1
|
Kindratt TB, Smith A. Cognitive Difficulty in Middle Eastern and North African Adults Living in the United States Compared With Other Racial and Ethnic Categories, 2017-2021. Am J Public Health 2024; 114:1265-1274. [PMID: 39357001 PMCID: PMC11447784 DOI: 10.2105/ajph.2024.307803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2024]
Abstract
Objectives. To estimate the odds of having cognitive difficulties among Middle Eastern and North African (MENA) American adults and compare these odds with those of White, Black, Hispanic/Latino, Asian, American Indian or Alaska Native (AI/AN), and Native Hawaiian/Other Pacific Islander adults nationally and in the 4 states with the largest MENA populations (California, New York, Michigan, and Texas) after adjusting for sociodemographic factors. Methods. We analyzed 2017-2021 American Community Survey data (aged ≥ 45 years; n = 7 284 988), comparing presence of cognitive difficulties by race/ethnicity. Results. MENA adults had greater odds of reporting cognitive difficulties than did White (odds ratio [OR] = 1.49; 95% confidence interval [CI] = 1.42, 1.56), Black (OR = 1.20; 95% CI = 1.14, 1.26), Hispanic (OR = 1.46; 95% CI = 1.39, 1.53), Asian (OR = 1.31; 95% CI = 1.25, 1.38), and AI/AN (OR = 1.07; 95% CI = 1.01, 1.14) adults. In all 4 states, odds of having cognitive difficulties were higher among MENA than Asian adults. Other racial/ethnic comparisons differed by state. Conclusions. A separate checkbox for MENA Americans approved by the Office of Management and Budget is important so health outcomes can be studied in more detail and funds can be allocated for research and resources at state and national levels. (Am J Public Health. 2024;114(11):1265-1274. https://doi.org/10.2105/AJPH.2024.307803).
Collapse
Affiliation(s)
- Tiffany B Kindratt
- Both authors are with the Department of Kinesiology, University of Texas at Arlington
| | - Alexandra Smith
- Both authors are with the Department of Kinesiology, University of Texas at Arlington
| |
Collapse
|
2
|
Bakhtiari E, Das J. The Immigrant Mortality Advantage Among Over-65 Middle Eastern and North African Immigrants to the United States. J Immigr Minor Health 2024:10.1007/s10903-024-01622-5. [PMID: 39097841 DOI: 10.1007/s10903-024-01622-5] [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: 07/20/2024] [Indexed: 08/05/2024]
Abstract
Immigrants to the United States often have longer life expectancies than their U.S.-born counterparts, however it is unclear whether a similar "immigrant advantage" exists for immigrants from the Middle East and North Africa (MENA). This study uses a novel machine-learning name classifier to offer one of the first national-level examinations of MENA mortality patterns by nativity in the United States. A recurrent neural network model was developed to identify MENA individuals based on given name and surname characteristics. The model was trained on more than 2.5 million mortality-linked social security records in the Berkeley Unified Numident Mortality Database (BUNMD). Mortality rates and life expectancy were estimated using a Gompertz distribution and maximum likelihood estimation, focusing on high-coverage years between 1988 and 2005 and deaths over age 65. Foreign-born MENA men over 65 showed a significant immigrant mortality advantage with a hazard ratio (HR) of 0.64 and an estimated 3.13 additional years of life expectancy at age 65 compared to U.S.-born counterparts. Foreign-born MENA women also exhibited an advantage, with a HR of 0.71 and an additional 2.24 years of life expectancy at age 65. This study is one of the first national-level analyses of mortality outcomes among the over-65 MENA population in the United States, finding a MENA immigrant mortality advantage. The results suggest further research is needed to identify and disaggregate the MENA population in health research.
Collapse
Affiliation(s)
- Elyas Bakhtiari
- Department of Sociology, William and Mary, Williamsburg, VA, 23185, USA.
| | - Jacinta Das
- William and Mary, Williamsburg, VA, 23185, USA
| |
Collapse
|
3
|
Sharif MZ, Maghbouleh N, Baback Boozary AS. COVID-19 Disparities Among Arab, Middle Eastern, and West Asian Populations in Toronto: Implications for Improving Health Equity Among Middle Eastern and North African Communities in the United States. Health Promot Pract 2024; 25:531-536. [PMID: 36624978 PMCID: PMC9834619 DOI: 10.1177/15248399221142898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Equity-oriented efforts to mitigate and prevent COVID-related disparities are hindered due to methodological limitations of the categorization of racial and ethnic groups, including Arabs and Middle Eastern and North African (MENA) communities, which remain invisible in national data collection efforts. This study highlights the disparities in COVID-related outcomes in Toronto, Canada and supports ongoing calls to collect public health data among MENA communities in the United States. METHODS Data on racial/ethnic identity and hospitalizations were collected by the Toronto Public Health (TPH) of the Ontario Ministry of Public Health Case between May 20, 2020, and September 30, 2021 from people with a confirmed or probable case of COVID-19. RESULTS The reported COVID-19 infection rate for Arab, Middle Eastern, West Asians (i.e., categories used to self-identify as MENA in Canada) relative to Whites in Toronto was 3.51. The age-standardized hospitalization rate ratio between Arab, Middle Eastern, West Asians and Whites was 4.59. DISCUSSION Data from Toronto highlight that Arab, Middle Eastern, and West Asians have higher rates of COVID-19 infections and hospitalizations than their White counterparts. Comparable studies are currently not possible in the United States due to lack of data that can disaggregate MENA individuals. This study underscores the critical need to collect data among MENA communities in the United States to advance our field's goal of promoting and advancing equity.
Collapse
Affiliation(s)
- Mienah Z. Sharif
- University of Washington, Seattle, WA,
USA
- University of California, Los Angeles,
CA, USA
| | | | | |
Collapse
|
4
|
Glass DJ, al-Tameemi Z, Farquhar S. Advancing an individual-community health nexus: Survey, visual, and narrative meanings of mental and physical health for Arab emerging adults. SSM - MENTAL HEALTH 2023; 4:100281. [PMID: 38188867 PMCID: PMC10767648 DOI: 10.1016/j.ssmmh.2023.100281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024] Open
Affiliation(s)
- Delaney J. Glass
- The University of Washington, Departments of Anthropology and Epidemiology, USA
| | | | | |
Collapse
|
5
|
Brandenberger J, Duchen R, Lu H, Wanigaratne S, Cohen E, To T, Piché-Renaud PP, Guttmann A. COVID-19 Vaccine Uptake in Immigrant, Refugee, and Nonimmigrant Children and Adolescents in Ontario, Canada. JAMA Netw Open 2023; 6:e2325636. [PMID: 37494039 PMCID: PMC10372706 DOI: 10.1001/jamanetworkopen.2023.25636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 06/13/2023] [Indexed: 07/27/2023] Open
Abstract
Importance COVID-19 vaccinations are recommended for minors. Surveys indicate lower vaccine acceptance by some immigrant and refugee groups. Objective To identify characteristics in immigrant, refugee, and nonimmigrant minors associated with vaccination. Design, Setting, and Participants This retrospective cohort study used linked, population-based demographic and health care data from Ontario, Canada, including all children aged 4 to 17 years registered for universal health insurance on January 1, 2021, across 2 distinct campaigns: for adolescents (ages 12-17 years), starting May 23, 2021, and for children (ages 5-11 years), starting November 25, 2021, through April 24, 2022. Data were analyzed from May 9 to August 2, 2022. Exposures Immigrant or refugee status and immigration characteristics (recency, category, region of origin, and generation). Main Outcomes and Measures Outcomes of interest were crude rates of COVID-19 vaccination (defined as ≥1 vaccination for children and ≥2 vaccinations for adolescents) and adjusted odds ratios (aORs) with 95% CIs for vaccination, adjusted for clinical, sociodemographic, and health system factors. Results The total cohort included 2.2 million children and adolescents, with 1 098 749 children (mean [SD] age, 7.06 [2.00] years; 563 388 [51.3%] males) and 1 142 429 adolescents (mean [SD] age, 14.00 [1.99] years; 586 617 [51.3%] males). Among children, 53 090 (4.8%) were first-generation and 256 886 (23.4%) were second-generation immigrants or refugees; among adolescents, 104 975 (9.2%) were first-generation and 221 981 (19.4%) were second-generation immigrants or refugees, most being economic or family-class immigrants. Immigrants, particularly refugees, were more likely to live in neighborhoods with highest material deprivation (first-generation immigrants: 18.6% of children and 20.2% of adolescents; first-generation refugees: 46.4% of children and 46.3% of adolescents; nonimmigrants: 18.5% of children and 17.2% of adolescents) and COVID-19 risk (first-generation immigrants; 20.0% of children and 20.5% of adolescents; first-generation refugees: 9.4% of children and 12.6% of adolescents; nonimmigrants: 6.9% of children and 6.8% of adolescents). Vaccination rates (53.1% in children and 79.2% in adolescents) were negatively associated with material deprivation. In both age groups, odds for vaccination were higher in immigrants (children: aOR, 1.30; 95% CI, 1.27-1.33; adolescents: aOR, 1.10; 95% CI, 1.08-1.12) but lower in refugees (children: aOR, 0.34; 95% CI, 0.33-0.36; adolescents: aOR, 0.88; 95% CI, 0.84-0.91) compared with nonimmigrants. In immigrant- and refugee-only models stratified by generation, region of origin was associated with uptake, compared with the overall rate, with the lowest odds observed in immigrants and refugees from Eastern Europe (children: aOR, 0.40; 95% CI, 0.35-0.46; adolescents: aOR, 0.41; 95% CI, 0.38-0.43) and Central Africa (children: aOR, 0.24; 95% CI, 0.16-0.35; adolescents: aOR, 0.51,CI: 0.45-0.59) and the highest odds observed in immigrants and refugees from Southeast Asia (children: aOR, 2.68; 95% CI, 2.47-2.92; adolescents aOR, 4.42; 95% CI, 4.10-4.77). Adjusted odds of vaccination among immigrants and refugees from regions with lowest vaccine coverage were similar across generations. Conclusions and Relevance In this cohort study using a population-based sample in Canada, nonrefugee immigrants had higher vaccine coverage than nonimmigrants. Substantial heterogeneity by region of origin and lower vaccination coverage in refugees persisted across generations. These findings suggest that vaccine campaigns need precision public health approaches targeting specific barriers in identified, undervaccinated subgroups.
Collapse
Affiliation(s)
- Julia Brandenberger
- Edwin S.H. Leong Centre for Healthy Children, University of Toronto, Toronto, Ontario, Canada
- Division of Pediatric Emergency Medicine, Hospital for Sick Children, Toronto, Ontario, Canada
- Pediatric Emergency Department, University Hospital of Bern, Bern, Switzerland
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada
| | | | - Hong Lu
- ICES, Toronto, Ontario, Canada
| | - Susitha Wanigaratne
- Edwin S.H. Leong Centre for Healthy Children, University of Toronto, Toronto, Ontario, Canada
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
| | - Eyal Cohen
- Edwin S.H. Leong Centre for Healthy Children, University of Toronto, Toronto, Ontario, Canada
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Division of Paediatric Medicine, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Teresa To
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Pierre-Philippe Piché-Renaud
- Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
- Division of Pediatric Infectious Diseases, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Astrid Guttmann
- Edwin S.H. Leong Centre for Healthy Children, University of Toronto, Toronto, Ontario, Canada
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Division of Paediatric Medicine, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
6
|
Zaki TA, Ziogas A, Chang J, Murphy CC, Anton-Culver H. Survival of Middle Eastern and North African Individuals Diagnosed with Colorectal Cancer: A Population-Based Study in California. Cancer Epidemiol Biomarkers Prev 2023; 32:795-801. [PMID: 37012208 PMCID: PMC11338047 DOI: 10.1158/1055-9965.epi-22-1326] [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: 12/20/2022] [Revised: 02/27/2023] [Accepted: 03/29/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Literature on colorectal cancer outcomes in individuals of Middle Eastern and North African (MENA) descent is limited. To address this gap, we estimated five-year colorectal cancer-specific survival by race and ethnicity, including MENA individuals, in a diverse, population-based sample in California. METHODS We identified adults (ages 18-79 years) diagnosed with a first or only colorectal cancer in 2004 to 2017 using the California Cancer Registry (CCR), including non-Hispanic White, non-Hispanic Black, non-Hispanic Asian, Hispanic, and MENA individuals. For each racial/ethnic group, we calculated five-year colorectal cancer-specific survival and used Cox proportional hazards regression models to examine the association of race/ethnicity and survival, adjusting for clinical and socio demographic factors. RESULTS Of 110,192 persons diagnosed with colorectal cancer, five-year colorectal cancer-specific survival was lowest in Black (61.0%) and highest in MENA (73.2%) individuals. Asian (72.2%) individuals had higher survival than White (70.0%) and Hispanic (68.2%) individuals. In adjusted analysis, MENA [adjusted HR (aHR), 0.82; 95% confidence interval (CI), 0.76-0.89], Asian (aHR, 0.86; 95% CI, 0.83-0.90), and Hispanic (aHR, 0.94; 95% CI, 0.91-0.97) race/ethnicity were associated with higher, and Black (aHR, 1.13; 95% CI, 1.09-1.18) race/ethnicity was associated with lower survival compared with non-Hispanic White race/ethnicity. CONCLUSIONS To our knowledge, this is the first study to report colorectal cancer survival in MENA individuals in the United States. We observed higher survival of MENA individuals compared with other racial/ethnic groups, adjusting for sociodemographic and clinical factors. IMPACT Future studies are needed to identify factors contributing to cancer outcomes in this unique population.
Collapse
Affiliation(s)
- Timothy A. Zaki
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX
| | - Argyrios Ziogas
- Department of Medicine, School of Medicine, University of California Irvine, Irvine, CA
| | - Jenny Chang
- Department of Medicine, School of Medicine, University of California Irvine, Irvine, CA
| | - Caitlin C. Murphy
- School of Public Health, University of Texas Health Science Center at Houston (UTHealth Houston), Houston, TX
| | - Hoda Anton-Culver
- Department of Medicine, School of Medicine, University of California Irvine, Irvine, CA
| |
Collapse
|
7
|
Kindratt TB, Dallo FJ, Zahodne LB, Ajrouch KJ. Cognitive Limitations Among Middle Eastern and North African Immigrants. J Aging Health 2022; 34:1244-1253. [PMID: 35606926 PMCID: PMC9633450 DOI: 10.1177/08982643221103712] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To estimate and compare the prevalence of cognitive limitations among Middle Eastern and North African (MENA) immigrants compared to US- and foreign-born non-Hispanic Whites from Europe (including Russia/former USSR) and examine differences after controlling for risk factors. METHODS Cross-sectional data using linked 2000-2017 National Health Interview Survey and 2001-2018 Medical Expenditure Panel Survey data (ages >=65 years, n = 24,827) were analyzed. RESULTS The prevalence of cognitive limitations was 17.3% among MENA immigrants compared to 9.6% and 13.6% among US- and foreign-born non-Hispanic Whites from Europe. MENA immigrants had higher odds (OR = 1.88; 95% CI = 1.06-3.34) of reporting a cognitive limitation than US-born non-Hispanic Whites after controlling for age, sex, education, hearing loss, hypertension, depression, social isolation, and diabetes. DISCUSSION To further examine cognitive health among the MENA aging population, policy changes are needed to identify this group that is often absent from research because of their federal classification as non-Hispanic Whites.
Collapse
Affiliation(s)
- Tiffany B. Kindratt
- Public Health Program, Department of Kinesiology, College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX, USA
| | - Florence J. Dallo
- Department of Public and Environmental Wellness, School of Health Sciences, Oakland University, Rochester, MI, USA
| | - Laura B. Zahodne
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Kristine J. Ajrouch
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
- Department of Sociology, Anthropology and Criminology, Eastern Michigan University, Ypsilanti, MI, USA
| |
Collapse
|
8
|
Abuelezam NN, Greenwood KL, Al-Ani M, Galea S, Al-Naser R. Risk Factors for COVID-19 Positivity and Hospital Admission Among Arab American Adults in Southern California. Public Health Rep 2022; 137:790-795. [PMID: 35466811 PMCID: PMC9066230 DOI: 10.1177/00333549221083740] [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] [Indexed: 11/17/2022] Open
Abstract
Objective: Little is known about risk factors associated with COVID-19 infection among Arab American people. We aimed to understand the predictors of receiving a positive COVID-19 test result and being admitted to the hospital for COVID-19 among Arab American adults using data from a hospital near an Arab ethnic enclave. Methods: We used electronic medical record data for Arab American adults aged ≥18 years from March 1, 2020, through January 31, 2021, at Sharp Grossmont Hospital in La Mesa, California. The primary outcomes were receiving a positive COVID-19 test result and being admitted to the hospital for COVID-19. We ran logistic regression models with individual- and population-level risk factors to determine the odds of each primary outcome. Results: A total of 2744 Arab American adults were tested for COVID-19, of whom 783 (28.5%) had a positive test result. In the fully adjusted model, women had lower odds of receiving a positive test result than men (adjusted odds ratio [aOR] = 0.77; 95% CI, 0.64-0.92), and adults living in high-poverty areas had higher odds of receiving a positive test result than adults in lower-poverty areas (aOR = 1.25; 95% CI, 1.04-1.51). Of the 783 Arab American adults with data on admission, 131 (16.7%) were admitted. For every 1-unit increase in the Charlson Comorbidity Index, the odds of admission increased by 66% (aOR = 1.66; 95% CI, 1.36-2.04). Conclusion: The risk of receiving a positive test result for COVID-19 was higher among Arab American adults living in high-poverty areas than in lower-poverty areas. The risk of admission was directly related to overall health status. Future work should aim to understand the barriers to prevention and testing in this population.
Collapse
Affiliation(s)
- Nadia N Abuelezam
- William F. Connell School of Nursing, Boston College, Chestnut Hill, MA, USA
| | | | - Mawj Al-Ani
- UC San Diego Health, University of California at San Diego, San Diego, CA, USA
| | - Sandro Galea
- School of Public Health, Boston University, Boston, MA, USA
| | | |
Collapse
|
9
|
Differential COVID-19 testing, admissions, and mortality for Arab Americans in Southern California. PLoS One 2022; 17:e0267116. [PMID: 35421208 PMCID: PMC9009685 DOI: 10.1371/journal.pone.0267116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 04/02/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Understanding of COVID-19 acquisition and severity risk in minoritized groups is limited by data collection on race and ethnicity; very little is known about COVID-19 risk among Arab Americans in the United States. PURPOSE To quantify whether Arab Americans in the El Cajon region of California experienced differential levels of SARS-CoV-2 infection, severity and mortality when compared to other racial/ethnic groups. METHODS A retrospective study was conducted using Sharp Grossmont Hospital's electronic medical records. Patients were included in the study if they were: 18 years of age or older, tested for SARS-CoV-2, admitted for COVID-19 infection, or had COVID-19 listed as a cause of death between March 1, 2020 and January 31, 2021. The primary outcomes of interest were a positive COVID-19 test result, admission to the hospital due to COVID-19, and in hospital COVID-19 related mortality. Comparisons were made across racial/ethnic groups using chi-squared statistics and logistic regression models adjusted for sociodemographics, comorbidities, and time from March 2020. RESULTS Arab Americans had greater odds of testing positive for SARS-CoV-2 than non-Hispanic White (adjusted odds ratio, AOR: 3.83, 95% confidence interval, CI: 3.29, 4.46) and non-Hispanic Black (AOR: 2.34, 95% CI: 1.91, 2.88) patients but lower odds of admission (AOR: 0.47, 95% CI: 0.36, 0.63) and in-hospital mortality (AOR: 0.43, 95% CI: 0.28, 0.65) than Hispanic patients. CONCLUSIONS There were distinct patterns for COVID-19 infection, severity, and mortality for Arab Americans in Southern California. Without a dedicated ethnic identifier, COVID-19 disparities facing Arab Americans will continue to go undocumented.
Collapse
|
10
|
Abuelezam NN, El-Sayed A, Galea S, Gordon NP. Understanding differences within ethnic group designation: comparing risk factors and health indicators between Iranian and Arab Americans in Northern California. BMC Public Health 2021; 21:1074. [PMID: 34090389 PMCID: PMC8178892 DOI: 10.1186/s12889-021-11121-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 05/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Middle Eastern and North African (MENA) ethnic group is a diverse group composed of two primary subsets in the United States: Iranian and Arab Americans. We aimed to compare health risk factors, chronic health conditions, and mental health conditions of Iranian and Arab American adults in Northern California. METHODS We used cross-sectional electronic health record (EHR) data from a 2016 Northern California health plan study cohort to compare adults classified as Iranian or Arab American based on ethnicity, language, or surname. We produced age-standardized prevalence estimates of obesity, smoking, hyperlipidemia, prediabetes, diabetes, hypertension, depression, and anxiety for Iranian and Arab American men and women by age group (35-44, 45-64, and 65-84) and overall (35-84). We used generalized linear models to calculate prevalence ratios (PR) to compare Iranian and Arab American adults ages 35-84 on all health indicators. RESULTS Compared to Arab Americans, Iranian Americans had a lower prevalence of obesity (PR: 0.77, 95% confidence interval, CI: 0.73, 0.82), current smoking (PR: 0.80, 95% CI: 0.73, 0.89), and ever smoking (PR: 0.95, 95% CI: 0.91, 0.99), but a higher prevalence of hyperlipidemia (PR: 1.09, 95% CI: 1.06, 1.12), prediabetes (PR: 1.12, 95% CI: 1.09, 1.16), depression (PR; 1.41, 95% CI: 1.30, 1.52), and anxiety (PR: 1.52, 95% CI: 1.42, 1.63). Similar patterns were observed for men and women. CONCLUSION This work supports the need to collect granular data on race and ethnicity within the MENA ethnic group to improve identification in clinical care settings and population health reporting to better address the physical and mental health needs of different MENA subgroups.
Collapse
Affiliation(s)
- Nadia N Abuelezam
- Boston College William F. Connell School of Nursing, 140 Commonwealth Avenue, Chestnut Hill, MA, 02467, USA.
| | - Abdulrahman El-Sayed
- College of Literature, Science, & the Arts & Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Sandro Galea
- Boston University School of Public Health, Boston, MA, USA
| | - Nancy P Gordon
- Kaiser Permanente Division of Research, Oakland, CA, USA
| |
Collapse
|
11
|
Abuelezam NN, El-Sayed AM, Galea S, Gordon NP. Health Risks and Chronic Health Conditions among Arab American and White Adults in Northern California. Ethn Dis 2021; 31:235-242. [PMID: 33883864 DOI: 10.18865/ed.31.2.235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objectives To characterize the prevalence of chronic cardiovascular conditions and risk factors among Arab American adults stratified by sex and compare these with non-Hispanic Whites. Design Cross-sectional study using electronic health record data from visits between January 2015 and December 2016. Age-adjusted prevalence estimates were calculated for men and women and compared using generalized linear models. Setting Kaiser Permanente health plan in Northern California. Participants Non-Hispanic White (N=969,566) and Arab American (N=18,072) adult members. Main Outcome Measures Sex-stratified prevalence and prevalence ratios of diabetes, pre-diabetes, hypertension, and hyperlipidemia diagnosed by December 2016 and of obesity, ever smoking, and current smoking status. Results Arab American men had a significantly higher prevalence of ever smoking (41.8 vs 40.8%), diabetes (17.3 vs 12.5%), and hyperlipidemia (40.8 vs 34.7%) than White men, but a significantly lower prevalence of obesity (34.4 vs 37.8%) and hypertension (30.5 vs 33.3%). Arab American women had a significantly higher prevalence of diabetes (11.1 vs 8.7%) and hyperlipidemia (31.5 vs 28.3%) than White women but significantly lower prevalence of obesity (31.0 vs 34.2%), ever smoking (24.8 vs 34.5%), and hypertension (25.8 vs 28.4%). Conclusions Hospital and health systems should intentionally collect data on Middle Eastern and North African ethnicity in electronic health records to identify and reduce the disparities this minority group faces.
Collapse
Affiliation(s)
- Nadia N Abuelezam
- Boston College William F. Connell School of Nursing, Chestnut Hill, MA
| | - Abdulrahman M El-Sayed
- College of Literature, Science, & the Arts & Department of Internal Medicine, University of Michigan, MI
| | - Sandro Galea
- Boston University School of Public Health, Boston, MA
| | | |
Collapse
|
12
|
Jungquist RM, Abuelezam NN. Disparities in influenza vaccination: Arab Americans in California. BMC Public Health 2021; 21:443. [PMID: 33663444 PMCID: PMC7932900 DOI: 10.1186/s12889-021-10476-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 02/18/2021] [Indexed: 01/24/2023] Open
Abstract
Background Influenza vaccination among minoritized groups remains below federal benchmarks in the United States (US). We used data from the 2004–2016 California Health Interview Surveys (CHIS) to characterize influenza vaccination patterns among Arab Americans in California. Methods Influenza vaccination was self-reported by Arab American adults (N = 1163) and non-Hispanic Whites (NHW, N = 166,955). Differences in influenza vaccination prevalence and odds were compared using chi-squared tests and survey-weighted logistic regression, respectively. Results Across all years, 30.3% of Arab Americans self-reported receiving an influenza vaccine (vs. 40.5% for NHW, p < 0.05). After sequential adjustment by sociodemographic, health behavior, and acculturation variables no differences in odds of self-reported influenza vaccination were observed between Arab Americans and NHW (odds ratio: 1.02, 95% confidence interval: 0.76–1.38). Male and unemployed Arab Americans had higher odds of reporting influenza vaccination than female and employed Arab Americans. Conclusions Future work should consider specific barriers to influenza vaccination in Arab American communities.
Collapse
Affiliation(s)
| | - Nadia N Abuelezam
- William F. Connell School of Nursing, Boston College, 140 Commonwealth Avenue, Chestnut Hill, MA, 02467, USA.
| |
Collapse
|
13
|
Bulut E, Brewster KL. Psychological distress in middle eastern immigrants to the United States: A challenge to the healthy migrant model? Soc Sci Med 2021; 274:113765. [PMID: 33639394 DOI: 10.1016/j.socscimed.2021.113765] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 12/29/2020] [Accepted: 02/07/2021] [Indexed: 01/09/2023]
Abstract
RATIONALE AND OBJECTIVE Research has documented a robust mental health advantage among Asian and Latino immigrants to the United States relative to the native-born. The current investigation extended this line of research, asking whether Middle Eastern immigrants to the United States enjoy a similar mental health advantage. METHODS Drawing on pooled cross-sections from the 2007-2018 National Health Interview Surveys, we used OLS regression to examine psychological distress in Middle Eastern immigrants relative to both native-born Whites and immigrants from other global regions. We used statistical interactions to assess whether gender and period differences are contingent on region of birth. RESULTS Findings reveal that the average level of psychological distress is higher among Middle Eastern immigrants than among both U.S.-born Whites and immigrants from other regions. Despite changing circumstances of migration for Middle Easterners and implementation in the United States of anti-immigrant policies, we see no evidence that distress increased more among immigrants compared to native-born Whites. Results point to greater psychological distress among Middle Eastern women than their native-born White counterparts and women from other immigrant groups, as well as Middle Eastern men. In contrast, psychological distress levels for Middle Eastern and native-born White men were indistinguishable, suggesting that the Middle Eastern mental health disadvantage in the United States is borne solely by women. CONCLUSIONS Results show that the mental health advantage enjoyed by some immigrant groups does not extend to Middle Eastern women, contradicting the healthy migrant model and challenging the assumption of a uniform mental health advantage across immigrant groups.
Collapse
Affiliation(s)
- Elif Bulut
- Postdoctoral Fellow, Center for Demography & Population Health, Florida State University, USA.
| | - Karin L Brewster
- Professor of Sociology and Research Associate, Center for Demography & Population Health, Florida State University, USA.
| |
Collapse
|
14
|
Differences in Health Characteristics of Geographic Subgroups of Arab Americans in a Northern California Health Plan. J Racial Ethn Health Disparities 2021; 9:399-405. [PMID: 33502685 DOI: 10.1007/s40615-021-00970-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/14/2021] [Accepted: 01/15/2021] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Arab Americans are a diverse ethnic group originating from a large geographic area in the Middle East and North Africa (MENA). We aim to characterize differences in health between Arab Americans from different geographic subgroups within MENA. METHODS We used cross-sectional electronic health record (EHR) data for a subset of 4913 Arab Americans aged 20-84 in a 2016 Northern California health plan study cohort who could be assigned to one of 4 geographic subgroups (Gulf, African, Levant, and Other) based on EHR ethnicity data. We calculated age-adjusted prevalence estimates for men and women and used generalized linear models to compare Gulf, African, and Other subgroups to Levant Arabs on risk factors (obesity and smoking), chronic conditions (diabetes, hypertension, hyperlipidemia, and asthma), and mental health (depression and anxiety). RESULTS Among women, prevalence of smoking was lower among Gulf, African, and Other Arabs than Levant Arabs. Among men, prevalence of obesity, diabetes, and hyperlipidemia was lower among Gulf, African, and Other Arabs than Levant Arabs, while prevalence of depression was higher for these subgroups than Levant Arabs. DISCUSSION We found substantial differences in health characteristics across Arab Americans from different geographic subgroups. Our results suggest that more detailed race and ethnicity information should be collected on Arab Americans to better understand their diverse health risks.
Collapse
|
15
|
Dallo FJ, Kindratt TB, Zahodne L. Prevalence of Self-reported Cognitive Impairment Among Arab American Immigrants in the United States. Innov Aging 2021; 5:igaa058. [PMID: 33442566 PMCID: PMC7788314 DOI: 10.1093/geroni/igaa058] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Indexed: 11/28/2022] Open
Abstract
Background and Objectives Studies evaluating self-reported cognitive impairment among Arab American immigrants have not been conducted. Our objective was 2-fold: (a) to estimate and compare the age- and sex-adjusted prevalence of self-reported cognitive impairment between Arab American immigrants and U.S.- and immigrant non-Hispanic Whites, non-Hispanic Blacks, Hispanics and non-Hispanic Asians and (b) to examine associations between race, ethnicity, nativity status, and cognitive impairment among Arab American immigrants and non-Hispanic Whites (U.S.- and foreign-born) after controlling for explanatory factors. Research Design and Methods We used 18 years (2000–2017) of National Health Interview Survey data (n = 228 985; ages ≥ 45 years). Weighted percentages, prevalence estimates, and multivariable logistic regression models were calculated. Results The age- and sex-adjusted prevalence of self-reported cognitive impairment was significantly higher among Arab American immigrants (9.7%) compared to U.S.-born and non-Hispanic White immigrants (~7.4%). Discussion and Implications This is the first study to indicate that ethnic disparities in self-reported cognitive impairment may extend to Arab American immigrants. Additional studies need to be conducted to better understand the prevalence of cognitive impairment.
Collapse
Affiliation(s)
- Florence J Dallo
- Department of Public & Environmental Wellness, Oakland University, Rochester, Michigan, US
| | - Tiffany B Kindratt
- Public Health Program, Department of Kinesiology, College of Nursing and Health Innovation, University of Texas at Arlington, US
| | - Laura Zahodne
- Department of Psychology, University of Michigan, Ann Arbor, US
| |
Collapse
|
16
|
Kamatham S, Trak J, Alzouhayli S, Fehmi Z, Rahoui N, Sulieman N, Khoury Z, Fehmi O, Rakine H, El-Masri D, Ujayli D, Elhagehassan H, Naaman J, Almsaddi F, Salloum M, Farooquee I, Syed N, Kim S, Lattouf O, Cote ML, Ali-Fehmi R. Characteristics and distribution of obesity in the Arab-American population of southeastern Michigan. BMC Public Health 2020; 20:1685. [PMID: 33172422 PMCID: PMC7653872 DOI: 10.1186/s12889-020-09782-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 10/27/2020] [Indexed: 12/23/2022] Open
Abstract
Background Arab-Americans constitute ~ 5% of Michigan’s population. Estimates of obesity in Arab-Americans are not up-to-date. We aim to describe the distribution of and factors associated with obesity in an Arab-American population in Southeastern Michigan (SE MI). Methods Retrospective medical record review identified n = 2363 Arab-American patients seeking care at an Arab-American serving clinic in SE MI, located in a city which is home to a large proportion of Arab-Americans in the United States (US). Body mass index (BMI) was the primary outcome of interest. Distribution of BMI was described using percentages, and logistic regression models were constructed to examine the association between obesity, other comorbid conditions and health behaviors. This cohort was compared to Michigan’s Behavioral Risk Factor Surveillance System (BRFSS) data from 2018 (n = 9589) and to a cohort seeking care between 2013 and 2019 from a free clinic (FC) located in another city in SE MI (n = 1033). Results Of the 2363 Arab-American patients, those who were older or with HTN, DM or HLD had a higher prevalence of obesity than patients who were younger or without these comorbidities (all p-value < 0.001). Patients with HTN were 3 times as likely to be obese than those without HTN (95% CI: 2.41–3.93; p < 0.001). Similarly, the odds of being obese were 2.5 times higher if the patient was diabetic (95% CI: 1.92–3.16; p < 0.001) and 2.2 times higher if the patient had HLD (95% CI: 1.75–2.83; p < 0.001). There was no significant difference in obesity rates between Arab-Americans (31%) and the BRFSS population (32.6%). Compared to Arab-Americans, patients seen at the FC had a higher obesity rate (52.6%; p < 0.001) as well as significantly higher rates of HTN, DM and HLD (all p < 0.001). Conclusion Overall obesity rates in Arab-Americans were comparable to the population-based BRFSS rates, and lower than the patients seen at the FC. Further studies are required to understand the impact of obesity and the association of comorbidities in Arab-Americans.
Collapse
Affiliation(s)
- Saivaishnavi Kamatham
- Department of Pathology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Joseph Trak
- Department of Pathology, Wayne State University School of Medicine, Detroit, MI, USA
| | | | - Ziad Fehmi
- University of Michigan, Ann Arbor, MI, USA
| | - Nabil Rahoui
- Department of Pathology, Wayne State University School of Medicine, Detroit, MI, USA
| | | | | | - Omar Fehmi
- University of Michigan, Ann Arbor, MI, USA
| | | | - Dana El-Masri
- Wayne State University School of Medicine, Department of Family Medicine and Public Health Sciences, Detroit, MI, USA
| | | | | | - James Naaman
- Michigan State University, East Lansing, MI, USA
| | | | | | | | - Nadia Syed
- Arab Community Center for Economic and Social Services, Dearborn, MI, USA
| | - Seongho Kim
- Biostatistics Core, Karmanos Cancer Institute, Department of Oncology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Omar Lattouf
- Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA
| | - Michele L Cote
- Department of Oncology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Rouba Ali-Fehmi
- Department of Pathology, Wayne State University School of Medicine, Detroit, MI, USA.
| |
Collapse
|
17
|
Bolster-Foucault C, Bilodeau-Bertrand M, Djeha A, Auger N. Infant mortality among Arabic-speakers in Quebec, Canada, 1989-2017. J Immigr Minor Health 2020; 23:215-221. [PMID: 33098650 DOI: 10.1007/s10903-020-01115-1] [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: 10/20/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND We assessed trends in infant mortality for Arabic-speakers in Quebec, Canada between 1981 and 2017. METHODS We computed infant mortality rates for Arabic versus French and English-speakers in Quebec over time. We used adjusted risk ratios (aRR) and 95% confidence intervals (CI) to investigate trends among Arabic-speakers according to socioeconomic status, age, and cause of death. RESULTS Infant mortality rates were 3.0 for Arabic-speakers and 5.1 for French and English-speakers per 1,000 live births. Infant mortality increased for Arabic-speakers between 1989-1995 and 2010-2017 (aRR 2.07; 95% CI, 1.04-4.12), but decreased for French and English-speakers (aRR 0.77; 95% CI, 0.73-0.81). The increase in infant mortality was greater for socioeconomically advantaged Arabic-speakers (aRR 2.52; 95% CI, 1.20-5.28) and early neonatal mortality (aRR 1.64; 95% CI, 0.98-2.76). DISCUSSION Arabic-speakers in Quebec have a lower risk of infant mortality than French and English-speakers, but increasing infant mortality among Arabic-speakers is narrowing the gap.
Collapse
Affiliation(s)
- Clara Bolster-Foucault
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | | | - Améyo Djeha
- Institut national de santé publique du Québec, Montreal, Quebec, Canada
| | - Nathalie Auger
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada. .,Institut national de santé publique du Québec, Montreal, Quebec, Canada. .,University of Montreal Hospital Research Centre, Montreal, Quebec, Canada. .,Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Quebec, Canada.
| |
Collapse
|
18
|
Resnicow K, Patel MR, Green M, Smith A, Bacon E, Goodell S, Tariq M, Alhawli A, Syed N, Van Horn ML, Stiffler M. Development of an Ethnic Identity Measure for Americans of Middle Eastern and North African Descent: Initial Psychometric Properties, Sociodemographic, and Health Correlates. J Racial Ethn Health Disparities 2020; 8:1067-1078. [PMID: 32974877 PMCID: PMC8285340 DOI: 10.1007/s40615-020-00863-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 08/26/2020] [Accepted: 09/01/2020] [Indexed: 11/30/2022]
Abstract
Background Southeast Michigan is home to the second largest Middle Eastern and North African (MENA) US population. There is increasing interest in understanding correlates of psychosocial outcomes and health behaviors in this growing population. One potentially important health correlate is ethnic identity (EI). This paper reports the development, validity, and initial correlates of a new measure of MENA identity named the MENA-IM. Methods We used convenience sampling at locations frequented by individuals of MENA descent in southeast Michigan. We also measured EI centrality, religiosity, cultural mistrust, substance use, and health status to assess convergent and divergent validity. Exloratory and Confirmatory Factor Analysis identified three subscales, which were valid for both Arab and Chaldean respondents and were named (1) MENA cultural affiliation, (2) MENA media use, and (3) multicultural affiliation. We also created and tested a 20-item, single-factor version. Results We obtained data from 378 adults, 73% of whom identified as Arab and 27% as Chaldean. MENA-IM scores were higher among older, lower-educated, lower-income, non-US born, and Arabic-speaking respondents. Arab respondents reported significantly higher scores than Chaldeans. MENA-IM scores were positively associated with EI centrality and religiosity. Higher MENA-IM scores were found among those not reporting use of marijuana, alcohol, and opiates. Higher MENA-IM scores were also found among those without a self-reported history of heart disease and among those with better mental health status. Discussion The MENA-IM has strong psychometric properties and demonstrated initial evidence of convergent and discriminant validity. In general, values on the measure were associated with better psychosocial and health status. How the measure performs with MENA populations outside of Michigan and how it may relate to other health outcomes merit investigation.
Collapse
Affiliation(s)
- Ken Resnicow
- Department of Health Behavior & Health Education, University of Michigan School of Public Health, 109 Observatory Street, Room 3867 SPH I, Ann Arbor, MI, 48109-2029, USA. .,University of Michigan Rogel Cancer Center, Ann Arbor, MI, USA.
| | - Minal R Patel
- Department of Health Behavior & Health Education, University of Michigan School of Public Health, 109 Observatory Street, Room 3867 SPH I, Ann Arbor, MI, 48109-2029, USA.,University of Michigan Rogel Cancer Center, Ann Arbor, MI, USA
| | - Molly Green
- Department of Health Behavior & Health Education, University of Michigan School of Public Health, 109 Observatory Street, Room 3867 SPH I, Ann Arbor, MI, 48109-2029, USA
| | - Alyssa Smith
- Department of Health Behavior & Health Education, University of Michigan School of Public Health, 109 Observatory Street, Room 3867 SPH I, Ann Arbor, MI, 48109-2029, USA
| | - Elizabeth Bacon
- University of Michigan Rogel Cancer Center, Ann Arbor, MI, USA
| | | | - Madiha Tariq
- ACCESS, 6450 Maple St., Dearborn, MI, 48126, USA
| | | | - Nadia Syed
- ACCESS, 6450 Maple St., Dearborn, MI, 48126, USA
| | - M Lee Van Horn
- Department of Psychology, University of New Mexico, Albuquerque, NM, USA
| | | |
Collapse
|
19
|
Abuelezam NN. Health Equity During COVID-19: the Case of Arab Americans. Am J Prev Med 2020; 59:455-457. [PMID: 32703699 PMCID: PMC7298462 DOI: 10.1016/j.amepre.2020.06.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 06/05/2020] [Accepted: 06/09/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Nadia N Abuelezam
- Boston College William F. Connell School of Nursing, Chestnut Hill, Massachusetts.
| |
Collapse
|
20
|
Abuelezam NN, Cuevas AG, Galea S, Hawkins SS. Maternal Health Behaviors and Infant Health Outcomes Among Arab American and Non-Hispanic White Mothers in Massachusetts, 2012-2016. Public Health Rep 2020; 135:658-667. [PMID: 32805192 DOI: 10.1177/0033354920941146] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES The health profile of Arab American mothers and infants may differ from that of non-Arab American mothers and infants in the United States as a result of social stigma experienced in the historical and current sociopolitical climate. The objective of our study was to compare maternal health behaviors, maternal health outcomes, and infant health outcomes of Arab American mothers and non-Hispanic white mothers in Massachusetts and to assess the role of nativity as an effect modifier. METHODS Using data from Massachusetts birth certificates (2012-2016), we conducted adjusted logistic and linear regression models for maternal health behaviors, maternal health outcomes, and infant health outcomes. We used Arab ethnicity as the exposure of interest and nativity as an effect modifier. RESULTS Arab American mothers had higher odds than non-Hispanic white mothers of initiating breastfeeding (adjusted odds ratio [aOR] = 2.61; 95% CI, 2.39-2.86), giving birth to small-for-gestational-age infants (aOR = 1.28; 95% CI, 1.18-1.39), and having gestational diabetes (aOR = 1.31; 95% CI, 1.20-1.44). Among Arab American mothers, non-US-born mothers had higher odds than US-born mothers of having gestational diabetes (aOR = 1.80; 95% CI, 1.33-2.44) and lower odds of initiating prenatal care in the first trimester (aOR = 0.41; 95% CI, 0.33-0.50). In linear regression models, infants born to non-US-born Arab American mothers weighed 42.1 g (95% CI, -75.8 to -8.4 g) less than infants born to US-born Arab American mothers. CONCLUSION Although Arab American mothers engage in positive health behaviors, non-US-born mothers had poorer maternal health outcomes and access to prenatal care than US-born mothers, suggesting the need for targeted interventions for non-US-born Arab American mothers.
Collapse
Affiliation(s)
- Nadia N Abuelezam
- 6019 Boston College, William F. Connell School of Nursing, Chestnut Hill, MA, USA
| | - Adolfo G Cuevas
- 1810 Department of Community Health, Tufts University, Medford, MA, USA
| | - Sandro Galea
- 1846 Boston University School of Public Health, Boston, MA, USA
| | | |
Collapse
|
21
|
Stark L, Robinson MV, Seff I, Hassan W, Allaf C. SALaMA study protocol: a mixed methods study to explore mental health and psychosocial support for conflict-affected youth in Detroit, Michigan. BMC Public Health 2020; 20:38. [PMID: 31924196 PMCID: PMC6954582 DOI: 10.1186/s12889-020-8155-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 01/02/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Families resettling to the U.S. from conflict-affected countries in the Middle East and North Africa (MENA) face countless challenges. These families must cope with experiences of armed conflict and forced migration while also assimilating to a new society. According to the 'immigrant paradox,' time spent in a new country can compound the effects of migration and assimilation challenges and lead to deteriorated mental health. This study aims to assess the psychosocial wellbeing of MENA-born or first-generation adolescents attending school in the Detroit metropolitan area (DMA) to understand how schools, families, and communities play a role in supporting these adolescents' wellbeing. METHODS The quantitative component of this mixed methods study will involve a self-administered survey with a sample of students whose responses will be linked to academic records and behavioral assessments. The survey will utilize validated instruments to measure depressive and anxiety symptoms (Hopkins Symptom Checklist-37A), hope (Children's Hope Scale), resilience (Child and Youth Resilience Measure-12), externalizing and prosocial behavior (Hopkins Symptom Checklist-37A, Strengths and Difficulties Questionnaire), school belonging (Psychological Sense of School Membership), and peer relationships (Multidimensional Scale of Perceived Social Support). Differences in outcomes will be analyzed across two strata: students born in the MENA region and first-generation students whose parents immigrated to the US from the MENA region. The qualitative component will involve semi-structured key informant interviews with parents, school administrators, educators, and mental health providers, and focus group discussions (FGDs) with a purposive sample of adolescents born - or whose parents were born - in the MENA region. The FGDs will include a participatory ranking activity where participants will be asked to free-list and rank ideas about how schools can better support students like them. Thematic content analysis will be conducted to identify common themes. DISCUSSION This study will contribute evidence about the wellbeing of adolescents who come from - or whose parents come from - conflict-affected countries currently living in the U.S. Findings can be used to inform program and policy development to enable schools and their community partners to serve this population more effectively.
Collapse
Affiliation(s)
- Lindsay Stark
- Brown School, Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO, 63130, USA.
| | - Mackenzie V Robinson
- Brown School, Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO, 63130, USA
| | - Ilana Seff
- Mailman School of Public Health, Columbia University, 722 West 168th St., New York, NY, 10032, USA
| | - Wafa Hassan
- Global Educational Excellence, 2455 S. Industrial Hwy, Ann Arbor, MI, 48104, USA
| | - Carine Allaf
- Qatar Foundation International, 1225 New York Avenue NW, Suite 500, Washington, DC, 20005, USA
| |
Collapse
|
22
|
Zayed L, Chebli P, Shalabi I, Taha N, Abboud S. Health Assessment of the Arab American Community in Southwest Chicago. J Community Health 2020; 45:761-767. [PMID: 31916178 DOI: 10.1007/s10900-020-00791-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Chicago is among the top five metropolitan areas in the United States where Arab Americans reside; however, we have little available data on their perceptions of personal or community health. We collected 200 community health surveys in collaboration with a community-based organization that serves mainly Arabs in Chicago's southwest suburbs. The survey evaluated perceived community and personal health. In a mostly female, married, and low-income sample, participants identified cancers, diabetes, and high blood pressure/cholesterol as the top three health problems, while alcohol abuse, drug abuse, and overweight/obesity as the top three risky behaviors within the community. Gender differences, age differences, and educational level differences were found on certain determinants of health regarding the health of the community, perceived health problems, and risky behaviors. Our data validates previous findings from the literature highlighting cancer, diabetes, and high blood pressure as health priorities among Arabs, but offers new insights into unidentified issues within the Arab American community in Southwest Chicago such as alcohol, drug abuse, and child neglect/abuse. Furthermore, our findings warrant the need for classifying Arabs as a separate minority population facing health disparities.
Collapse
Affiliation(s)
- Linda Zayed
- Community Health Worker, Alliance Chicago, Chicago, IL, USA
| | - Perla Chebli
- Community Health Sciences Division, School of Public Health, University of Illinois At Chicago, Chicago, IL, USA
| | | | | | - Sarah Abboud
- Department of Women, Children, and Family Health Science, College of Nursing, University of Illinois At Chicago, 845 S. Damen Avenue, Chicago, IL, 60612, USA.
| |
Collapse
|