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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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Rodriguez J, Golzarri-Arroyo L, Rodriguez C, Maupomé G. Stress and Alcohol Intake among Hispanic Adult Immigrants in the U.S. Midwest. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16244. [PMID: 36498318 PMCID: PMC9738040 DOI: 10.3390/ijerph192316244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 11/28/2022] [Accepted: 12/01/2022] [Indexed: 06/17/2023]
Abstract
Alcohol intake and Alcohol Use Disorder (AUD) among recent and very recent Hispanic immigrants are not well characterized, in particular in the context of perceived stress among such groups. The objective of the present study was to shed light on alcohol intake and AUD overall, as well as potential modifications derived from varying levels of stress and socioeconomic status (SES). The study population was immigrants with six or fewer months of having arrived in the American Midwest, and members of their peer networks who had been in the U.S. for 2+ years. We found that AUD and alcohol intake spanned from very high to a considerable proportion who abstained; perceived stress did not have an obvious impact on AUD or alcohol intake. Moreover, neither New vs. Established immigrant statuses, or SES levels, were associated with AUD or alcohol intake. Future research should examine in a more finely-grained approach the components of SES to verify if the complex circumstances of recent immigrants are in fact amenable to SES classification using standard quantification approaches-even using the functional descriptions of the SES surrogates we used.
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Affiliation(s)
- Jacqueline Rodriguez
- Department of Global Health, Richard M. Fairbanks School of Public Health, Indiana University–Purdue University Indianapolis, Indianapolis, IN 46202, USA
| | - Lilian Golzarri-Arroyo
- Department of Epidemiology and Biostatistics, School of Public Health Bloomington, Indiana University Bloomington, Bloomington, IN 47405, USA
| | - Cindy Rodriguez
- Department of Global Health, Richard M. Fairbanks School of Public Health, Indiana University–Purdue University Indianapolis, Indianapolis, IN 46202, USA
| | - Gerardo Maupomé
- Department of Global Health, Richard M. Fairbanks School of Public Health, Indiana University–Purdue University Indianapolis, Indianapolis, IN 46202, USA
- Indiana University Network Science Institute, Bloomington, IN 47408, USA
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3
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Sirin SR, Choi E, Sin EJ. Meta-Analysis on the Relation Between Acculturation and Alcohol Use Among Immigrant Youth. J Adolesc Health 2022; 70:361-377. [PMID: 34756641 DOI: 10.1016/j.jadohealth.2021.09.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 08/30/2021] [Accepted: 09/14/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE We empirically examined the relation between acculturation and alcohol use in immigrant youth, with attention to demographic and methodological moderators. METHODS We identified 43 studies (38 empirical studies published in peer-reviewed journals and 6 dissertations) yielding 66 independent samples and 118 effect sizes. The total sample size was 61,851 immigrant youth from birth to 25 years of age (M = 937.14, standard deviation = 1,271.24) with a mean age of 15.50 years (standard deviation = 2.46). RESULTS The average effect size for the fixed effects model was .04 with a 95% confidence interval of .03-.05, which was significantly different from zero (p < .001). The average effect size for the random effects model was .05 with a 95% confidence interval of .02-.08, which was significantly different from zero (p = .002). Location of the study, age of participants, type of measurements used to assess acculturation and alcohol use, and publication year were significant moderators. CONCLUSIONS This meta-analytic review supported the immigrant paradox in which acculturation puts immigrant youth at risk for alcohol use. Several demographic and methodological factors also moderated this relation in a significant way. Important implications are discussed.
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Affiliation(s)
- Selcuk R Sirin
- Department of Applied Psychology, New York University, New York, New York.
| | - Elysia Choi
- Department of Applied Psychology, New York University, New York, New York
| | - Esther J Sin
- Department of Applied Psychology, New York University, New York, New York
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Alegria K, Fleszar-Pavlović S, Hua J, Ramirez Loyola M, Reuschel H, Song AV. How Socioeconomic Status and Acculturation Relate to Dietary Behaviors Within Latino Populations. Am J Health Promot 2022; 36:450-457. [PMID: 35038263 DOI: 10.1177/08901171211059806] [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: 11/15/2022]
Abstract
PURPOSE Despite having lower socioeconomic status, Latinos in the US experience fewer adverse health outcomes than non-Latinos. However, they are disproportionately affected by diet-related diseases. Among other racial/ethnic groups, high acculturation and low socioeconomic status are associated with worse dietary intake, yet, few studies have investigated these relationships among Latinos. DESIGN 2013-2014 NHANES analyzed to examine pathways through which acculturation, income, nativity, and food security are associated with dietary behaviors. SETTING U.S. population-based survey. SAMPLE Survey respondents >18 years old and identified as Latino/Hispanic (N = 1197; 53.88% female; Mage = 44.61). MEASURES Primary language spoken (acculturation), total household income (income), place of birth (nativity), Food security, and the Flexible Consumer Behavior Survey (dietary behavior). ANALYSIS Univariate and multivariate regressions in STATA. Covariates include length of time in the US, ethnicity/Hispanic origin (i.e., "Mexican American" or "Other Hispanic"), and gender. RESULTS Nativity (β = -1.16; SE = .19; P < .001) and income (β = .39; SE = .07; P < .001) were significant predictors of dietary behavior. Foreign-born Latinos and those with lower income consumed significantly lower numbers of fast-food or pizza. Food security was not a significant predictor of dietary behavior (β = .16; SE = .1; P > .05). CONCLUSIONS Results suggest that income is not a protective factor against unhealthy dietary behavior and a renewed importance of nativity as a predictor of health behavior among Latinos.
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Affiliation(s)
- Katie Alegria
- Department of Psychological Sciences, 33244University of California, Merced, CA, USA
| | - Sara Fleszar-Pavlović
- Department of Psychological Sciences, 33244University of California, Merced, CA, USA
| | - Jacqueline Hua
- Department of Psychological Sciences, 33244University of California, Merced, CA, USA
| | - Maria Ramirez Loyola
- Department of Psychological Sciences, 33244University of California, Merced, CA, USA
| | - Hope Reuschel
- Department of Psychological Sciences, 33244University of California, Merced, CA, USA
| | - Anna V Song
- Department of Psychological Sciences, 33244University of California, Merced, CA, USA
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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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Delaney CL, Spaccarotella K, Quick V, Byrd-Bredbenner C. A Comparison of Weight-Related Behaviors of Hispanic Mothers and Children by Acculturation Level. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:E503. [PMID: 33435478 PMCID: PMC7827543 DOI: 10.3390/ijerph18020503] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 01/04/2021] [Accepted: 01/08/2021] [Indexed: 12/13/2022]
Abstract
Hispanic mothers and children in the United States experience a high prevalence of obesity, which may be affected by maternal acculturation level. Little is known about the association of acculturation on weight-related behaviors. This study describes differences in weight-related behaviors by acculturation level of Hispanic mothers residing in the U.S. and compares them to behaviors of White mothers. Acculturation level was determined using personal acculturation and acculturation environment variables. Cluster analysis of acculturation variables identified three groups of Hispanic mothers: low personal and environmental acculturation (n = 46), high personal and low environmental acculturation (n = 65), and high personal and environmental acculturation (n = 38). Results indicate that, compared to White mothers (n = 340), the least acculturated cluster of Hispanic mothers tended to model physical activity less often and the most acculturated exerted more pressure on children to eat. Mothers in the least acculturated cluster tended to rate children's health status lower, indicate that children had greater fruit juice and less milk intakes, have more meals in locations associated with less healthy meals, and have the least space and supports for physical activity. Findings highlight relationships between maternal acculturation level and weight-related behaviors and suggest strategies for helping acculturating Hispanic mothers create healthier lifestyles and home environments.
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Affiliation(s)
- Colleen L. Delaney
- Department of Nutritional Science, Rutgers University, New Brunswick, NJ 08901-8554, USA; (V.Q.); (C.B.-B.)
| | - Kim Spaccarotella
- Department of Biological Sciences, Kean University, Union, NJ 07083-7131, USA;
| | - Virginia Quick
- Department of Nutritional Science, Rutgers University, New Brunswick, NJ 08901-8554, USA; (V.Q.); (C.B.-B.)
| | - Carol Byrd-Bredbenner
- Department of Nutritional Science, Rutgers University, New Brunswick, NJ 08901-8554, USA; (V.Q.); (C.B.-B.)
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7
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Delaney CL, Spaccarotella K, Byrd-Bredbenner C. A Comparison of Maternal Health Status and Weight-Related Cognitions, Behaviors, and Home Environments by Race/Ethnicity. Nutrients 2020; 12:E3592. [PMID: 33238533 PMCID: PMC7700294 DOI: 10.3390/nu12113592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 11/18/2020] [Accepted: 11/19/2020] [Indexed: 12/22/2022] Open
Abstract
This cross-sectional study compared weight-related cognitions, behaviors, and home environments of 568 mothers of young children (ages 2 to <9 years) by racial/ethnic group. Maternal health status was good and did not differ by race/ethnicity. Mothers were somewhat confident in their ability to promote healthy physical activity and eating behaviors in their children, with White and Asian mothers having greater confidence than Hispanic mothers. Mothers had low physical activity, with Hispanic mothers getting more sedentary screentime than White and Asian mothers. Mothers' dietary intake did not differ. Modeling of healthful behaviors was more frequent in White than Hispanic mothers. Asian mothers tended to use non-recommended feeding patterns more than White, Hispanic, and Black mothers. Children's physical activity and screentime did not differ by race/ethnicity. Asian children tended to drink less sugar-sweetened beverages and more milk than counterparts. All reported frequent family meals, with Hispanic mothers reporting more family meals eaten in less healthful locations. Household food environments did not differ. However, White mothers reported greater access to physical activity space and supports than Hispanic mothers. Race/ethnicity may link with maternal weight-related cognitions, behaviors, and home environments and thus can help inform the development of interventions tailored by race/ethnicity.
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Affiliation(s)
- Colleen L. Delaney
- Department of Nutritional Science, Rutgers University, New Brunswick, NJ 08854, USA;
| | - Kim Spaccarotella
- Department of Biological Sciences, Kean University, Union, NJ 07083-7131, USA;
| | - Carol Byrd-Bredbenner
- Department of Nutritional Science, Rutgers University, New Brunswick, NJ 08854, USA;
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8
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Toth-Bos A, Wisse B, Farago K. The Interactive Effect of Goal Attainment and Goal Importance on Acculturation and Well-Being. Front Psychol 2020; 11:704. [PMID: 32373031 PMCID: PMC7186441 DOI: 10.3389/fpsyg.2020.00704] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 03/23/2020] [Indexed: 01/07/2023] Open
Abstract
The purpose of the present research is to shed light on whether and when migrants’ goal pursuit relates to their acculturation and well-being. Previous research has demonstrated the beneficial role of striving for and attaining intrinsic goals on well-being. Yet, the relationship between the pursuit of intrinsic goals and acculturation has hardly been addressed. To fill this void, we investigated whether migrants’ acculturation and well-being can be seen as a function of their pursuit of intrinsic goals. We posited that the attainment of intrinsic goals would positively predict migrants’ level of acculturation and subsequent well-being, particularly when migrants deemed these goals to be important. We tested our hypotheses in two scenario studies and two surveys. In all four studies we confirmed our hypothesis that migrants’ intrinsic goal attainment and well-being is mediated by their acculturation level. However, in only two of the four studies did we find support for our hypothesis that the relationship between intrinsic goal attainment and acculturation is moderated by intrinsic goal importance. We discuss the theoretical implications and the practical consequences of our findings. Furthermore, we outline future research directions that could deepen our understanding of the relationship between migrants’ goal pursuit and their acculturation.
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Affiliation(s)
- Agnes Toth-Bos
- Department of Psychology, University of Groningen, Groningen, Netherlands.,Department of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Barbara Wisse
- Department of Psychology, University of Groningen, Groningen, Netherlands.,Business School, Durham University, Durham, United Kingdom
| | - Klara Farago
- Department of Psychology, Eötvös Loránd University, Budapest, Hungary
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Mattei J, McClain AC, Falcón LM, Noel SE, Tucker KL. Dietary Acculturation among Puerto Rican Adults Varies by Acculturation Construct and Dietary Measure. J Nutr 2018; 148:1804-1813. [PMID: 30383277 PMCID: PMC6669953 DOI: 10.1093/jn/nxy174] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Accepted: 07/10/2018] [Indexed: 01/14/2023] Open
Abstract
Background The role of acculturation in dietary behaviors among Hispanics/Latinos in the United States remains unclear. Discrepancies may be explained by variations in acculturation constructs or ethnicity-specific dynamics. Objective We aimed to compare relations between 3 different acculturation constructs with dietary quality and patterns among Puerto Ricans in the mainland United States. Methods We analyzed cross-sectional data with 1194-1380 Puerto Ricans, aged 45-75 y. Acculturation was measured with the use of a language-based scale (0-100; higher score denotes more English use), a psychological-based scale (0-50; higher score denotes stronger US orientation), and years living in the mainland United States. Diet quality scores (higher scores denote healthier diet) were defined with the use of the Alternate Healthy Eating Index-2010 (AHEI) and the Mediterranean Diet Score (MeDS). Three dietary patterns were previously derived with the use of principal components analysis. Adjusted multivariable regression models tested the association of each acculturation construct with diet quality score or pattern. Interaction terms were included for income or education status. Results Psychological-based acculturation, but not the other constructs, was positively associated with AHEI (β ± SE: 0.013 ± 0.004; P = 0.002) and MeDS (0.009 ± 0.005; P = 0.041). Income, but not education, moderated this association (P = 0.03), with higher diet quality observed with higher income (>$25,000) and stronger US orientation. All constructs were inversely associated with a traditional dietary pattern, with the language-based scale being stronger (z score β ± SE: -0.160 ± 0.032; P < 0.0001) than the psychological-based scale (-0.097 ± 0.028; P = 0.001) or years living in the mainland United States (-0.058 ± 0.028; P = 0.041). No associations were observed for the Western or sweets/desserts patterns. Conclusions In Puerto Rican adults, stronger psychological US orientation was associated with higher diet quality, particularly with higher income. More Spanish use, stronger psychological Puerto Rican orientation, and shorter length of mainland-US residency were associated with traditional dietary patterns. Appropriate diet-related acculturation constructs should be carefully considered among Hispanics/Latinos. This trial was registered at clinicaltrials.gov as NCT01231958.
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Affiliation(s)
- Josiemer Mattei
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA,Address correspondence to JM (e-mail: )
| | - Amanda C McClain
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA
| | - Luis M Falcón
- College of Fine Arts, Humanities & Social Sciences, University of Massachusetts, Lowell, MA
| | - Sabrina E Noel
- Department of Biomedical and Nutritional Sciences, University of Massachusetts, Lowell, MA
| | - Katherine L Tucker
- Department of Biomedical and Nutritional Sciences, University of Massachusetts, Lowell, MA
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10
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Scholaske L, Buss C, Wadhwa PD, Entringer S. Acculturation and interleukin (IL)-6 concentrations across pregnancy among Mexican-American women. Brain Behav Immun 2018; 73:731-735. [PMID: 30086398 PMCID: PMC6369138 DOI: 10.1016/j.bbi.2018.08.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 08/01/2018] [Accepted: 08/03/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The process of acculturation (post-migration acquisition of host culture and/or loss of heritage culture) likely represents a key mediator of the observed post-migration decline in health that is evident among immigrant populations such as Mexican Americans. The observations that migrant health declines progressively as not only a function of length of stay in the U.S. but also across generations, and that this inter-generational decline in health is evident as early as at the time of birth itself, supports the concept of fetal programming of acculturation's effects. However, the underlying mechanisms remain to be elucidated. Inflammation during pregnancy represents a candidate pathway of particular interest for 2 reasons: it represents a key biological mediator of the psychosocial and/or behavioral sequelae of acculturation on health, and it represents a key pathway by which maternal states and conditions during pregnancy may influence fetal development and subsequent birth and child developmental and health outcomes. Therefore, the aim of this study was to examine the relationship between acculturation and inflammation across pregnancy in a population of Mexican-American women. Specifically, we tested the hypothesis that a higher level of acculturation is associated with higher circulating concentrations across pregnancy of the pro-inflammatory cytokine interleukin-6 (IL-6). METHODS 75 pregnant first- or second-generation Mexican-American women constituted the study population. Acculturation was quantified using a commonly-used and previously validated measure - the Acculturation Rating Scale for Mexican Americans (ARSMA). Maternal blood samples were collected during early, mid and late pregnancy for analysis of circulating IL-6 concentrations. RESULTS Hierarchical linear models indicated a significantly and positive main effect of acculturation on IL-6 concentrations across pregnancy after adjusting for key covariates including gestational age(s) at blood sampling, socioeconomic status, pre-pregnancy BMI, and presence of obstetric risk conditions. CONCLUSIONS Maternal inflammation during pregnancy may represent a biological pathway of interest in the context of the inter-generational effects of acculturation from a mother to her as-yet-unborn child.
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Affiliation(s)
- Laura Scholaske
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Institute of Medical Psychology, Luisenstrasse 57, 10117 Berlin, Germany
| | - Claudia Buss
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Institute of Medical Psychology, Luisenstrasse 57, 10117 Berlin, Germany; Development, Health and Disease Research Program, University of California, Irvine, 837 Health Sciences Drive, Irvine, CA 92697, United States
| | - Pathik D Wadhwa
- Development, Health and Disease Research Program, University of California, Irvine, 837 Health Sciences Drive, Irvine, CA 92697, United States.
| | - Sonja Entringer
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Institute of Medical Psychology, Luisenstrasse 57, 10117 Berlin, Germany; Development, Health and Disease Research Program, University of California, Irvine, 837 Health Sciences Drive, Irvine, CA 92697, United States.
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11
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Diep CS, Leung R, Thompson D, Gor BJ, Baranowski T. Physical Activity Behaviors and Influences Among Chinese-American Children Aged 9-13 Years: A Qualitative Study. J Immigr Minor Health 2018; 19:358-366. [PMID: 27384684 DOI: 10.1007/s10903-016-0457-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Low physical activity is a major health issue among Chinese Americans. This study explored Chinese-American children's physical activity behaviors and influencing factors. Twenty-five children of Chinese or Taiwanese descent were interviewed to understand their favorite sports or physical activities, physical activity environments, and influences on their physical activity. All were between the ages of 9 and 13. Interviews were transcribed and coded using thematic data analysis procedures. Major themes included: (1) team sports, particularly basketball, were commonly listed as favorite sports or activities; (2) physical activity occurred mostly at school or an after-school setting; and (3) family played a major role in physical activity. Some trends/differences were detected based on age, sex, and socioeconomic status. Interventions to promote physical activity among Chinese-American children should emphasize team sports and encourage physical activity in schools, but also explore ways to involves families outside of school.
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Affiliation(s)
- Cassandra S Diep
- Department of Pediatrics, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA. .,Department of Health Disparities Research - Unit 1440, The University of Texas MD Anderson Cancer Center, P.O. Box 301402, Houston, TX, 77230-1402, USA.
| | - Randall Leung
- Department of Health Sciences, Boston University, Boston, MA, USA
| | - Debbe Thompson
- Department of Pediatrics, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
| | - Beverly J Gor
- Houston Health Department, Office of Planning, Evaluation and Research for Effectiveness, Houston, TX, USA
| | - Tom Baranowski
- Department of Pediatrics, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
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12
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Diep CS, Baranowski T, Kimbro RT. Acculturation and weight change in Asian-American children: Evidence from the ECLS-K:2011. Prev Med 2017; 99:286-292. [PMID: 28344119 DOI: 10.1016/j.ypmed.2017.03.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 03/14/2017] [Accepted: 03/19/2017] [Indexed: 01/30/2023]
Abstract
Despite relatively low rates of overweight and obesity among Asian-American children, disparities exist based on acculturation, socioeconomic status, and Asian ethnicity. The purpose of this study was to examine the association between acculturation and weight change in Asian-American children. Secondary aims were to compare changes by Asian ethnic group and acculturation x socioeconomic status. Participants included 1200 Asian-American children from the Early Childhood Longitudinal Study, Kindergarten Class of 2010-11, a longitudinal study of U.S. children attending kindergarten in 2010-2011. Multinomial logistic regressions were conducted to predict weight change based on body mass indices in kindergarten (spring 2011) and second grade (spring 2013): consistently healthy weight, consistently overweight/obese, healthy weight change, and unhealthy weight change. Models included demographic, household, socioeconomic status, and acculturation measures, specifically mother's English proficiency and percentage of life spent in the U.S. Overall, 72.3% of children were at healthy weights in kindergarten and second grade. Of all Asian ethnic groups, Filipino children had the highest rate of being consistently overweight/obese (24.8%) and the lowest rate of being consistently healthy weight (62.9%). In addition, mother's English proficiency predicted unhealthy weight change (OR: 0.83; 95% CI: 0.75-0.92) and healthy weight change (OR: 0.75; 95% CI: 0.65-0.86), relative to "consistently healthy weight." English proficiency also predicted being consistently overweight/obese for children with less educated mothers. Findings enhance our understanding of obesity disparities within Asian Americans and highlight the need to disaggregate the population. Obesity interventions are needed for Filipino children and families with low socioeconomic status but high English proficiency.
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Affiliation(s)
- Cassandra S Diep
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Tom Baranowski
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
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Health of the Elderly Migration Population in China: Benefit from Individual and Local Socioeconomic Status? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14040370. [PMID: 28368314 PMCID: PMC5409571 DOI: 10.3390/ijerph14040370] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Revised: 03/12/2017] [Accepted: 03/30/2017] [Indexed: 11/29/2022]
Abstract
The study aims to estimate the relationship between the individual/local socioeconomic status and the health of internal elderly migrants in China. A multilevel logistic model was used to estimate this association. The estimations were undertaken for 11,111 migrants aged over 60 years, using nationally representative data: the 2015 Migrant Dynamics Monitoring Survey (MDMS), which was carried out in China. Odds ratios with 95% confidence intervals were reported. Both the household income per capita and the area-level average wage were positively associated with migrants’ self-reported health; however, public service supply was not significantly related to their health. In addition, given the household income, migrants living in communities with a higher average wage were more likely to report poor health. Migrants’ health benefited from individual socioeconomic status, but not from the local socioeconomic status, which the migrants cannot enjoy. This study highlights the importance of multilevel and non-discriminatory policies between migrants and local residents.
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14
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Diep CS, Leung R, Thompson DI, Gor BJ, Baranowski T. Culture and Diet Among Chinese American Children Aged 9-13 Years: A Qualitative Study. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2017; 49:275-284.e1. [PMID: 28027858 DOI: 10.1016/j.jneb.2016.11.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 11/01/2016] [Accepted: 11/06/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To examine Chinese American children's behaviors, food preferences, and cultural influences on their diet. DESIGN Qualitative individual interviews using constructs from the proposed model of dietary acculturation. SETTING Community centers and Chinese schools in Houston, TX. PARTICIPANTS Twenty-five Chinese American children aged 9-13 years. PHENOMENON OF INTEREST Diet, favorite restaurants, and parents' cooking and grocery shopping habits. ANALYSIS Content analysis and thematic data analysis to identify code categories and themes. Coders also identified patterns based on demographic and acculturation factors. RESULTS Overall, participants described their diets and associated behaviors as Asian and non-Asian. Key themes included preference for Asian and non-Asian foods; consumption of non-Asian foods for breakfast and lunch, but Asian foods for dinner; infrequent dining at restaurants; grocery shopping at Asian and non-Asian stores; and familial influences on diet. Acculturated children and children of higher socioeconomic status appeared to prefer and consume a more Westernized/non-Asian diet. CONCLUSIONS AND IMPLICATIONS Results illustrate that Chinese American children in this study practiced both Asian and non-Asian dietary behaviors. Findings corroborated existing acculturation research with parents and caregivers; supported constructs in the model of dietary acculturation; and provide guidance for research and programs related to dietary behaviors, determinants, and culture among this population.
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Affiliation(s)
- Cassandra S Diep
- US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX; Department of Health Disparities Research, University of Texas MD Anderson Cancer Center, Houston, TX.
| | - Randall Leung
- Department of Health Sciences, Boston University, Boston, MA
| | - Debbe I Thompson
- US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Beverly J Gor
- Office of Planning, Evaluation and Research for Effectiveness, Houston Health Department, Houston, TX
| | - Tom Baranowski
- US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX
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Health information seeking of low socioeconomic status Hispanic adults using smartphones. ASLIB J INFORM MANAG 2015. [DOI: 10.1108/ajim-12-2014-0181] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
– Smartphones have great potential to bridge the digital divide that low-socioeconomic status (SES) Hispanics have been experiencing. However, little is known about this group’s use of smartphones for health information. The purpose of this paper is to fill the gap by exploring the context in which smartphones were used for health information.
Design/methodology/approach
– The authors interviewed 20 low-SES Hispanic participants using the semi-structured interview method. Participants had not obtained college degrees and had annual incomes less than $30,000, but had used their smartphones for health information. The interviews were transcribed and analyzed using the qualitative content analysis method.
Findings
– Being economical was an important reason for low-SES Hispanic users to use smartphones for health information. The users relied heavily on public Wi-Fi to access the internet. They searched a wide range of health topics, mostly using the mobile web rather than apps. They lacked knowledge and skills to effectively using apps, evaluating the quality of health information, and comprehend information.
Research limitations/implications
– Having access to smartphones alone does not help bridge the digital gap for low-SES Hispanics. Interventions need to consider improving these users’ smartphone literacy and health literacy, as well as improving their access to Wi-Fi services and to more quality content in Spanish.
Originality/value
– Prior studies speculated that smartphones could be a means to bridge digital divide experienced by the Hispanic ethnic group. This study provided empirical knowledge about how smartphones are used by these users for health information, and shed light on the design of future informational interventions.
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Carney MA. Eating and Feeding at the Margins of the State: Barriers to Health Care for Undocumented Migrant Women and the "Clinical" Aspects of Food Assistance. Med Anthropol Q 2015; 29:196-215. [PMID: 25715903 DOI: 10.1111/maq.12151] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
In this article, I examine the various meanings of Mexican and Central American migrant women's utilization of private food assistance programs. I present findings from 20 months of ethnographic fieldwork conducted between 2008 and 2011 with migrant women, public health workers, and staff and volunteers of food assistance programs in Santa Barbara County, California. I discuss the barriers undocumented women face in accessing formal health care and the social and moral obligations that underpin these women's role in feeding others. I also document the ways in which private food assistance programs are orienting toward a focus on health in service delivery, and how women depend on provisions from these programs to support feeding practices at home. I argue that these findings are significant for current engagement by critical medical anthropologists in studying framings of "the clinic" and cultural beliefs about "deservingness."
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Affiliation(s)
- Megan A Carney
- Department of Anthropology, University of Washington, Seattle.
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17
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O’Brien MJ, Shuman SJ, Barrios DM, Alos VA, Whitaker RC. A qualitative study of acculturation and diabetes risk among urban immigrant Latinas: implications for diabetes prevention efforts. THE DIABETES EDUCATOR 2014; 40:616-25. [PMID: 24872386 PMCID: PMC4169339 DOI: 10.1177/0145721714535992] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE The purpose of this qualitative study was to understand how acculturation influences diabetes risk among urban immigrant Latinas (Hispanic women). METHODS Five focus groups were conducted with 26 urban immigrant Latinas who were at high clinical risk for developing diabetes. The focus group sessions were audiotaped and transcribed verbatim. The authors independently analyzed transcripts using an inductive method of open coding and established themes by consensus. RESULTS All participants were foreign born and had low levels of acculturation. During the acculturation process, they noted changes in their lifestyle behaviors and the family context in which those behaviors are shaped. They reported that since living in the United States, their improved economic circumstances led to increased consumption of less healthy foods and beverages and a more sedentary lifestyle. They also described changing family roles and responsibilities, including working outside the home, which constrained healthy food choices. However, they perceived that their position of influence within the family offered opportunities to help family members prevent diabetes. CONCLUSIONS Lifestyle interventions to prevent diabetes in Latinas should address their acculturation experiences, which affect family functioning and health behaviors related to diabetes risk. For example, given the perceived link between Latinas' improved economic circumstances and their diabetes risk, prevention programs should incorporate strategies to help Latinas avoid adopting less healthy lifestyle behaviors that become affordable during the acculturation process.
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Affiliation(s)
- Matthew J. O’Brien
- Center for Obesity Research and Education, Temple University, Philadelphia, PA
- Department of Medicine, Section of General Internal Medicine, Temple University School of Medicine, Philadelphia, PA
- Department of Public Health, Temple University, Philadelphia, PA
- Puentes de Salud Health Center, Philadelphia, PA
| | - Sara J. Shuman
- Center for Obesity Research and Education, Temple University, Philadelphia, PA
- Department of Public Health, Temple University, Philadelphia, PA
- Puentes de Salud Health Center, Philadelphia, PA
| | - Dulce M. Barrios
- Center for Obesity Research and Education, Temple University, Philadelphia, PA
- Puentes de Salud Health Center, Philadelphia, PA
| | - Victor A. Alos
- Center for Obesity Research and Education, Temple University, Philadelphia, PA
- Department of Public Health, Temple University, Philadelphia, PA
- Puentes de Salud Health Center, Philadelphia, PA
| | - Robert C. Whitaker
- Center for Obesity Research and Education, Temple University, Philadelphia, PA
- Department of Public Health, Temple University, Philadelphia, PA
- Department of Pediatrics, Temple University School of Medicine, Philadelphia, PA
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Khadilkar A, Chen Y. Rate of cervical cancer screening associated with immigration status and number of years since immigration in Ontario, Canada. J Immigr Minor Health 2014; 15:244-8. [PMID: 22918694 DOI: 10.1007/s10903-012-9711-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Cervical cancer screening is a vital public health measure intended to reduce the morbidity and mortality from what is a largely preventable cancer. Previous Canadian studies have documented that immigrants have significantly lower Papanicolaou (Pap) testing rates than women born in Canada. However, the impact of number of years since immigration is less clear. Data were taken from the 2007-2008 Canadian Community Health Survey. Responses from 16, 706 women living in Ontario, Canada were included. The focus was on self-reported Pap testing rates within the last 3 years, immigrant status and number of years since immigration. A robust Poisson regression model was used to determine prevalence ratios (PR) with 95 % confidence intervals (CIs) after adjustment for covariates. The results demonstrated that recent immigrant women (less than 10 years in Canada) were less likely to have had a Pap test in the past 3 years than those who were Canadian-born (PR = 0.77; 95 % CI: 0.71, 0.84). In contrast, immigrants who had lived in Canada for 10 years or longer showed similar compliance with recommended Pap testing intervals as non-immigrants. Higher income, higher level of education, younger age and being married were independently associated with better Pap testing rates. A strategy targeting recent immigrants to Canada is needed to promote Pap testing in this population and reduce their risk of invasive cervical cancer.
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Affiliation(s)
- Amole Khadilkar
- Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
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Hilmers A, Chen TA, Cullen KW. Household food insecurity and dietary intake among Mexican-American women participating in federal food assistance programs. Am J Health Promot 2013; 28:e146-54. [PMID: 24200253 DOI: 10.4278/ajhp.130104-quan-13] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To explore the association between food insecurity and dietary intake among Mexican-American women after controlling for sociocultural and economic factors including participation in federal food assistance programs. DESIGN Cross-sectional. SETTING Three cities in Texas. SUBJECTS Seven hundred seven Mexican-American women (26-44 years). MEASURES Demographics, anthropometrics, acculturation, and food security status were obtained using validated measures. Dietary intake was assessed by a 24-hour dietary food record. ANALYSIS Logistic regression was used to examine the association between individual and household characteristics on food security status. One-way analysis of covariance tested the association between food security status and dietary intake after adjusting for socio-demographic variables, acculturation, body mass index, participation in federal food assistance programs, and energy intake. RESULTS About 77% of food-insecure women participated in at least one federal food assistance program. Each additional child in the household increased the odds of being food insecure by 25%. A higher proportion of obese women was found in the food-insecure group. No significant differences in dietary intake were found by food security status. CONCLUSION Food insecurity did not negatively influence dietary intake independently of women's participation in federal food assistance programs. Food security did not ensure consumption of nutritionally adequate foods. Educational and food assistance programs need to be optimized to facilitate enrollment and improve the nutritional status of this ethnic group, food secure or not.
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Andrews TJ, Ybarra V, Matthews LL. For the Sake of our Children: Hispanic Immigrant and Migrant Families’ Use of Folk Healing and Biomedicine. Med Anthropol Q 2013; 27:385-413. [DOI: 10.1111/maq.12048] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
| | - Vickie Ybarra
- Robert Woods Johnson Foundation Fellow, Political Science; University of New Mexico
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de Leon Siantz ML, Castaneda X, Benavente V, Peart T, Felt E. The health status of latino immigrant women in the United States and future health policy implications of the affordable care act. Glob Adv Health Med 2013; 2:70-4. [PMID: 24416697 PMCID: PMC3833563 DOI: 10.7453/gahmj.2013.066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Immigrant women of Mexican birth face unique health challenges in the United States. They are at increased risk for developing many preventable health conditions due in part to limited access to healthcare and benefits, legal status, and inadequate income. Increased vulnerability of women has established a growing need to focus on their healthcare needs because of their role, position, and influence in the family. The purpose of this article is to review factors that impact the health status of Mexican-born women living in the United States and review policy implications of the Affordable Care Act for this population. Mexican-born women are the largest female immigrant group in the United States. Therefore, they comprise the group that will need health coverage in the greatest proportion. As a result, there will be a need for culturally and linguistically appropriate healthcare services and culturally sensitive providers.
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Affiliation(s)
- Mary Lou de Leon Siantz
- Betty Irene Moore School of Nursing, University of California Davis, Sacramento, California, United States
| | - Xochitl Castaneda
- School of Public Health, Health Initiative of the Americas, University of California, Berkeley, United States
| | - Viola Benavente
- William F. Connell School of Nursing, Boston College, Massachusetts, United States
| | - Tasha Peart
- Betty Irene Moore School of Nursing, University of California Davis, Sacramento, California, United States
| | - Emily Felt
- School of Public Health, Health Initiative of the Americas, University of California, Berkeley, United States
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22
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Slawson DL, Fitzgerald N, Morgan KT. Position of the Academy of Nutrition and Dietetics: the role of nutrition in health promotion and chronic disease prevention. J Acad Nutr Diet 2013; 113:972-9. [PMID: 23790411 DOI: 10.1016/j.jand.2013.05.005] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Indexed: 01/15/2023]
Abstract
It is the position of the Academy of Nutrition and Dietetics that primary prevention is the most effective and affordable method to prevent chronic disease, and that dietary intervention positively impacts health outcomes across the life span. Registered dietitians and dietetic technicians, registered are critical members of health care teams and are essential to delivering nutrition-focused preventive services in clinical and community settings, advocating for policy and programmatic initiatives, and leading research in disease prevention and health promotion. Health-promotion and disease-prevention strategies are effective at reducing morbidity and mortality and improving quality of life, and have a significant impact on the leading causes of disease. By applying these principles within a social ecological theoretical framework, positive influence can be applied across the spectrum of engagement: at intrapersonal, interpersonal, institutional, community, and public policy levels. Through the application of efficacious and cost-effective interventions, registered dietitians and dietetic technicians, registered, can positively impact public health as well as health outcomes for the individuals that they counsel. This position paper supports the "Practice Paper of the Academy of Nutrition and Dietetics: The Role of Nutrition in Health Promotion and Chronic Disease Prevention" published on the Academy's website at: www.eatright.org/positions.
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Abstract
Health concerns for Latinos, the largest ethnic minority in the United States, merit attention by policy makers. Given the importance of the Latino population to the economic well-being of the United States, ensuring good health for this group is crucial. Lack of access to health care is the most obvious barrier to maintaining good health for Latinos, but it is not the only important factor. Sociocultural factors, including acculturation, culturally competent health professionals, immigration status, income, and education are also influential to health concerns. Recommendations to decrease health disparities among Latino men include theoretically based health interventions, better integration of research findings, working with local communities, and incorporating Latino masculine values into both health care and health education. Given the importance of the sociocultural factors, the discussion that follows emphasizes these and the interaction of these factors with Latino cultural values.
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Affiliation(s)
- Julie Gast
- Department of Health, Physical Education, and Recreation (JG), Utah State University, Logan, Utah
- Department of Sociology, Social Work, and Anthropology (TP), Utah State University, Logan, Utah
| | - Terry Peak
- Department of Health, Physical Education, and Recreation (JG), Utah State University, Logan, Utah
- Department of Sociology, Social Work, and Anthropology (TP), Utah State University, Logan, Utah
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Schluter PJ, Tautolo ES, Paterson J. Acculturation of Pacific mothers in New Zealand over time: findings from the Pacific Islands Families study. BMC Public Health 2011; 11:307. [PMID: 21569444 PMCID: PMC3115860 DOI: 10.1186/1471-2458-11-307] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2010] [Accepted: 05/12/2011] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The epidemiological investigation of acculturation has often been hampered by inconsistent definitions and measurement, and methodological short-comings. Adopting a bi-directional model, with good theoretical and psychometric properties, this study aimed to describe the temporal, ethnic and socio-demographic influences of acculturation for a group of Pacific mothers residing in New Zealand. METHODS Pacific mothers of a cohort of Pacific infants born at a large tertiary hospital in South Auckland in 2000 were interviewed at 6-weeks, 4-years and 6-years postpartum. At each measurement wave a home interview lasting approximately 90 minutes was conducted with each mother. Adapting the General Ethnicity Questionnaire, two scales of acculturation were elicited: one measuring New Zealand cultural orientation (NZAccult) and one measuring Pacific Islands cultural orientation (PIAccult). Acculturation scores were standardised and analysed using random intercept polynomial and piecewise mixed-effects regression models, accounting for the longitudinal nature of the repeated measured data. Mothers who immigrated to New Zealand and those who lived their lives in New Zealand were investigated separately. RESULTS Overall, 1276 Pacific mothers provided 3104 NZAccult and 3107 PIAccult responses over the three measurement waves. Important and significant differences were observed in both bi-directional acculturation measures between the two maternal groups studied. New Zealand cultural orientation increased, on average, linearly with years lived in New Zealand both for immigrant mothers (0.013 per year, 95% CI: 0.012, 0.014), after adjusting for maternal age, and for mothers who lived their lives in New Zealand (0.008 per year, 95% CI: 0.06, 0.010). Immigrant mothers maintained their Pacific cultural orientation for, on average, 12 years before it began to linearly decrease with each year lived in New Zealand thereafter (-0.009 per year, 95% CI: -0.010, -0.008), after adjusting for maternal age. Mothers who lived their lives in New Zealand had a Pacific orientation that was, on average, unchanged regardless of the number of years lived in New Zealand. Significant ethnic and socio-demographic variations were noted. CONCLUSIONS Understanding the patterns and trajectories of acculturation over time, and its key determinants, is necessary for the development of appropriate targeted health policy and care in typically vulnerable and marginalised immigrant populations.
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Affiliation(s)
- Philip J Schluter
- University of Otago, Department of Public Health and General Practice, Christchurch, New Zealand
- AUT University, School of Public Health and Psychosocial Studies, Auckland, New Zealand
- The University of Queensland, School of Nursing and Midwifery, Herston QLD 4029, Australia
| | - El-Shadan Tautolo
- AUT University, School of Public Health and Psychosocial Studies, Auckland, New Zealand
| | - Janis Paterson
- AUT University, School of Public Health and Psychosocial Studies, Auckland, New Zealand
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Abstract
BACKGROUND Latinos have become the largest minority group in the United States and will represent 25% of the US population by 2050. Latinos experience a disproportionate burden of poverty and poor health outcomes. OBJECTIVES We critically examined the evidence for a link between acculturation and health disparities in Latinos with a focus on type 2 diabetes (T2D) and nutrition-related risk factors and illustrated how acculturation principles can help design a culturally appropriate T2D self-management intervention in Latinos. DESIGN Evidence presented in this article was drawn from 1) systematic reviews identified through PubMed searches, 2) backward searches that were based on articles cited, 3) experts in the field, and 4) the author's personal files. RESULTS The preponderance of the evidence supported an association of acculturation with poor dietary quality and obesity. These associations appeared to be modified by several socioeconomic and demographic factors and were not always linear. The association between acculturation and T2D is unclear. CONCLUSIONS Longitudinal studies and more sophisticated analytic approaches are needed to better understand if and how acculturation affects health-disparity outcomes in Latinos. Tailoring interventions to the acculturation level of individuals is likely to help reduce health disparities in Latinos.
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