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Scott A, Kunicki ZJ, Greaney ML, Carvalho C, DaRosa N, Oliveira C, Allen JD. Sociodemographic Variables Associated with Self-reported Access to Mental Healthcare Among Brazilian Immigrant Women in the U.S. J Immigr Minor Health 2025; 27:224-233. [PMID: 39812767 DOI: 10.1007/s10903-024-01666-7] [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: 12/18/2024] [Indexed: 01/16/2025]
Abstract
Brazilians are a rapidly growing immigrant population in the United States (U.S.), yet little is known about their mental health and access to mental healthcare. Our goal was to access associations between the pursuit of- and access to-mental healthcare with mental health status and socio-demographic characteristics among Brazilian immigrant women. We conducted an online survey of Brazilian women aged 18 or older who reported being born in Brazil and currently residing in the U.S. We recruited respondents via Brazilian cultural media, community organizations serving Brazilian immigrants, and social media. We assessed respondents' perceived access to mental healthcare, self-reported mental health (CES-D-10), and socio-demographic characteristics and conducted multivariable logistic regression. Our analysis included 351 participants. Half (52%) had CES-D-10 scores indicating high levels of depressive symptomatology. A third (33%) reported seeking care for their mental health in the past 12 months, 87% of whom reported obtaining care. Results of multivariable logistic regression determined that respondents who sought mental healthcare were more likely to have higher CES-D-10 scores (OR = 1.09, 95% CI 1.03-1.15), very low incomes (<$10,000 per year; OR = 0.34, 95% CI 0.12-0.96), and were marginally more likely to have a primary care provider (OR = 2.11, 95% CI 1.00, 4.46). We found that despite a high level of depressive symptomology, only one-third reported accessing care. While difficulty accessing care for mental issues is a widespread issue, our findings suggest that efforts are needed to ameliorate mental health issues for Brazilian women to reduce systemic, interpersonal, and individual barriers to seeking care among the 13% who sought healthcare but were unable to receive it.
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Affiliation(s)
- Ashley Scott
- Boston University School of Public Health, 715 Albany St, Boston, MA, 20118, USA
| | - Zachary J Kunicki
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, 345 Blackstone Boulevard Box G-BH, Providence, RI, USA
| | - Mary L Greaney
- Department of Health Studies, University of Rhode Island, 25 West Independence Way, Kingston, RI, USA
| | - Clarissa Carvalho
- Department of Sociology and Anthropology, College of the Holy Cross, 1 College St, Worcester, MA, 01.610, USA
| | - Nicholas DaRosa
- Department of Community Health, Tufts University School of Arts and Sciences, 574 Boston Avenue, Medford, MA, 02155, USA
| | - Chrystyan Oliveira
- Department of Community Health, Tufts University School of Arts and Sciences, 574 Boston Avenue, Medford, MA, 02155, USA
| | - Jennifer D Allen
- Department of Community Health, Tufts University School of Arts and Sciences, 574 Boston Avenue, Medford, MA, 02155, USA.
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Simon SS, Brucki SMD, Fonseca LM, Becker J, Cappi C, Marques AH, Heyn PC, Gonçalves PD, Martins SS, Busatto G, Bertola L, Suemoto CK, Nitrini R, Caramelli P, Yassuda MS, Miotto EC, Grinberg LT, Arce Renteria M, Alegria M, Stern Y, Rivera‐Mindt M. The (in)visible Brazilians: A perspective review on the need for brain health and dementia research with Brazilian immigrants in the United States. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2023; 9:e12425. [PMID: 37744309 PMCID: PMC10517444 DOI: 10.1002/trc2.12425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 08/23/2023] [Accepted: 08/26/2023] [Indexed: 09/26/2023]
Abstract
Introduction The Brazilian population in the United States (U.S.), a Latinx subgroup, is rapidly growing and aging but remains underrepresented in U.S. health research. In addition to group-specific genetic and environmental risks, Brazilian immigrants and their offspring in the U.S. likely have cumulative risks for health inequities.It is estimated that 71% of Brazilian immigrants in the U.S. are undocumented, which may limit healthcare access/utilization. Furthermore, mental health is reported as a health priority by Brazilian immigrants in the U.S., and there is a lack of research on Alzheimer's disease and related dementia (AD/ADRD) in this population. Methods We reviewed the scientific literature using traditional (e.g., PubMed) sources and databases generated by U.S. and Brazilian governments, as well as international organizations, and press articles. Results This perspective review lists recommendations for researchers, health providers, and policymakers to promote greater inclusion of U.S. Brazilian populations in health research and care. The review identifies research areas in need of attention to address health inequities and promote mental/brain health in Brazilian immigrants and their offspring living in the U.S. These research areas are: 1) epidemiological studies to map the prevalence and incidence of mental/brain health conditions; 2) research on aging and AD/ADRD risk factors among Brazilian populations in the U.S.; and 3) the need for greater representation of U.S-residing Brazilian population in other relevant research areas involving genetics, neuropathology, and clinical trials. Conclusions The recommendation and research efforts proposed should help to pave the way for the development of community-engagement research and to promote mental/brain health education, improvement of mental/brain health and AD/ADRD services, and the development of culturally-informed intervention to the U.S.-residing Brazilian communities. HIGHLIGHTS The Brazilian population in the United States is growing but is underrepresented in U.S. health research.Approximately 71% of Brazilian immigrants in the United States are undocumented, with an increased risk for health inequities.Mental health is reported as a central health priority by Brazilian immigrants in the United States.There is a lack of research on Alzheimer's disease and other dementias (ADRD) in Brazilian immigrants in the United States.Epidemiological research is needed to map the prevalence/incidence of mental health conditions and ADRD risk factors among Brazilian immigrants in the United States.
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Affiliation(s)
- Sharon Sanz Simon
- Cognitive Neuroscience DivisionDepartment of NeurologyColumbia UniversityVagelos College of Physicians and SurgeonsNew YorkNew YorkUSA
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Department of NeurologyColumbia UniversityVagelos College of Physicians and SurgeonsNew YorkNew YorkUSA
- Old Age Research Group, Department of PsychiatryUniversity of São Paulo Medical SchoolSão PauloSão PauloBrazil
| | | | - Luciana Mascarenhas Fonseca
- Old Age Research Group, Department of PsychiatryUniversity of São Paulo Medical SchoolSão PauloSão PauloBrazil
- Department of Community and Behavioral HealthElson S. Floyd College of MedicineWashington State UniversitySpokaneWashingtonUSA
| | - Jacqueline Becker
- Division of General Internal MedicineIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Carolina Cappi
- Department of PsychiatryIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
- Seaver Autism Center for Research and TreatmentIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
- Department of PsychiatryClinics HospitalUniversity of São PauloSchool of MedicineSão PauloSão PauloBrazil
| | - Andrea Horvath Marques
- Elliott School International AffairsThe George Washington UniversityWashingtonDistrict of ColumbiaUSA
| | - Patricia C. Heyn
- Center for Optimal AgingDepartment of Physical TherapyMarymount UniversityArlingtonVirginiaUSA
| | - Priscila Dib Gonçalves
- Department of EpidemiologyColumbia University Mailman School of Public HealthNew YorkNew YorkUSA
| | - Silvia S. Martins
- Department of EpidemiologyColumbia University Mailman School of Public HealthNew YorkNew YorkUSA
| | - Geraldo Busatto
- Laboratory of Psychiatric Neuroimaging (LIM‐21)Department of PsychiatryUniversity of São Paulo Medical SchoolSão PauloSão PauloBrazil
| | - Laiss Bertola
- Department of PsychiatryEscola Paulista de Medicina, Universidade Federal de São PauloSão PauloBrazil
| | - Claudia Kimie Suemoto
- Division of GeriatricsDepartment of Clinical MedicineUniversity of São Paulo Medical SchoolSão PauloSão PauloBrazil
| | - Ricardo Nitrini
- Old Age Research Group, Department of PsychiatryUniversity of São Paulo Medical SchoolSão PauloSão PauloBrazil
| | - Paulo Caramelli
- Behavioral and Cognitive Neurology Research GroupFaculdade de MedicinaUniversidade Federal de Minas GeraisBelo HorizonteMinas GeraisBrazil
| | - Monica Sanches Yassuda
- Department of NeurologyUniversity of São Paulo Medical SchoolSão PauloSão PauloBrazil
- Gerontology, School of Arts, Sciences, and HumanitiesUniversity of São PauloSão PauloSão PauloBrazil
| | - Eliane Correa Miotto
- Old Age Research Group, Department of PsychiatryUniversity of São Paulo Medical SchoolSão PauloSão PauloBrazil
| | - Lea Tenenholz Grinberg
- Memory and Aging CenterDepartment of NeurologyUniversity of California San FranciscoSan FranciscoCaliforniaUSA
- Department of PathologyUniversity of California San FranciscoSan FranciscoCaliforniaUSA
- LIM‐22Department of PathologyUniversity of São Paulo Medical SchoolSão PauloSão PauloBrazil
- Global Brain Health InstituteUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Miguel Arce Renteria
- Cognitive Neuroscience DivisionDepartment of NeurologyColumbia UniversityVagelos College of Physicians and SurgeonsNew YorkNew YorkUSA
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Department of NeurologyColumbia UniversityVagelos College of Physicians and SurgeonsNew YorkNew YorkUSA
| | - Margarita Alegria
- Disparities Research UnitDepartment of MedicineMassachusetts General HospitalBostonMassachusettsUSA
- Department of MedicineHarvard Medical SchoolBostonMassachusettsUSA
- Department of PsychiatryHarvard Medical SchoolBostonMassachusettsUSA
| | - Yaakov Stern
- Cognitive Neuroscience DivisionDepartment of NeurologyColumbia UniversityVagelos College of Physicians and SurgeonsNew YorkNew YorkUSA
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Department of NeurologyColumbia UniversityVagelos College of Physicians and SurgeonsNew YorkNew YorkUSA
| | - Monica Rivera‐Mindt
- Department of PsychologyFordham UniversityNew YorkNew YorkUSA
- Department of NeurologyIcahn School of MedicineNew YorkNew YorkUSA
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Paixão TM, Teixeira LR, de Andrade CAF, Sepulvida D, Martinez-Silveira M, Nunes C, Siqueira CEG. Systematic Review and Meta-Analysis of Metabolic Syndrome and Its Components in Latino Immigrants to the USA. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1307. [PMID: 36674066 PMCID: PMC9858988 DOI: 10.3390/ijerph20021307] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 01/04/2023] [Accepted: 01/05/2023] [Indexed: 06/17/2023]
Abstract
The Metabolic Syndrome (MetS) is an increasingly prevalent condition globally. Latino populations in the USA have shown an alarming increase in factors associated with MetS in recent years. The objective of the present systematic review was to determine the prevalence of MetS and its risk factors in immigrant Latinos in the USA and perform a meta-analysis of those prevalence. The review included cross-sectional, cohort, or case−control studies involving adult immigrant Latinos in the USA, published during the period 1980−2020 in any language. Studies involving individuals who were pregnant, aged <18 years, immigrant non-Latinos, published outside the 1980−2020 period, or with other design types were excluded. The Pubmed, Web of Science, Embase, Lilacs, Scielo, and Google Scholar databases were searched. The risk of bias was assessed using the checklists of the Joanna Briggs Institute. The review included 60 studies, and the meta-analysis encompassed 52 studies. The pooled prevalence found for hypertension, diabetes, general obesity, and abdominal obesity were 28% (95% Confidence Interval (CI): 23−33%), 17% (95% CI: 14−20%), 37% (95% CI: 33−40%), and 54% (95% CI: 48−59%), respectively. The quality of the evidence of the primary studies was classified as low or very low. Few studies including immigrants from South America were identified. Further studies of those immigrants are needed due to the cultural, dietary, and language disparities among Latin American countries. The research protocol was registered with the Open Science Framework (OSF).
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Affiliation(s)
- Talita Monsores Paixão
- Center of Studies of Worker Health and Human Ecology, National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro 21041-210, Brazil
| | - Liliane Reis Teixeira
- Center of Studies of Worker Health and Human Ecology, National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro 21041-210, Brazil
| | - Carlos Augusto Ferreira de Andrade
- Department of Epidemiology and Quantitative Methods in Health, National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro 21041-210, Brazil
| | | | | | - Camila Nunes
- Fluminense Federal Institute of Education Science and Technology, Campos dos Goytacazes 28030-130, Brazil
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Lindsay AC, Caires T, Le Q, Nogueira DL, Tavares Machado MM, Greaney ML. Where Do Brazilian Immigrant Parents Obtain Information to Support the Healthful Energy Balance-related Behaviors of Their Preschool-age Children?: A Cross-sectional Study. AMERICAN JOURNAL OF HEALTH EDUCATION 2021. [DOI: 10.1080/19325037.2021.2001775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
| | | | - Qun Le
- Rutgers University, the State University of New Jersey
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Gut Microbiota Profile and Its Association with Clinical Variables and Dietary Intake in Overweight/Obese and Lean Subjects: A Cross-Sectional Study. Nutrients 2021; 13:nu13062032. [PMID: 34199239 PMCID: PMC8231825 DOI: 10.3390/nu13062032] [Citation(s) in RCA: 96] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/02/2021] [Accepted: 06/11/2021] [Indexed: 02/07/2023] Open
Abstract
We aimed to differentiate gut microbiota composition of overweight/obese and lean subjects and to determine its association with clinical variables and dietary intake. A cross-sectional study was performed with 96 overweight/obese subjects and 32 lean subjects. Anthropometric parameters were positively associated with Collinsella aerofaciens, Dorea formicigenerans and Dorea longicatena, which had higher abundance the overweight/obese subjects. Moreover, different genera of Lachnospiraceae were negatively associated with body fat, LDL and total cholesterol. Saturated fatty acids (SFAs) were negatively associated with the genus Intestinimonas, a biomarker of the overweight/obese group, whereas SFAs were positively associated with Roseburia, a biomarker for the lean group. In conclusion, Dorea formicigenerans, Dorea longicatena and Collinsella aerofaciens could be considered obesity biomarkers, Lachnospiraceae is associated with lipid cardiovascular risk factors. SFAs exhibited opposite association profiles with butyrate-producing bacteria depending on the BMI. Thus, the relationship between diet and microbiota opens new tools for the management of obesity.
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Amiri S. Obesity and overweight prevalence in immigration: A meta-analysis. OBESITY MEDICINE 2021; 22:100321. [DOI: 10.1016/j.obmed.2021.100321] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/28/2023]
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Health Conditions and Dietary Intake Among Brazilian Immigrants in the United States of America. J Immigr Minor Health 2021; 23:1259-1266. [PMID: 33486659 DOI: 10.1007/s10903-021-01139-1] [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: 01/06/2021] [Indexed: 10/22/2022]
Abstract
Immigration can improve economic status and access to education compared to the country of origin, but it challenges access to health and preventive care. Assess Brazilian immigrants' overall health conditions and dietary intake in New Jersey (US). This pilot study assessed health conditions and dietary intake. Brazilians immigrants were interviewed through their communities. Trained dietitians interviewed them using a questionnaire and three days of 24H recall. Dietary intake was analyzed using the Nutrition Data System for Research software. A sample of 118 individuals completed the protocol, majority female and overweight/obese, living in the US for 11.3 years with 21.1% declaring having Noncommunicable Diseases. The average number of daily meals was 2.20 ± 1.04. Energy intake does not correlate with time in the US. Obesity, dyslipidemia, and hypertension are the most prevalent Noncommunicable Diseases, demanding interventions that include managing saturated fat, cholesterol, and sodium intake.
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Liu M, Cao B, Liu M, Liang X, Wu D, Li W, Su C, Chen J, Gong C. High Prevalence of Obesity but Low Physical Activity in Children Aged 9-11 Years in Beijing. Diabetes Metab Syndr Obes 2021; 14:3323-3335. [PMID: 34321899 PMCID: PMC8312620 DOI: 10.2147/dmso.s319583] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 07/06/2021] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE To investigate the prevalence and associated factors of childhood overweight/obesity in the Shunyi district of Beijing, China. METHODS This study adopted a cross-sectional survey and included 10,855 children aged 6-18 years in the Shunyi district of Beijing, China. Analyses were stratified by age group (6-8, 9-11, 12-14, and 15-18 years). RESULTS The prevalence of overweight and obesity among children aged 6-18 years was high with 17.62% and 29.05% in boys, 17.57% and 18.04% in girls, respectively. Both boys and girls aged 9-11 years had the highest rate of obesity in comparison with the other age groups, though the differences in children aged 9-11 years and 12-14 years were not statistically significant. Compared with age 6-8 years, age 9-11 years (OR=1.59, 95% CI 1.41-1.79, P<0.01) and 12-14 years (OR=1.26, 95% CI 1.48-1.73, P<0.01) were independently positively associated with obesity. Importantly, in all subjects, the percentages of being physically active (exercise time ≥120 minutes/week) were lower in children aged 9-11 years in comparison to children in other age groups. This phenomenon remained when this comparison was performed respectively in the normal-weight, overweight, and obesity groups. Even after adjustment for other potential confounders, the probability of being physically active (exercise time ≥120 minutes/week) was lower in children aged 9-11 years (OR=0.86, 95% CI 0.78-0.94, P<0.01), but higher in children aged 12-14 years (OR=1.91, 95% CI 1.69-2.17, P<0.01) and aged 15-18 years (OR=2.22, 95% CI 1.85-2.66, P<0.01), when compared with children aged 6-8 years. CONCLUSION Children aged 9-11 years had a higher prevalence of obesity, but a lower percentage of being physically active. Targeted intervention programs in this key group are needed to address this problem in China.
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Affiliation(s)
- Meijuan Liu
- Department of Endocrinology, Genetics and Metabolism, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China
| | - Bingyan Cao
- Department of Endocrinology, Genetics and Metabolism, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China
| | - Min Liu
- Department of Endocrinology, Genetics and Metabolism, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China
| | - Xuejun Liang
- Department of Endocrinology, Genetics and Metabolism, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China
| | - Di Wu
- Department of Endocrinology, Genetics and Metabolism, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China
| | - Wenjing Li
- Department of Endocrinology, Genetics and Metabolism, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China
| | - Chang Su
- Department of Endocrinology, Genetics and Metabolism, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China
| | - Jiajia Chen
- Department of Endocrinology, Genetics and Metabolism, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China
| | - Chunxiu Gong
- Department of Endocrinology, Genetics and Metabolism, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China
- Correspondence: Chunxiu Gong Department of Endocrinology, Genetics and Metabolism, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, 100045, People’s Republic of ChinaTel +86-10-59616161 Email
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