1
|
Maj A, Matynia M, Michalak N, Bis A, Andersson G. New in Town-An internet-based self-efficacy intervention for internal migrants: A randomized controlled trial. PLoS One 2024; 19:e0299638. [PMID: 38452136 PMCID: PMC10919843 DOI: 10.1371/journal.pone.0299638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 02/08/2024] [Indexed: 03/09/2024] Open
Abstract
OBJECTIVE Migration is a profound life transition that may threaten migrants' well-being and mental health. Results of several studies suggest that social self-efficacy beliefs may be beneficial for the psychological adjustment of migrants, buffering the effect of specific stressors related to migration, helping them reduce anxiety levels, and providing support in forming of new social bonds and better integration with a new community or culture. The primary purpose of this randomized controlled trial was to examine the effectiveness of the New in Town internet-based self-efficacy intervention for internal migrants in Poland. METHODS Participants were 158 internal adult migrants who had changed residence in the last 6 months. They were randomized into two groups: an experimental group (receiving an internet-based self-efficacy intervention), and a waiting list control group. We examined if the intervention was effective in enhancing participants' social self-efficacy (primary outcome), general self-efficacy, social support, satisfaction with life, and reduced reported loneliness (secondary outcomes). Outcome measures were assessed at baseline (Time 1) and 3-weeks later (Time 2). The dropout rate was 50.6%. Initially, we planned to gather follow-up data also 8-weeks after baseline (Time 3). However, due to health and safety reasons related to the COVID-19 pandemic, we decided to stop the trial. Finally, we included in our analysis only data gathered before the COVID-19 pandemic at Time 1 and Time 2. RESULTS A total of 159 individuals who met the study's inclusion criteria and completed the baseline assessment were randomly assigned to either the experimental group (n = 80) or the waiting list control group (n = 79). Nevertheless, one participant assigned to the control group was excluded from the analyses because they withdrew their consent to participate after being randomized. The study results suggest that compared to the waitlist control group (n = 78), participants in the experimental group (n = 80) reported a higher level of general self-efficacy beliefs at Time 2 (Cohen's d = 0.47; 95% CI: 0.15-0.79). However, there were no statistically significant effects on social self-efficacy, social support, satisfaction with life, and loneliness. CONCLUSION The study offers preliminary support for the effectiveness of an internet-based self-efficacy intervention designed for internal migrants on general self-efficacy beliefs. TRIAL REGISTRATION The trial was registered with ClinicalTrials.gov (identifier: NCT04088487) on 11th September 2019.
Collapse
Affiliation(s)
- Anna Maj
- Faculty of Psychology, SWPS University, Warsaw, Poland
| | - Maria Matynia
- Faculty of Psychology, SWPS University, Warsaw, Poland
| | | | | | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
2
|
Akushevich I, Kravchenko J, Yashkin A, Doraiswamy PM, Hill CV. Expanding the scope of health disparities research in Alzheimer's disease and related dementias: Recommendations from the "Leveraging Existing Data and Analytic Methods for Health Disparities Research Related to Aging and Alzheimer's Disease and Related Dementias" Workshop Series. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2023; 15:e12415. [PMID: 36935764 PMCID: PMC10020680 DOI: 10.1002/dad2.12415] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 02/06/2023] [Accepted: 02/15/2023] [Indexed: 03/18/2023]
Abstract
Topics discussed at the "Leveraging Existing Data and Analytic Methods for Health Disparities Research Related to Aging and Alzheimer's Disease and Related Dementias" workshop, held by Duke University and the Alzheimer's Association with support from the National Institute on Aging, are summarized. Ways in which existing data resources paired with innovative applications of both novel and well-known methodologies can be used to identify the effects of multi-level societal, community, and individual determinants of race/ethnicity, sex, and geography-related health disparities in Alzheimer's disease and related dementia are proposed. Current literature on the population analyses of these health disparities is summarized with a focus on identifying existing gaps in knowledge, and ways to mitigate these gaps using data/method combinations are discussed at the workshop. Substantive and methodological directions of future research capable of advancing health disparities research related to aging are formulated.
Collapse
Affiliation(s)
- Igor Akushevich
- Social Science Research InstituteBiodemography of Aging Research UnitDuke UniversityDurhamNorth CarolinaUSA
| | - Julia Kravchenko
- Duke University School of MedicineDepartment of SurgeryDurhamNorth CarolinaUSA
| | - Arseniy Yashkin
- Social Science Research InstituteBiodemography of Aging Research UnitDuke UniversityDurhamNorth CarolinaUSA
| | - P. Murali Doraiswamy
- Departments of Psychiatry and MedicineDuke University School of MedicineDurhamNorth CarolinaUSA
| | | | | |
Collapse
|
3
|
Squires A, Thompson R, Sadarangani T, Amburg P, Sliwinski K, Curtis C, Wu B. International migration and its influence on health. Res Nurs Health 2022; 45:503-511. [DOI: 10.1002/nur.22262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 08/23/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Allison Squires
- Rory Meyers College of Nursing New York University New York New York USA
- Grossman School of Medicine New York University New York New York USA
| | - Roy Thompson
- Sinclair School of Nursing University of Missouri Columbia Missouri USA
| | - Tina Sadarangani
- Rory Meyers College of Nursing New York University New York New York USA
| | - Polina Amburg
- School of Nursing Monmouth University Long Branch New Jersey USA
| | - Kathy Sliwinski
- School of Nursing, Center for Health Outcomes and Policy Research University of Pennsylvania Philadelphia Pennsylvania USA
| | - Cedonnie Curtis
- School of Nursing La Salle University Philadelphia Pennsylvania USA
| | - Bei Wu
- P50 Center for Asian Health Promotion and Equity, Rory Meyers College of Nursing New York University New York New York USA
| |
Collapse
|
4
|
Kiang L, Stein GL, Juang LP. Ethnic and Racial Identity of Immigrants and Effects on Mental Health. Curr Opin Psychol 2022; 47:101424. [DOI: 10.1016/j.copsyc.2022.101424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 06/27/2022] [Accepted: 07/05/2022] [Indexed: 11/26/2022]
|
5
|
Champion CD, Thomas SM, Plichta JK, Parrilla Castellar E, Rosenberger LH, Greenup RA, Hyslop T, Hwang ES, Fayanju OM. Disparities at the Intersection of Race and Ethnicity: Examining Trends and Outcomes in Hispanic Women With Breast Cancer. JCO Oncol Pract 2022; 18:e827-e838. [PMID: 33026950 PMCID: PMC9797230 DOI: 10.1200/op.20.00381] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
PURPOSE We sought to examine tumor subtype, stage at diagnosis, time to surgery (TTS), and overall survival (OS) among Hispanic patients of different races and among Hispanic and non-Hispanic (NH) women of the same race. METHODS Women 18 years of age or older who had been diagnosed with stage 0-IV breast cancer and who had undergone lumpectomy or mastectomy were identified in the National Cancer Database (2004-2014). Tumor subtype and stage at diagnosis were compared by race/ethnicity. Multivariable linear regression and Cox proportional hazards modeling were used to estimate associations between race/ethnicity and adjusted TTS and OS, respectively. RESULTS A total of 44,374 Hispanic (American Indian [AI]: 79 [0.2%]; Black: 1,011 [2.3%]; White: 41,126 [92.7%]; Other: 2,158 [4.9%]) and 858,634 NH women (AI: 2,319 [0.3%]; Black: 97,206 [11.3%]; White: 727,270 [84.7%]; Other: 31,839 [3.7%]) were included. Hispanic Black women had lower rates of triple-negative disease (16.2%) than did NH Black women (23.5%) but higher rates than did Hispanic White women (13.9%; P < .001). Hispanic White women had higher rates of node-positive disease (23.2%) versus NH White women (14.4%) but slightly lower rates than Hispanic (24.6%) and NH Black women (24.5%; P < .001). Hispanic White women had longer TTS versus NH White women regardless of treatment sequence (adjusted means: adjuvant chemotherapy, 42.71 v 38.60 days; neoadjuvant chemotherapy, 208.55 v 201.14 days; both P < .001), but there were no significant racial differences in TTS among Hispanic patients. After adjustment, Hispanic White women (hazard ratio, 0.77 [95% CI, 0.74 to 0.81]) and Black women (hazard ratio, 0.75 [95% CI, 0.58 to 0.96]) had improved OS versus NH White women (reference) and Black women (hazard ratio, 1.15 [95% CI, 1.12 to 1.18]; all P < .05). CONCLUSION Hispanic women had improved OS versus NH women, but racial differences in tumor subtype and nodal stage among Hispanic women highlight the importance of disaggregating racial/ethnic data in breast cancer research.
Collapse
Affiliation(s)
- Cosette D. Champion
- Department of Medicine, Washington University School of Medicine, St Louis, MO,Oluwadamilola M. Fayanju, MD, MA, MPHS, DUMC 3513, Durham, NC 27710; e-mail:
| | - Samantha M. Thomas
- Biostatistics Shared Resource, Duke Cancer Institute, Durham, NC,Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC
| | - Jennifer K. Plichta
- Department of Surgery, Duke University Medical Center, Durham, NC,Women’s Cancer Program, Duke Cancer Institute, Durham, NC
| | - Edgardo Parrilla Castellar
- Women’s Cancer Program, Duke Cancer Institute, Durham, NC,Department of Pathology, Duke University Medical Center, Durham, NC
| | - Laura H. Rosenberger
- Department of Surgery, Duke University Medical Center, Durham, NC,Women’s Cancer Program, Duke Cancer Institute, Durham, NC
| | - Rachel A. Greenup
- Department of Surgery, Duke University Medical Center, Durham, NC,Women’s Cancer Program, Duke Cancer Institute, Durham, NC,Department of Population Health Sciences, Duke University School of Medicine, Durham, NC
| | - Terry Hyslop
- Biostatistics Shared Resource, Duke Cancer Institute, Durham, NC,Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC
| | - E. Shelley Hwang
- Department of Surgery, Duke University Medical Center, Durham, NC,Women’s Cancer Program, Duke Cancer Institute, Durham, NC
| | - Oluwadamilola M. Fayanju
- Department of Surgery, Duke University Medical Center, Durham, NC,Women’s Cancer Program, Duke Cancer Institute, Durham, NC,Department of Population Health Sciences, Duke University School of Medicine, Durham, NC,Duke Forge, Duke University, Durham, NC,Department of Surgery, Durham VA Medical Center, Durham, NC,Oluwadamilola M. Fayanju, MD, MA, MPHS, DUMC 3513, Durham, NC 27710; e-mail:
| |
Collapse
|
6
|
Hawkins MM, Holliday DD, Weinhardt LS, Florsheim P, Ngui E, AbuZahra T. Barriers and facilitators of health among older adult immigrants in the United States: an integrative review of 20 years of literature. BMC Public Health 2022; 22:755. [PMID: 35421979 PMCID: PMC9008931 DOI: 10.1186/s12889-022-13042-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 03/09/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
There are over seven million older adult immigrants in the United States, and that number is expected to increase. Older adult immigrants in the United States have unique factors that influence their health.
Methods
In this integrative review, we systematically review 20 years of peer-reviewed literature on the barriers (i.e. isolation, lack of English Language Proficiency, low health literacy, lack of SES resources, discrimination) and facilitators (i.e. English Language Proficiency and maintaining ones native language, social support, culturally sensitive providers, healthcare access) of health among older adult immigrants in the United States.
Results
We found differing uses of the term ‘older adult’, emphasis on the lack of homogeneity among older adult immigrants, social support and isolation as significant barriers and facilitators of older adult immigrant health, and inconsistencies in uses and definitions of acculturation. We also examined relevant theories in the literature. Based on the literature review, focusing on Acculturation Theory, Social Cognitive Theory, and Successful Aging Theory, combining these three theories with findings from the literature to create the Older Adult Immigrant Adapted Model for Health Promotion.
Conclusions
Public health strives to promote health and prevent adverse health outcomes. Our integrative review not only systematically and thoroughly explicates 20 years of literature, but the Older Adult Immigrant Adapted Model for Health Promotion, provides guidance for future research and interventions.
Collapse
|
7
|
Nkimbeng M, Akumbom A, Granbom M, Szanton SL, Shippee TP, Thorpe RJ, Gaugler JE. Where to Retire? Experiences of Older African Immigrants in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1040. [PMID: 35162063 PMCID: PMC8834587 DOI: 10.3390/ijerph19031040] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 01/08/2022] [Accepted: 01/11/2022] [Indexed: 12/28/2022]
Abstract
Doubling in size since the 1970s, the aging needs of the African immigrant population are not fully understood. This qualitative study examined experiences of aging and retirement planning for African immigrant older adults in the United States (U.S.). Specifically, it explored the factors, processes, and ultimate decision of where these older adults planned to retire. Secondary analysis of semi-structured interviews with 15 older African immigrants in the Baltimore-Washington Metropolitan area was conducted. Data was analyzed using thematic analyses in NVivo. The majority of participants were women, with a mean age of 64. Three overarching themes with ten sub-themes were identified. The themes included: (1) cultural identity, which indicated the participant's comfort with the U.S. society and culture; (2) decision making, meaning factors that impact participants' choice of retirement location; and (3) decision made, meaning the final choice of where participants would like to retire. Age-friendliness for immigrant older adults in the U.S. is complex and it includes traditional domains such as physical and sociocultural environment (e.g., housing, transportation, and income). However, immigrant age-friendliness also needs to include wider contextual aspects such as political climate of their country of origin, immigrant status, family responsibilities, and acculturation in the U.S. More research is needed to better understand and facilitate age-friendly environments and transnational aging of immigrant older adults.
Collapse
Affiliation(s)
- Manka Nkimbeng
- Division of Health Policy and Management, University of Minnesota School of Public Health, 420 Delaware St SE., Minneapolis, MN 55455, USA; (T.P.S.); (J.E.G.)
| | - Alvine Akumbom
- Johns Hopkins School of Nursing, 525 N. Wolfe Street, Baltimore, MD 21205, USA; (A.A.); (S.L.S.)
| | - Marianne Granbom
- Department of Health Sciences, Lund University, 22100 Lund, Sweden;
| | - Sarah L. Szanton
- Johns Hopkins School of Nursing, 525 N. Wolfe Street, Baltimore, MD 21205, USA; (A.A.); (S.L.S.)
| | - Tetyana P. Shippee
- Division of Health Policy and Management, University of Minnesota School of Public Health, 420 Delaware St SE., Minneapolis, MN 55455, USA; (T.P.S.); (J.E.G.)
| | - Roland J. Thorpe
- Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, 624 Broadway, Baltimore, MD 21205, USA;
| | - Joseph E. Gaugler
- Division of Health Policy and Management, University of Minnesota School of Public Health, 420 Delaware St SE., Minneapolis, MN 55455, USA; (T.P.S.); (J.E.G.)
| |
Collapse
|
8
|
Co M, Couch E, Gao Q, Martinez A, Das-Munshi J, Prina M. Differences in survival and mortality in minority ethnic groups with dementia: A systematic review and meta-analysis. Int J Geriatr Psychiatry 2021; 36:1640-1663. [PMID: 34324226 DOI: 10.1002/gps.5590] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 06/12/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Although there are disparities in both risk of developing dementia and accessibility of dementia services for certain minority ethnic groups in the United States and United Kingdom, disparities in survival after a dementia diagnosis are less well-studied. Our objective was to systematically review the literature to investigate racial/ethnic differences in survival and mortality in dementia. METHODS We searched Embase, Ovid MEDLINE, Global Health and PsycINFO from inception to November 2018 for studies comparing survival or mortality over time in at least two race/ethnicity groups. Studies from any country were included but analysed separately. We used narrative synthesis and random-effects meta-analysis to synthesise findings. The Newcastle-Ottawa Scale was used to assess quality and risk of bias in individual studies. RESULTS We identified 22 articles, most from the United States (n = 17), as well as the United Kingdom (n = 3) and the Netherlands (n = 1). In a meta-analysis of US studies, hazard of mortality was lower in Black/African American groups (Pooled Hazard Ratio = 0.86, 95% CI = 0.82-0.91, I2 = 17%, from four studies) and Hispanic/Latino groups (Pooled HR = 0.65, 95% CI = 0.50-0.84, I2 = 86%, from four studies) versus comparison groups. However, study quality was mixed, and in particular, quality of reporting of race/ethnicity was inconsistent. CONCLUSION Literature indicates that Black/African American and Hispanic/Latino groups may experience lower mortality in dementia versus comparison groups in the United States, but further research, using clearer and more and consistent reporting of race/ethnicity, is necessary to understand what drives these patterns and their implications for policy and practice.
Collapse
Affiliation(s)
- Melissa Co
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Elyse Couch
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Qian Gao
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Andrea Martinez
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Jayati Das-Munshi
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Trust, London, UK
| | - Matthew Prina
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| |
Collapse
|
9
|
Levchenko Y. Aging into disadvantage: Disability crossover among Mexican immigrants in America. Soc Sci Med 2021; 285:114290. [PMID: 34352506 PMCID: PMC8416786 DOI: 10.1016/j.socscimed.2021.114290] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 07/08/2021] [Accepted: 07/30/2021] [Indexed: 10/20/2022]
Abstract
The "Hispanic paradox" refers to the accepted finding that Mexican immigrants have lower mortality compared to the US-born population, despite having lower levels of income, educational attainment, and health insurance coverage. However, Mexican immigrants' mortality advantage is not matched by lower disability rates, particularly later in the life course. Past studies have identified a crossover in disability rates for Mexican immigrants using age-specific disability rates but confound the effects of aging and duration of residence. By using the synthetic cohort method, I extend prior work on the disability crossover by tracing immigrant cohorts across the life course and disentangling newly arrived immigrants from those already established in the U.S. I use American Community Survey (ACS) 2015-2019 data to test whether the acculturation or cumulative disadvantage hypotheses account for the disability crossover. I find that, contrary to the expected finding of a socioeconomic health gradient in disability rates, Mexican immigrants' high disability rates converge regardless of education level or immigrant cohort. In addition, Mexican female immigrants are doubly disadvantaged, living in a protracted period of disability compared to males of the same education level. My findings support the negative health acculturation hypothesis as the dominant pathway for Mexican immigrants' later-life disability trajectories and consequently the explanation behind the disability crossover.
Collapse
Affiliation(s)
- Yuliana Levchenko
- Department of Sociology and Criminology, Pennsylvania State University, 412 Oswald Tower, University Park, 16802, Pennsylvania, United States.
| |
Collapse
|
10
|
Conversion of Mild Cognitive Impairment to Alzheimer Disease in Monolingual and Bilingual Patients. Alzheimer Dis Assoc Disord 2021; 34:225-230. [PMID: 32049674 DOI: 10.1097/wad.0000000000000373] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Conversion rates from mild cognitive impairment (MCI) to Alzheimer disease (AD) were examined considering bilingualism as a measure of cognitive reserve. METHODS Older adult bilingual (n=75) and monolingual (n=83) patients attending a memory clinic who were diagnosed with MCI were evaluated for conversion to AD. Age of MCI and AD diagnoses and time to convert were recorded and compared across language groups. PATIENTS Patients were consecutive patients diagnosed with MCI at a hospital memory clinic. RESULTS Bilingual patients were diagnosed with MCI at a later age than monolingual patients (77.8 and 75.5 y, respectively), a difference that was significant in some analyses. However, bilingual patients converted faster from MCI to AD than monolingual patients (1.8 and 2.8 y, respectively) resulting in no language group difference in age of AD diagnosis. This relationship held after accounting for education, cognitive level, immigration status, and sex. DISCUSSION The findings suggest that greater cognitive reserve as measured by language status leads to faster conversion between MCI and AD, all else being equal.
Collapse
|
11
|
Vásquez E, Zhang W, Dreby J, Lee S, Botoseneanu A. Nativity, Family, Disability: Results from the Hispanic Established Populations for the Epidemiologic Study of the Elderly. Ethn Dis 2021; 31:253-262. [PMID: 33883866 DOI: 10.18865/ed.31.2.253] [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] [Indexed: 11/18/2022] Open
Abstract
Objectives ativity and family support may influence attitudes and behaviors that delay or accelerate the disability process in older adults. The objectives of this study were twofold: 1) to evaluate nativity and migration cohort differences in trajectories of disability (assessed by activities of daily living [ADL]) among older Mexican Americans; and 2) to determine the role of objectively measured family support in the association between nativity, migration cohort, and disability changes over time. Methods This is a longitudinal study with up to 18 years follow-up (1993-2011) using data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly (N=2,785, mean age =72.4 years). Disability was assessed using self-reported limitations in activities of daily living (ADL). Nativity and migration cohort were self-reported. Family support was assessed by marital status and the number of their children participants saw each month. Linear growth curve models evaluated the trajectory of ADL disability over 18 years and assessed variations by nativity status, migration cohort and family support. Results Foreign-born respondents who migrated before age 20 had more starting ADL limitations (β= .36, P<.001) and accumulated disability faster (β=.04, P<.01) compared with their US-born counterparts. In contrast, foreign-born respondents who migrated at later ages showed disability trajectories similar to US-born respondents. Married respondents had a lower level of disability (β= -.14, P<.01) and a lower rate of accumulation over time (β= -.02, P=.001) compared with participants who were not married. Discussion Mexican Americans who migrate at younger ages may experience greater disability over time; however, family support may help mitigate the accumulation of disability among older Mexican Americans.
Collapse
Affiliation(s)
- Elizabeth Vásquez
- University at Albany School of Public Health (SUNY), Department of Epidemiology, Albany, NY
| | - Weihui Zhang
- University at Albany School of Public Health (SUNY), Department of Sociology/Biostastics/Epidemiology, Albany, NY
| | - Joanna Dreby
- University at Albany School of Public Health (SUNY), Department of Sociology, Albany, NY
| | - Sunghee Lee
- University of Michigan, Institute for Social Research, Ann Arbor, MI
| | - Anda Botoseneanu
- University of Michigan, Department of Health & Human Services and Institute of Gerontology, Ann Arbor, MI
| |
Collapse
|
12
|
Mendez-Figueroa H, Chauhan SP, Sangi-Haghpeykar H, Aagaard K. Pregnancy Outcomes among Hispanics Stratified by Country of Origin. Am J Perinatol 2021; 38:497-506. [PMID: 31655488 PMCID: PMC9059160 DOI: 10.1055/s-0039-1698835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE This study aimed to compare the perinatal outcomes among U.S.-born and foreign-born Hispanics and Caucasians and ascertain if length of time in the US was associated with the rate of adverse outcomes. STUDY DESIGN Retrospective cohort analysis of gravidae enrolled in our institutional perinatal database. Women delivering a non-anomalous, singleton, at 24 weeks or more and self-identified as Caucasian or Hispanic were included. Women were stratified by country of birth and ethnicity into U.S.-born Caucasian, U.S.-born Hispanic, and U.S. foreign-born Hispanic. Composite maternal (CMM) and neonatal (CNM) morbidity was assessed. RESULTS Of 20,422 women, 21% were Caucasian, 15% were U.S.-born Hispanics, and 64% were U.S. foreign-born Hispanics. Compared to Caucasians, U.S.-born and foreign-born Hispanic were older, more likely to be a grand multiparous, obese and less likely to be married. Compared to Caucasians, foreign-born Hispanics had a 1.42-fold increased risk of CMM (95% CI 1.26-1.30). Paradoxically, the rate of CNM was 40% lower among neonates born to foreign-born Hispanics (95% CI 0.51-0.74). A significant direct relationship was noted between time in the USA and CMM but not CNM among foreign-born Hispanics. CONCLUSION Despite less favorable baseline characteristics, U.S. foreign-born Hispanics have 40% less CNM compared to both Caucasians and U.S.-born Hispanics.
Collapse
Affiliation(s)
- Hector Mendez-Figueroa
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas
| | - Suneet P. Chauhan
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, McGovern Medical School at UTHealth, Houston, Texas
| | - Haleh Sangi-Haghpeykar
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas
| | - Kjersti Aagaard
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas
| |
Collapse
|
13
|
Determinants of Disability in Minority Populations in Spain: A Nationwide Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073537. [PMID: 33805538 PMCID: PMC8037545 DOI: 10.3390/ijerph18073537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 03/20/2021] [Accepted: 03/25/2021] [Indexed: 11/17/2022]
Abstract
Some population groups could be especially vulnerable to the effects of population ageing. The Global Activity Limitation Indicator (GALI) has been proposed as a measure of disability, but it has not been used in minority groups. The aim of this study is to estimate the prevalence of disability using the GALI and to analyse its determinants in immigrant and Roma populations. Data from the Spanish National Health Survey 2017 and the National Health Survey of the Roma Population 2014 were used, including adults aged 50 and above. Prevalence of disability was estimated, and odds ratios were calculated using logistic regression models to assess the association between disability and demographic, socioeconomic, and health variables. The prevalence of disability was estimated at 39.4%, 30.6%, and 58.7% in the native, immigrant, and Roma populations, respectively. Gender was a common determinant for the native and Roma populations. On the other hand, among immigrants, the risk of disability increased over the time residing in Spain. There were significant interactions with age and gender in the native population. Disability has different determinants in the three population groups. Public health measures to protect the Roma population and immigrants' health should be considered.
Collapse
|
14
|
Wang S, Mak HW. Generational health improvement or decline? Exploring generational differences of British ethnic minorities in six physical health outcomes. ETHNICITY & HEALTH 2020; 25:1041-1054. [PMID: 29699405 DOI: 10.1080/13557858.2018.1469736] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Objectives: To explore ethnic and generational differences in six physical health outcomes and whether these differences can be explained by health-related behaviors and socio-economic status. Design: Multivariate analyses using nationally representative data in 2010-2011 on self-assessed general health, activity-limiting illness, doctor-diagnosed diabetes, doctor-diagnosed high blood pressure, doctor-diagnosed asthma and body mass index from 21,651 White British, 997 Pakistanis, 695 Bangladeshis, 1,126 Indians, 573 Black Caribbeans and 873 Black Africans, adjusted for age, gender, health-related behaviors and socio-economic status. Results: While ethnicity is of great importance in patterning health differences, we find that ethnic differences in activity-limiting illness, diabetes, asthma and body mass index vary across generations. Health-related behaviors and socio-economic status are shown to partly explain ethnic and generational differences in some health outcomes. Conclusions: This study enables a better understanding of more nuanced patterns of ethnic and generational differences in health, highlighting the need to understand ethnicity as a fluid and changing characteristic, and the importance of socio-economic status and health-related behaviors in shaping ethnic differences in certain health outcomes.
Collapse
Affiliation(s)
- Senhu Wang
- Department of Sociology, University of Cambridge, Free School Lane, Cambridge, United Kingdom
| | - Hei-Wan Mak
- Department of Sociology, University of Cambridge, Free School Lane, Cambridge, United Kingdom
| |
Collapse
|
15
|
Daniel CM, Davila L, Makris UE, Mayo H, Caplan L, Davis L, Solow EB. Ethnic Disparities in Atherosclerotic Cardiovascular Disease Incidence and Prevalence Among Rheumatoid Arthritis Patients in the United States: a Systematic Review. ACR Open Rheumatol 2020; 2:525-532. [PMID: 32869533 PMCID: PMC7504478 DOI: 10.1002/acr2.11170] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 07/17/2020] [Indexed: 12/16/2022] Open
Abstract
Objective Rheumatoid arthritis (RA) is associated with increased atherosclerotic cardiovascular disease (ASCVD). General population cohorts have shown African American individuals to have greater and Hispanic Americans to have lower cardiovascular disease prevalence when compared with non‐Hispanic white individuals; however, the reasons for these findings are not clear. This systematic review seeks to describe the incidence and prevalence of ASCVD stratified by race/ethnicity within the US RA population. Methods MEDLINE, Embase, and Cochrane databases were searched for studies that reported incidence or prevalence of ASCVD (including, but not limited to, fatal and nonfatal stroke, myocardial infarction, and cardiovascular death) in those with RA. Abstracts and full texts were screened separately for inclusion by two reviewers, with a third reviewer to resolve discrepancies. Results We screened 2625 abstracts and fully reviewed 138 manuscripts. Twenty‐one were included that cited at a minimum the percentage of non‐Hispanic whites in their population. No publication meeting entry criteria initially stratified ASCVD by race/ethnicity. The average prevalent ASCVD in RA is 46.9% (95% CI: 46.8–47) (range of prevalent ASCVD: 30%‐47%). The average incident ASCVD is 8.2% (95% CI: 8.14–8.25) (range of incident ASCVD 1%–46%). Conclusion In this systematic review, we found a paucity of data on racially/ethnically diverse RA patients and ASCVD outcomes. Future studies should report the prevalence of ASCVD in various races/ethnicities with RA in the United States. These data would help inform clinicians on how best to manage cardiovascular disease risk in RA.
Collapse
Affiliation(s)
| | - Lesley Davila
- University of Texas Southwestern Medical Center, Dallas, Texas
| | - Una E Makris
- University of Texas Southwestern Medical Center, Dallas, Texas and Medical Service VA North Texas Health Care System, Dallas, Texas
| | - Helen Mayo
- Health Sciences Digital Library and Learning Center, UT Southwestern Medical Center, Dallas, Texas
| | - Liron Caplan
- Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado and University of Colorado, Aurora
| | | | - E Blair Solow
- University of Texas Southwestern Medical Center, Dallas, Texas
| |
Collapse
|
16
|
Outcomes of the Health Insurance Card Scheme on Migrants' Use of Health Services in Ranong Province, Thailand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124431. [PMID: 32575651 PMCID: PMC7345284 DOI: 10.3390/ijerph17124431] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 06/15/2020] [Accepted: 06/18/2020] [Indexed: 11/30/2022]
Abstract
In 2002, Thailand achieved Universal Health Coverage for all citizens; however, it remains the case that undocumented migrants are not fully covered. The Health Insurance Card Scheme (HICS) of the Ministry of Public Health is the key policy aiming to cover undocumented migrants. This study examined the impact of this policy on the utilisation rate of public health facilities among HICS beneficiaries including undocumented migrants. Facility-based individual records between 2011 and 2015 were purposively retrieved from one provincial hospital, one district hospital, and two health centres in one of the most densely migrant-populated provinces in Thailand. Poisson regression was conducted on inpatient (IP) utilisation, while negative binomial regression was conducted on outpatient (OP) utilisation. Of 74,722 admissions, 19.0% were insured by HICS. About 14.0% of the outpatient records were for HICS beneficiaries. Overall, the HICS utilisation rate in migrants was lower than in Thai patients. Being insured with the HICS significantly increased OP utilisation by 1.7%, and IP utilisation by 11.1% (relative to uninsured). Disease status was the most important factor that positively influenced the utilisation rate. Further studies that explore the differences in health service utilisation among HICS beneficiaries with diverse economic backgrounds are recommended
Collapse
|
17
|
Davison KM, Lung Y, Lin SL, Tong H, Kobayashi KM, Fuller-Thomson E. Psychological distress in older adults linked to immigrant status, dietary intake, and physical health conditions in the Canadian Longitudinal Study on Aging (CLSA). J Affect Disord 2020; 265:526-537. [PMID: 32090781 DOI: 10.1016/j.jad.2020.01.024] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 12/03/2019] [Accepted: 01/05/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Psychological distress increases mortality risk; there is little knowledge about its prevelance and contributory factors in older populations. METHODS Canadian Longitudinal Study on Aging baseline data (2010-2015) were analyzed to examine the relationship between Kessler's Psychological Distress Scale-K10 and immigrant status (recent/mid-term,<20 years; long-term, ≥20 years; Canadian-born). Covariates included socioeconomic and health-related variables. Stratified by sex, two series of multinomial logistic regression were used to calculate the likelihood of having mild distress (20 < K10 score ≤24) and moderate/severe distress (K10 score >24). RESULTS Respondents (n = 25,700) were mainly Canadian-born (82.8%), 45-65 years (59.3%), earning <C$100,000/year (58.2%), and had a post-secondary education (78.4%). For women, psychological distress was associated with being a recent/mid-term immigrant(OR=1.76, 99% CI 1.09-2.83), marital status (widowed/divorced/separated, OR=1.62, 99% CI 1.19-2.20), lower education level (<secondary school; OR = 1.95, 99% CI 1.32-2.88), lower intake of fruit and vegetable (≤ 2/day; OR=1.50, 99% CI 1.05-2.14), higher waist-to-height ratio (>cut-off; OR=1.32, 99% CI 1.02-1.70), and higher nutritional risk (ORs = 2.16-3.31, p's <0.001). For men, psychological distress was associated with under-nutrition (grip strength<cut-off, OR=1.57, 99% CI 1.14-2.16). For men and women, psychological distress was associated with age (>56 years, ORs=0.19-0.79, p's<0.01), lower income (≤C$149,000, ORs = 1.68-7.79, p's<0.01), multi-morbidities (ORs = 1.67-4.70, p's<0.01), chronic pain (ORs = 1.67-3.09, p's<0.001) and higher intake of chocolate (≥ 0.6 bar/week, ORs=1.61-2.23, p's<0.001). LIMITATIONS Cross-sectional design prohibits causal inferences. CONCLUSIONS Nutritional factors, immigration status, social, and health-related problems are strongly associated with psychological distress among midlife and older adults.
Collapse
Affiliation(s)
- Karen M Davison
- Kwantlen Polytechnic University, Canada; University of Hawai'i, USA.
| | - Yu Lung
- Factor-Inwentash Faculty of Social Work & Institute for Life Course and Aging, University of Toronto, 246 Bloor Street W, Toronto, Ontario M5S 1V4, Canada.
| | - Shen Lamson Lin
- Factor-Inwentash Faculty of Social Work & Institute for Life Course and Aging, University of Toronto, 246 Bloor Street W, Toronto, Ontario M5S 1V4, Canada.
| | | | | | - Esme Fuller-Thomson
- Factor-Inwentash Faculty of Social Work & Institute for Life Course and Aging, University of Toronto, 246 Bloor Street W, Toronto, Ontario M5S 1V4, Canada; Department of Family & Community Medicine and Faculty of Nursing, University of Toronto, Canada.
| |
Collapse
|
18
|
Has Rural-Urban Migration Promoted the Health of Chinese Migrant Workers?. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041218. [PMID: 32070056 PMCID: PMC7068351 DOI: 10.3390/ijerph17041218] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 02/09/2020] [Accepted: 02/10/2020] [Indexed: 01/17/2023]
Abstract
The relationship between health and migration has always been an important theme in immigration research. This research develops a new approach to test the healthy migrant hypothesis and the salmon bias hypothesis in China by examining an interaction term combining agricultural hukou and migrant status, non-agricultural employment history, and subsequent area of residence. Based on two Chinese micro-databases, CGSS 2015 and Harmonized CHARLS, we conducted an empirical test on the relationship between migration and health. Our empirical evidence suggests that the initial health advantage among Chinese rural migrant workers was largely due to self-selection rather than migration effects. After controlling for demographic and socioeconomic characteristics, this advantage disappeared. After their health deteriorated, migrant workers returned to their original location. This could exacerbate the contradiction between the allocation of medical resources and the demand in rural and urban China, further intensifying the already widening health status gap between rural and urban residents.
Collapse
|
19
|
Assari S, Cobb S, Cuevas AG, Bazargan M. Diminished Health Returns of Educational Attainment Among Immigrant Adults in the United States. Front Psychiatry 2020; 11:535624. [PMID: 33329080 PMCID: PMC7728619 DOI: 10.3389/fpsyt.2020.535624] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 10/09/2020] [Indexed: 11/13/2022] Open
Abstract
Objectives: Marginalization-related diminished returns (MDRs) refer to weaker health effects of educational attainment for socially marginalized groups compared to the socially privileged groups. Most of the existing literature on MDRs, however, has focused on marginalization due to race, ethnicity, and sexual orientation. Thus, very limited information exists on MDRs of educational attainment among immigrant populations in the United States. Aims: Building on the MDRs framework and using a nationally representative sample of US adults, we compared immigrant and native-born adults for the effects of educational attainment on psychological distress, self-rated health (SRH), and chronic diseases (CDs). Methods: The 2015 National Health Interview Survey (NHIS) has enrolled 33,672 individuals who were either immigrant (n = 6,225; 18.5%) or native born (n = 27,429; 81.5%). The independent variable (IV) was educational attainment, which was treated as a categorical variable. The dependent variables included psychological distress, SRH, and CDs, all of which were dichotomous variables. Age, gender, race, ethnicity, and region were confounders. Immigration (nativity status) was the moderator. Results: Higher educational attainment was associated with lower odds of psychological distress, poor SRH, and CDs. However, immigration showed a significant statistical interaction with college graduation on all outcomes, which were suggestive of smaller protective effects of college graduation on psychological distress, poor SRH, and CDs for immigrant than native-born adults. Conclusions: In the US, the associations between educational attainment and psychological distress, SRH, and CDs are all weaker for immigrant than native-born adults. To prevent health disparities, it is essential to decompose health inequalities that are due to low educational attainment from those that are due to diminished returns of educational attainment (i.e., MDRs). There is a need to help highly educated immigrant adults secure positive health outcomes, similar to their native-born counterparts. Such changes may require bold and innovative economic, public, and social policies that help immigrant adults to more effectively mobilize their educational attainment to secure tangible outcomes. Elimination of health disparities in the US requires efforts that go beyond equalizing access to education.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States.,Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States
| | - Sharon Cobb
- School of Nursing, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States
| | - Adolfo G Cuevas
- Department of Community Health, Tufts University, Boston, MA, United States
| | - Mohsen Bazargan
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States.,Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States
| |
Collapse
|
20
|
Davison KM, Lung Y, Lin SL, Tong H, Kobayashi KM, Fuller-Thomson E. Depression in middle and older adulthood: the role of immigration, nutrition, and other determinants of health in the Canadian longitudinal study on aging. BMC Psychiatry 2019; 19:329. [PMID: 31690283 PMCID: PMC6833158 DOI: 10.1186/s12888-019-2309-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 10/09/2019] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Little is known about depression in middle-aged and older Canadians and how it is affected by health determinants, particularly immigrant status. This study examined depression and socio-economic, health, immigration and nutrition-related factors in older adults. METHODS Using weighted comprehensive cohort data from the baseline Canadian Longitudinal Study on Aging (n = 27,162) of adults aged 45-85, gender-specific binary logistic regression was conducted with the cross-sectional data using the following variables: 1) Depression (outcome) measured using the Center for Epidemiologic Studies Short Depression (CESD-10) rating scale; 2) Immigration status: native-born, recent and mid-term (< 20 years), and long-term immigrants (≥20 years); and 3) covariates: socioeconomic status, physical health (e.g., multi-morbidity), health behavior (e.g., substance use), over-nutrition (e.g., anthropometrics), under-nutrition (e.g., nutrition risk), and dietary intake. RESULTS The sample respondents were mainly Canadian-born (82.6%), women (50.6%), 56-65 years (58.9%), earning between C$50,000-99,999 (33.2%), and in a relationship (69.4%). When compared to Canadian-born residents, recent, mid-term (< 20 years), and longer-term (≥ 20 years) immigrant women were more likely to report depression and this relationship was robust to adjustments for 32 covariates (adjusted ORs = 1.19, 2.54, respectively, p < 0.001). For women, not completing secondary school (OR = 1.23, p < 0.05), stage 1 hypertension (OR = 1.31, p < 0.001), chronic pain (OR = 1.79, p < 0.001), low fruit/vegetable intakes (OR = 1.33, p < 0.05), and fruit juice (OR = 1.80, p < 0.001), chocolate (ORs = 1.15-1.66, p's < 0.05), or salty snack (OR = 1.19, p < 0.05) consumption were associated with depression. For all participants, lower grip strength (OR = 1.25, p < 0.001) and high nutritional risk (OR = 2.24, p < 0.001) were associated with depression. For men, being in a relationship (OR = 0.62, p < 0.001), completing post-secondary education (OR = 0.82, p < 0.05), higher fat (ORs = 0.67-83, p's < 0.05) and omega-3 egg intake (OR = 0.86, p < 0.05) as well as moderate intakes of fruits/vegetables and calcium/high vitamin D sources (ORs = 0.71-0.743, p's < 0.05) predicted a lower likelihood of depression. For men, chronic conditions (ORs = 1.36-3.65, p's < 0.001), chronic pain (OR = 1.86, p < 0.001), smoking (OR = 1.17, p < 0.001), or chocolate consumption (ORs = 1.14-1.72, p's < 0.05) predicted a higher likelihood of depression. CONCLUSIONS The odds of developing depression were highest among immigrant women. Depression in middle-aged and older adults is also associated with socioeconomic, physical, and nutritional factors and the relationships differ by sex. These results provide insights for mental health interventions specific to adults aged 45-85.
Collapse
Affiliation(s)
- Karen M Davison
- Faculty of Social Science, University of Hawaii, Honolulu, Hawaii, USA
- Faculty of Science and Horticulture (Health Science), Kwantlen Polytechnic University, Surrey, British Columbia, Canada
| | - Yu Lung
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Shen Lamson Lin
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
- Institute for Life Course & Aging, University of Toronto, Toronto, Ontario, Canada
| | - Hongmei Tong
- Faculty of Health and Community Studies, MacEwan University, Edmonton, Alberta, Canada
| | - Karen M Kobayashi
- Faculty of Social Science, University of Victoria, Victoria, British Columbia, Canada
| | - Esme Fuller-Thomson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada.
- Institute for Life Course & Aging, University of Toronto, Toronto, Ontario, Canada.
| |
Collapse
|
21
|
Marquez-Velarde G, Jones NE, Keith VM. Racial stratification in self-rated health among Black Mexicans and White Mexicans. SSM Popul Health 2019; 10:100509. [PMID: 32025566 PMCID: PMC6997553 DOI: 10.1016/j.ssmph.2019.100509] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 10/03/2019] [Accepted: 10/28/2019] [Indexed: 11/17/2022] Open
Abstract
How do Mexicans of distinct racial backgrounds fit into the recognized patterns of racial health disparities? We conduct regression analyses using data from the 2000-2017 National Health Interview Survey to determine if Mexicans who self-identify as White or Black have a relative advantage or disadvantage in self-rated health in relation to Non-Hispanic (NH) Whites and Blacks in the U.S. Our results indicate that both Black Mexicans and White Mexicans have a significant disadvantage in relation to NH-Whites while White Mexicans have a slight advantage in relation to both NH-Blacks and Black Mexicans. Overall, our results suggest that studying health outcomes among Hispanics without considering race may mask inequalities not observed in the aggregate.
Collapse
Affiliation(s)
| | - Nicole E Jones
- Department of Sociology and Criminology & Law, University of Florida, United States
| | - Verna M Keith
- Department of Sociology, University of Alabama at Birmingham, United States
| |
Collapse
|
22
|
Explaining Chronic Illness and Self-Rated Health Among Immigrants of Five Hispanic Ethnicities. J Racial Ethn Health Disparities 2019; 7:177-191. [PMID: 31654338 DOI: 10.1007/s40615-019-00647-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 10/05/2019] [Accepted: 10/09/2019] [Indexed: 10/25/2022]
Abstract
The largest racial/ethnic minority group in the United States, Hispanics, especially Hispanic immigrants, have been considered healthier than groups of other ethnicity (including Whites, the majority). However, chronic illnesses such as cancer and diabetes are often seen in this culturally, ethnically diverse group. The present study had two aims. First was to explain two health outcomes, which were presence of chronic illness (any of the five common conditions cardiovascular disease, stroke, hypertension, cancer, and/or diabetes/prediabetes) and self-rated health, in terms of links to certain factors in acculturation, social status, health, social support, and lifestyle. Second was to determine how uniform these links might be across five ethnic groups: Mexican, Puerto Rican, Cuban, Dominican, Central/South American. We combined data from 17 years of the National Health Interview Survey (1999-2015) and subjected these secondary measures to logistic and linear regression, separately by ethnicity, to explain both outcomes. With few exceptions, results generally linked illness/health to the tested independent variables. Additionally, results confirmed ethnicity to moderate the outcomes' associations with the independent variables. Ethnicity-specific analysis showed the two outcomes to exhibit dissimilar relationships with certain independent variables across ethnic groups. Research that (as has been common) lumps together respondents whose Hispanic ethnicities may differ disregards some meaningful variation rather than accounting for it. In future research-and in subsequent evidence-based policy/practice development-all essential sociocultural factors, including ethnicity, should be carefully outlined, advancing good health for the entire Hispanic immigrant population.
Collapse
|
23
|
Does migration matter? The case of older Russian speakers receiving long term services and supports. J Aging Stud 2019; 50:100789. [PMID: 31526492 DOI: 10.1016/j.jaging.2019.100789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 06/27/2019] [Indexed: 11/22/2022]
|
24
|
Abstract
Data from the Mexican Census reveal that between 2005 and 2015, nearly two million migrants returned voluntarily to Mexico from the United States. Currently, high rates of voluntary-return migration to Mexico continue at the same time that migration flows to the U.S. steadily decline. This return migration trend presents serious challenges for Mexico, a country that has long struggled to satisfy the health care demands of its population. However, little is known about return migrants' health care needs. In this study, we examine the health risk profiles and healthcare utilization for Mexican return migrants and the non-migrant population. We examine how these outcomes are affected by both the migration and return migration experience of the returnee population, while paying close attention to age-group differences. We employ inverse probability weighting regression adjustment (IPWRA) and logistic regression analysis of a sample of 348,450 respondents from the 2014 National Survey of Demographic Dynamics (ENADID) to test for differences in health conditions between those Mexican return migrants and non-migrants. We then turn to the Survey of Migration at Mexico's Northern Border (EMIF Norte, for its Spanish acronym) for the 2014-2017 period to further assess whether certain characteristics linked to aging and the migration experience influence the prevalence of chronic health conditions, and health insurance coverage among 17,258 returned migrants. Findings reveal that compared to non-migrants, returnees are more likely to be physically impaired. These poor health outcomes are influenced by the migration and return migration experience and vary by age group and duration of residence, the time that has elapsed since returning to Mexico. We do not find an association between return migration and mental or emotional distress. Policy implications are discussed in light of immigration reform and restrictions on eligibility for health insurance coverage for older adults in Mexico.
Collapse
|
25
|
Exploring Generational Differences of British Ethnic Minorities in Smoking Behavior, Frequency of Alcohol Consumption, and Dietary Style. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16122241. [PMID: 31242661 PMCID: PMC6616626 DOI: 10.3390/ijerph16122241] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 06/08/2019] [Accepted: 06/21/2019] [Indexed: 12/24/2022]
Abstract
Background: This article explores ethnic minority generational differences in smoking behavior, frequency of alcohol consumption, and dietary style in Britain, and whether these differences can be explained by generational differences in socioeconomic status and ethnic identity. Method: Multivariate analyses using wave 2 (2010–2012) and wave 5 (2013–2015) of the United Kingdom Household Longitudinal Study on smoking behavior, frequency of alcohol consumption, and dietary style from 59,189 White British, 1690 Indians, 960 Pakistanis, 555 Bangladeshis, 1060 Black Caribbeans, and 1059 Black Africans, adjusted for demographic characteristics, socioeconomic status and ethnic identity. Results: While we find little evidence for generational differences in dietary style, second-generation Indians, Pakistanis, and Black Caribbeans have a significantly higher probability of smoking than the first-generation, and all second-generation minorities are significantly more likely to consume alcohol than their first-generation counterparts. Such generational differences in alcohol consumption are partly explained by second-generation minorities’ weakened ethnic identity and higher socioeconomic status. Conclusions: This study facilitates a better understanding of minority generational differences in health behaviors and the role of socioeconomic status and ethnic identity, highlighting the need for future policy interventions to target certain second-generation ethnic minorities who have adopted certain host society unhealthy lifestyles.
Collapse
|
26
|
Chantzaras AE, Yfantopoulos JN. Income-related health inequalities among the migrant and native-born populations in Greece during the economic crisis: a decomposition analysis. Eur J Public Health 2019; 28:24-31. [PMID: 30476092 DOI: 10.1093/eurpub/cky203] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background The economic crisis has induced detrimental socio-economic and health effects in Greece. This study aims to measure overall income-related health inequalities and examine their determinants, and to compare the respective within estimates for major subpopulations defined by citizenship (Greece, Albania, other countries) in Greece. Methods Data for 1332 cases were collected from a cross-sectional observational survey (MIGHEAL) conducted at a national level in 2016. Income-related inequalities in poor subjective health, limiting long-standing illness, elevated depressive symptoms and non-communicable diseases were measured with the standard and Erreygers concentration indices. Decomposition analysis identified key factors explaining the inequalities. Results Overall, significant inequalities favouring the better-off were established in all ill-health indicators, particularly in depression. Greek citizens were associated with consistent health inequalities, while, concerning the other groups, significant disparities were found only in depression for Albanians. Decomposition analyses identified socio-economic status, income in particular, as the main contributor to overall income-related health inequalities, followed by barriers to healthcare access, adverse family background and hazardous working conditions. Risk behaviours and discrimination were relatively less important, whereas area of residence was mainly reducing inequality. Citizens from Albania and other countries were found to be poorer, but with fewer health problems, hence, different citizenship decreased inequalities. Conclusion Socio-economic health inequalities in Greece can be mitigated by means of appropriate multi-sectorial policy interventions, by focussing primarily on the most socio-economically disadvantaged groups. The overall inequality-producing mechanisms and the different health needs of ethnic groups should be taken into account when formulating such policies.
Collapse
Affiliation(s)
- Athanasios E Chantzaras
- Department of Political Science and Public Administration, School of Economics and Political Sciences, National and Kapodistrian University of Athens, Athens, Greece
| | - John N Yfantopoulos
- Department of Political Science and Public Administration, School of Economics and Political Sciences, National and Kapodistrian University of Athens, Athens, Greece
| |
Collapse
|
27
|
Nkimbeng M, Cudjoe J, Turkson-Ocran RA, Commodore-Mensah Y, Thorpe RJ, Szanton SL. Disparities in the Prevalence and Correlates of Disability in Older Immigrants in the USA: a Systematic Review of the Literature. J Racial Ethn Health Disparities 2019; 6:552-562. [PMID: 30618007 PMCID: PMC6500484 DOI: 10.1007/s40615-018-00554-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 12/12/2018] [Accepted: 12/18/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Disability in older adults leads to poor quality of life, is costly for the health system, and is a risk for mortality. Little is known about disability in older immigrants to the USA. OBJECTIVE To synthesize the evidence on the prevalence and factors associated with disability in older adult immigrants. METHODS We conducted searches in PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Scopus. Disability was defined as difficulty in performing basic or instrumental activities of daily living. Older adult was defined as 65 years and older. Immigrant status was defined as someone born outside of the USA. RESULTS Eighteen articles met the inclusion criteria. Seven studied Hispanic/Latino immigrants, six studied Asian immigrants, four studied diverse older immigrant samples, and one studied European immigrants. Prevalence of disability ranged from 2 to 49% in Asians and 3 to 58.1% in Hispanic/Latinos. In a diverse sample of immigrants, the prevalence of disability was 19.3%. Correlates of disability included female gender, low income, limited education, single status, migration in late adulthood, obesity, arthritis, and diabetes. Factors protective against disability in older adult immigrants were acculturation, migrating at a younger age, exercise, alcohol intake, and church attendance. CONCLUSION Disability prevalence was generally lower in Asian immigrants compared to Hispanic/Latino immigrants. Identification of the precise rates and factors associated with disability in older immigrants can inform health interventions for this population.
Collapse
Affiliation(s)
- Manka Nkimbeng
- Johns Hopkins School of Nursing, 525 N Wolfe St., Baltimore, MD, 21205, USA.
| | - Joycelyn Cudjoe
- Johns Hopkins School of Nursing, 525 N Wolfe St., Baltimore, MD, 21205, USA
| | | | | | - Roland J Thorpe
- Johns Hopkins Bloomberg School of Public Health, 525 N Wolfe St., Baltimore, MD, 21205, USA
| | - Sarah L Szanton
- Johns Hopkins School of Nursing, 525 N Wolfe St., Baltimore, MD, 21205, USA
- Johns Hopkins Bloomberg School of Public Health, 525 N Wolfe St., Baltimore, MD, 21205, USA
| |
Collapse
|
28
|
Vasquez Guzman CE, Sanchez GR. The Impact of Acculturation and Racialization on Self-Rated Health Status Among U.S. Latinos. J Immigr Minor Health 2019; 21:129-135. [PMID: 29380096 DOI: 10.1007/s10903-018-0696-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We investigate the Hispanic paradox by examining the relationship between acculturation and health status of Latinos to understand nuances among this growing heterogeneous population using a 2011 Latino Decisions survey. We find that acculturation remains an important determinant of Latino health; however, this varies based on whether the sample is restricted to immigrants or includes all Latino adults and on the measures of acculturation employed. We find Latino citizens reported better health than non-citizens; however, other acculturation measures, such as language use and time in the U.S. do not have a marked effect. Furthermore, skin color matters only for U.S.-born Latinos. Racialization is therefore important to consider within the context of the Hispanic paradox. Our findings suggest that some of the disadvantages stemming from minority status in the U.S. are more prominent among Latinos who have greater experience with the racial hierarchy of the U.S. and greater acculturation more broadly.
Collapse
Affiliation(s)
- Cirila Estela Vasquez Guzman
- Department of Sociology, The University of New Mexico, Albuquerque, NM, USA. .,Robert Wood Johnson Foundation Center for Health Policy, 1 University of New Mexico, MSC05-2400, 1909 Las Lomas NE, Albuquerque, NM, 87131-0001, USA.
| | - Gabriel R Sanchez
- Department of Political Science, The University of New Mexico, Albuquerque, NM, USA.,Robert Wood Johnson Foundation Center for Health Policy, 1 University of New Mexico, MSC05-2400, 1909 Las Lomas NE, Albuquerque, NM, 87131-0001, USA
| |
Collapse
|
29
|
Antón E, Carreiras M, Duñabeitia JA. The impact of bilingualism on executive functions and working memory in young adults. PLoS One 2019; 14:e0206770. [PMID: 30759096 PMCID: PMC6374013 DOI: 10.1371/journal.pone.0206770] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 01/10/2019] [Indexed: 12/03/2022] Open
Abstract
A bilingual advantage in a form of a better performance of bilinguals in tasks tapping into executive function abilities has been reported repeatedly in the literature. However, recent research defends that this advantage does not stem from bilingualism, but from uncontrolled factors or imperfectly matched samples. In this study we explored the potential impact of bilingualism on executive functioning abilities by testing large groups of young adult bilinguals and monolinguals in the tasks that were most extensively used when the advantages were reported. Importantly, the recently identified factors that could be disrupting the between groups comparisons were controlled for, and both groups were matched. We found no differences between groups in their performance. Additional bootstrapping analyses indicated that, when the bilingual advantage appeared, it very often co-occurred with unmatched socio-demographic factors. The evidence presented here indicates that the bilingual advantage might indeed be caused by spurious uncontrolled factors rather than bilingualism per se. Secondly, bilingualism has been argued to potentially affect working memory also. Therefore, we tested the same participants in both a forward and a backward version of a visual and an auditory working memory task. We found no differences between groups in either of the forward versions of the tasks, but bilinguals systematically outperformed monolinguals in the backward conditions. The results are analysed and interpreted taking into consideration different perspectives in the domain-specificity of the executive functions and working memory.
Collapse
Affiliation(s)
- Eneko Antón
- Facultad de Lenguas y Educación, Universidad Nebrija; Madrid, Spain
- BCBL. Basque Center on Cognition, Brain and Language; Donostia, Spain
| | - Manuel Carreiras
- BCBL. Basque Center on Cognition, Brain and Language; Donostia, Spain
- Ikerbasque, Basque Foundation for Science; Bilbao, Spain
- Euskal Herriko Unibertsitatea–Universidad del País Vasco; Bilbao, Spain
| | - Jon Andoni Duñabeitia
- Facultad de Lenguas y Educación, Universidad Nebrija; Madrid, Spain
- BCBL. Basque Center on Cognition, Brain and Language; Donostia, Spain
| |
Collapse
|
30
|
The Healthy Immigrant Effect: The role of educational selectivity in the good health of migrants. DEMOGRAPHIC RESEARCH 2019. [DOI: 10.4054/demres.2019.40.4] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
|
31
|
Abstract
The connection between migration and health has long been established, but relatively little is known about this relationship for older persons, particularly in sub-Saharan Africa (SSA). In this paper, we examine migration selection with regards to health status among older individuals in Malawi, by testing whether older migrants differ from non-migrants in health status before migration. To do so, we use data from the Malawi Longitudinal Study of Families and Health, a longitudinal panel dataset that includes a relatively large number of individuals at older ages. We focus on three measures: mental health, physical health, and HIV status. We find that the relationship between migration and health selection differs by gender. Older women who are HIV-positive are nearly 10 times more likely to migrate compared to their HIV-negative counterparts. For men, those with better mental health are less likely to migrate in the future. These results suggest that, although research in some settings shows that migrants have better health before moving, some older migrants have worse health than their non-migrant peers, and may, therefore, add to the already-heavy burden on rural health centres in Africa.
Collapse
Affiliation(s)
- Jacob Kendall
- Social Work Department, Taylor University, 236 W Reade Avenue, Upland, IN 46989, 765-998-5353,
| | - Philip Anglewicz
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Suite 2210, New Orleans, LA 70112, 504-988-7324,
| |
Collapse
|
32
|
Vásquez E, Germain CM, Tang F, Lohman MC, Fortuna KL, Batsis JA. The Role of Ethnic and Racial Disparities in Mobility and Physical Function in Older Adults. J Appl Gerontol 2018; 39:502-508. [PMID: 29909728 DOI: 10.1177/0733464818780631] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Objective: To compare estimates of the prevalence of mobility and physical function limitations by race and ethnicity using data from the Medical Expenditure Panel Survey (MEPS). Method: The sample comprised of 28,854 adults aged ≥60 from the MEPS (2004-2013). Physical function (limitations in basic and instrumental activities of daily living [ADL/IADL]) and mobility limitations were assessed by self-report. Results: Non-Hispanic Whites (NHWs) represented the majority of the sample followed by non-Hispanic Blacks (NHBs), Hispanic and non-Hispanic Other (Other). For mobility limitation, NHBs had the highest prevalence followed by NHWs and Hispanics (33.3%, 28.6%, and 26.2%, respectively). Multivariable logistic regression analyses were performed for the primary outcome of mobility limitation. In the adjusted model, Hispanics had lower odds of mobility limitations (prevalence odds ratio [POR]: 0.78; 95% confidence interval [CI] = [0.67,0.91]) compared with NHWs. For ADL limitations, NHBs had higher odds of having ADLs (POR: 1.87; 95% CI = [1.44, 2.44]) when compared with NHWs. Conclusion: This article evaluated the influence of race and ethnicity, on the prevalence of mobility and functional limitations that are not always consistent with expected racial and ethnic differences.
Collapse
Affiliation(s)
| | | | - Fei Tang
- University at Albany, Rensselaer, NY, USA
| | - Matthew C Lohman
- Geisel School of 004Dedicine at Dartmouth, Hanover, NH, USA.,Dartmouth Centers for Health and Aging, Dartmouth College, Hanover, New Hampshire
| | - Karen L Fortuna
- Geisel School of 004Dedicine at Dartmouth, Hanover, NH, USA.,Dartmouth Centers for Health and Aging, Dartmouth College, Hanover, New Hampshire
| | - John A Batsis
- Geisel School of 004Dedicine at Dartmouth, Hanover, NH, USA.,Dartmouth Centers for Health and Aging, Dartmouth College, Hanover, New Hampshire.,The Dartmouth Institute for Health Policy & Clinical Practice, Lebanon, NH, USA
| |
Collapse
|
33
|
Fang J, Yuan K, Gindi RM, Ward BW, Ayala C, Loustalot F. Association of Birthplace and Coronary Heart Disease and Stroke Among US Adults: National Health Interview Survey, 2006 to 2014. J Am Heart Assoc 2018; 7:e008153. [PMID: 29592969 PMCID: PMC5907595 DOI: 10.1161/jaha.117.008153] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Accepted: 02/11/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND The proportion of foreign-born US adults has almost tripled since 1970. However, less is known about the cardiovascular morbidity by birthplace among adults residing in the United States. This study's objective was to compare the prevalence of coronary heart disease (CHD) and stroke among US adults by birthplace. METHODS AND RESULTS We used data from the 2006 to 2014 National Health Interview Survey. Birthplace was categorized as United States or foreign born. Foreign born was then grouped into 6 birthplace regions. We defined CHD and stroke as ever being told by a physician that she or he had CHD or stroke. We adjusted for select demographic and health characteristics in the analysis. Of US adults, 16% were classified as foreign born. Age-standardized prevalence of both CHD and stroke were higher among US- than foreign-born adults (CHD: 8.2% versus 5.5% for men and 4.8% versus 4.1% for women; stroke: 2.7% versus 2.1% for men and 2.7% versus 1.9% for women; all P<0.05). Comparing individual regions with those of US- born adults, CHD prevalence was lower among foreign-born adults from Asia and Mexico, Central America, or the Caribbean. For stroke, although men from South America or Africa had the lowest prevalence, women from Europe had the lowest prevalence. Years of living in the United States was not related to risk of CHD or stroke after adjustment with demographic and health characteristics. CONCLUSIONS Overall, foreign-born adults residing in the United States had a lower prevalence of CHD and stroke than US-born adults. However, considerable heterogeneity of CHD and stroke risk was found by region of birth.
Collapse
Affiliation(s)
- Jing Fang
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, U.S.
| | - Keming Yuan
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, U.S
| | - Renee M Gindi
- Division for Health Interview Statistics, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, U.S
| | - Brian W Ward
- Division for Health Interview Statistics, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, U.S
| | - Carma Ayala
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, U.S
| | - Fleetwood Loustalot
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, U.S
| |
Collapse
|
34
|
Duncan HD, Nikelski J, Pilon R, Steffener J, Chertkow H, Phillips NA. Structural brain differences between monolingual and multilingual patients with mild cognitive impairment and Alzheimer disease: Evidence for cognitive reserve. Neuropsychologia 2018; 109:270-282. [DOI: 10.1016/j.neuropsychologia.2017.12.036] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 10/19/2017] [Accepted: 12/22/2017] [Indexed: 01/17/2023]
|
35
|
Mungas D, Early DR, Glymour MM, Al Hazzouri AZ, Haan MN. Education, bilingualism, and cognitive trajectories: Sacramento Area Latino Aging Study (SALSA). Neuropsychology 2018; 32:77-88. [PMID: 28967765 PMCID: PMC5814330 DOI: 10.1037/neu0000356] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE This study examined the influence of education, country where education occurred, and monolingual-bilingual (English/Spanish) language usage on late life cognitive trajectories in the Sacramento Area Latino Study on Aging (SALSA), an epidemiological study of health and cognition in Hispanics, mostly of Mexican origin, age 60 and over (N = 1,499). METHOD SALSA followed a large cohort of older Latinos for up to 7 assessment waves from 1998 to 2007. Global cognition was assessed by using the Modified Mini Mental State Examination, and the Spanish English Verbal Learning Test was used to measure episodic memory. Education, country of origin, and language usage patterns were collected at the baseline assessment and used as predictors of longitudinal trajectories of cognition. Parallel process mixed effects models were used to examine effects of education and language variables on baseline cognition and rate of cognitive decline. RESULTS Mixed effects longitudinal models showed that education had strong effects on baseline global cognition and verbal memory but was not related to decline over up to 9 years of longitudinal follow-up. Differences in education effects between subgroups educated in Mexico and in the United States were minor. Monolingual-bilingual language usage was not related to cognitive decline, and bilinguals did not significantly differ from monolingual English speakers on baseline cognitive scores. CONCLUSIONS Hypotheses that higher education and bilingualism protect against late life cognitive decline were not supported and education effects on late-life cognitive trajectories did not substantially differ across U.S.- and Mexico-educated groups. (PsycINFO Database Record
Collapse
Affiliation(s)
- Dan Mungas
- Department of Neurology, University of California, Davis, Davis, CA
| | - Dawnté R. Early
- Department of Neurology, University of California, Davis, Davis, CA
| | - M. Maria Glymour
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA
| | | | - Mary N. Haan
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA
| |
Collapse
|
36
|
Kim HJ, Jen S, Fredriksen-Goldsen KI. Race/Ethnicity and Health-Related Quality of Life Among LGBT Older Adults. THE GERONTOLOGIST 2017; 57:S30-S39. [PMID: 28087793 DOI: 10.1093/geront/gnw172] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 10/24/2016] [Indexed: 01/09/2023] Open
Abstract
PURPOSE OF THE STUDY Few existing studies have addressed racial/ethnic differences in the health and quality of life of lesbian, gay, bisexual, and transgender (LGBT) older adults. Guided by the Health Equity Promotion Model, this study examines health-promoting and health risk factors that contribute to racial/ethnic health disparities among LGBT adults aged 50 and older. DESIGN AND METHODS We utilized weighted survey data from Aging with Pride: National Health, Aging, and Sexuality/Gender Study. By applying multiple mediator models, we analyzed the indirect effects of race/ethnicity on health-related quality of life (HRQOL) via demographics, lifetime LGBT-related discrimination, and victimization, and socioeconomic, identity-related, spiritual, and social resources. RESULTS Although African Americans and Hispanics, compared with non-Hispanic Whites, reported lower physical HRQOL and comparable psychological HRQOL, indirect pathways between race/ethnicity and HRQOL were observed. African Americans and Hispanics had lower income, educational attainment, identity affirmation, and social support, which were associated with a decrease in physical and psychological HRQOL. African Americans had higher lifetime LGBT-related discrimination, which was linked to a decrease in their physical and psychological HRQOL. African Americans and Hispanics had higher spirituality, which was associated with an increase in psychological HRQOL. IMPLICATIONS Findings illustrate the importance of identifying both health-promoting and health risk factors to understand ways to maximize the health potential of racially and ethnically diverse LGBT older adults. Interventions aimed at health equity should be tailored to bolster identity affirmation and social networks of LGBT older adults of color and to support strengths, including spiritual resources.
Collapse
Affiliation(s)
- Hyun-Jun Kim
- School of Social Work, University of Washington, Seattle.
| | - Sarah Jen
- School of Social Work, University of Washington, Seattle
| | | |
Collapse
|
37
|
Zhong BL, Chan SSM, Liu TB, Jin D, Hu CY, Chiu HFK. Mental health of the old- and new-generation migrant workers in China: who are at greater risk for psychological distress? Oncotarget 2017; 8:59791-59799. [PMID: 28938682 PMCID: PMC5601778 DOI: 10.18632/oncotarget.15985] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 02/28/2017] [Indexed: 01/25/2023] Open
Abstract
Rural-to-urban migrant workers (MWs) are a large vulnerable population in China and, recently, the new-generation MWs (those born in 1980 or later) have become the majority of this population. Examining difference in the epidemiology of poor mental health between the new- and old-generation (those born before 1980) MWs would facilitate mental health promotion efforts. However, very few related studies are available and they produced conflicting findings. This study investigated intergenerational difference in prevalence and correlates of psychological distress (PD) in MWs. A total of 3031 MWs (691 old- and 2340 new-generation MWs) completed a standardized questionnaire containing socio-demographic, migration-related, and work-related variables and the Chinese 12-item General Health Questionnaire (GHQ-12). A GHQ-12 score of 3 or higher was used to denote PD. PD was more prevalent in the new- than old-generation MWs (36.2% versus 28.2%, P < 0.001). The elevated risk of PD in the new- versus old-generation remained significant after controlling for potential confounders (OR=1.51, P < 0.001). For the new-generation, correlates for PD included low monthly income, recent two-week physical morbidity, migrating alone, poor Mandarin proficiency and long working hours; while for the old-generation, correlates for PD included low education, recent two-week physical morbidity, and having worked in many cities. The new-generation MWs are at higher risk for PD than the old-generation MWs. Mental health services for addressing the generation-specific needs may be an effective way to prevent or reduce PD of MWs.
Collapse
Affiliation(s)
- Bao-Liang Zhong
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, PR China
- Affiliated Wuhan Mental Health Center/The Ninth Clinical School, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, Hubei Province, PR China
| | - Sandra S M Chan
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, PR China
| | - Tie-Bang Liu
- Shenzhen Key Laboratory for Psychological Healthcare, Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, Guangdong Province, PR China
| | - Dong Jin
- Shenzhen Key Laboratory for Psychological Healthcare, Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, Guangdong Province, PR China
| | - Chi-Yi Hu
- Shenzhen Key Laboratory for Psychological Healthcare, Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, Guangdong Province, PR China
| | - Helen F K Chiu
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, PR China
| |
Collapse
|
38
|
Solis GR, Champion JD. Examining Fall Recurrence Risk of Homebound Hispanic Older Adults Receiving Home Care Services. HISPANIC HEALTH CARE INTERNATIONAL 2017; 15:20-26. [PMID: 28558509 DOI: 10.1177/1540415317691490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Unintentional falls and injuries is a major problem among older adults and the fourth cause of death in the United States. A previous fall event doubles the risk of recurrence and lessens the person's quality of life. Hispanic older adults have higher rates of disability and lower independent functioning due to poor medical health and risk for fall recurrence. Most fall studies focus on fall risk with few studies on fall recurrence in older adults receiving home health care services unrelated to fall incident. METHOD A descriptive pilot study of 30 homebound Hispanic older adults receiving home care services who reported a fall within 3 months was conducted by a multidisciplinary team to evaluate risk of fall recurrence. RESULTS A heightened risk for fall recurrence was identified with high number of chronic illnesses, high intake of medications, vision problems, and prevalence of urinary incontinence. CONCLUSION Findings highlight significant number of intrinsic factors for fall risk recurrence and injuries in a Hispanic older adults population that is homebound and receiving home care services. A multidisciplinary evaluation and culturally appropriate interventions to lessen the risk of fall recurrence are recommended.
Collapse
|
39
|
Garcia MA, Valderrama-Hinds LM, Chiu CT, Mutambudzi MS, Chen NW, Raji M. Age of Migration Life Expectancy with Functional Limitations and Morbidity in Mexican Americans. J Am Geriatr Soc 2017; 65:1591-1596. [PMID: 28369692 DOI: 10.1111/jgs.14875] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The U.S. Mexican American population enjoys longer life expectancies relative to other racial/ethnic groups but is disproportionately affected by chronic conditions and functional limitations. Studying the impact of heterogeneity in age, time and other characteristics of migration among older Mexican Americans can inform our understanding of health disparities and healthcare needs in later-life. This research used 20 years of data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly to assess the proportion of life spent with functional limitations and one or more morbidity (according to age of migration and sex) in the U.S. Mexican-American population. The results indicate that early-life and late-life migrant women spend more years with Performance-Oriented Mobility Assessment limitations than U.S.-born women. Conversely, midlife migrant women were not statistically different from U.S.-born women in years spent disabled. In men, midlife migrants had longer life expectancies and had more disability-free years than U.S.-born men. For morbidity, late-life migrant women spent a significantly smaller proportion of their elderly years with morbidity than U.S.-born women, but late-life migrant men spent more years with morbidity than U.S.-born men. These findings illustrate that older Mexican Americans in the United States are heterogeneous in nativity and health outcomes. More years spent disabled or unhealthy may result in greater burden on family members and greater dependence on public resources. These findings have implications for the development of social and health policies to appropriately target the medical conditions and disabilities of older Mexican Americans entering late life.
Collapse
Affiliation(s)
- Marc A Garcia
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, Texas
| | | | - Chi-Tsun Chiu
- Institute of European and American Studies, Academia Sinica, Taipei, Taiwan
| | - Miriam S Mutambudzi
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, Texas
| | - Nai-Wei Chen
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, Texas
| | - Mukaila Raji
- Division of Geriatrics, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas
| |
Collapse
|
40
|
Camacho-Rivera M, Kawachi I, Bennett GG, Subramanian SV. Revisiting the Hispanic health paradox: the relative contributions of nativity, country of origin, and race/ethnicity to childhood asthma. J Immigr Minor Health 2016; 17:826-33. [PMID: 24380929 DOI: 10.1007/s10903-013-9974-6] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
This study examined the relationship between race and Hispanic ethnicity, maternal and child nativity, country of origin and asthma among 2,558 non-Hispanic white and Hispanic children across 65 Los Angeles neighborhoods. A series of two-level multilevel models were estimated to examine the independent effects of race, ethnicity, and country of origin on childhood asthma. Lifetime asthma prevalence was reported among 9% of children, with no significant differences between Hispanics and non-Hispanic whites overall. However, in fully adjusted models, Hispanic children of non-Mexican origin reported higher odds of asthma compared to non-Hispanic white children. A protective nativity effect was also observed among children of foreign born mothers compared to US born mothers. Our study provides evidence in support of the heterogeneity of childhood asthma by Hispanic ethnicity and maternal nativity. These findings suggest moving beyond solely considering racial/ethnic classifications which could mask subgroups at increased risk of childhood asthma.
Collapse
Affiliation(s)
- Marlene Camacho-Rivera
- Department of Population Health, North Shore-Long Island Jewish Health System, 175 Community Drive, Room 233, Great Neck, NY, 11021, USA,
| | | | | | | |
Collapse
|
41
|
Velasco-Mondragon E, Jimenez A, Palladino-Davis AG, Davis D, Escamilla-Cejudo JA. Hispanic health in the USA: a scoping review of the literature. Public Health Rev 2016; 37:31. [PMID: 29450072 PMCID: PMC5809877 DOI: 10.1186/s40985-016-0043-2] [Citation(s) in RCA: 285] [Impact Index Per Article: 35.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 11/16/2016] [Indexed: 12/14/2022] Open
Abstract
Hispanics are the largest minority group in the USA. They contribute to the economy, cultural diversity, and health of the nation. Assessing their health status and health needs is key to inform health policy formulation and program implementation. To this end, we conducted a scoping review of the literature and national statistics on Hispanic health in the USA using a modified social-ecological framework that includes social determinants of health, health disparities, risk factors, and health services, as they shape the leading causes of morbidity and mortality. These social, environmental, and biological forces have modified the epidemiologic profile of Hispanics in the USA, with cancer being the leading cause of mortality, followed by cardiovascular diseases and unintentional injuries. Implementation of the Affordable Care Act has resulted in improved access to health services for Hispanics, but challenges remain due to limited cultural sensitivity, health literacy, and a shortage of Hispanic health care providers. Acculturation barriers and underinsured or uninsured status remain as major obstacles to health care access. Advantageous health outcomes from the "Hispanic Mortality Paradox" and the "Latina Birth Outcomes Paradox" persist, but health gains may be offset in the future by increasing rates of obesity and diabetes. Recommendations focus on the adoption of the Health in All Policies framework, expanding access to health care, developing cultural sensitivity in the health care workforce, and generating and disseminating research findings on Hispanic health.
Collapse
Affiliation(s)
- Eduardo Velasco-Mondragon
- College of Osteopathic Medicine, Touro University California, 1310 Johnson Lane; H-82, Rm. 213, Vallejo, CA 94592 USA
| | - Angela Jimenez
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, USA
| | | | - Dawn Davis
- St. Louis University School of Medicine, St. Louis, USA
| | - Jose A. Escamilla-Cejudo
- Regional Advisor on Health Information and Analysis, Pan American Health Organization/World Health Organization, Foggy Bottom, USA
| |
Collapse
|
42
|
Garcia L, Lee A, Zeki Al Hazzouri A, Neuhaus J, Epstein M, Haan M. The Impact of Neighborhood Socioeconomic Position on Prevalence of Diabetes and Prediabetes in Older Latinos: The Sacramento Area Latino Study on Aging. HISPANIC HEALTH CARE INTERNATIONAL 2016; 13:77-85. [PMID: 26078026 DOI: 10.1891/1540-4153.13.2.77] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Diabetes is a leading cause of morbidity and mortality in Latinos, but few studies of disease risk in this subpopulation examine both area-level socioeconomic position (SEP) and its association with individual-level risk factors. This study sought to examine the cross-sectional relationship between neighborhood socioeconomic position (NSEP) and prevalent diabetes and prediabetes status among older Latinos. Longitudinal health data were collected from 1,789 participants in the Sacramento Area Latino Study on Aging (SALSA). Among SALSA participants, higher NSEP was associated with lower diabetes prevalence (p = .001). Adjustment for body mass index and other individual-level factors did not affect this relationship. No association was observed between NSEP and prediabetes in both unadjusted and adjusted models. Neighborhoods with higher SEP had a lower prevalence of diabetes. This study highlights the importance of considering neighborhood factors that may place older Latinos at high risk for this disease.
Collapse
|
43
|
Fuller-Thomson E, Brennenstuhl S, Cooper R, Kuh D. An investigation of the healthy migrant hypothesis: Pre-emigration characteristics of those in the British 1946 birth cohort study. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2016; 106:e502-8. [PMID: 26986911 PMCID: PMC6972096 DOI: 10.17269/cjph.106.5218] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 11/17/2015] [Accepted: 09/27/2015] [Indexed: 12/22/2022]
Abstract
OBJECTIVES The finding that migrants to high-income countries have lower rates of morbidity and mortality than non-migrants, controlling for socioeconomic position, is often attributed to the "healthy migrant" hypothesis, which suggests that only the healthiest individuals choose to migrate. This prospective study investigates the healthy migrant hypothesis in a cohort of British emigrants using pre-migration health indicators. We also investigate how early-life health characteristics relate to age at emigration and whether or not the emigrant returned home. METHODS Data are from the Medical Research Council National Survey of Health and Development, a nationally representative cohort study of people born in England, Scotland or Wales in March 1946. Childhood socio-economic position, health and cognitive ability were compared between 4,378 non-emigrants and 984 emigrants. Of the emigrants, 427 emigrated before age 20 and 557 after that age; 602 emigrants remained abroad and 382 returned home. RESULTS Emigrants had better childhood health (especially greater height), higher childhood socio-economic position and better childhood cognitive ability at age 8 than non-emigrants. Return emigrants were very similar to emigrants who remained abroad. CONCLUSIONS We found support for the healthy migrant hypothesis in a cohort of British emigrants. Our findings improve an understanding of how health is distributed within and across nations.
Collapse
|
44
|
Caicedo M, van Gameren E. Desempleo y salud mental en la población de origen hispano en Estados Unidos: un análisis epidemiológico. CIENCIA & SAUDE COLETIVA 2016; 21:955-66. [DOI: 10.1590/1413-81232015213.16592014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 07/23/2015] [Indexed: 11/22/2022] Open
Abstract
Resumen Las altas tasas desempleo observadas en Estados Unidos durante la reciente crisis económica, que además son diferenciadas de acuerdo al origen étnico, hacen pertinente indagar acerca de cómo este problema se relaciona con la salud mental de los empleados y desempleados. Por tanto, en este artículo analizamos la relación entre desempleo y salud mental de los inmigrantes mexicanos, mexicanos nacidos en EE.UU, y otros hispanos en comparación con nativos blancos no hispanos y afroestadounidenses. Para alcanzar este propósito calculamos prevalencias, razones de prevalencias y razones de momios en la población entre 18 y 65 años en la fuerza laboral. Utilizamos información de la National Health Interview Survey (1999 y 2009). Encontramos que en tiempos de crisis aumenta la prevalencia de Tensión Psicológica no Específica (TPNE) en la fuerza laboral para todos los grupos étnicos. Las razones de prevalencias indican que los desempleados tienen mayor riesgo de presentar una TPNE que los empleados, particularmente los hispanos no mexicanos, en contraste, los inmigrantes mexicanos muestran riesgos más bajos.
Collapse
|
45
|
Watson CWM, Manly JJ, Zahodne LB. Does bilingualism protect against cognitive aging?: Methodological issues in research on bilingualism, cognitive reserve, and dementia incidence. LINGUISTIC APPROACHES TO BILINGUALISM 2016; 6:590-604. [PMID: 30505373 PMCID: PMC6263976 DOI: 10.1075/lab.15043.wat] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Recent studies of bilingualism as a protective factor in cognitive aging have reported conflicting findings, and researchers have begun to explore the methodological complications that may explain differences across studies. This article details the current research landscape and addresses several issues relevant to the study of bilingualism and late-life cognitive function: study design, establishing causal relationships, confounding factors, operationalizing bilingualism, predicting cognitive level versus cognitive change, and incorporating brain structural variables to interrogate cognitive reserve.
Collapse
Affiliation(s)
- Caitlin Wei-Ming Watson
- Columbia University Medical Center, Neurology, Clinical Research Coordinator, 630 West 168th Street, P&S Box 16, New York, 10032, UNITED STATES
| | | | | |
Collapse
|
46
|
Overton TL, Phillips JL, Moore BJ, Campbell-Furtick MB, Gandhi RR, Shafi S. The Hispanic paradox: does it exist in the injured? Am J Surg 2015; 210:827-32. [PMID: 26321296 DOI: 10.1016/j.amjsurg.2015.05.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Revised: 05/27/2015] [Accepted: 05/27/2015] [Indexed: 11/21/2022]
Abstract
BACKGROUND Hispanics have similar or lower all-cause mortality rates in the general population than non-Hispanic whites (NHWs), despite higher risks associated with lower socioeconomic status, hence termed the "Hispanic Paradox." It is unknown if this paradox exists in the injured. We hypothesized that Hispanic trauma patients have equivalent or lower risk-adjusted mortality and observed-to-expected mortality ratios than other racial/ethnic groups. METHODS Retrospective analysis of adult patients from the 2010 National Trauma Data Bank was performed. Hispanic patients were compared with NHWs and African Americans (AAs) to assess in-hospital mortality risk in each group. RESULTS Compared with NHWs, Hispanic patients had lower unadjusted risk of mortality. After adjusting for potential confounders, the difference was no longer statistically significant. Mortality risk was significantly lower for Hispanic patients compared with AAs in both crude and adjusted models. Hispanic patients had significantly lower observed-to-expected mortality ratios than NHWs and AAs. CONCLUSION Despite reports of racial/ethnic disparities in trauma outcomes, Hispanic patients are not at greater risk of death than NHW patients in a nationwide representative sample of trauma patients.
Collapse
Affiliation(s)
- Tiffany L Overton
- Trauma Services, JPS Health Network, 1500 S. Main St., Fort Worth, TX 76104, USA.
| | - J Laureano Phillips
- Trauma Services, JPS Health Network, 1500 S. Main St., Fort Worth, TX 76104, USA
| | - Billy J Moore
- Trauma Services, JPS Health Network, 1500 S. Main St., Fort Worth, TX 76104, USA
| | | | - Rajesh R Gandhi
- Trauma Services, JPS Health Network, 1500 S. Main St., Fort Worth, TX 76104, USA
| | - Shahid Shafi
- Trauma Services, JPS Health Network, 1500 S. Main St., Fort Worth, TX 76104, USA
| |
Collapse
|
47
|
Salinero-Fort MÁ, Gómez-Campelo P, Bragado-Alvárez C, Abánades-Herranz JC, Jiménez-García R, de Burgos-Lunar C. Health-related quality of life of latin-american immigrants and spanish-born attended in spanish primary health care: socio-demographic and psychosocial factors. PLoS One 2015; 10:e0122318. [PMID: 25835714 PMCID: PMC4383449 DOI: 10.1371/journal.pone.0122318] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Accepted: 02/19/2015] [Indexed: 11/22/2022] Open
Abstract
Background This study compares the health-related quality of life of Spanish-born and Latin American-born individuals settled in Spain. Socio-demographic and psychosocial factors associated with health-related quality of life are analyzed. Methods A cross-sectional Primary Health Care multi center-based study of Latin American-born (n = 691) and Spanish-born (n = 903) outpatients from 15 Primary Health Care Centers (Madrid, Spain). The Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) was used to assess health-related quality of life. Socio-demographic, psychosocial, and specific migration data were also collected. Results Compared to Spanish-born participants, Latin American-born participants reported higher health-related quality of life in the physical functioning and vitality dimensions. Across the entire sample, Latin American-born participants, younger participants, men and those with high social support reported significantly higher levels of physical health. Men with higher social support and a higher income reported significantly higher mental health. When stratified by gender, data show that for men physical health was only positively associated with younger age. For women, in addition to age, social support and marital status were significantly related. Both men and women with higher social support and income had significantly better mental health. Finally, for immigrants, the physical and mental health components of health-related quality of life were not found to be significantly associated with any of the pre-migration factors or conditions of migration. Only the variable “exposure to political violence” was significantly associated with the mental health component (p = 0.014). Conclusions The key factors to understanding HRQoL among Latin American-born immigrants settled in Spain are age, sex and social support. Therefore, strategies to maintain optimal health outcomes in these immigrant communities should include public policies on social inclusion in the host society and focus on improving social support networks in order to foster and maintain the health and HRQoL of this group.
Collapse
Affiliation(s)
- Miguel Ángel Salinero-Fort
- Gerencia Adjunta de Planificación y Calidad, Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain; Group 27- Aging and fragility in the elderly, Hospital La Paz Institute for Health Research-IdiPAZ, Madrid, Spain; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain
| | - Paloma Gómez-Campelo
- Group 27- Aging and fragility in the elderly, Hospital La Paz Institute for Health Research-IdiPAZ, Madrid, Spain; Plataforma de Apoyo al Investigador Novel- PAIN Platform, Hospital La Paz Institute for Health Research-IdiPAZ, Madrid, Spain
| | | | - Juan Carlos Abánades-Herranz
- Group 27- Aging and fragility in the elderly, Hospital La Paz Institute for Health Research-IdiPAZ, Madrid, Spain; Dirección Técnica de Docencia e Investigación, Gerencia Adjunta de Planificación y Calidad, Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain
| | | | - Carmen de Burgos-Lunar
- Group 27- Aging and fragility in the elderly, Hospital La Paz Institute for Health Research-IdiPAZ, Madrid, Spain; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain; Servicio de Medicina Preventiva, Hospital Universitario La Paz, Madrid, Spain
| | | |
Collapse
|
48
|
Shallcross AJ, Ojie MJ, Chaplin W, Levy N, Odedosu T, Ogedegbe G, Spruill TM. Race/ethnicity moderates the relationship between chronic life stress and quality of life in type 2 diabetes. Diabetes Res Clin Pract 2015; 108:150-6. [PMID: 25704600 PMCID: PMC4388790 DOI: 10.1016/j.diabres.2015.01.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Revised: 10/29/2014] [Accepted: 01/02/2015] [Indexed: 11/15/2022]
Abstract
AIMS To determine whether chronic life stress is differentially associated with quality of life (QoL) for Blacks vs. Hispanics with type 2 diabetes. METHODS We assessed self-reported chronic stress and QoL in 125 patients with type 2 diabetes who self-identified as either non-Hispanic Black or Hispanic. Separate cross-sectional two-way interaction models (stress × race/ethnicity) with physical and mental health as outcomes were examined. RESULTS The two-way interaction predicted mental (b=3.12, P=.04) but not physical health. Simple slopes analyses indicated that under conditions of high stress, Blacks (b=-4.4, P<.001), but not Hispanics, experienced significantly lower levels of mental health. In exploratory analyses, we examined a three-way interaction (stress × race/ethnicity × social support) with physical and mental health as outcomes. Results indicated the three-way interaction predicted mental (b=.62, P=.01) but not physical health. Simple slopes analyses indicated that under conditions of high stress, high levels of social support improved mental health for Hispanics (b=1.2, P<.001), but not for Blacks. CONCLUSIONS Black patients with type 2 diabetes may be particularly vulnerable to the deleterious effects of high chronic stress. Social support buffers effects of stress on mental health in Hispanics but not Blacks, which suggests differences in the use and/or quality of social support between Hispanics and Blacks. Longitudinal investigations that examine race/ethnicity, stress, social support, and QoL should help clarify the processes that underlie these observed relations.
Collapse
Affiliation(s)
- Amanda J Shallcross
- Center for Healthful Behavior Change, Department of Population Health, New York University School of Medicine, 227 E. 30th St., Floor 6, New York, NY 10016, United States
| | - Mary-Jane Ojie
- Center for Healthful Behavior Change, Department of Population Health, New York University School of Medicine, 227 E. 30th St., Floor 6, New York, NY 10016, United States
| | - William Chaplin
- Center for Healthful Behavior Change, Department of Population Health, New York University School of Medicine, 227 E. 30th St., Floor 6, New York, NY 10016, United States
| | - Natalie Levy
- Center for Healthful Behavior Change, Department of Population Health, New York University School of Medicine, 227 E. 30th St., Floor 6, New York, NY 10016, United States
| | - Taiye Odedosu
- Center for Healthful Behavior Change, Department of Population Health, New York University School of Medicine, 227 E. 30th St., Floor 6, New York, NY 10016, United States
| | - Gbenga Ogedegbe
- Center for Healthful Behavior Change, Department of Population Health, New York University School of Medicine, 227 E. 30th St., Floor 6, New York, NY 10016, United States
| | - Tanya M Spruill
- Center for Healthful Behavior Change, Department of Population Health, New York University School of Medicine, 227 E. 30th St., Floor 6, New York, NY 10016, United States.
| |
Collapse
|
49
|
Clark H, Surendera Babu A, Harris S, Hardnett F. HIV-Related Mortality Among Adults (≥ 18 years) of Various Hispanic or Latino Subgroups--United States, 2006-2010. J Racial Ethn Health Disparities 2015; 2:53-61. [PMID: 26863241 PMCID: PMC5381268 DOI: 10.1007/s40615-014-0047-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 07/29/2014] [Accepted: 08/22/2014] [Indexed: 10/24/2022]
Abstract
Hispanics or Latinos residing in the USA are disproportionately affected by HIV when compared to whites. Health outcomes for Hispanics or Latinos diagnosed with HIV infection may vary by Hispanic or Latino subgroup. We analyzed national mortality data from the National Center for Health Statistics for the years 2006 to 2010 to examine differences in HIV-related mortality among Hispanics or Latinos by sociodemographic factors and by Hispanic or Latino subgroup. After adjusting for age, HIV-related death rates per 100,000 population were highest among Hispanics or Latinos who were male (45.6, 95 % confidence interval [CI], 44.4 to 46.9) compared to female (12.0, 95 % CI 11.4 to 12.6), or resided in the Northeast (75.1, 95 % CI 72.2 to 77.9) compared to other US regions at the time of death. The age-adjusted HIV-related death rate was highest among Puerto Ricans (100.9, 95 % CI 97.0 to 104.8) and lowest among Mexicans (16.9, 95 % CI 16.2 to 17.6). Among all deaths, the proportion of HIV-related deaths was more than four times as high among Puerto Ricans (adjusted prevalence ratio = 4.3, 95 % CI 4.1 to 4.5) compared to Mexicans. To ensure better health outcomes for Hispanics or Latinos living with HIV in the USA, medical care and treatment programs should be adapted to address the needs of various Hispanic or Latino subgroups.
Collapse
Affiliation(s)
- Hollie Clark
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, MS E47, Atlanta, GA, 30329, USA.
| | | | | | - Felicia Hardnett
- Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd., NE, MS E48, Atlanta, GA, 30329, USA
| |
Collapse
|
50
|
Michael YL, Yen IH. Aging and place--neighborhoods and health in a world growing older. J Aging Health 2014; 26:1251-60. [PMID: 25502240 DOI: 10.1177/0898264314562148] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The articles in this special issue make it clear that there are interesting and policy-relevant research to identify place-based strategies to improve health and reduce health disparities among older adults. The articles also reveal important areas of future research and policy innovation that are needed related to place and aging.
Collapse
Affiliation(s)
- Yvonne L Michael
- Drexel University School of Public Health, Philadelphia, PA, USA
| | - Irene H Yen
- University of California, San Francisco, Departments of Medicine and Epidemiology & Biostatistics, San Francisco, CA USA
| |
Collapse
|