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Watowich MM, Arner AM, Wang S, John E, Kahumbu JC, Kinyua P, Lopurudoi A, Lotukoi F, Mwai CM, Muhoya B, Mukoma B, Tam KL, Huat TBTATB, Gurven M, Lim YAL, Martins D, Njeru S, Seong NK, Venkataraman VV, Wallace IJ, Ayroles JF, Kraft TS, Lea AJ. The built environment is more predictive of cardiometabolic health than other aspects of lifestyle in two rapidly transitioning Indigenous populations. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.08.26.24312234. [PMID: 39252903 PMCID: PMC11383452 DOI: 10.1101/2024.08.26.24312234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 09/11/2024]
Abstract
Background Many subsistence-level and Indigenous societies around the world are rapidly experiencing urbanization, nutrition transition, and integration into market-economies, resulting in marked increases in cardiometabolic diseases. Determining the most potent and generalized drivers of changing health is essential for identifying vulnerable communities and creating effective policies to combat increased chronic disease risk across socio-environmental contexts. However, comparative tests of how different lifestyle features affect the health of populations undergoing lifestyle transitions remain rare, and require comparable, integrated anthropological and health data collected in diverse contexts. Methods We developed nine scales to quantify different facets of lifestyle (e.g., urban infrastructure, market-integration, acculturation) in two Indigenous, transitioning subsistence populations currently undergoing rapid change in very different ecological and sociopolitical contexts: Turkana pastoralists of northwest Kenya (n = 3,692) and Orang Asli mixed subsistence groups of Peninsular Malaysia (n = 688). We tested the extent to which these lifestyle scales predicted 16 measures of cardiometabolic health and compared the generalizability of each scale across the two populations. We used factor analysis to decompose comprehensive lifestyle data into salient axes without supervision, sensitivity analyses to understand which components of the multidimensional scales were most important, and sex-stratified analyses to understand how facets of lifestyle variation differentially impacted cardiometabolic health among males and females. Findings Cardiometabolic health was best predicted by measures that quantified urban infrastructure and market-derived material wealth compared to metrics encompassing diet, mobility, or acculturation, and these results were highly consistent across both populations and sexes. Factor analysis results were also highly consistent between the Turkana and Orang Asli and revealed that lifestyle variation decomposes into two distinct axes-the built environment and diet-which change at different paces and have different relationships with health. Interpretation Our analysis of comparable data from Indigenous peoples in East Africa and Southeast Asia revealed a surprising amount of generalizability: in both contexts, measures of local infrastructure and built environment are consistently more predictive of cardiometabolic health than other facets of lifestyle that are seemingly more proximate to health, such as diet. We hypothesize that this is because the built environment impacts unmeasured proximate drivers like physical activity, increased stress, and broader access to market goods, and serves as a proxy for the duration of time that communities have been market-integrated.
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Affiliation(s)
- Marina M Watowich
- Department of Biological Sciences, Vanderbilt University, Nashville, Tennessee, USA
| | - Audrey M Arner
- Department of Biological Sciences, Vanderbilt University, Nashville, Tennessee, USA
| | - Selina Wang
- Department of Biological Sciences, Vanderbilt University, Nashville, Tennessee, USA
| | - Echwa John
- Turkana Health and Genomics Project, Kenya
| | | | - Patricia Kinyua
- Turkana Health and Genomics Project, Kenya
- Kenya Medical Research Institute, Nairobi, Kenya
| | | | | | - Charles M Mwai
- Turkana Health and Genomics Project, Kenya
- Kenya Medical Research Institute, Nairobi, Kenya
- Lewis-Sigler Institute for Integrative Genomics, Princeton University, Princeton, New Jersey, USA
| | - Benjamin Muhoya
- Turkana Health and Genomics Project, Kenya
- Lewis-Sigler Institute for Integrative Genomics, Princeton University, Princeton, New Jersey, USA
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, New Jersey, USA
| | | | - Kar Lye Tam
- Department of Parasitology, Universiti Malaya, Kuala Lumpur, Malaysia
| | | | - Michael Gurven
- Department of Anthropology, University of California Santa Barbara, Santa Barbara, USA
| | - Yvonne A L Lim
- Department of Parasitology, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Dino Martins
- Turkana Health and Genomics Project, Kenya
- Turkana Basin Institute, Stony Brook University, Stony Brook, NY
| | | | - Ng Kee Seong
- Department of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Vivek V Venkataraman
- Department of Anthropology and Archaeology, University of Calgary, Calgary, Alberta, Canada
| | - Ian J Wallace
- Department of Anthropology, University of New Mexico, Albuquerque, New Mexico, USA
| | - Julien F Ayroles
- Lewis-Sigler Institute for Integrative Genomics, Princeton University, Princeton, New Jersey, USA
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, New Jersey, USA
| | - Thomas S Kraft
- Department of Anthropology, University of Utah, Salt Lake City, Utah, USA
| | - Amanda J Lea
- Department of Biological Sciences, Vanderbilt University, Nashville, Tennessee, USA
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Mohamed AFH, Modanloo S. Re-thinking the Concept of Cultural Competency in Nursing Care of Older Adults. Can J Nurs Res 2024:8445621241272673. [PMID: 39129351 DOI: 10.1177/08445621241272673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/13/2024] Open
Abstract
The influx of migrants to Canada has resulted in a shift in the country's demographic landscape. Individuals often interpret and approach health and wellness through the lens of their cultural heritage, which has led to stereotyping behaviors and discriminatory practices, exacerbating the notion of "Othering". Immigrant older adults are likely to experience discrimination in a more dreadful way in the form of societal isolation and marginalization due to the collective systems of power such as ageism, ableism, and racism. This paper results from continuous thought-provoking discussions initiated by the first author (AM) in her doctoral program at the University of Western Ontario for the Philosophy of Nursing Science course, taught and facilitated by the second author (SM). After studying the course materials on "revolutionary science" and reflection on the process of paradigm shift introduced by Thomas Khun and engaging in critical discussions on a range of relevant philosophical concepts such as bio-power, othering, silencing and ignorance, marginalization, oppression, neoliberalism, health equity, and social justice, we have been prompted to rethink the concept of cultural competence in nursing education and healthcare practices, particularly in the context of nursing care of older adults. Therefore, in this paper, we will critique the concept of cultural competency in the context of an anti-racist and anti-oppressive lens and suggest a pivotal response to move towards an inquiry-driven approach based on cultural humility and respect in the nursing care of older adults.
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Affiliation(s)
| | - Shokoufeh Modanloo
- Arthur Labatt Family School of Nursing, University of Western Ontario, London, Ontario, Canada
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Chua KJ, Knorr DA, Jimenez J, Francia A, Rojas V, Garcia JI, Fox M. What Do Your Neighbors Think About You? How Perceived Neighbor Attitudes Toward Latinos Influence Mental Health Among a Pregnant Latina Cohort. J Racial Ethn Health Disparities 2024; 11:2154-2165. [PMID: 37391606 PMCID: PMC10756922 DOI: 10.1007/s40615-023-01684-5] [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: 04/14/2023] [Revised: 06/10/2023] [Accepted: 06/12/2023] [Indexed: 07/02/2023]
Abstract
Latina women living in the USA experience disproportionately higher rates of psychological distress compared to their non-Latina White counterparts. Poor maternal mental health during pregnancy can contribute to intergenerational mental health disparities. Through this pathway, mothers' experiences, environments, and exposures (henceforth "exposures") during pregnancy become biologically embodied and can negatively affect the fetus and life-long developmental trajectories of her child. One of the exposures that can affect mother-offspring dyads is the neighborhood. With the goal of integrating anthropological and sociological theories to explain mental health disparities among pregnant Latina women, we explored how perceptions of neighbor attitudes may influence mental health during pregnancy. We analyzed self-reported responses from 239 pregnant Latina women in Southern California (131 foreign-born, 108 US-born) on their mental health and perceived attitudes of their neighbors using multiple linear regression models. Among foreign-born Latina women, living in neighborhoods with more favorable views of Latinos was associated with lower depression scores (pooled β = - .70, SE = .29, p = .019) and lower pregnancy-related anxiety scores (pooled β = - .11, SE = .05, p = .021), but greater state anxiety scores (pooled β = .09, SE = .04, p = .021). Among US-born women, there were no associations between neighbor attitudes and mental health. Overall, results suggest that social environments are correlated with mental health and that foreign-born and US-born Latinas have varied mental health experiences in the USA. Our findings highlight the importance of improving aspects of neighborhood cohesion as part of maternal-fetal care management.
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Affiliation(s)
- Kristine J Chua
- Department of Anthropology, University of California Los Angeles, 341 Haines Hall, 375 Portola Plaza, Los Angeles, CA, 90095, USA
- California Center for Population Research, University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - Delaney A Knorr
- Department of Anthropology, University of California Los Angeles, 341 Haines Hall, 375 Portola Plaza, Los Angeles, CA, 90095, USA
- California Center for Population Research, University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - Janelly Jimenez
- Department of Anthropology, University of California Los Angeles, 341 Haines Hall, 375 Portola Plaza, Los Angeles, CA, 90095, USA
| | - Arlene Francia
- Department of Anthropology, University of California Los Angeles, 341 Haines Hall, 375 Portola Plaza, Los Angeles, CA, 90095, USA
| | - Valeria Rojas
- Department of Anthropology, University of California Los Angeles, 341 Haines Hall, 375 Portola Plaza, Los Angeles, CA, 90095, USA
| | - Jhoana Infante Garcia
- Department of Anthropology, University of California Los Angeles, 341 Haines Hall, 375 Portola Plaza, Los Angeles, CA, 90095, USA
| | - Molly Fox
- Department of Anthropology, University of California Los Angeles, 341 Haines Hall, 375 Portola Plaza, Los Angeles, CA, 90095, USA.
- California Center for Population Research, University of California Los Angeles, Los Angeles, CA, 90095, USA.
- Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, 90095, USA.
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Campbell RK, Dewage BG, Cordero C, Maldonado LE, Sotres-Alvarez D, Daviglus ML, Argos M. Prevalence and Risk Factors of Iron Deficiency and Anemia in Women of Reproductive Age in the Hispanic Community Health Study/Study of Latinos. Curr Dev Nutr 2024; 8:104419. [PMID: 39224140 PMCID: PMC11367547 DOI: 10.1016/j.cdnut.2024.104419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 07/10/2024] [Accepted: 07/14/2024] [Indexed: 09/04/2024] Open
Abstract
Background Women of reproductive age are at elevated risk of iron deficiency (ID) and anemia; in the United States, those of Hispanic/Latino background are at especially high risk. Causes of ID and anemia and variations in risk within Hispanic/Latino women of reproductive age are not well described. Objectives To characterize ID and anemia and their risk factors/markers in Hispanic/Latina women. Methods Data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) were used. HCHS/SOL enrolled participants in 2008-2011 at 4 sites: Bronx, Chicago, Miami, and San Diego; 5386 were non-pregnant women ages 18-49 y. Primary outcomes were ID (ferritin <30 μg/L) and anemia (hemoglobin <12 g/dL). Predictors were background/heritage, Short Acculturation Scale for Hispanics scores, years lived in the United States, and interview language, diet summarized in the Alternate Healthy Eating Index 2010, sociodemographic covariates, and study site. Main analyses used survey log binomial regressions adjusted for age, site, and smoking. Results Almost half (42%) of participants were of Mexican background, 15% of Cuban background, and <15% each were of Puerto Rican, Dominican, Central American, or South American background. ID prevalence was 34.4% overall but differed by site-background pairings. The lowest and highest prevalence were 26% and 42% among women of Cuban background in Miami and women of Mexican background in Chicago, respectively. Anemia prevalence was 16% and ranged from 8.9% (Central American background/Miami) to 22% (Dominican background/Bronx). Acculturation, sociodemographic, and diet variables examined did not explain observed prevalence differences by site/background. Conclusions Prevalence of ID and anemia were high among HCHS/SOL women and differed by field center and background. These differences highlight the importance of characterizing nutritional risk by background within Hispanic/Latino women.
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Affiliation(s)
- Rebecca K Campbell
- Division of Epidemiology and Biostatistics, University of Illinois Chicago School of Public Health, Chicago, IL, United States
| | - Bhagya Galkissa Dewage
- Division of Environmental and Occupational Health Sciences, University of Illinois Chicago School of Public Health, Chicago, IL, United States
| | - Christina Cordero
- Department of Psychology, University of Miami, Coral Gables, FL, United States
| | - Luis E Maldonado
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, United States
| | - Daniela Sotres-Alvarez
- Department of Biostatistics, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, United States
| | - Martha L Daviglus
- University of Illinois College of Medicine, Chicago, IL, United States
| | - Maria Argos
- Division of Epidemiology and Biostatistics, University of Illinois Chicago School of Public Health, Chicago, IL, United States
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Alatrash M, Alkrisat S. Knowledge, Age, and Perceived Social Barriers Regarding Mammography Screening Among Immigrant Arab Women in the United States: A Predictive and Associative Analysis. J Womens Health (Larchmt) 2024. [PMID: 38979628 DOI: 10.1089/jwh.2023.1167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024] Open
Abstract
Background: Ethnic minority women in the United States continue to experience racial disparities. Immigrant Arab women (IAW) underutilize mammography screening (MS) even compared with other ethnic minorities. This population still has gaps in knowledge regarding breast cancer (BC) and screening methods and encounters social barriers, highlighting the imperative role of the male figure and the family, which hinders screening. Materials and Methods: A cross-sectional design with an exploratory and predictive approach was employed to examine knowledge gaps and perceived social barriers associated with MS and to identify predictive factors of MS among IAW in California. The analysis included 316 women that met the eligibility criteria. Results: Familiarity with MS and awareness of screening recommendations were the specific areas of knowledge significantly associated with mammography uptake (odds ratio [OR] 15.4, 95% confidence interval [CI]: 5.6-40.8, p < 0.001) and (OR 12.07, 95% CI: 7-21, p < 0.001), respectively. Logistic regression revealed three MS predictors, the two knowledge areas and age. Perceived social barriers were significantly associated with age [F (3,312) = 4.684, p = 0.003]. There was a significant difference in social barriers between women in their 40s and those in their 60s (p = 0.002) and between women in their 50s and those in their 60s (p = 0.003), suggesting lower barriers among women in their 60s (M = 14.3). Living status was significantly associated with perceived social barriers [F (1,314) = 8.83, p = 0.003]. Conclusions: This study offered valuable insights for health care professionals, policymakers, and community organizations working to improve BC early detection in immigrant and ethnic women to reduce social disparities and reinforce social justice. Knowledge-deficit areas and social barriers must be analyzed and incorporated in awareness programs to improve screening practices of IAW.
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Affiliation(s)
| | - Sarah Alkrisat
- Alliant International University, Alhambra, California, USA
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Briggs Early K, Valencia SI, Stendell‐Hollis N, Klyve D, Gee DL. Hypertension Prevalence and Related Risk Factors Among Mexican American Adults Are Increasing: National Health and Nutrition Examination Survey 1999 to 2018. J Am Heart Assoc 2024; 13:e030126. [PMID: 38818945 PMCID: PMC11255634 DOI: 10.1161/jaha.123.030126] [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: 04/03/2023] [Accepted: 04/15/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND Acculturation affects hypertension prevalence among Hispanic people, but there have been no recent analyses specifically focused on Mexican American (MA) people. We sought to determine age-adjusted hypertension prevalence, abdominal obesity, and acculturation trends among MA adults and non-Hispanic White adults. METHODS AND RESULTS Data from the NHANES (National Health and Nutrition Examination Survey) were analyzed in 2-year increments to observe trends in hypertension and risk factors (age, sex, body mass index, smoking status, abdominal obesity, waist-to-height ratio (WHtR), education, and income). Acculturation was based on three commonly used measures. The sample included 30 920 adults. Age-adjusted hypertension prevalence is higher in MA adults (52.7%) than White adults (48.3%). Hypertension risk factors-age, obesity prevalence, WHtR, acculturation-all significantly increased among MA adults, while smoking declined. Higher acculturation scores increased hypertension likelihood (odds ratio [OR], 1.44 [95% CI, 0.91-1.97]) for MA adults compared with those with lower acculturation scores. White adults with elevated WHtR >0.5 had a 40% higher risk of hypertension than those with WHtR <0.5, but among MA adults, elevated WHtR did not increase risk for hypertension. There was a significant increase in hypertension prevalence among MA adults from 2003 to 2018 at an average biennial rate of 2.23%. There was no change in hypertension prevalence among White adults from 1999 to 2018. CONCLUSIONS Over 20 years of NHANES, more highly acculturated MA adults were at greater risk for hypertension, despite declines in smoking and controlling for age, sex, obesity status, education, and income. Finding ways to promote more traditional lifestyle and eating habits for MA adults could be a beneficial approach to reducing hypertension risk factors in this population.
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Affiliation(s)
- Kathaleen Briggs Early
- Department of Biomedical SciencesPacific Northwest University of Health SciencesYakimaWAUSA
| | - Sandra I. Valencia
- Department of Health SciencesCentral Washington UniversityEllensburgWAUSA
| | | | - Dominic Klyve
- Department of MathematicsCentral Washington UniversityEllensburgWAUSA
| | - David L. Gee
- Department of Health SciencesCentral Washington UniversityEllensburgWAUSA
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Algarin YA, Jaalouk D, Pulumati A, Nouri K. The Impact of Acculturation on Skin Cancer Risk and Protective Behaviors in Hispanic Populations. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2024; 39:315-324. [PMID: 38393448 DOI: 10.1007/s13187-024-02413-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/12/2024] [Indexed: 02/25/2024]
Abstract
The US Hispanic population faces rising skin cancer risks and poorer clinical outcomes, despite lower incidence rates. Acculturation, adopting elements of the dominant culture, may influence skin cancer attitudes and behaviors among Hispanics. We systematically reviewed PubMed articles from 2000 to 2023. Peer-reviewed English articles that assessed the relationship between acculturation and skin cancer in the Hispanic population were included. Andreeva et al. observed that lower acculturation levels correlated with increased use of shade and protective clothing (P < 0.05). More acculturated Latinos were more likely to use sunscreen, but this association weakened after adjusting for covariates (P > 0.48). Heckman et al. highlighted significant differences in skin cancer concern among Hispanic youth, with less acculturated individuals expressing greater worry (P < 0.05). Coups et al. found that higher acculturation was linked to less sun protective clothing usage and more frequent sunburns. Their subsequent online survey indicated that English-acculturated Hispanics engaged less in protective behaviors. Viola et al. reported that English-acculturated Hispanics perceived greater suntan benefits and had lower perceptions of skin cancer risk, severity, and concerns about photo-aging, along with higher melanoma risk factors, compared to Spanish-acculturated Hispanics. Acculturation influences skin cancer attitudes and behaviors in Hispanics. Tailored interventions based on acculturation levels are essential to reduce skin cancer risk. For example, educating English-acculturated Hispanics about skin cancer risks and prioritizing knowledge dissemination for Spanish-acculturated individuals may be effective approaches. These findings emphasize the need for targeted skin cancer prevention efforts to address disparities among US Hispanics.
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Affiliation(s)
- Yanci A Algarin
- Eastern Virginia Medical School, Norfolk, VA, USA.
- Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA.
| | - Dana Jaalouk
- Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
| | - Anika Pulumati
- University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
- Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
| | - Keyvan Nouri
- Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
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Pabbla A, Agyemang C, van der Heijden G, Duijster D. Association of integration with oral health among Indian migrants living in the Netherlands. PLoS One 2024; 19:e0298768. [PMID: 38451936 PMCID: PMC10919615 DOI: 10.1371/journal.pone.0298768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 01/31/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND Limited data exist about the relationship between acculturation and oral health. Hence, the aim of this study was to assess the association of integration with self-reported oral health, behaviours, and oral healthcare utilization among Indian migrants living in the Netherlands, a cross sectional survey study. METHODS Between February and April 2021, a random sample from Dutch municipalities was obtained for the Indian migrants living in the Netherlands (n = 147). A validated questionnaire was used to collect information on independent variables, namely socio-demographic, integration assessment tool: Immigration Policy Lab (IPL-12) and everyday discrimination scale (EDS). The outcome variables were self-reported oral health, oral health behaviours, and oral healthcare utilization. Multiple regression analysis was used to assess the associations. RESULTS Higher integration among Indian migrants was associated with longer stay in the Netherlands, having a Dutch passport, intention to settle in the Netherlands, and having a permanent residence. After adjusting for covariates such as age, gender, marital status, education, income, occupation, and dental insurance, regression analysis showed that Indians with higher integration had lower odds of reporting their oral health as fair to poor [OR = 0.92(95%CI:0.0.85;0.99)] than the Indians with low integration scores. Also, Indians with higher integration had lower odds of using a manual toothbrush as compared to an electric toothbrush or use of both [OR = 0.86(95%CI:0.76;0.97)]. Highly integrated Indians had lower odds of consuming Indian sweets than lower integrated Indians (OR = 0.91; 95%CI:0.86;0.97). Indians with higher integration had 1.15 times (95% CI:1.03;1.29) higher odds of visiting a Dutch dental professional than visiting a dentist in both places (India and the Netherlands). No significant association was found between discrimination and the three outcome variables. CONCLUSION Integration is positively association with self-reported oral health outcomes among the Indian migrants. Measure to improve integration among Indian migrants may help to promote healthy oral health behaviours and improve their oral health care utilization.
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Affiliation(s)
- Amandeep Pabbla
- Department of Oral Public Health, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Amsterdam, The Netherlands
| | - Charles Agyemang
- Department of Public Health, Academic Medical Centre (AMC), University of Amsterdam, Amsterdam, The Netherlands
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Geert van der Heijden
- Department of Oral Public Health, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Amsterdam, The Netherlands
| | - Denise Duijster
- Department of Oral Public Health, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Amsterdam, The Netherlands
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Bennetter KE, Waage CW, Jenum AK, Vøllestad NK, Robinson HS, Richardsen KR. Cross-Cultural Contact and Norwegian Language Skills Among Ethnic Minority Women in Norway, and Relationship with Physical Activity in Pregnancy and Postpartum: The STORK-Groruddalen Cohort Study. J Immigr Minor Health 2024; 26:63-71. [PMID: 37639042 PMCID: PMC10771598 DOI: 10.1007/s10903-023-01535-9] [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] [Accepted: 08/03/2023] [Indexed: 08/29/2023]
Abstract
There are few studies of the migration context factors and physical activity (PA) level among minority ethnic women in Europe. We investigated the association between migration context factors and moderate to vigorous physical activity (MVPA) among minority ethnic women. Objectively recorded MVPA were obtained from 487 minority ethnic women included in the STORK-Groruddalen Cohort Study at three time points in pregnancy/postpartum. We investigated the associations between (a) contact with ethnic Norwegians and (b) Norwegian language skills and. No associations were observed in pregnancy. Postpartum, women who reported contact with ethnic Norwegians accumulated 17 MVPA min/day (95% CI: -.60, 34.54) more than women with no contact. In complete case analyses, this difference was significant (27 MVPA min/day (95% CI: 8.60, 44.54)). In early postpartum women with contact with ethnic Norwegians seems to be more physically active than women without contact. No associations were observed in pregnancy.
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Affiliation(s)
- Karin Elisabeth Bennetter
- Institute of Health and Society, Department of General Practice, Faculty of Medicine, University of Oslo, Box 1130, 0318, Blindern, Oslo, Norway.
| | - Christin Wiegels Waage
- Institute of Health and Society, Department of General Practice, Faculty of Medicine, University of Oslo, Box 1130, 0318, Blindern, Oslo, Norway
- Institute of Physiotherapy, Faculty of Health Science, Oslo Metropolitan University, Oslo, Norway
| | - Anne Karen Jenum
- Institute of Health and Society, Department of General Practice, Faculty of Medicine, University of Oslo, Box 1130, 0318, Blindern, Oslo, Norway
- General Practice Research Unit (AFE), Department of General Practice, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Nina Køpke Vøllestad
- Institute of Health and Society, Department of Interdisciplinary Health Sciences, University of Oslo, Oslo, Norway
| | - Hilde Stendal Robinson
- Institute of Health and Society, Department of Interdisciplinary Health Sciences, University of Oslo, Oslo, Norway
| | - Kåre Rønn Richardsen
- Institute of Health and Society, Department of General Practice, Faculty of Medicine, University of Oslo, Box 1130, 0318, Blindern, Oslo, Norway
- Institute of Physiotherapy, Faculty of Health Science, Oslo Metropolitan University, Oslo, Norway
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Van Dam L, Diab E, Johnson J. Canadian immigrants' oral health and oral health care providers' cultural competence capacity. CANADIAN JOURNAL OF DENTAL HYGIENE : CJDH = JOURNAL CANADIEN DE L'HYGIENE DENTAIRE : JCHD 2024; 58:34-47. [PMID: 38505317 PMCID: PMC10946319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 08/23/2023] [Accepted: 11/22/2023] [Indexed: 03/21/2024]
Abstract
Background Immigrants to Canada count among the socially disadvantaged groups experiencing higher rates of oral disease. Culturally competent oral health care providers (OHCPs) stand to be allies for immigrant oral health. The literature reveals limited knowledge of practising OHCPs' cultural competency, and little synthesis of the topic has been completed. A scoping review is warranted to identify and map current knowledge of OHCPs' understanding of culturally competent care along with barriers and facilitators to developing capacity. Methods This study was conducted between December 2022 and April 2023 using Arksey and O'Malley's 5-step framework and PRISMA-ScR checklist. Four databases were searched using keywords related to 4 themes: population, provider, oral health, and cultural competence. Peer-reviewed articles published in English in the last 10 years were included. Results Search results yielded 74 articles. Title and abstract review was completed and an author-developed critical appraisal tool was applied. Forty-six (46) articles were subject to full-text review and 14 met eligibility criteria: 7 qualitative and 7 quantitative. Six barriers and six facilitators at individual and systemic levels were identified, affecting oral care for immigrants and providers' ability to work cross-culturally. Discussion Lack of cultural or linguistically appropriate resources, guidance, and structural supports were identified as contributing to low utilization of services and to lack of familiarity between providers and immigrants. Conclusion OHCPs' cultural competency development is required to improve oral health care access and outcomes for diverse populations. Further research is warranted to identify factors impeding OHCPs' capacity to provide culturally sensitive care. Intentional policy development and knowledge mobilization are needed.
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Affiliation(s)
- Lindsay Van Dam
- School of Dental Hygiene, Faculty of Dentistry, Dalhousie University, Halifax, NS, Canada
| | - Elizabet Diab
- School of Dental Hygiene, Faculty of Dentistry, Dalhousie University, Halifax, NS, Canada
| | - Jennifer Johnson
- School of Dental Hygiene, Faculty of Dentistry, Dalhousie University, Halifax, NS, Canada
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Jawad D, Wen LM, Rissel C, Baur L, Mihrshahi S, Taki S. Barriers and enablers to accessing child health resources and services: Findings from qualitative interviews with Arabic and Mongolian immigrant mothers in Australia. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241242674. [PMID: 38561970 PMCID: PMC10989050 DOI: 10.1177/17455057241242674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 01/10/2024] [Accepted: 03/12/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Over the past two decades, there has been an increase of immigrants in Australia. Despite this, the availability of culturally responsive resources and services that cater to their needs remains insufficient. OBJECTIVE The aim of this study was to explore the resources used and trusted by Mongolian- and Arabic-speaking migrant mothers in Australia for child health information and examine how they navigate and overcome challenges they encounter accessing this information. DESIGN Semi-structured telephone interview. METHODS A theory informed semi-structured 60-min telephone interview was conducted in Arabic and Mongolian with 20 Arabic- and 20 Mongolian-speaking migrant mothers of children younger than 2 years or currently pregnant and living in Australia. Data were analysed thematically using the framework method. RESULTS The reliance on digital platforms such as google emerged as a common trend among both groups of mothers when seeking child health information. Notably, there were differences in resources selection, with Mongolian mothers showing a preference for Australian-based websites, while Arabic-speaking mothers tended to opt for culturally familiar resources. There were various barriers that hindered their access to health services and resources, including language barriers, cost, and limited knowledge or familiarity with their existence. Negative encounters with healthcare professionals contributed to a perception among many mothers that they were unhelpful. Both groups of mothers employed a cross-checking approach across multiple websites to verify trustworthiness of information. Acculturation was shown only among the Mongolian-speaking mothers who adapted their cultural practices in line with their country of residence. CONCLUSION The findings of this study highlight the importance of addressing the needs of migrant mothers in accessing child health information. Health professionals, government agencies, and researchers have an opportunity to provide culturally responsive support by fostering a culturally inclusive approach to developing and promoting equitable access to services and resources, ultimately enhancing the wellbeing of migrant families.
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Affiliation(s)
- Danielle Jawad
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
- Health Promotion Unit, Population Health Research and Evaluation Hub, Sydney Local Health District, Camperdown, NSW, Australia
- Centre of Research Excellence in Translating Early Prevention of Obesity in Childhood (EPOCH-Translate CRE), The University of Sydney, Camperdown, NSW, Australia
| | - Li Ming Wen
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
- Health Promotion Unit, Population Health Research and Evaluation Hub, Sydney Local Health District, Camperdown, NSW, Australia
- Centre of Research Excellence in Translating Early Prevention of Obesity in Childhood (EPOCH-Translate CRE), The University of Sydney, Camperdown, NSW, Australia
- Sydney Institute for Women, Children and their Families, Sydney Local Health District, NSW Health, Camperdown, NSW, Australia
| | - Chris Rissel
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
- College of Medicine and Public Health, Rural and Remote Health SA and NT, Flinders University, Darwin, Bedford Park, SA, Australia
| | - Louise Baur
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
- Centre of Research Excellence in Translating Early Prevention of Obesity in Childhood (EPOCH-Translate CRE), The University of Sydney, Camperdown, NSW, Australia
- Specialty of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Camperdown, NSW, Australia
| | - Seema Mihrshahi
- Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Sarah Taki
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
- Health Promotion Unit, Population Health Research and Evaluation Hub, Sydney Local Health District, Camperdown, NSW, Australia
- Centre of Research Excellence in Translating Early Prevention of Obesity in Childhood (EPOCH-Translate CRE), The University of Sydney, Camperdown, NSW, Australia
- Sydney Institute for Women, Children and their Families, Sydney Local Health District, NSW Health, Camperdown, NSW, Australia
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Ryu S, Morey BN, Shi Y, Lee S. Acculturation and self-rated health among Chinese and Korean immigrants aged 49 to 75. Front Public Health 2023; 11:1272428. [PMID: 38179574 PMCID: PMC10766358 DOI: 10.3389/fpubh.2023.1272428] [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: 08/04/2023] [Accepted: 12/04/2023] [Indexed: 01/06/2024] Open
Abstract
Background Given the rapidly growing Asian populations in the U.S. due to immigration, and the aging demographic of Asian immigrants, it is crucial to understand how acculturation shapes health among older adult Asian immigrants. We study the relationship between acculturation and self-rated health (SRH) and moderating roles of age and Asian subgroup. Methods Our cross-sectional study consisted of 200 Chinese and 200 Korean immigrants aged 49-75 living in Baltimore-Washington DC metropolitan area, who were recruited from primary care physicians' clinics in Maryland and Northern Virginia. The participants completed the survey either in-person or by phone in their preferred language. Multidimensional proxies were used to measure acculturation: years living in the U.S. (≥23 years, <23 years), English proficiency (fluently/well, so-so, poorly/not at all), and ethnic identity (very Asian, mostly Asian, bicultural/westernized). SRH was measured using the question "How would you rate your general health?" (excellent/very good/good, fair/poor). Poisson regression models with robust error variance examined associations between acculturation and SRH, accounting for socioeconomic and health insurance factors. Results Speaking English so-so and fluently/well had 0.73 (95% confidence intervals (CI): 0.55-0.97) and 0.51 (95% CI: 0.30-0.87) times the prevalence of having fair or poor SRH compared to speaking English poorly/not at all, respectively. The magnitudes and statistical significance of these associations were stronger among Chinese participants than Korean participants. Moreover, individuals who self-identified as bicultural/westernized had 0.63 times the prevalence of having fair or poor SRH (95% CI: 0.43-0.92) as those who self-identified as very Asian. The association was more pronounced among older participants (≥58) compared to younger participants (<58). Conclusion Further research should identify the possible mechanisms linking acculturation with health to find effective strategies to enhance health among aging Asian immigrant populations.
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Affiliation(s)
- Soomin Ryu
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Brittany N. Morey
- Program in Public Health, Department of Health, Society, and Behavior, University of California, Irvine, Irvine, CA, United States
| | - Yuxi Shi
- Department of Medicine, School of Medicine, University of California, Irvine, Irvine, CA, United States
| | - Sunmin Lee
- Department of Medicine, School of Medicine, University of California, Irvine, Irvine, CA, United States
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Hamid M, Gill J, Okoh P, Yanga N, Gupta V, Zhang JC, Singh N, Matelski J, Boakye P, James CE, Waterman A, Mucsi I. Knowledge About Renal Transplantation Among African, Caribbean, and Black Canadian Patients With Advanced Kidney Failure. Kidney Int Rep 2023; 8:2569-2579. [PMID: 38106596 PMCID: PMC10719606 DOI: 10.1016/j.ekir.2023.09.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 07/31/2023] [Accepted: 09/11/2023] [Indexed: 12/19/2023] Open
Abstract
Introduction Variable transplant-related knowledge may contribute to inequitable access to living donor kidney transplant (LDKT). We compared transplant-related knowledge between African, Caribbean, and Black (ACB) versus White Canadian patients with kidney failure using the Knowledge Assessment of Renal Transplantation (KART) questionnaire. Methods This was a cross-sectional cohort study. Data were collected from a cross-sectional convenience sample of adults with kidney failure in Toronto. Participants also answered an exploratory question about their distrust in the kidney allocation system. Clinical characteristics were abstracted from medical records. The potential contribution of distrust to differences in transplant knowledge was assessed in mediation analysis. Results Among 577 participants (mean [SD] age 57 [14] years, 63% male), 25% were ACB, and 43% were White Canadians. 45% of ACB versus 26% of White participants scored in the lowest tertile of the KART score. The relative risk ratio to be in the lowest tertile for ACB compared to White participants was 2.22 (95% confidence interval [CI]: 1.11, 4.43) after multivariable adjustment. About half of the difference in the knowledge score between ACB versus White patients was mediated by distrust in the kidney allocation system. Conclusion Participants with kidney failure from ACB communities have less transplant-related knowledge compared to White participants. Distrust is potentially contributing to this difference.
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Affiliation(s)
- Marzan Hamid
- Multi-Organ Transplant Program and Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada
- Stanford University School of Medicine, Stanford, California, USA
| | - Jasleen Gill
- Multi-Organ Transplant Program and Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Princess Okoh
- Multi-Organ Transplant Program and Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Nawang Yanga
- Multi-Organ Transplant Program and Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Vardaan Gupta
- Multi-Organ Transplant Program and Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Jing Chen Zhang
- Multi-Organ Transplant Program and Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Navneet Singh
- Multi-Organ Transplant Program and Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - John Matelski
- Biostatistical Research Unit, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Priscilla Boakye
- Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Carl E. James
- Jean Augustine Chair in Education, Community & Diaspora, Faculty of Education, York University, Toronto, Ontario, Canada
| | - Amy Waterman
- Department of Surgery and J.C. Walter Jr. Transplant Center, Houston Methodist Hospital, Houston, Texas, USA
| | - Istvan Mucsi
- Multi-Organ Transplant Program and Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada
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Ronaldson A, de la Torre JA, Broadbent M, Ashworth M, Armstrong D, Bakolis I, Hatch SL, Hotopf M, Dregan A. Ethnic differences in physical and mental multimorbidity in working age adults with a history of depression and/or anxiety. Psychol Med 2023; 53:6212-6222. [PMID: 36420618 PMCID: PMC10520586 DOI: 10.1017/s0033291722003488] [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: 11/05/2021] [Revised: 08/09/2022] [Accepted: 10/17/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND The current study used data from an ethnically diverse population from South London to examine ethnic differences in physical and mental multimorbidity among working age (18-64 years) adults in the context of depression and anxiety. METHOD The study included 44 506 patients who had previously attended Improving Access to Psychological Therapies services in the London Borough of Lambeth. Multinomial logistic regression examined cross-sectional associations between ethnicity with physical and mental multimorbidity. Patterns of multimorbidity were identified using hierarchical cluster analysis. RESULTS Within 44 056 working age adults with a history of depression or anxiety from South London there were notable ethnic differences in physical multimorbidity. Adults of Black Caribbean ethnicity were more likely to have physical multimorbidity [adjusted relative risk ratio (aRRR) = 1.25, 95% confidence interval (CI) 1.15-1.36] compared to adults of White ethnicity. Relative to adults of White ethnicity, adults of Asian ethnicity were more likely to have physical multimorbidity at higher thresholds only (e.g. 4 + conditions; aRRR = 1.53, 95% CI 1.17-2.00). Three physical (atopic, cardiometabolic, mixed) and three mental (alcohol/substance use, common/severe mental illnesses, personality disorder) multimorbidity clusters emerged. Ethnic minority groups with multimorbidity had a higher probability of belonging to the cardiometabolic cluster. CONCLUSION In an ethnically diverse population with a history of common mental health disorders, we found substantial between- and within-ethnicity variation in rates of physical, but not mental, multimorbidity. The findings emphasised the value of more granular definitions of ethnicity when examining the burden of physical and mental multimorbidity.
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Affiliation(s)
- Amy Ronaldson
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Jorge Arias de la Torre
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Institute of Biomedicine (IBIOMED), University of Leon, Leon, Spain
| | - Matthew Broadbent
- NIHR Maudsley Biomedical Research Centre, King's College London, London, UK
| | - Mark Ashworth
- School of Population Health & Environmental Sciences, King's College London, London, UK
| | - David Armstrong
- School of Population Health & Environmental Sciences, King's College London, London, UK
| | - Ioannis Bakolis
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Stephani L. Hatch
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
- ESRC Centre for Society and Mental Health, King's College London, London, UK
| | - Matthew Hotopf
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Alex Dregan
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
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15
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Aqua JK, White K, Johnson DA. A systematic review of acculturation and sleep health among adult immigrants in the United States. Sleep Health 2023; 9:288-305. [PMID: 36849283 PMCID: PMC10293026 DOI: 10.1016/j.sleh.2023.01.007] [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: 06/09/2022] [Revised: 12/21/2022] [Accepted: 01/10/2023] [Indexed: 02/27/2023]
Abstract
The United States (US) has more immigrants than any other country in the world, with an estimated 44 million non-US-born individuals residing in the country as of 2018. Previous studies have linked US acculturation to both positive and negative health outcomes, including sleep. However, the relationship between US acculturation and sleep health is not well understood. This systematic review aims to identify and synthesize scientific studies on acculturation and sleep health among adult immigrants in the US. A systematic search of the literature was performed in PubMed, Ovid MEDLINE, and Web of Science in 2021 and 2022 with no date limiters. Quantitative studies published anytime in a peer-reviewed journal in English among an adult immigrant population with an explicit measure of acculturation and a sleep health dimension, sleep disorder, or daytime sleepiness measure were considered for inclusion. The initial literature search yielded 804 articles for review; after removing duplicates, applying inclusion and exclusion criteria, and searching reference lists, 38 total articles were included. We found consistent evidence that acculturative stress was associated with worse sleep quality/continuity, daytime sleepiness, and sleep disorders. However, we discovered limited consensus on the association of acculturation scales and acculturation proxy measures with sleep. Our review demonstrated that compared to US-born adult populations, there is a high prevalence of adverse sleep health among immigrant populations, and acculturation likely plays an important role in shaping this disparity, particularly through acculturative stress.
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Affiliation(s)
- Jasmine Ko Aqua
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
| | - Kaylin White
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Dayna A Johnson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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Kolossváry E, Farkas K, Karahan O, Golledge J, Schernthaner GH, Karplus T, Bernardo JJ, Marschang S, Abola MT, Heinzmann M, Edmonds M, Catalano M. The importance of socio-economic determinants of health in the care of patients with peripheral artery disease: A narrative review from VAS. Vasc Med 2023; 28:241-253. [PMID: 37154387 PMCID: PMC10265288 DOI: 10.1177/1358863x231169316] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Socio-economic determinants of health (SDoH) include various nonmedical factors in the socio-economic sphere with a potentially significant impact on health outcomes. Their effects manifest through several mediators/moderators (behavioral characteristics, physical environment, psychosocial circumstances, access to care, and biological factors). Various critical covariates (age, gender/sex, race/ethnicity, culture/acculturation, and disability status) also interact. Analyzing the effects of these factors is challenging due to their enormous complexity. Although the significance of SDoH for cardiovascular diseases is well documented, research regarding their impact on peripheral artery disease (PAD) occurrence and care is less well documented. This narrative review explores to what extent SDoH are multifaceted in PAD and how they are associated with its occurrence and care. Additionally, methodological issues that may hamper this effort are addressed. Finally, the most important question, whether this association may contribute to reasonable interventions aimed at SDoH, is analyzed. This endeavor requires attention to the social context, a whole systems approach, multilevel-thinking, and a broader alliance that reaches out to more stakeholders outside the medical sphere. More research is needed to justify the power in this concept to improve PAD-related outcomes like lower extremity amputations. At the present time, some evidence, reasonable consideration, and intuitive reasoning support the implementation of various interventions in SDoH in this field.
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Affiliation(s)
- Endre Kolossváry
- VAS-European Independent Foundation in Angiology/Vascular Medicine
- VAS-International Consortium – International PAD Strategic Network
- Inter-University Research Center on Vascular Disease, Department Biomedical and Clinical Science, University of Milan, Milan, Italy
- Department of Angiology, St Imre University Teaching Hospital, Budapest, Hungary
| | - Katalin Farkas
- VAS-European Independent Foundation in Angiology/Vascular Medicine
- VAS-International Consortium – International PAD Strategic Network
- Inter-University Research Center on Vascular Disease, Department Biomedical and Clinical Science, University of Milan, Milan, Italy
- Department of Angiology, St Imre University Teaching Hospital, Budapest, Hungary
| | - Oguz Karahan
- VAS-European Independent Foundation in Angiology/Vascular Medicine
- VAS-International Consortium – International PAD Strategic Network
- Inter-University Research Center on Vascular Disease, Department Biomedical and Clinical Science, University of Milan, Milan, Italy
- Department of Cardiovascular Surgery, Medical School of Alaaddin Keykubat University, Alanya/Antalya, Diyarbakir, Turkey
| | - Jonathan Golledge
- VAS-European Independent Foundation in Angiology/Vascular Medicine
- VAS-International Consortium – International PAD Strategic Network
- Inter-University Research Center on Vascular Disease, Department Biomedical and Clinical Science, University of Milan, Milan, Italy
- James Cook University & Townsville University Hospital, Townsville, QLD, Australia
| | - Gerit-Holger Schernthaner
- VAS-European Independent Foundation in Angiology/Vascular Medicine
- VAS-International Consortium – International PAD Strategic Network
- Inter-University Research Center on Vascular Disease, Department Biomedical and Clinical Science, University of Milan, Milan, Italy
- Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Thomas Karplus
- VAS-European Independent Foundation in Angiology/Vascular Medicine
- VAS-International Consortium – International PAD Strategic Network
- Inter-University Research Center on Vascular Disease, Department Biomedical and Clinical Science, University of Milan, Milan, Italy
- Department of Vascular Medicine, Concord Repatriation General Hospital, Sydney, NSW, Australia
| | - Jonathan James Bernardo
- VAS-European Independent Foundation in Angiology/Vascular Medicine
- VAS-International Consortium – International PAD Strategic Network
- Inter-University Research Center on Vascular Disease, Department Biomedical and Clinical Science, University of Milan, Milan, Italy
- Department of Vascular Medicine, St Luke’s Medical Center, Quezon, NCR, Philippines
| | - Sascha Marschang
- VAS-European Independent Foundation in Angiology/Vascular Medicine
- VAS-International Consortium – International PAD Strategic Network
- Inter-University Research Center on Vascular Disease, Department Biomedical and Clinical Science, University of Milan, Milan, Italy
- Department Managing Committee, VAS-European Independent Foundation in Angiology/Vascular Medicine, Bruxelles, Belgium
| | - Maria Teresa Abola
- VAS-European Independent Foundation in Angiology/Vascular Medicine
- VAS-International Consortium – International PAD Strategic Network
- Inter-University Research Center on Vascular Disease, Department Biomedical and Clinical Science, University of Milan, Milan, Italy
- University of the Philippines College of Medicine–Philippine, Philippine Heart Center, Quezon, Philippines
| | - Monica Heinzmann
- VAS-European Independent Foundation in Angiology/Vascular Medicine
- VAS-International Consortium – International PAD Strategic Network
- Inter-University Research Center on Vascular Disease, Department Biomedical and Clinical Science, University of Milan, Milan, Italy
- Angiology Unit, Allende Sanatorium, Nueva, Cordóba, Argentina
| | - Michael Edmonds
- VAS-European Independent Foundation in Angiology/Vascular Medicine
- VAS-International Consortium – International PAD Strategic Network
- Inter-University Research Center on Vascular Disease, Department Biomedical and Clinical Science, University of Milan, Milan, Italy
- King’s College Hospital, Diabetic Foot Clinic, London, UK
| | - Mariella Catalano
- VAS-European Independent Foundation in Angiology/Vascular Medicine
- VAS-International Consortium – International PAD Strategic Network
- Inter-University Research Center on Vascular Disease, Department Biomedical and Clinical Science, University of Milan, Milan, Italy
- Department of Biomedical and Clinical Sciences L Sacco Hospital, Inter-University Research Center on Vascular Disease, University of Milan, Milan, Italy
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Rengifo-Reina H, Barrientos-Gutiérrez T, López-Olmedo N, Sánchez BN, Diez Roux AV. Frailty in Older Adults and Internal and Forced Migration in Urban Neighborhood Contexts in Colombia. Int J Public Health 2023; 68:1605379. [PMID: 37215649 PMCID: PMC10196000 DOI: 10.3389/ijph.2023.1605379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 04/20/2023] [Indexed: 05/24/2023] Open
Abstract
Objective: We investigated the association between the density of internal human migration, in the urban neighborhood, on frailty in the older adult population in Colombia. Methods: The data used in this study are from four Colombian population surveys. We analyzed 633 census tracts with a sample of 2,194 adults 60 years and over for frailty (measured using the Fried criteria). We considered the proportion of inhabitants in a census tract with a history of internal migration as the exposure variable considering three temporalities. For contextual forced migration, we identified two types: 5-year, and 1-year. Poisson multivariable regression models with two hierarchical levels (individual and census tracts) were estimated. Results: The prevalence of pre-fragile/frailty was 80.63% [CI 95%: 77.67, 83.28]. The prevalence ratio were significantly higher for the older adults who live in neighborhoods where a higher proportion of internal migrants reside. Conclusion: We conclude that older adults who lived in neighborhoods with a high proportion of internal migrants experience more frailty. Potential explanations are that neighborhoods with high internal migration could experience social (l increase in cultural heterogeneity, in the perception of insecurity, violence and physical conditions (pressure on local economies and services, leading elderly residents to compete for neighborhood resources), translated into social stress.
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Affiliation(s)
- Herney Rengifo-Reina
- Center for Population Health Research, National Institute of Public Health (Mexico), Cuernavaca, Mexico
| | | | - Nancy López-Olmedo
- Center for Population Health Research, National Institute of Public Health (Mexico), Cuernavaca, Mexico
| | - Brisa N. Sánchez
- Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, PA, United States
| | - Ana V. Diez Roux
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States
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Olko J, Galbarczyk A, Maryniak J, Krzych-Miłkowska K, Tepec HI, de la Cruz E, Dexter-Sobkowiak E, Jasienska G. The spiral of disadvantage: Ethnolinguistic discrimination, acculturative stress and health in Nahua indigenous communities in Mexico. AMERICAN JOURNAL OF BIOLOGICAL ANTHROPOLOGY 2023. [PMID: 37060286 DOI: 10.1002/ajpa.24745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 02/21/2023] [Accepted: 03/22/2023] [Indexed: 04/16/2023]
Abstract
OBJECTIVES The aim of this study was to test the hypothesis that ethnic and ethnolinguistic discrimination, and Post-Traumatic Stress Disorder (PTSD) related to being Indigenous as well as different aspects of acculturative stress, are associated with poorer health and higher levels of depression among the Nahua Indigenous communities. MATERIALS AND METHODS Our quantitative survey was carried out in four different regions inhabited by the Nahua people in Mexico. Self-rated health and depression, the symptoms of PTSD, two facets of acculturative stress and ethnolinguistic discrimination were assessed by questionnaires. The data were analyzed using binary logistic regression models. RESULTS The symptoms of PTSD and acculturative stress experienced in the workplace were significantly associated with a higher risk of poor self-rated health, adjusted for various socio-demographic characteristics. Acculturative stress, discouragement of language use, language avoidance and ethnolinguistic discrimination were related to a higher risk of depression and PTSD. DISCUSSION Our research implies that ethnic and linguistic discrimination, acculturative stress and the memory of harm linked to being Indigenous reflected in the symptoms of PTSD, are important predictors of poorer health and depression among Nahua groups in Mexico. These adverse effects could be significantly counteracted by effective dealing with stigmatization and discrimination against Indigenous people in Mexico and by replacing strong assimilation pressures with integrational approaches that respect ethnolinguistic diversity and reduce socioeconomic marginalization.
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Affiliation(s)
- Justyna Olko
- Center for Research and Practice in Cultural Continuity, Faculty of "Artes Liberales", University of Warsaw, Warsaw, Poland
| | - Andrzej Galbarczyk
- Department of Environmental Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
- Department of Human Behavior, Ecology and Culture, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - Joanna Maryniak
- Center for Research and Practice in Cultural Continuity, Faculty of "Artes Liberales", University of Warsaw, Warsaw, Poland
| | - Karolina Krzych-Miłkowska
- Department of Environmental Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | | | - Eduardo de la Cruz
- Center for Research and Practice in Cultural Continuity, Faculty of "Artes Liberales", University of Warsaw, Warsaw, Poland
- Instituto de Docencia e Investigación Etnológica de Zacatecas, Zacatecas, Mexico
| | - Elwira Dexter-Sobkowiak
- Center for Research and Practice in Cultural Continuity, Faculty of "Artes Liberales", University of Warsaw, Warsaw, Poland
| | - Grazyna Jasienska
- Department of Environmental Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
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Gonzalez CJ, Copeland M, Shapiro MF, Moody J. Associations of peer generational status on adolescent weight across Hispanic immigrant generations: A social network analysis. Soc Sci Med 2023; 323:115831. [PMID: 36931036 DOI: 10.1016/j.socscimed.2023.115831] [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: 06/21/2022] [Revised: 12/30/2022] [Accepted: 03/06/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND Childhood obesity disproportionately impacts Hispanics in the United States (US), the nation's largest ethnic minority population. However, even among Hispanic children, those born in the US are at increased risk of developing obesity than those not born in the US (i.e. first-generation Hispanics). The objective of this study is to assess whether ethnic and generational differences in the friend networks of Hispanic adolescents moderate the association between immigrant generation and weight. METHODS We analyzed data from first-generation, second-generation, and third-generation Hispanic 12 to 19 year-old participants in Wave 1 of the Longitudinal Study of Adolescent to Adult Health (Add Health). Using multivariable linear regression, we examined the association between generational status and body mass index (BMI), and whether the ethnic and generational composition of friends moderated that association. RESULTS Higher generational status was associated with higher BMI. The ethnic and generational composition of friends was not independently associated with BMI among Hispanic adolescents. However, a social network with a greater proportion of second-generation Hispanics was positively associated with BMI among first-generation Hispanics, and negatively associated with BMI among second-generation Hispanics. CONCLUSIONS The generational status of peers in Hispanic adolescents' social networks, particularly the proportion that are second-generation Hispanic, moderates the positive association between immigrant generation and BMI. Moreover, this moderation effect is different across immigrant generations so that the proportion of second-generation adolescents within a social network is associated with higher BMI in first-generation Hispanic adolescents, but with lower BMI among those who are second-generation. These results were confirmed in sensitivity analyses. Our findings suggest that the generational composition of social networks alters the association between the generational status and weight of Hispanic adolescents, and thus that social factors within those networks may contribute to those associations.
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Affiliation(s)
- Christopher J Gonzalez
- Department of Medicine, Weill Medical College of Cornell University, 525 E 68th St., New York, NY, 10065, USA.
| | - Molly Copeland
- Department of Sociology, Michigan State University, East Lansing, MI, 48824, USA
| | - Martin F Shapiro
- Department of Medicine, Weill Medical College of Cornell University, 525 E 68th St., New York, NY, 10065, USA
| | - James Moody
- Department of Sociology, Duke University, Durham, NC, 27708, USA
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Olmos B, Nava A, Jones EJ. Theory Integration for Examining Health Care Discrimination among Minoritized Older Adults with Chronic Illness. West J Nurs Res 2023; 45:262-271. [PMID: 36254404 DOI: 10.1177/01939459221128123] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Prevalence of chronic illnesses, including type 2 diabetes (T2DM), is increasing disproportionately among Latinx adults in the United States. Health care inequities such as health care discrimination contribute to the disparities in this population. Academic and clinical nurses must address health care discrimination from a strong theoretical framework. In this article, we integrate the minority stress theory and ecosocial theory of disease distribution to offer a whole-person model that identifies the concepts most relevant to Latinx older adults who function at multiple levels of intersectionality. This paper uses T2DM as an exemplar of chronic illness. The integrated model depicts possible pathways of physiological and psychological embodiment of lived experiences of minoritized older persons managing chronic illness who are living in a society deeply embedded with structural racism and oppression. This model may guide future research aimed at elucidating the social and structural determinants that impact health-related outcomes among Latinx older adults.
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Affiliation(s)
- Brenda Olmos
- Fran and Earl Ziegler College of Nursing, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Adrianna Nava
- National Committee for Quality Assurance (NCQA), Washington, DC, USA
| | - Emily J Jones
- Fran and Earl Ziegler College of Nursing, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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21
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Prevalence of musculoskeletal complaints and health-related quality of life in a Maroon and Kalinya Indigenous rural village in Suriname. Qual Life Res 2023:10.1007/s11136-023-03363-8. [PMID: 36823327 DOI: 10.1007/s11136-023-03363-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2023] [Indexed: 02/25/2023]
Abstract
PURPOSE Musculoskeletal complaints (MSCs), a leading contributor to disability worldwide, have a major impact on health-related quality of life (HRQoL). Poor general health related to lifestyle factors such as smoking, alcohol consumption and physical inactivity can lead to a higher risk to suffer MSCs. For minority groups in Suriname such as the Maroons and the Indigenous peoples no research has been conducted regarding prevalence of MSCs, HRQoL and various lifestyle factors. The aims were to determine the prevalence of MSCs and HRQoL in two rural tribal villages in the forested interior of Suriname and to identify various lifestyle factors associated with HRQoL in these communities. METHOD This was a cross-sectional community-based study using the Community Oriented Program for the Control of Rheumatic Diseases stage 1, phase 1 & 2 methodology in Goejaba, a Maroon village and Galibi, an Indigenous rural village. Sociodemographic data, self-reported comorbidities, past MSCs (for longer than seven days), lifestyle factors including smoking, alcohol use, body mass index (BMI) and physical activity (PA), and HRQoL (using the 36-item Short Form Survey (SF-36)) data were gathered among 153 Indigenous individuals in Galibi, and 516 Maroons in Goejaba. Regression models were constructed to explore associations between presence of MSCs, lifestyle factors and HRQoL. RESULTS High prevalence rates for past MSCs were reported in Galibi (72.4%) and Goejaba (58.3%). In both communities, respondents with MSCs reported significantly worse HRQoL than persons without MSCs. MSCs and the presence of comorbidities had a strong negative association with HRQoL, whereas PA positively influenced the physical and mental health domains of the SF-36. Smoking, alcohol use and BMI showed no association with HRQoL. CONCLUSIONS In this first study, a high prevalence for MSCs was reported in an Indigenous and Maroon rural community in Suriname. MSCs and comorbidities had a significant negative impact on HRQoL. PA was associated with higher self-reported HRQoL.
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Hendriks M, Birnberg R. Happiness in the Daily Socio-Cultural Integration Process: A day Reconstruction Study among American Immigrants in Germany. INTERNATIONAL MIGRATION REVIEW 2023. [DOI: 10.1177/01979183221149022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Many immigrants struggle to integrate into host societies, despite the frequent long-term benefits of integration for immigrants and host societies. This article aims to increase understandings of immigrants’ experiences and obstacles in the daily socio-cultural integration process by examining the understudied impact of daily integration behaviors on momentary happiness. The daily experiences of 213 immigrants from the United States in Germany were captured, using a day reconstruction method. Our panel fixed-effects estimates show that immigrants who were not fluent in the host country's majority language generally felt happier when communicating in their mother tongue, as opposed to the majority language. Moreover, interacting with majority group members negatively affected the momentary happiness of less culturally integrated immigrants. By contrast, socio-cultural integration related positively to immigrants’ enduring happiness. Our results suggest that socio-cultural integration is an investment involving short-term costs to happiness, with important daily obstacles being the cost to momentary happiness of speaking the majority language and, to a lesser extent, interacting with majority group members. We argue that integration behaviors’ short-term costs also occur in many other migration contexts. The revealed short-term costs can increase understandings of immigrants’ integration struggles and related outcomes, including segregation and loneliness, and decreasing the costs may improve socio-cultural integration trajectories.
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Affiliation(s)
- Martijn Hendriks
- Erasmus Happiness Economics Research Organisation, Erasmus Universiteit Rotterdam, Rotterdam, Netherlands
| | - Randall Birnberg
- Erasmus Happiness Economics Research Organisation, Erasmus Universiteit Rotterdam, Rotterdam, Netherlands
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Daiy K, Frieson T, Palacio-Londono L, Barnes I, Olmedo S, Aranda P, Cirigliano F, Valeggia C. Body norms, body image, and media in a market-integrating indigenous population in Argentina: A mixed-methods investigation. Am J Hum Biol 2023; 35:e23813. [PMID: 36196909 DOI: 10.1002/ajhb.23813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 08/25/2022] [Accepted: 09/17/2022] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE The aim of this study was to investigate the relationship between media, body norms, and body image among the Qom, a market-integrating indigenous population in Argentina that has historically idealized larger body sizes. METHODS With men and women (n = 87), we measured frequency of media/technology use through a Likert-type questionnaire. Using the Stunkard Figure Rating Scale, we asked participants to select the most healthy and ideal body size for their gender, as well as their own body size. We calculated body dissatisfaction as the difference between ideal and own body size. We conducted semi-structured interviews to describe the role of media in body norms and body image. RESULTS Media exposure was not significantly associated with perceptions of the "healthiest" or most "ideal" body sizes, nor body dissatisfaction. Men and women perceived categorically "middle-range" body sizes as both healthy and ideal, differing from a similar study in 2010, where larger bodies were favored. Interviews revealed that: media is not recognized as affecting body norms and body image, but is conceptually associated with cultural loss (Theme 1); a "dual stigma" of fatness and thinness is perpetuated by peers, family, and healthcare providers (Theme 2); and body acceptance is highly valued (Theme 3). CONCLUSION In this context, while some body norms have changed over time, the impact of media on body norms and image may be secondary to influences from individuals' social networks, and may be occluded by norms favoring body acceptance.
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Affiliation(s)
- Katherine Daiy
- Department of Anthropology, Yale University, New Haven, Connecticut, USA.,Chaco Area Reproductive Ecology Program, Dept. of Anthropology, Yale University, New Haven, Connecticut, USA
| | - Tomeka Frieson
- Department of Anthropology, Yale University, New Haven, Connecticut, USA.,Chaco Area Reproductive Ecology Program, Dept. of Anthropology, Yale University, New Haven, Connecticut, USA.,School of Public Health, Boston University, Boston, Massachusetts, USA
| | | | - Ivana Barnes
- Department of Anthropology, Yale University, New Haven, Connecticut, USA
| | | | | | | | - Claudia Valeggia
- Department of Anthropology, Yale University, New Haven, Connecticut, USA.,Chaco Area Reproductive Ecology Program, Dept. of Anthropology, Yale University, New Haven, Connecticut, USA
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Bai B, Ge Y, Li Z. Psychological study of international doctoral students studying in China: cross-cultural adaptation. CURRENT PSYCHOLOGY 2023. [DOI: 10.1007/s12144-022-04133-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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25
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Jang Y, Kim J, Yoon H, Park NS, Chiriboga DA, Rice E, Kim MT. Older Korean Americans' Perceived Burdensomeness to Their Healthcare Partners: An Egocentric Network Assessment. J Aging Health 2023; 35:62-70. [PMID: 35580996 DOI: 10.1177/08982643221103057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Objectives: The objective is to examine how older Korean Americans' perceived burdensomeness to their healthcare partners is associated with the characteristics of older adult participants (egos) and their healthcare partners (alters). Methods:Surveys of 2150 participants in the Study of Older Korean Americans provided ego data. Participants were also asked to list up to three individuals whom they usually asked for help on health-related matters or healthcare use, which generated 3402 alters. Multilevel modeling was conducted to examine the role of the characteristics of egos and alters, as well as their cross-level interactions. Results: Perceived burdensomeness was negatively associated with English-speaking ability and residence in a low Korean density area. Perceived burden was also lowered when emotional support was received from the alters, and this pattern was pronounced among those with multi-comorbidity. Discussion: By identifying older immigrants prone to the sense of burdensomeness, the study suggests strategies to promote their health and healthcare use.
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Affiliation(s)
- Yuri Jang
- Edward R. Roybal Institute on Aging, Los Angeles, CA, USA.,Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Jangmin Kim
- School of Social Work, 5116Texas State University, San Marcos, TX, USA
| | - Hyunwoo Yoon
- Department of Social Welfare, 65361Kongju National University, Gongju, South Korea
| | - Nan Sook Park
- School of Social Work, 7831University of South Florida, Tampa, FL, USA
| | - David A Chiriboga
- Department of Child and Family Studies, 7831University of South Florida, Tampa, FL, USA
| | - Eric Rice
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Miyong T Kim
- School of Nursing, 7174University of Texas at Austin, Austin, TX, USA
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Pristojkovic Suko I, Holter M, Stolz E, Greimel ER, Freidl W. Acculturation, Adaptation, and Health among Croatian Migrants in Austria and Ireland: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16960. [PMID: 36554841 PMCID: PMC9779160 DOI: 10.3390/ijerph192416960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 12/11/2022] [Accepted: 12/13/2022] [Indexed: 06/17/2023]
Abstract
Since Croatia joined the European Union, majority of the studies on Croatian emigrants have predominantly addressed the reasons for migration and their future predictions. The primary purpose of this study was to investigate the relationship between the sense of coherence, health behavior, acculturation, adaptation, perceived health, and quality of life (QoL) in first-generation Croatian migrants living in Austria and Ireland. Our study is the first study that addresses the perceived health and QoL of Croatian migrants since the last emigration wave in 2013. An online survey was conducted in Austria (n = 112) and Ireland (n = 116) using standardized questionnaires. Multiple linear regression analyses were conducted for emigrated Croats to identify the predictors of perceived health and QoL. The analyses revealed that the sense of coherence and psychological adaptation were the strongest predictors of perceived health and QoL in Austria and Ireland. Furthermore, in the environmental domain of QoL, a higher education, higher net income, life in Austria rather than Ireland, better health behavior, higher sense of coherence, and better psychological and sociocultural adaptation explained 55.9% of the variance. Health policies and programs should use the salutogenic model to improve the health-related quality of life and psychological adaptation of Croatian migrants.
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Affiliation(s)
| | - Magdalena Holter
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, 8036 Graz, Austria
| | - Erwin Stolz
- Institute of Social Medicine and Epidemiology, Medical University of Graz, 8010 Graz, Austria
| | | | - Wolfgang Freidl
- Institute of Social Medicine and Epidemiology, Medical University of Graz, 8010 Graz, Austria
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Cheng Y, Yu Q, Li W, Zuo G. Impact of main residential locations on depressive symptoms among older adults in China: A Blinder-Oaxaca decomposition analysis. Front Public Health 2022; 10:934940. [PMID: 36544787 PMCID: PMC9760731 DOI: 10.3389/fpubh.2022.934940] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 11/15/2022] [Indexed: 12/08/2022] Open
Abstract
Background With the development of urbanization in China, the scale of internal migration and the number of immigrants among older adults are increasing. This requires paying attention to the living conditions and environment of immigrants. Many studies note a gap in the prevalence of depressive symptoms among older adults living in different main residential locations. However, few studies have examined the extent to which main residential locations influence depressive symptoms among older adults. This study aims to quantify the effect of main residential locations on depressive symptoms. Methods For this study, we used data from the 2018 Chinese Longitudinal Health and Longevity Survey and randomly selected 8,210 individuals aged 65 years and older were from the community to determine the effect of main residential locations on depressive symptoms among older adults. We further used the Blinder-Oaxaca decomposition method to quantify the explanatory factors of depressive symptom gaps among older adults and to estimate the relative effect of individual characteristics on depressive symptoms. Results In this study, we noted significant differences in depressive symptoms among older adults in different main residential locations. Rural-urban migrants had higher depressive symptom scores (7.164). According to the Blinder-Oaxaca decomposition analysis, the high proportion of the depressive symptom gap can be explained by years of education, income, and exercise among different main residential locations groups. In addition, in the main parts of the explained differences, the proportions of the limitation of activities of daily living (2.28, 0.46, and -52.11%) showed opposite effects, while their share in different main residential locations groups varied widely. Conclusion Urbanization has resulted in more rural people moving to urban areas in China; Rural-urban migrants have the highest prevalence of depressive symptoms, which needs attention. Thus, there is an urgent need to integrate the health insurance and pension policy for urban and rural residents. This study provides a basis for formulating health policies and promoting the mental health of older adults in China as well as in low- and middle-income countries.
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Affiliation(s)
- Yuqing Cheng
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine Shandong University, Jinan, Shandong, China,NHC Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China
| | - Qiutong Yu
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine Shandong University, Jinan, Shandong, China,NHC Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China
| | - Wei Li
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine Shandong University, Jinan, Shandong, China,NHC Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China
| | - Genyong Zuo
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine Shandong University, Jinan, Shandong, China,NHC Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China,*Correspondence: Genyong Zuo
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Thayer Z, Uwizeye G, McKerracher L. Toolkit article: Approaches to measuring social inequities in health in human biology research. Am J Hum Biol 2022; 34:e23804. [PMID: 36173013 DOI: 10.1002/ajhb.23804] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 08/24/2022] [Accepted: 09/02/2022] [Indexed: 01/25/2023] Open
Abstract
Across populations, human morbidity and mortality risks generally follow clear gradients, with socially-disadvantaged individuals and groups tending to have higher morbidity and mortality at all life stages relative to those more socially advantaged. Anthropologists specialize in understanding the proximate and ultimate factors that shape variation in human biological functioning and health and are therefore well-situated to explore the relationships between social position and health in diverse ecological and cultural contexts. While human biologists have developed sophisticated methods for assessing health using minimally-invasive methods, at a disciplinary level, we have room for conceptual and methodological improvement in how we frame, measure, and analyze the social inequities that might shape health inequities. This toolkit paper elaborates on some steps human biologists should take to enhance the quality of our research on health inequities. Specifically, we address: (1) how to frame unequal health outcomes (i.e., inequalities vs. disparities vs. inequities) and the importance of identifying our conceptual models of how these inequities emerge; (2) how to measure various axes of social inequities across diverse cultural contexts, and (3) approaches to community collaboration and dissemination. We end by discussing (4) future directions in human biology research of health inequities, including understanding the ultimate causes of sensitivity to social inequities and transitioning from research to action.
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Affiliation(s)
- Zaneta Thayer
- Department of Anthropology, Dartmouth College, Hanover, New Hampshire, USA
| | - Glorieuse Uwizeye
- Arthur Labatt School of Nursing, University of Western Ontario, London, Ontario, Canada
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Jagroep W, Cramm JM, Denktaş S, Nieboer AP. Health behaviours and well-being among older adults with a Surinamese migration background in the Netherlands. BMC Public Health 2022; 22:2006. [PMID: 36324120 PMCID: PMC9628019 DOI: 10.1186/s12889-022-14414-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 10/21/2022] [Indexed: 11/05/2022] Open
Abstract
Background This study aims to identify the relationships between health behaviours (healthy diet, physical activity, not smoking and social activity) and well-being among older adults with a Surinamese background. Methods Community-dwelling older adults (≥ 70 years) with a Surinamese background living in Rotterdam, the Netherlands, were identified by the municipal register. A survey study was conducted to assess background information, health behaviours (healthy diet, physical activity, not smoking and social activity) and well-being. Multiple regression analyses were performed to assess the relationships of health behaviours with well-being while controlling for background characteristics. Results Average age of participants was 76.2 (4.9) years, slightly more than half of them were female (54.2%). Almost half of the participants had a low-income level (49.6%). More than half of the participants met the Dutch guidelines of fruit intake (63.0%) and vegetable intake (62.8%). Less than half of the participants met the guidelines of fish intake (40.9%) and physical activity (39.8%). The majority of the participants were non-smokers (87.9%). Most of the participants had daily contact with family/friends (90.9%) and slightly more than half of the participants visited family/friends often (53.6%). Looking at the health behaviours, a positive relationship was found between eating enough fruit (β = .109; p ≤ 0.05) and vegetables (β = .135; p ≤ 0.01), physical activity (β = .164; p ≤ 0.001) and often visiting family/friends (β = .158; p ≤ 0.001) with well-being. Conclusion This study suggests that next to traditional health behaviours also social activity is an essential health behaviour for the well-being of older Surinamese adults. Research about health promotion should expand its focus by including social activity as health behaviour. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14414-z.
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Affiliation(s)
- Warsha Jagroep
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands.
| | - Jane M Cramm
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Semiha Denktaş
- Department of Psychology, Education and Child Studies, Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Anna P Nieboer
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands
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30
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Siddiqui SM. Acculturative stress, everyday racism, and mental health among a community sample of South Asians in Texas. Front Public Health 2022; 10:954105. [PMID: 36353288 PMCID: PMC9638105 DOI: 10.3389/fpubh.2022.954105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 10/06/2022] [Indexed: 01/24/2023] Open
Abstract
South Asian Americans are part of the fastest growing racial/ethnic group in the United States and make up a substantial portion of the U.S. immigrant population. Research on this group has often focused on acculturation, the adoption of different values and behaviors in a new sociocultural environment. While there is evidence to suggest that acculturation (and the stress associated with this process) has a negative effect on the health and well-being of Asian Americans, more recent research has emphasized the need to examine the role of broader social forces-including everyday racism-in impacting mental health. Drawing on the stress process model, this study uses an original survey instrument to investigate the relationships between acculturative stress, anti-Asian racism, and mental health among a community sample of 200 South Asians in Texas. Results from hierarchical multiple regression models indicate that both acculturative stress and everyday racism are strongly linked to higher levels of anxiety-related symptoms and more frequent depressive symptoms. Everyday racism, however, explained variance in these outcomes, well beyond the effect of acculturative stress and other sociodemographic factors. These results underscore the potential benefit and importance of including questions about racism in community health surveys that aim to study health disparities among Asian Americans and highlight the persistence of social issues that U.S. South Asians face.
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Jang Y, Choi EY, Wu B, Dong X, Kim MT. Linguistic Adaptation and Cognitive Function in Older Chinese and Korean Immigrants in the United States: A Cross-Sectional Study. J Aging Health 2022; 34:951-960. [PMID: 35387521 PMCID: PMC9950789 DOI: 10.1177/08982643221083107] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVES To examine the cross-sectional association of linguistic adaptation with cognitive function, as well as its interactions with sociodemographic and health profiles in older Chinese and Korean immigrants in the U.S. METHODS Using harmonized data (N = 5063) from the Population Study of Chinese Elderly (PINE) and the Study of Older Korean Americans (SOKA), we examined between- and within-group differences in the role of linguistic adaptation (English use in older Chinese Americans and English proficiency in older Korean Americans) in cognitive function. RESULTS The positive association between linguistic adaptation and cognitive function was common in both groups. We also found that the relationship was pronounced among subgroups with the underlying linguistic and cognitive vulnerabilities (i.e., the very old, women, those with low education, and newly immigrated individuals). DISCUSSION Findings show the importance of linguistic adaptation in older immigrants' cognitive health and suggest a need for targeted interventions for high-risk groups.
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Affiliation(s)
- Yuri Jang
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Eun Young Choi
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - XinQi Dong
- Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Jersey, NJ, USA
| | - Miyong T. Kim
- School of Nursing, University of Texas at Austin, Austin, TX, USA
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Perrotte J, Shrestha NR, MacPhail DCG, Ximenes MC, Ali YR, Baumann MR. Thinking about drinking: Acculturation and alcohol-related cognitions among college-bound Latinas. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022:1-8. [PMID: 36170460 PMCID: PMC10043051 DOI: 10.1080/07448481.2022.2119858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 07/18/2022] [Accepted: 08/25/2022] [Indexed: 06/16/2023]
Abstract
Objective: This study examined acculturation with positive alcohol expectancies (PAE) and alcohol use intentions among college-bound Latinas using a bidimensional (ie U.S. acculturation/enculturation) and bidomain (ie behaviors/values) acculturation framework. Participants: A total of 298 Latina young adults between 18 and 20 years old were included in this analysis. Methods: Data were collected the summer before participants began college for the first time. We used an online survey to assess acculturation, PAE, and alcohol use expectancies. Results: Path analyses showed that U.S. acculturation values were related to more PAE and alcohol use intentions. U.S. acculturation behaviors were related to more alcohol use intentions, and the pathway was moderated by PAE. There was also an interaction between U.S. acculturation and enculturation behaviors predicting alcohol use intentions. Conclusion: This study sheds light on how acculturating Latina young women think about alcohol use prior to beginning college, which is an opportune window for targeted prevention programs.
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Affiliation(s)
- Jessica Perrotte
- Department of Psychology, Texas State University, San Marcos, United States
| | | | | | - Megan C. Ximenes
- Department of Psychology, Texas State University, San Marcos, United States
| | - Yasmin R. Ali
- Department of Psychology, Texas State University, San Marcos, United States
| | - Michael R. Baumann
- Department of Psychology, University of Texas at San Antonio, San Antonio, United States
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Bai Y, Abulitifu R, Wang D. Impact of an Early Childhood Development Intervention on the Mental Health of Female Caregivers: Evidence from a Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11392. [PMID: 36141665 PMCID: PMC9516973 DOI: 10.3390/ijerph191811392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/26/2022] [Accepted: 09/07/2022] [Indexed: 06/16/2023]
Abstract
Investing in early childhood development is an effective way to enhance human capital accumulation. Caregivers' mental health is one of the most important factors influencing children's development. Previous studies have found that mental health issues in caregivers are widespread all over the world, especially in low- and middle-income countries. In this study, we explored the effects of the "Integrated Program for Early Childhood Development" on the mental health of female caregivers in Southwest China through a randomized intervention trial, with infants aged 5-25 months and their caregivers as the target subjects. The heterogeneity of the effects of different characteristics of the caregivers and the mechanism of the intervention effect were also analyzed. Primary caregivers were provided comprehensive early development interventions for the children in the treatment group via bi-weekly home visiting activities and monthly family group activities. The results showed that the prevalence of depression, anxiety, and stress symptoms among female caregivers in this rural area were 32%, 42%, and 30%, respectively. Whether the child was breastfed, parent's age, parent's education level, primary caregiver type, the ratio of the number of months the mother was at home full time to the child's age, the grandmother's rearing ability, and the family asset index were the factors influencing the mental health of female caregivers. The intervention significantly increased the proportion of depressive symptoms in 28% of the grandmothers. It significantly reduced the anxiety symptoms of daughters-in-law not from the local town, while the social interactions of both local and non-local daughters-in-law were significantly improved.
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Affiliation(s)
- Yu Bai
- School of Economics, Minzu University of China, Beijing 100081, China
- China Institute for Vitalizing Border Areas and Enriching the People, Beijing 100081, China
| | - Reyila Abulitifu
- School of Economics, Minzu University of China, Beijing 100081, China
| | - Dan Wang
- School of Economics, Minzu University of China, Beijing 100081, China
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Roncoroni J, Okun M, Hudson A. Systematic review: sleep health in the US Latinx population. Sleep 2022; 45:zsac092. [PMID: 35460556 DOI: 10.1093/sleep/zsac092] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 04/10/2022] [Indexed: 09/19/2023] Open
Abstract
Sleep disturbances are a common and unmet health problem in Latinx. While Latinx report similar sleep disturbances as non-Hispanic Whites [NHW], Latinx suffer from these disturbances to a greater degree than their NHW counterparts. Sleep disturbances are associated with increased risk of chronic health conditions, which Latinx experience at high rates. Research also points to significant sleep differences within Latinx. Given that Latinx are a rapidly growing population in the United States, sleep disparities between Latinx and NHWs and sleep differences within Latinx warrant further investigation. While research on Latinx sleep is growing, the last narrative review on US Latinx sleep health was published by Loredo and colleagues in 2010. Our narrative review expands on Loredo et al.'s work, adding the literature on Latinx sleep published since 2010 (N = 70). A total of 78 peer-reviewed articles related to young to middle-aged (i.e., 18-65 years) healthy Latinx adult sleep were identified in three databases-PsycInfo, PubMed/Medline, and Web of Science. With the socioecological model as framework, this review (1) summarizes current evidence pertaining to sleep health in healthy, community dwelling, urban Latinx adults; (2) discusses measurement challenges related to investigating Latinx sleep disparities and differences; and (3) discusses potential contributors to Latinx sleep. The prevalence of short sleep duration, long sleep duration, and poor sleep quality is high among Latinx; there are differences by Latinx subgroup. Our review identifies several multi-level influences associated with poor sleep: SES, sexual minority status, racial discrimination, access to care, neighborhood environment, and shift work. N = 250/250.
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Affiliation(s)
- Julia Roncoroni
- Department of Counseling Psychology, University of Denver, Denver, CO, USA
| | - Michele Okun
- Psychology Department University of Colorado, Colorado Springs, CO, USA
| | - Amy Hudson
- Department of Counseling Psychology, University of Denver, Denver, CO, USA
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Moussaoui S, Combes S, Ibanez G, Gautier A, Relyea B, Vignier N. Are immigrants living in France more reluctant to receive vaccines than native-born French citizens? findings from the national health Barometer study. Vaccine 2022; 40:3869-3883. [DOI: 10.1016/j.vaccine.2022.05.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 04/12/2022] [Accepted: 05/14/2022] [Indexed: 01/04/2023]
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Vila-Castelar C, Fox-Fuller JT, Guzmán-Vélez E, Schoemaker D, Quiroz YT. A cultural approach to dementia - insights from US Latino and other minoritized groups. Nat Rev Neurol 2022; 18:307-314. [PMID: 35260817 PMCID: PMC9113534 DOI: 10.1038/s41582-022-00630-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2022] [Indexed: 12/14/2022]
Abstract
Alzheimer disease and related dementias present considerable challenges to health-care and medical systems worldwide. In the USA, older Black and Latino individuals are more likely than older white individuals to have Alzheimer disease and related dementias. In this Perspective, we leverage our experience and expertise with older US Latino groups to review and discuss the need to integrate cultural factors into dementia research and care. We examine the importance of considering the effects of cultural factors on clinical presentation and diagnosis, dementia risk, clinical research and recruitment, and caregiving practices, with a focus on minoritized groups in the USA. We highlight critical gaps in the literature to stimulate future research aimed at improving the prevention and early detection of Alzheimer disease and related dementias and developing novel treatments and interventions across ethnoracially diverse populations. In addition, we briefly discuss some of our own initiatives to promote research and clinical care among Latino populations living in the USA.
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Affiliation(s)
- Clara Vila-Castelar
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Joshua T Fox-Fuller
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Edmarie Guzmán-Vélez
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Dorothee Schoemaker
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Yakeel T Quiroz
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
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A Bridging-Community (ABC) Project: A Community Building Social Participation Intervention Among Resettled Refugees in Boston. JOURNAL OF INTERNATIONAL MIGRATION AND INTEGRATION 2022. [DOI: 10.1007/s12134-021-00908-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AbstractGiven the complexities of displacement and resettlement in the United States (US), few resources have been invested in facilitating social relationships, social integration, and social support for recently resettled refugees. Studies indicate low levels of socialization and thus extreme isolation among refugees, suggesting the need to create additional safety nets that encourage social connectivity (Strang & Quinn, 2019). In partnership with a resettlement agency, university researchers developed a pilot study exploring the feasibility and impact of a social participation intervention for a target group of recently resettled refugees. Research facilitators from the A Bridging-Community (or ABC) Project hosted weekly social events for resettled refugees (N=12). Participants were split into three groups and attended social events either two, four, or six times over a four month period. To assess the experiences of participants in the program, survey data were collected at the beginning and end of the program, and semi-structured qualitative interviews were conducted upon entry into the program and at the conclusion of the study. Findings suggest that the ABC Project helped cultivate new relationships and a sense of belonging among participants, with stronger results observed among participants who met four or six times. The overall effectiveness of the program was rated highly by all participants, indicating a need for additional research about targeted social interventions among groups at risk for social isolation.
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Ogunwole SM, Turkson-Ocran RAN, Boakye E, Creanga AA, Wang X, Bennett WL, Sharma G, Cooper LA, Commodore-Mensah Y. Disparities in cardiometabolic risk profiles and gestational diabetes mellitus by nativity and acculturation: findings from 2016-2017 National Health Interview Survey. BMJ Open Diabetes Res Care 2022; 10:e002329. [PMID: 35168940 PMCID: PMC8852664 DOI: 10.1136/bmjdrc-2021-002329] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 01/19/2022] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Gestational diabetes mellitus (GDM) is a common complication of pregnancy with implications for cardiovascular health. Among reproductive-aged women, less is known about nativity-related disparities in cardiometabolic risk profiles and GDM history. We examined how cardiometabolic risk profiles and GDM history differed by nativity and explored associations between acculturation, cardiometabolic risk profiles and GDM history. RESEARCH DESIGN AND METHODS We analyzed cross-sectional data from the 2016-2017 National Health Interview Survey among reproductive-aged women (18-49 years) who both reported ever being pregnant and answered the question on GDM history. Using multivariable logistic regression, we examined the percentage with GDM history and compared cardiometabolic profiles by nativity status and acculturation (duration of US residence). RESULTS Of 9525 women, 22.5% were foreign-born. Also, 11.7% of foreign-born women had a GDM history vs 9.6% of US-born women. Foreign-born women with ≥10 years US residence had the highest age-standardized percentage with GDM history (11.0%) compared with US-born women (9.2%) and foreign-born women with <10 years US residence (6.7%). US-born women had a higher prevalence of hypertension, current smoking, and alcohol use than foreign-born women. Among foreign-born women, those with ≥10 years US residence had a higher prevalence of hypertension, current smoking, and alcohol use than those with <10 years US residence. In the fully adjusted model, foreign-born women with ≥10 years US residence had higher odds of GDM history than US-born women (OR 1.43; 95% CI 1.17 to 1.76) while foreign-born women with <10 years US residence and US-born women has similar odds of GDM history. CONCLUSIONS Greater duration of US residence may be associated with nativity-related disparities in GDM. Acculturation, including changing health-related behaviors may explain the disparities among foreign-born women and should be further investigated to appropriately target interventions to prevent GDM and future cardiometabolic diseases.
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Affiliation(s)
- S Michelle Ogunwole
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | - Ellen Boakye
- Ciccarone Center for Prevention of Cardiovascular Diseases, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Andreea A Creanga
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Xiaobin Wang
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Wendy L Bennett
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Garima Sharma
- Ciccarone Center for Prevention of Cardiovascular Diseases, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Lisa A Cooper
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Yvonne Commodore-Mensah
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Community-Public Health, Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
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Chapagai S, Martyn-Nemeth P. Sleep Health, Acculturation, and Acculturative Stress in Immigrants in the United States: A Scoping Review. J Transcult Nurs 2022; 33:398-415. [PMID: 35075946 DOI: 10.1177/10436596211072884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
INTRODUCTION Poor sleep health has been widely associated with chronic illnesses, and immigrant populations in the United States do not experience optimal sleep, putting them at increased risk of such illnesses. The purpose of this scoping review was to synthesize published literature on the influence of acculturation and acculturative stress on the sleep health of immigrant populations in the United States. METHOD This scoping review was guided by Arksey and O'Malley's framework and the Preferred Reporting Items for Systematic reviews and Meta-Analyses guideline, and 16 research articles were included in its synthesis of results. RESULTS Findings indicated that immigrants in the United States have poor sleep health and that acculturation and acculturative stress may be major influencing factors. In addition, demographic and socio-contextual factors such as gender, economic status, education, and employment characteristics influenced immigrants' sleep. Race and ethnicity were additional factors influencing sleep, but the limited number of studies in this area precludes determination of which groups are most affected. Chronic stress, depressive symptoms, and language influenced immigrants' sleep health, but mixed results were observed for generational status. DISCUSSION Future sleep studies should include vulnerable and understudied immigrant groups and consider all socio-contextual and psychological factors potentially affecting sleep health. In health settings serving immigrant groups, nurses should emphasize screening for these factors. Also, comparative studies are needed to identify specific factors that may affect sleep health in particular immigrant ethnic groups.
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Phung VH, Asghar DZ, Anitha PS, Siriwardena PAN. The prehospital care experiences and perceptions of ambulance staff and Eastern European patients: An interview study in Lincolnshire, UK. J Migr Health 2022; 6:100133. [PMID: 36148324 PMCID: PMC9486614 DOI: 10.1016/j.jmh.2022.100133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 09/12/2022] [Accepted: 09/12/2022] [Indexed: 11/20/2022] Open
Abstract
Staff and patients challenged the negative media Eastern European stereotypes. Language barriers impacted on how staff delivered prehospital care and how Eastern European patients experienced it. Medical travel complicated how ambulance staff delivered prehospital care but patients used it to overcome perceived shortcomings in the NHS, e.g. waiting times, lack of availability of antibiotics, perceived lack of staff competency, etc. Anxieties about conversing with call handlers was a deterrent to using the ambulance service for patients.
Background EU enlargement after 2004 was a major factor in increasing Eastern European migration to the UK. This population requires access to high quality public services generally, and ambulance services more specifically. To understand how Eastern European migrants use ambulance care, this study explored the perceptions and experiences of ambulance staff and the Eastern European patients themselves. Methods We undertook qualitative semi-structured interviews across Lincolnshire. Purposive and maximum variation sampling ensured that participants were knowledgeable about Eastern European patients’ use of ambulance care and were demographically diverse. Data were analysed using framework analysis. Results There were interviews with 15 ambulance staff and 12 Eastern European patients. A staff interviewee problematised “Health Tourism”, which suggests that migrants deliberately exploit state-funded healthcare. However, most disagreed. Patient interviewees often undertook medical travel to access healthcare in response to perceived healthcare problems in the UK. Medical travel increased the likelihood of ambulance staff encountering foreign medication. Variable quality of, and access to, professional interpreters prompted patients to rely instead on informal interpreters. Patients did not register with GPs perhaps due to limited understanding of how the NHS worked. This led to inappropriate use of ambulance services. Recommendations for service delivery improvements included: Eastern European language information on how and when to use ambulance care; improving GP registration; and greater engagement between the ambulance service and Eastern European communities. Conclusions Frequent medical travel can limit how Eastern Europeans acculturate to the NHS and anchor roots in the UK. Acculturation is about how migrant cultures adjust to the host country. This is not assimilation, where they dilute their cultural identity. Language and communication barriers, as well as inadequate availability and quality of interpreting services, can impede patient-staff dialogue in time-critical emergencies.
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Affiliation(s)
- Viet-Hai Phung
- Community and Health Research Unit (CaHRU), School of Health and Social Care, University of Lincoln, Lincoln, LN6 7TS, UK
- Corresponding author
| | - Dr Zahid Asghar
- Community and Health Research Unit (CaHRU), School of Health and Social Care, University of Lincoln, Lincoln, LN6 7TS, UK
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Montiel Ishino FA, McNab P, Villalobos K, Cohen JH, Nápoles AM, Williams F. Hispanic/Latino Acculturation Profiles and Telomere Length: Latent Class Analysis on a Nationally Representative Sample. Front Public Health 2021; 9:640226. [PMID: 34988044 PMCID: PMC8722469 DOI: 10.3389/fpubh.2021.640226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 11/29/2021] [Indexed: 11/24/2022] Open
Abstract
Background: Acculturation profiles and their impact on telomere length among foreign-born Hispanics/Latinos living in the United States (US) are relatively unknown. The limited research available has linked acculturation with shortened telomere length. Objectives: To identify acculturation profiles among a US representative sample of Hispanics/Latinos and to then examine telomere length differences between profiles. Methods: We conducted a latent class analysis among a non-institutionalized US-representative sample of Hispanics/Latinos using the 1999-2002 National Health and Nutrition Examination Survey (N = 2,292). The latent variable of acculturation was assessed by length of time in the US and language used as a child, read and spoken, usually spoken at home, used to think, and used with friends (i.e., Spanish and/or English). Telomere length assessed from leukocytes was used as the distal continuous outcome. Results: We identified five profiles: (1) low acculturated [33.2% of sample]; (2) partially integrated [18.6% of sample]; (3) integrated [19.4% of sample]; (4) partially assimilated [15.1% of sample]; and (5) assimilated [13.7% of sample]. Acculturation profiles revealed nuanced differences in conditional probabilities with language use despite the length of time spent in the US. While telomere length did vary, there were no significant differences between profiles. Conclusion: Profiles identified revealed that possible life-course and generational effects may be at play in the partially assimilated and assimilated profiles. Our findings expand public health research using complex survey data to identify and assess the dynamic relationship of acculturation profiles and health biomarkers, while being among the first to examine this context using a person-centered approach.
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Affiliation(s)
- Francisco Alejandro Montiel Ishino
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, United States
| | - Philip McNab
- Department of Environmental Health & Engineering, Center for a Livable Future, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Kevin Villalobos
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, United States
| | - Jeffrey H. Cohen
- Department of Anthropology, The Ohio State University, Columbus, OH, United States
| | - Anna M. Nápoles
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, United States
| | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, United States
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Fox M. Discrimination as a Moderator of the Effects of Acculturation and Cultural Values on Mental Health Among Pregnant and Postpartum Latina Women. AMERICAN ANTHROPOLOGIST 2021; 123:780-804. [PMID: 36776224 PMCID: PMC9909989 DOI: 10.1111/aman.13665] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 12/23/2020] [Indexed: 11/30/2022]
Abstract
It is important to consider how identity, culture, and social adversity influence maternal mental health among Latina women both because this community faces unique cultural stressors and also because factors that undermine women's mental health during pregnancy and postpartum could have injurious consequences that cascade across generations. This study uses data from a questionnaire administered to Latina pregnant and postpartum women in Southern California, examining cultural orientation, discrimination, and mental health. Results demonstrate mental health benefits for both American and Latino cultural orientations, but the latter's benefit of lower anxiety was only apparent with high discrimination. American and Latino cultural values systems had opposite relationships with depression, with the latter protective and also positively associated with happiness. More traditional gender roles values were associated with greater perceived stress and lower happiness. Different aspects of familism had opposite effects as obligation was associated with less anxiety and referent (defining oneself communally with kin) with more. Results suggest that social adversity and cultural identity and values influence maternal psychology. This study makes a unique contribution by integrating anthropological and biopsychosocial methods and theories towards addressing an issue of public-health importance.
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Affiliation(s)
- Molly Fox
- Departments of Anthropology and Psychiatry & Biobehavioral Sciences, UCLA, Los Angeles, CA 90095, USA
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Sanjeevi N. Mediation of the Relationship of Acculturation With Glycemic Control in Asian Americans With Diabetes. Am J Health Promot 2021; 36:279-287. [PMID: 34787493 DOI: 10.1177/08901171211052562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To assess the role of physical activity and healthcare access in mediating the association of acculturation with cardiometabolic health in Asian American adults with diabetes. DESIGN Cross-sectional study. SETTING National Health and Nutrition Examination Survey (NHANES) 2011-2018. SUBJECTS Non-pregnant Asian American adults with doctor diagnosed diabetes. MEASURES Participants were classified into low, moderate, and high acculturation status. Self-reported leisure-time, work, and transportation-based physical activity were summed for overall physical activity. Health insurance, frequency of healthcare receipt, and glycohemoglobin (HbA1c) check in the past year indicated healthcare access. Cardiometabolic health indicators included HbA1c, total and high density lipoprotein-cholesterol, and systolic and diastolic blood pressure. ANALYSIS Linear and logistic regression estimates, standardized using y-standardization, and assessed mediation of acculturation with cardiometabolic health. RESULTS Low acculturation was significantly related to greater leisure-time inactivity odds [OR (95% CI) = 2.25 (1.05, 4.82)], overall insufficient activity [OR (95% CI) = 2.30 (1.12, 4.74)], and uninsured status [OR (95% CI) = 5.62 (1.55, 20.41)]. Asian Americans with low acculturation had significantly higher log HbA1c than those with high acculturation (β ± SE = .078 ± .038); however, this association was not significant after adjusting for leisure-time activity. Leisure-time activity mediated 48.9% of acculturation and HbA1c association, and the indirect effect was statistically significant [estimate (95% CI) = .021 (.002, 0.047)]. CONCLUSIONS Results suggest that promoting sufficient leisure-time activity could improve glycemic control in least acculturated Asian Americans with diabetes.
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Affiliation(s)
- Namrata Sanjeevi
- Department of Nutritional Sciences, College of Natural Sciences, 12330The University of Texas at Austin, Austin, TX, USA
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Ortega AN, Bustamante AV, Roby DH. New Directions for Public Health Research on the Health and Health Care of Undocumented Immigrants. Am J Public Health 2021; 111:1910-1912. [PMID: 34678052 PMCID: PMC8607342 DOI: 10.2105/ajph.2021.306506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Alexander N Ortega
- Alexander N. Ortega is with the Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, PA. Arturo Vargas Bustamante is with the Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles. Dylan H. Roby is with the Department of Health Policy and Management, School of Public Health, University of Maryland, College Park
| | - Arturo Vargas Bustamante
- Alexander N. Ortega is with the Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, PA. Arturo Vargas Bustamante is with the Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles. Dylan H. Roby is with the Department of Health Policy and Management, School of Public Health, University of Maryland, College Park
| | - Dylan H Roby
- Alexander N. Ortega is with the Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, PA. Arturo Vargas Bustamante is with the Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles. Dylan H. Roby is with the Department of Health Policy and Management, School of Public Health, University of Maryland, College Park
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Acculturation and biological stress markers: A systematic review. Psychoneuroendocrinology 2021; 132:105349. [PMID: 34246155 PMCID: PMC8527572 DOI: 10.1016/j.psyneuen.2021.105349] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 06/25/2021] [Accepted: 06/27/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND The association of acculturation with health among immigrant populations is believed to be mediated, in part, by acculturation-related stress and stress biology. OBJECTIVES To review and qualitatively synthesize empirical findings on the relationship of acculturation with stress-related inflammatory and endocrine biomarkers and composite allostatic load (AL) scores. METHODS A literature search was performed in the PubMed and PsycInfo databases. Article titles, abstracts or full-texts were screened and checked for match with the search criteria. Studies were eligible if they empirically tested the relationship between acculturation and inflammatory/endocrine stress biomarkers or composite AL scores, and were published in the English language. RESULTS Among the 41 articles identified as relevant and included in this review, the majority were published after 2010, included adult Hispanic U.S.-based populations, used cross-sectional study designs, operationalized acculturation as a unidimensional construct, and varied considerably in the selection of covariates in the analyses. Acculturation was significantly associated with stress biomarkers in 29 studies, but the direction of effects varied across studies. Specifically, acculturation, operationalized as a higher orientation towards the host culture, was associated with inflammatory biomarkers in 10 of 14 studies, with endocrine stress biomarkers in 12 of 20 studies, and with composite AL scores in 7 of 8 studies. Overall, language-based proxy measures of acculturation were related to higher levels of stress-related inflammatory and endocrine biomarkers and to lower levels of AL scores, whereas nativity-, generation status- and length of stay-based proxy measures of acculturation were related to higher levels of inflammatory biomarkers and AL score. DISCUSSION The majority of studies reported associations between measures of acculturation and stress biomarkers, however the directions of effects varied across studies. We suggest this heterogeneity may, in part, be a function of limitations imposed by cross-sectional research designs and unidimensional measures of acculturation measures, and we highlight the need for longitudinal studies and use of multidimensional measures of acculturation to better uncover the biobehavioral mechanisms and pathways linking acculturation with health outcomes.
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Bouilly R, Gatica-Domínguez G, Mesenburg M, Cáceres Ureña FI, Leventhal DGP, Barros AJD, Victora CG, Wehrmeister FC. [Maternal and child health inequalities among migrants: the case of Haiti and the Dominican RepublicDesigualdades na saúde materno-infantil entre migrantes: o caso do Haiti e da República Dominicana]. Rev Panam Salud Publica 2021; 45:e100. [PMID: 34539764 PMCID: PMC8442708 DOI: 10.26633/rpsp.2021.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 10/19/2020] [Indexed: 11/24/2022] Open
Abstract
Objective To assess coverage and inequalities in maternal and child health interventions among Haitians, Haitian migrants in the Dominican Republic and Dominicans. Methods Cross-sectional study using data from nationally representative surveys carried out in Haiti in 2012 and in the Dominican Republic in 2014. Nine indicators were compared: demand for family planning satisfied with modern methods, antenatal care, delivery care (skilled birth attendance), child vaccination (BCG, measles and DPT3), child case management (oral rehydration salts for diarrhea and careseeking for suspected pneumonia), and the composite coverage index. Wealth was measured through an asset-based index, divided into tertiles, and place of residence (urban or rural) was established according to the country definition. Results Haitians showed the lowest coverage for demand for family planning satisfied with modern methods (44.2%), antenatal care (65.3%), skilled birth attendance (39.5%) and careseeking for suspected pneumonia (37.9%), and the highest for oral rehydration salts for diarrhea (52.9%), whereas Haitian migrants had the lowest coverage in DPT3 (44.1%) and oral rehydration salts for diarrhea (38%) and the highest in careseeking for suspected pneumonia (80.7%). Dominicans presented the highest coverage for most indicators, except oral rehydration salts for diarrhea and careseeking for suspected pneumonia. The composite coverage index was 79.2% for Dominicans, 69.0% for Haitian migrants, and 52.6% for Haitians. Socioeconomic inequalities generally had pro-rich and pro-urban pattern in all analyzed groups. Conclusion Haitian migrants presented higher coverage than Haitians, but lower than Dominicans. Both countries should plan actions and policies to increase coverage and address inequalities of maternal health interventions.
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Affiliation(s)
- Roberta Bouilly
- Universidad Federal de Pelotas Pelotas Brasil Universidad Federal de Pelotas, Pelotas, Brasil
| | | | - Marilia Mesenburg
- Universidad Federal de Pelotas Pelotas Brasil Universidad Federal de Pelotas, Pelotas, Brasil.,Universidad Federal de Ciencias de la Salud Porto Alegre Brasil Universidad Federal de Ciencias de la Salud, Porto Alegre, Brasil
| | - Francisco I Cáceres Ureña
- Universidad Autónoma de Santo Domingo Santo Domingo República Dominicana Universidad Autónoma de Santo Domingo, Santo Domingo, República Dominicana.,Oficina Nacional de Estadística Santo Domingo República Dominicana Oficina Nacional de Estadística, Santo Domingo, República Dominicana
| | - Daniel G P Leventhal
- Universidad Federal de Pelotas Pelotas Brasil Universidad Federal de Pelotas, Pelotas, Brasil
| | - Aluísio J D Barros
- Universidad Federal de Pelotas Pelotas Brasil Universidad Federal de Pelotas, Pelotas, Brasil
| | - Cesar G Victora
- Universidad Federal de Pelotas Pelotas Brasil Universidad Federal de Pelotas, Pelotas, Brasil
| | - Fernando C Wehrmeister
- Universidad Federal de Pelotas Pelotas Brasil Universidad Federal de Pelotas, Pelotas, Brasil
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Premkumar A, Yee LM, Benes L, Miller ES. Social Vulnerability among Foreign-Born Pregnant Women and Maternal Virologic Control of HIV. Am J Perinatol 2021; 38:753-758. [PMID: 33368072 DOI: 10.1055/s-0040-1721714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The aim of this study was to assess whether social vulnerability among foreign-born pregnant women living with HIV is associated with maternal viremia during pregnancy. STUDY DESIGN This retrospective cohort study included all foreign-born pregnant women living with HIV who received prenatal care in a multidisciplinary prenatal clinic between 2009 and 2018. A licensed clinical social worker evaluated all women and kept detailed clinical records on immigration status and social support. Social vulnerability was defined as both living in the United States for less than 5 years and reporting no family or friends for support. The primary outcome was evidence of viral non-suppression after achievement of initial suppression. Secondary outcomes were the proportion of women who required > 12 weeks after starting antiretroviral therapy to achieve viral suppression, median time to first viral suppression (in weeks) after initiation of antiretroviral therapy, and the proportion who missed ≥ 5 doses of antiretroviral therapy. Bivariable analyses were performed. RESULTS A total of 111 foreign-born women were eligible for analysis, of whom 25 (23%) were classified as socially vulnerable. Social and clinical characteristics of women diverged by social vulnerability categorization but no differences reached statistical significance. On bivariable analysis, socially-vulnerable women were at increased risk for needing > 12 weeks to achieve viral suppression (relative risk: 1.78, 95% confidence interval: 1.18-2.67), though there was no association with missing ≥ 5 doses of antiretroviral therapy or median time to viral suppression after initiation of antiretroviral therapy. CONCLUSION Among foreign-born, pregnant women living with HIV, markers of virologic control during pregnancy were noted to be worse among socially-vulnerable women. Insofar as maternal viremia is the predominant driver of perinatal transmission, closer clinical surveillance and support may be indicated in this population. KEY POINTS · 23% of foreign-born pregnant women living with HIV were identified as socially vulnerable.. · Socially-vulnerable women were at higher risk for re-emergent viremia (24 vs. 7%, RR 3.44).. · Socially-vulnerable women were at higher risk for needing >12 weeks to become aviremic (64 vs. 36%, RR: 1.7)..
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Affiliation(s)
- Ashish Premkumar
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.,Department of Anthropology, The Graduate School, Northwestern University, Evanston, Illinois
| | - Lynn M Yee
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Lia Benes
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Emily S Miller
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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Body size ideals and body satisfaction among Dutch-origin and African-origin residents of Amsterdam: The HELIUS study. PLoS One 2021; 16:e0252054. [PMID: 34038446 PMCID: PMC8153493 DOI: 10.1371/journal.pone.0252054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 05/07/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Obesity is highly prevalent among ethnic minorities and acceptance of larger body sizes may put these ethnic minorities at risk of obesity. This study aimed to examine body size ideals and body satisfaction in relation to body weight, in two Sub-Saharan African (SSA)-origin groups in the Netherlands compared to the Dutch. Additionally, in the two SSA-origin groups, this study assessed the mediating role of acculturation in the relation between ethnicity and body size ideals and body satisfaction. METHODS Dutch, African Surinamese and Ghanaians living in Amsterdam, the Netherlands, participated in the observational HELIUS study (n = 10,854). Body size ideals were assessed using a validated nine figure scale. Body satisfaction was calculated as the concordance of current with ideal figure. Acculturation was only assessed among SSA-origin participants and acculturation proxies included age of migration, residence duration, ethnic identity and social network. Weight and height were measured using standardised protocols. RESULTS SSA-origin women and Ghanaian men had larger body size ideals compared to the Dutch; e.g. Surinamese and Ghanaian women had 0.37 (95%CI 0.32; 0.43) and 0.70 (95%CI 0.63; 0.78) larger body size ideals compared to Dutch women. SSA-origin participants were more often satisfied with their weight compared to the Dutch. Similarly, SSA-origin participants had more than twice the odds of being satisfied/preferring a larger figure compared to the Dutch (e.g. BSurinamese men 2.44, 95%CI 1.99; 2.99). Within the two SSA-origin groups, most acculturation proxies mediated the relation between ethnicity and body size ideals in women. Limited evidence of mediation was found for the outcome body satisfaction. CONCLUSION Public health strategies promoting a healthy weight may need to be differentiated according to sex and ethnic differences in body weight perception. Factors other than acculturation may underlie the ethnic differences between African Surinamese and Ghanaians in obesity.
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Connor JB, Janusek LW. A Biopsychosocial Framework to Examine Risk for Type 2 Diabetes in Asian Pacific Islander Immigrants. Res Theory Nurs Pract 2021; 35:82-96. [PMID: 33632924 DOI: 10.1891/rtnp-d-19-00132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
There is large disparity in the incidence of Type 2 diabetes (T2D) for Asian Pacific Islanders (APIs), one of the fastest growing minority populations in the United States. It is critical to examine biopsychosocial pathways and vulnerability factors that intensify risk for T2D in API. Increasing evidence links chronic stress to poor health outcomes and accelerated development and progression of diseases of aging, such as diabetes. Immigrant populations face unique life stressors, including the challenges associated with the process of adapting to a new environment, new language, and cultural differences. In addition, immigrants experience high levels of psychological distress related to changes of identity and values, loss of support, discrimination, and disempowerment. The purpose of this article is to propose a biopsychosocial framework to explicate potential mechanistic pathways that link cumulative life stress to risk for T2D in the API immigrant population. Unique to the proposed framework is the emphasis on inflammatory processes and accelerated cellular aging (telomere biology). A deeper understanding of biopsychosocial pathways can lead to tailored and targeted interventions to reduce the incidence of T2D in the API immigrant population.
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Affiliation(s)
- Jorgia B Connor
- Marcella Niehoff School of Nursing, Loyola University Chicago, Maywood, IL
| | - Linda W Janusek
- Marcella Niehoff School of Nursing, Loyola University Chicago, Maywood, IL
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López-Tamayo R, Jason LA. THE ASSOCIATION BETWEEN BEHAVIORAL AND ATTITUDINAL ACCULTURATION ON LATINX IMMIGRANTS AND U.S.-BORN LATINXS: A MULTIDIMENSIONAL ACCULTURATION MODEL. COMMUNITY PSYCHOLOGY IN GLOBAL PERSPECTIVE 2021; 7:81-102. [PMID: 36457550 PMCID: PMC9710741 DOI: 10.1285/i24212113v7i2p81] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Disparities in access and utilization of substance abuse treatment (SAT) among Latinxs, accentuated by this population's rapid growth, create a public health issue. Although substance abuse literature has given more consideration to environmental factors and social support concerning treatment outcomes, current substance abuse models fail to address important contextual and cultural aspects for Latinxs in recovery, including acculturation. The proposed study aims to test out a multidimensional acculturation model on a sample of 131 Latinxs (Mage= 36.3; SD±10.4, 117 males, 49% immigrants) who recently completed SAT. Specifically, the proposed study employed a conditional process model using the PROCESS Macro for SPSS to examine the association between behavioral acculturation and substance use behavior in the past six months on nativity status at different levels of attitudinal acculturation. Results yielded that, after controlling for age and substance use, higher endorsement of U.S. mainstream cultural practices was associated with a higher frequency of days using alcohol among Latinx immigrants, specifically those reporting high and very high affiliation to the U.S. mainstream culture. Also, a negative association between U.S. mainland-born Latinx and frequency of days using illicit drugs in the past six months was observed, but only among those who endorse very high affiliation of U.S. mainstream culture.
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Affiliation(s)
| | - Leonard A Jason
- Center for Community Research, DePaul University, Chicago, USA
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