Differences in life satisfaction among older community-dwelling Hispanics and non-Hispanic Whites

Resiliency and Barriers to Successful Aging Among Middle-Aged Mexican Immigrants Residing in a Rural Agricultural Community

OBJECTIVES

The Latino population is one of the largest, most diverse, and fastest-growing demographic groups in the United States. Although Latinos enjoy longer life spans and reduced mortality risk relative to non-Hispanic Whites, they have higher rates of chronic health conditions such as diabetes and dementia and live more of their older years with poor health and disability. Such inequities point to the need for this research focused on examining resiliency strategies and barriers to successful aging among various U.S. Latino subgroups.

METHODS

This qualitative study used thematic content analysis to examine resiliency strategies and barriers to successful aging among Mexican immigrant women (n = 40) residing in an underserved agricultural community and entering mid-life (mean = 49 years old).

RESULTS

With regards to barriers to successful aging, 3 themes emerged: (1) stressful lifestyle in the United States compared to the participants' home countries; (2) stress from expectations at home; and (3) stress due to work and the various components around work. The following 4 resiliency strategies emerged: (1) family as a motivation for moving forward in life and focusing on the success of children; (2) having a positive mindset; (3) praying to God for strength to overcome obstacles; and (4) self-care.

DISCUSSION

Despite experiencing barriers to successful aging, participants practice various resiliency strategies to age successfully. Because many of the barriers identified are related to poverty-related stressors, systemic solutions addressing the social determinants of health are needed.

Emotional health and its association with neurocognition in Hispanic and non-Hispanic White people with HIV

OBJECTIVE

Emotional functioning is linked to HIV-associated neurocognitive impairment, yet research on this association among diverse people with HIV (PWH) is scant. We examined emotional health and its association with neurocognition in Hispanic and White PWH.

METHODS

Participants included 107 Hispanic (41% primarily Spanish-speakers; 80% Mexican heritage/origin) and 216 White PWH (Overall age: M = 53.62, SD = 12.19; 86% male; 63% AIDS; 92% on antiretroviral therapy). Emotional health was assessed via the National Institute of Health Toolbox (NIHTB)-Emotion Battery, which yields T-scores for three factor-based summary scores (negative affect, social satisfaction, and psychological well-being) and 13 individual component scales. Neurocognition was measured via demographically adjusted fluid cognition T-scores from the NIHTB-cognition battery.

RESULTS

27%-39% of the sample had problematic socioemotional summary scores. Hispanic PWH showed less loneliness, better social satisfaction, higher meaning and purpose, and better psychological well-being than Whites (ps <.05). Within Hispanics, Spanish-speakers showed better meaning and purpose, higher psychological well-being summary score, less anger hostility, but greater fear affect than English speakers. Only in Whites, worse negative affect (fear affect, perceived stress, and sadness) was associated with worse neurocognition (p <.05); and in both groups, worse social satisfaction (emotional support, friendship, and perceived rejection) was linked with worse neurocognition (p <.05).

CONCLUSION

Adverse emotional health is common among PWH, with subgroups of Hispanics showing relative strengths in some domains. Aspects of emotional health differentially relate to neurocogntition among PWH and cross-culturally. Understanding these varying associations is an important step towards the development of culturally relevant interventions that promote neurocognitive health among Hispanic PWH.

The American Dream: Is Immigration Associated with Life Satisfaction for Latinos of Mexican Descent?

The Latino population is one of the largest immigrant groups in the United States, with the majority being of Mexican descent. Whether immigrating to the US is positive for the well-being of Mexican immigrants and future generations is an important question. We examined how nativity status and quality of life indicators relate to life satisfaction among foreign-born and US-born Mexican descent Latinos living in California. Participants (N = 893) were from the California Quality of Life Survey, a population-based mental health survey of the California population. Multiple regressions examining sociodemographic and indicators of life satisfaction found higher life satisfaction among the foreign-born compared to US-born: (US-born first generation: Wald F = 18.70, p < 0.001; US-born second generation and higher: Wald F = 12.09, p < 0.001), females (Wald F = 7.05, p < 0.01), and individuals reporting more social support (Wald F = 40.20, p < 0.001), absence of frequent distress (Wald F = 41.46, p < 0.001), and better physical health (Wald F = 15.28, p < 0.001). Life satisfaction was lower for US-born Mexicans than for Mexican immigrants. Research, interventions, and policies are needed for mental health equity that address this lack of well-being in US-born Mexican Latinos.

Examining Early Career Pediatrician Characteristics, Sacrifices, and Satisfaction

OBJECTIVE

Explore relationships between pediatrician characteristics, sacrifices made for career, and career and life satisfaction.

METHODS

Surveys of early career pediatricians (ECPs) who recently graduated residency (2016-18), as part of the AAP Pediatrician Life and Career Experience Study (PLACES) were administered in 2019. Logistic regression analyzed association of pediatrician characteristics with personal sacrifices (a lot vs some or no sacrifices) made for one's career and whether career was worth the sacrifices made to become a physician, and association of characteristics and sacrifices with overall career and life satisfaction.

RESULTS

Of 918 ECPs in the cohort, 90% responded to the 2019 survey. Seventy-seven percent agreed their career was worth the sacrifices and 40% reported they made a lot of personal sacrifices for their career. In multivariable analysis, female sex was associated with lower odds of viewing career as worth the sacrifices made [adjusted odds ratio [aOR] 0.45; 95% confidence interval [CI], 0.28-0.71], a higher odds of delaying starting a family [aOR 2.25; CI, 1.32-3.86] and making sacrifices in having children for career [aOR 2.60; CI, 1.48-4.58]. Those in fellowship training also reported making more sacrifices related to having children for their career [aOR 1.73; CI, 1.08-2.78]. ECPs who reported making a lot of sacrifices for their career were less likely to be satisfied with their overall career and life.

CONCLUSIONS

Most ECPs believe their sacrifices to become a pediatrician were worth it. Female pediatricians were less likely to feel personal sacrifices were worth it and reported more sacrifices related to having children.

Factors Associated With High and Low Life Satisfaction 10 Years After Traumatic Brain Injury

OBJECTIVE

To identify correlates of life satisfaction at 10 years after moderate to severe traumatic brain injury (TBI) using an extreme phenotyping approach.

DESIGN

Effect sizes were calculated in this observational cohort study to estimate relationships of 10-year postinjury extremely high, extremely low, and moderate life satisfaction with (1) pre-injury demographics, injury-related factors, and functional characteristics at inpatient rehabilitation admission and discharge; and (2) postinjury demographics and clinical and functional measures at 10 years postinjury.

SETTING

Multicenter longitudinal database study.

PARTICIPANTS

People identified from the National Institute on Disability, Independent Living, and Rehabilitation Research TBI Database with life satisfaction data at 10 years post TBI (N=4800).

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURE

Satisfaction With Life Scale.

RESULTS

Although few pre-injury factors or clinical and functional factors shortly after injury were associated with 10-year life satisfaction groups, the following 10-year postinjury factors were associated with extremely high vs extremely low life satisfaction group membership: greater independent functioning, less disability, more frequent community participation, being employed, and having fewer depressive and anxiety symptoms. Those with extremely high life satisfaction were distinctly different from those with moderate and extremely low satisfaction. Extremely high life satisfaction was underrepresented among non-Hispanic Black persons relative to non-Hispanic White persons. Relationships between life satisfaction and independent functioning, disability, and participation were attenuated among non-Hispanic Black persons.

CONCLUSIONS

Extreme phenotyping analysis complements existing knowledge regarding life satisfaction after moderate to severe TBI and may inform acute and postacute clinical service delivery by comparing extremely high and extremely low life satisfaction subgroups. Findings suggest little association among personal, clinical, and functional characteristics early post TBI and life satisfaction 10 years later. Contemporaneous correlates of extremely high life satisfaction exist at 10 years post TBI, although the positive relationship of these variables to life satisfaction may be attenuated for non-Hispanic Black persons.

Higher religiosity and spirituality are associated with ethnic group membership among middle-aged and older adults living with HIV

Background: HIV is a chronic illness that impacts the lives of more than 1 million people in the United States. As persons living with HIV (PWH) are living longer, it is important to understand the influence that religiosity/spirituality has among middle-aged and older PWH.

Objective: Compare the degree of religiosity/spirituality among middle-aged and older PWH and HIV-negative individuals, and to identify demographic, clinical, and psychosocial factors associated with religiosity/spirituality among PWH.

Method: Baseline data on 122 PWH and 92 HIV-negative individuals (ages 36-65 years; 61.1% Non-Hispanic White) from a longitudinal study were analyzed for the current study. Recruitment occurred through HIV treatment clinics and community organizations in San Diego. Participants completed questionnaires on religiosity, spirituality, and psychosocial functioning. Independent samples t-tests, Pearson correlations, and multiple linear regression analyses were conducted to test the study objective.

Results: No significant differences in religiosity/spirituality were found between PWH and HIV-negative individuals. Demographic and psychosocial variables were unrelated to religiously/spirituality among HIV-negative individuals. Among PWH, multiple linear regression models indicated higher daily spirituality was significantly associated with racial/ethnic minority membership (Hispanic/Latino, African American/Black, or Other), fewer years of estimated duration of HIV, greater social support, and higher grit. Greater engagement in private religious practices was significantly associated with racial/ethnic minority membership and higher social support.

Conclusions: For PWH, being a racial/ethnic minority and having higher social support was associated with greater engagement in religious/spiritual practices. Future longitudinal studies should examine whether religion/spirituality impacts well-being across the lifespan among racial/ethnic minority groups of PWH.

Impact of COVID-19 on life experiences reported by a diverse cohort of older adults with diabetes and obesity

OBJECTIVE

This study aimed to measure the impact of the COVID-19 pandemic on self-reported life experiences in older adults with diabetes and obesity.

METHODS

Participants were surveyed in 2020 regarding negative and positive impacts of the pandemic across domains of personal, social, and physical experiences. A cumulative negative risk index (a count of all reported negative impacts of 46 items) and a positive risk index (5 items) were characterized in relation to age, sex, race/ethnicity, BMI, and multimorbidity.

RESULTS

Response rate was high (2950/3193, 92%), average age was 76 years, 63% were women, and 39% were from underrepresented populations. Women reported more negative impacts than men (6.8 vs. 5.6; p < 0.001 [of 46 items]) as did persons with a greater multimorbidity index (p < 0.001). Participants reporting African American/Black race reported fewer negative impacts than White participants. Women also reported more positive impacts than men (1.9 vs. 1.6; p < 0.001 [of 5 items]).

CONCLUSIONS

Older adults with diabetes and obesity reported more positive impacts of the pandemic than negative impacts, relative to the number of positive (or negative) items presented. Some subgroups experienced greater negative impacts (e.g., for women, a greater multimorbidity index). Efforts to reestablish personal, social, and physical health after the pandemic could target certain groups.

An in-depth comparison of well-being among Latinx and non-Latinx White adults: A cautionary tale

Understanding how to optimize the health and well-being of Latinxs is crucial and will aid in informing actions to address inequities. Latinxs' unique cultural backgrounds and lived experiences could have implications for their well-being, which may differ from other racial/ethnic groups. We compared overall and domain-specific well-being and their socio-demographic correlates among two samples of Latinxs and a sample of non-Latinx Whites. Cross-sectional samples were independently drawn from the Stanford WELL Initiative (n = 217 Latinxs, n = 943 non-Latinx Whites) and the On the Move Trial (n = 238 Latinxs), both recruiting in Northern California. Well-being was assessed using the Stanford WELL scale, a novel multifaceted measure. Propensity score matching and mixed effect regressions were employed to compare well-being between samples. Overall well-being levels did not differ between groups. However, when examining constituent domains of well-being, several differences were found. Both Latinx samples reported experiencing more stress, having worse physical health, and being more religious than did the matched non-Latinx White sample. However, on four other well-being domains, only one of the Latinx samples differed from the non-Latinx White sample. Moreover, the two Latinx samples differed from each other in four out of nine domains examined. When evaluating well-being across racial/ethnic groups, we recommend employing multidimensional measures and multiple samples to promote greater confidence in the conclusions. This approach can better inform future research and the tailoring of public health efforts by furthering our understanding of the nature of group well-being differences. Our methods offer a blueprint for similar studies examining well-being in multi-ethnic groups.

Gendered racial differences and similarities in subjective cognitive decline and life satisfaction: results from a population-based sample

OBJECTIVE

The objectives of this study were to: 1) Determine the association between subjective cognitive decline (SCD) and life satisfaction; and 2) Assess the gendered racial/ethnic disparities in the association between SCD and life satisfaction.

METHOD

Data were obtained from 3,795 participants from the Behavioral Risk Factor Surveillance System survey. SCD was operationalized by "During the past 12 months, have you experienced confusion or memory loss that is happening more often or is getting worse?" Life satisfaction was operationalized by the question "In general how satisfied are you with your life?" Interaction terms of SCD*sex, SCD*race/ethnicity, and SCD*sex*race/ethnicity were used to determine potential effect measure modification. Crude and adjusted linear regression models, controlling for age, education, income and employment, were used to assess the association between SCD and life satisfaction by sex, race, and by gendered racial/ethnic groups: Black women, White women, Hispanic women, Other women; and Black men, White men, Hispanic men and Other men.

RESULTS

SCD was negatively associated with life satisfaction in the overall sample (β: -0.55; 95% CI: -0.66, -0.43). However, the negative associations seen across gender, race/ethnicity, and gendered racial/ethnic groups were statistically similar (p for interaction terms > 0.05). The highest effect estimate was seen for Other men (β: -1.22; 95% CI: -1.37, -1.09).

CONCLUSION

Interventions geared towards improving cognition may improve life satisfaction for all groups, irrespective of gender and/or race/ethnicity. Future research may include longitudinal studies to determine the temporal sequence between SCD and life satisfaction.

Spirituality, satisfaction with life and health-related behavior of older residents of long-term care institutions-a pilot study

Spirituality and satisfaction with life are psychological factors related to health behavior. The aim of the study was to determine whether satisfaction with life acts as a mediator in the relationship between the spirituality of residents of long-term care institutions and their health-related behavior. A total of 102 people aged 60-99 were examined. It was found that satisfaction with life played a mediating role in the relationship between spirituality and health behavior. The study addresses the gap in knowledge regarding institutionalized older adults, exploring the role of spirituality and satisfaction with life on lifestyle in nursing home settings.

Reading the Bible, Stressful Life Events, and Hope: Assessing an Overlooked Coping Resource

Many people rely on religion to deal with the stressors in their lives. The purpose of this study is to examine a religious coping resource that has received relatively little attention-reading the Bible. We evaluated three hypotheses: (1) reading the Bible moderates the relationship between stress and hope; (2) people who read the Bible more often are more likely to rely on benevolent religious reappraisal coping responses; and (3) individuals who rely on benevolent religious reappraisals will be more hopeful about the future. Support was found for all three hypotheses in our analyses.

Expanding the Happiness Paradox: Ethnoracial Disparities in Life Satisfaction Among Older Immigrants in the United States

OBJECTIVE

This study investigated nativity disparities in life satisfaction among ethnoracial groups of older adults in the United States and the factors associated with such disparities.

METHOD

Cross-sectional data from 7,348 respondents aged 60 and older from the 2012/2014 waves of the Health and Retirement Study (HRS) were used to estimate linear regression models.

RESULTS

Older immigrants experienced higher levels of life satisfaction than comparable native-born individuals. This "happiness advantage" was particularly salient for Hispanic immigrants, who reported the highest levels of life satisfaction of all groups included in the study. With increasing education, life satisfaction increased for White and "Other Race" groups, regardless of nativity. However, for both Black groups and native-born Hispanics, higher levels of education were associated with lower life satisfaction.

DISCUSSION

Findings suggest that the "happiness paradox" may not only be a matter of Hispanic ethnicity, but that it may also extend to immigrants from other ethnoracial backgrounds.

Cultural and emotional determinants of cervical cancer screening among older Hispanic women

Older adults are at highest risk of cancer and yet have the lowest rates of cancer screening participation. Older minority adults bear the burden of cancer screening disparities leading to late stage cancer diagnoses. This investigation, utilization data from the 2008 wave of the Health and Retirement study examined the cultural and emotional factors thought to influence cervical cancer screening among older Hispanic women. We utilized logistic regression models to conduct the analyses. Findings indicate that the emotional factors were not significant but the cultural factor, time orientation was a significant predictor for older Hispanics' cervical cancer screening behaviors.

The educational, racial and gender crossovers in life satisfaction: Findings from the longitudinal Health and Retirement Study

OBJECTIVE

To examine variations in life satisfaction by education, gender, and race/ethnicity over a period of eight years among middle-aged and older Americans.

METHODS

Mixed-effects models were used to analyze five waves (2006, 2008, 2010, 2012 and 2014) of longitudinal data from 16,163 participants born 1890-1953 in the U.S. Health and Retirement Study.

RESULTS

Life satisfaction was higher in older adults, and the Great Recession had great impact on life satisfaction. Crossover interactions were found by gender, education, and race/ethnicity. Higher education was associated with higher life satisfaction for both genders, with stronger effects for females. Hispanics had the higher level of life satisfaction than non-Hispanic Whites and African Americans.

DISCUSSION

Longitudinal evidence revealed disparities in life satisfaction. The racial/ethnic differences in the impact of education suggest that the economic and health returns of education vary by social group. Researchers should continue to examine reasons for these disparities.

Psychosocial correlates of cervical cancer screening among older Hispanic women

Early detection through screening can reduce mortality rates of cervical cancer, and yet Hispanic women who have incidence rates higher than their non-Hispanic White counterparts are least likely to participate in cancer screening initiatives. This study utilized data from the 2008 wave of the Health and Retirement Study to investigate the psychosocial correlates associated with older Hispanic women's participation in cervical cancer screening services. Logistic regression models were used. Findings indicated that greater life satisfaction and religiosity were associated with a greater likelihood of participating in cervical cancer screening. Despite ongoing national conversations, evidence indicates there is agreement that underserved women need to be screened, particularly the older Hispanic population.

Another Paradox? The Life Satisfaction of Older Hispanic Immigrants in the United States

Objective: To investigate disparities in life satisfaction among older Hispanic immigrants in the United States relative to their native-born Hispanic and non-Hispanic White counterparts, and to identify factors associated with such disparities. Method: Cross-sectional data from 9,798 individuals age 60 and above from the Health and Retirement Study (HRS) were used to estimate ordinary least squares (OLS) regression models. Results: Hispanic immigrants reported the highest levels of life satisfaction of all groups. Wealthier older adults, who were socially engaged, had social support, and experienced fewer functional limitations and lower exposure to discrimination, were more satisfied with their lives in the overall sample. Interaction effects revealed that although education was associated with greater life satisfaction only among non-Hispanic Whites, co-residing with children was associated with greater life satisfaction only among Hispanics. Discussion: Although older Hispanic immigrants had the least amount of socioeconomic resources of all groups in our study, they were the most satisfied with their lives. Possible explanations and directions for future research are discussed.

Exploring well-being among US Hispanics/Latinos in a church-based institution: a qualitative study

Major theories informing conceptions of psychological well-being draw heavily from Western-centric perspectives, which often neglect culturally bound frameworks. We investigated how U.S. Hispanics/Latinos conceptualize well-being, how psychosocial and behavioral aspects may increase well-being, and how psychosocial stressors may impact positive emotional states. Spanish-speaking Hispanic/Latino adults were recruited from a church in an urban city in the U.S. and invited to participate in focus groups. Two groups of women (n=19) and one group of men (n=8) participated. The importance of harmonious social relationships emerged as a theme with the central family unit as the fundamental force influencing long-lasting emotional well-being. Additional correlates of well-being included: faith/religiosity; physical health; self-love and -esteem; effective/open communication with family and friends; and financial security. Programs aimed at increasing well-being may need to be adapted before administration in Hispanics/Latinos to include a heightened focus on interpersonal factors. Delivery in religious institutions may also be particularly beneficial.