesity risk differed by country of origin, diabetes prevalence was typically higher for immigrant groups vs United States (US)-born individuals. Common barriers to achieving a healthy diet were food insecurity; lack of familiarity with US food procurement practices, food preparation methods, and dietary guidelines; lack of familiarity and distrust of US food processing and storage methods; alternative priorities for food purchasing (eg, freshness, cultural relevance); logistical obstacles (eg, transportation); stress; and ethnic identity maintenance. Conclusions To improve the health of immigrant populations, understanding similarities in cardiometabolic health disparities, diet, and barriers to health across immigrant communities-traversing racial/ethnic subgroups-may serve as a useful framework. This framework can guide research, policy, and public health practices to be more cohesive, generalizable, and meaningfully inclusive.
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Affiliation(s)
- Madison N. LeCroy
- Department of Population Health, Section for Health Equity, NYU Grossman School of Medicine, New York, NY
| | - Rachel Suss
- Department of Population Health, Section for Health Equity, NYU Grossman School of Medicine, New York, NY
| | - Rienna G. Russo
- Department of Population Health, Section for Health Equity, NYU Grossman School of Medicine, New York, NY
| | - Sonia Sifuentes
- Department of Population Health, Section for Health Equity, NYU Grossman School of Medicine, New York, NY
| | - Jeannette M. Beasley
- Department of Nutrition and Food Studies, NYU Steinhardt School of Culture, Education, and Health, New York, NY
- Department of Medicine, NYU Grossman School of Medicine, New York, NY
| | - R. Gabriela Barajas-Gonzalez
- Department of Population Health, Center for Early Childhood Health and Development, NYU Grossman School of Medicine, New York, NY
| | - Perla Chebli
- Department of Population Health, Section for Health Equity, NYU Grossman School of Medicine, New York, NY
| | - Victoria Foster
- Department of Population Health, Section for Health Equity, NYU Grossman School of Medicine, New York, NY
| | - Simona C. Kwon
- Department of Population Health, Section for Health Equity, NYU Grossman School of Medicine, New York, NY
| | - Chau Trinh-Shevrin
- Department of Population Health, Section for Health Equity, NYU Grossman School of Medicine, New York, NY
| | - Stella S. Yi
- Department of Population Health, Section for Health Equity, NYU Grossman School of Medicine, New York, NY
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Ramírez-Olivencia G, Arsuaga M, Torrús D, Belhassen-Garcia M, Rodríguez-Guardado A, Herrero-Mendoza MD, Mateo-Maestre M, Campos-Rivas RP, Membrillo-de Novales FJ. Prevalence of digestive disorders associated with imported Chagas disease (PADChI study): an observational study. Rev Clin Esp 2023; 223:193-201. [PMID: 36842660 DOI: 10.1016/j.rceng.2023.02.008] [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] [Received: 09/12/2022] [Accepted: 01/09/2023] [Indexed: 02/28/2023]
Abstract
BACKGROUND Chagas disease (CD) is a parasitic disease caused by Trypanosoma cruzi, in which up to 10-20% of those affected may suffer digestive disorders. Multiple studies have been carried out on CD in non-endemic countries, mainly related to cardiological involvement. However, digestive disorders have not been analyzed in such depth. The objective of the study was to determine the prevalence of digestive disorders in imported CD at the time of first care. METHODS An observational cross-sectional descriptive analysis of imported CD was performed. Chagasic structural damage and infectious digestive comorbidity were evaluated. The association between Chagasic structural damage and heart disease in Chagas patients was also investigated. RESULTS After reviewing a total of 1,216 medical records, those of 464 patients were selected for analysis. Globally, the prevalence of digestive disorders in imported Chagas was 57.76%, 95% CI (53.25-62.27). The prevalence of comorbidity of infectious diseases was 40.73% CI 95% (36.25-45.22). Colonic abnormalities were found in 84 of 378 barium enema patients. CD-related esophageal abnormalities were present in 63 of 380 patients studied with esophagogram. CONCLUSIONS The prevalence of digestive disorders associated with CD is high, so the presence of infectious diseases (mainly parasitic and H. pylori infection) should be ruled out. It is important to exclude structural involvement in all symptomatic patients, and asymptomatic patients should also be considered and offered.
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Affiliation(s)
- G Ramírez-Olivencia
- Sección de Infecciosas, Hospital Central de la Defensa Gómez Ulla, Madrid, Spain; Servicio de Medicina Interna, Hospital Central de la Defensa Gómez Ulla, Madrid, Spain.
| | - M Arsuaga
- Sección de Infecciosas, Servicio de Medicina Interna, Hospital Universitario La Paz-Carlos III, Madrid, Spain
| | - D Torrús
- Servicio de Medicina Interna, Hospital General Universitario Dr. Balmis de Alicante-Instituto de Investigación Sanitaria y Biomédica de ALICANTE (ISABIAL), Alicante, Spain
| | - M Belhassen-Garcia
- Servicio de Medicina Interna, Hospital Universitario de Salamanca, Salamanca, Spain
| | - A Rodríguez-Guardado
- Área de Gestión Clínica Medicina Interna, Hospital Universitario Central de Asturias, Grupo de Microbiología Traslacional, Instituto de Investigación del Principado de Asturias, Asturias, Spain
| | - M D Herrero-Mendoza
- Servicio de Medicina Interna, Hospital Central de la Defensa Gómez Ulla, Madrid, Spain
| | - M Mateo-Maestre
- Servicio de Microbiología, Hospital Central de la Defensa Gómez Ulla, Madrid, Spain
| | - R P Campos-Rivas
- Servicio de Radiología, Hospital Central de la Defensa Gómez Ulla, Madrid, Spain
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Ramírez-Olivencia G, Arsuaga M, Torrús D, Belhassen-Garcia M, Rodríguez-Guardado A, Herrero-Mendoza M, Mateo-Maestre M, Campos-Rivas R, Membrillo-de Novales F. Prevalencia de alteraciones digestivas asociadas a Chagas importado (estudio PADChI): un estudio observacional. Rev Clin Esp 2023. [DOI: 10.1016/j.rce.2023.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
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Abuse in Patients with Spinal Cord Injury During the COVID-19 Pandemic. ARCHIVES OF NEUROSCIENCE 2022. [DOI: 10.5812/ans.121167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: One of the chronic diseases with various challenges for patients and caregivers is spinal cord injury (SCI). The spread and prevalence of coronavirus disease 2019 (COVID-19) have been an influential risk factor for abuse. Objectives: The aim of this study was to assess the rate of abuse in patients with SCI during the COVID-19 pandemic. Methods: This cross-sectional descriptive study population was all SCI cases in Ilam, Iran. Researcher-made forms and questionnaires with confirmed validity and reliability, including the demographic characteristics, form and perceived abuse researcher-made questionnaire for people with SCI, were used. The perceived abuse questionnaire for patients with SCI was a researcher-made questionnaire designed based on library studies, interviews with patients, and determination of abuse instances. This instrument consists of 20 questions answered as yes (score 1) or no (score 0). After data collection, statistical analyzes were performed using the SPSS software version 16. Results: According to our results, the mean ± SD of the perceived abuse score by caregivers and patients was 8.48 ± 2.31 and 42.45% during the COVID-19 pandemic, respectively. Moreover, the mean ± SD of the age of patients was 62.86 ± 19.15 years, and the patient abuse increased with elevation in age (P = 0, F = 27.42). The possible abuse score was 0 - 20 divided into three categories of low (20, 20.4%), moderate (76, 76.5%), and high (2, 2%). The perceived abuse score was significantly higher among women and patients with a history of more than 10 years of SCI. Abuse prevalence did not have a significant relationship with income and marital status. Regarding age and abuse, our results showed a rise in perceived abuse scores with an increase in age. Conclusions: The present study showed that it is necessary to take measures to prevent abuse in patients with SCI. Moreover, the prevalence of abuse related to COVID-19 in patients with SCI was high. Therefore, preventive actions need to be proposed in this field.
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