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Fernandez-Sanchez H, Rocha-Fernandez M, Salma J, Santa Maria DM, Benavides-Torres RA, Salami B. Sexual Health Implications of Return Migration for Women and Their Partners in Rural Mexico: A Critical Ethnography. J Assoc Nurses AIDS Care 2024:00001782-990000000-00111. [PMID: 39145669 DOI: 10.1097/jnc.0000000000000494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/16/2024]
Abstract
ABSTRACT The return of a migrant partner can negatively impact the sexual health of women who stayed in their communities. Understanding their sexual health needs is crucial for developing targeted interventions and support systems. Our study used a critical ethnographic approach in Agua Dulce, a rural community in Mexico, involving 50 key informants: women who stayed behind (n = 20), returnees (n = 12), community leaders (n = 12), and health care professionals (n = 6). We used participant observation, policy analysis, and interviews, using purposeful and snowball sampling methods. A gender-based thematic analysis revealed economic hardships and early separations affect the sexual well-being of women who stay behind. Infidelity, discovered through social media or calls, causes emotional distress and family disruptions. Male migrants spend an average of 8.85 years abroad, leading to fears of risky sexual behaviors. Our study highlights the urgent need for specialized support centers and comprehensive health interventions.
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Affiliation(s)
- Higinio Fernandez-Sanchez
- Higinio Fernandez-Sanchez, PhD, RN, is an Assistant Professor, Cizik School of Nursing, University of Texas Health Science Center Houston, Houston, Texas, USA
- Minerva Rocha-Fernandez, BA, is a Community Partner, Agua Dulce, Veracruz, Mexico
- Jordana Salma, PhD, RN, is an Associate Professor, Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, Alberta, Canada
- Diane M. Santa Maria, PhD, RN, is Dean and Professor, Cizik School of Nursing, University of Texas Health Science Center Houston, Houston, Texas, USA
- Raquel A Benavides-Torres, PhD, RN, is a Professor, Facultad de Enfermería, Universidad Autonoma de Nuevo Leon, Monterrer, Mexico
- Bukola Salami, PhD, RN, is a Professor, Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Minerva Rocha-Fernandez
- Higinio Fernandez-Sanchez, PhD, RN, is an Assistant Professor, Cizik School of Nursing, University of Texas Health Science Center Houston, Houston, Texas, USA
- Minerva Rocha-Fernandez, BA, is a Community Partner, Agua Dulce, Veracruz, Mexico
- Jordana Salma, PhD, RN, is an Associate Professor, Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, Alberta, Canada
- Diane M. Santa Maria, PhD, RN, is Dean and Professor, Cizik School of Nursing, University of Texas Health Science Center Houston, Houston, Texas, USA
- Raquel A Benavides-Torres, PhD, RN, is a Professor, Facultad de Enfermería, Universidad Autonoma de Nuevo Leon, Monterrer, Mexico
- Bukola Salami, PhD, RN, is a Professor, Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jordana Salma
- Higinio Fernandez-Sanchez, PhD, RN, is an Assistant Professor, Cizik School of Nursing, University of Texas Health Science Center Houston, Houston, Texas, USA
- Minerva Rocha-Fernandez, BA, is a Community Partner, Agua Dulce, Veracruz, Mexico
- Jordana Salma, PhD, RN, is an Associate Professor, Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, Alberta, Canada
- Diane M. Santa Maria, PhD, RN, is Dean and Professor, Cizik School of Nursing, University of Texas Health Science Center Houston, Houston, Texas, USA
- Raquel A Benavides-Torres, PhD, RN, is a Professor, Facultad de Enfermería, Universidad Autonoma de Nuevo Leon, Monterrer, Mexico
- Bukola Salami, PhD, RN, is a Professor, Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Diane M Santa Maria
- Higinio Fernandez-Sanchez, PhD, RN, is an Assistant Professor, Cizik School of Nursing, University of Texas Health Science Center Houston, Houston, Texas, USA
- Minerva Rocha-Fernandez, BA, is a Community Partner, Agua Dulce, Veracruz, Mexico
- Jordana Salma, PhD, RN, is an Associate Professor, Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, Alberta, Canada
- Diane M. Santa Maria, PhD, RN, is Dean and Professor, Cizik School of Nursing, University of Texas Health Science Center Houston, Houston, Texas, USA
- Raquel A Benavides-Torres, PhD, RN, is a Professor, Facultad de Enfermería, Universidad Autonoma de Nuevo Leon, Monterrer, Mexico
- Bukola Salami, PhD, RN, is a Professor, Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Raquel A Benavides-Torres
- Higinio Fernandez-Sanchez, PhD, RN, is an Assistant Professor, Cizik School of Nursing, University of Texas Health Science Center Houston, Houston, Texas, USA
- Minerva Rocha-Fernandez, BA, is a Community Partner, Agua Dulce, Veracruz, Mexico
- Jordana Salma, PhD, RN, is an Associate Professor, Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, Alberta, Canada
- Diane M. Santa Maria, PhD, RN, is Dean and Professor, Cizik School of Nursing, University of Texas Health Science Center Houston, Houston, Texas, USA
- Raquel A Benavides-Torres, PhD, RN, is a Professor, Facultad de Enfermería, Universidad Autonoma de Nuevo Leon, Monterrer, Mexico
- Bukola Salami, PhD, RN, is a Professor, Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Bukola Salami
- Higinio Fernandez-Sanchez, PhD, RN, is an Assistant Professor, Cizik School of Nursing, University of Texas Health Science Center Houston, Houston, Texas, USA
- Minerva Rocha-Fernandez, BA, is a Community Partner, Agua Dulce, Veracruz, Mexico
- Jordana Salma, PhD, RN, is an Associate Professor, Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, Alberta, Canada
- Diane M. Santa Maria, PhD, RN, is Dean and Professor, Cizik School of Nursing, University of Texas Health Science Center Houston, Houston, Texas, USA
- Raquel A Benavides-Torres, PhD, RN, is a Professor, Facultad de Enfermería, Universidad Autonoma de Nuevo Leon, Monterrer, Mexico
- Bukola Salami, PhD, RN, is a Professor, Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Tran K, Shon H, Phan J, Cheng T, Kim GS, Jamal A, Srinivasan M, Palaniappan LP, Nguyen L, Huang RJ. Leading causes of death in Vietnamese Americans: An ecological study based on national death records from 2005-2020. PLoS One 2024; 19:e0303195. [PMID: 38787829 PMCID: PMC11125458 DOI: 10.1371/journal.pone.0303195] [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: 09/25/2023] [Accepted: 04/21/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Disaggregated data is a cornerstone of precision health. Vietnamese Americans (VietAms) are the fourth-largest Asian subgroup in the United States (US), and demonstrate a unique burden of disease and mortality. However, most prior studies have aggregated VietAms under the broader Asian American category for analytic purposes. This study examined the leading causes of death among VietAms compared to aggregated Asian Americans and non-Hispanic Whites (NHWs) during the period 2005-2020. METHODS Decedent data, including underlying cause of death, were obtained from the National Center for Health Statistics national mortality file from 2005 to 2020. Population denominator estimates were obtained from the American Community Survey one-year population estimates. Outcome measures included proportional mortality, age-adjusted mortality rates per 100,000 (AMR), and annual percent change (APC) in mortality over time. Data were stratified by sex and nativity status. Due to large differences in age structure, we report native- and foreign-born VietAms separately. FINDINGS We identified 74,524 VietAm decedents over the study period (71,305 foreign-born, 3,219 native-born). Among foreign-born VietAms, the three leading causes of death were cancer (26.6%), heart disease (18.0%), and cerebrovascular disease (9.0%). Among native-born VietAms the three leading causes were accidents (19.0%), self-harm (12.0%), and cancer (10.4%). For every leading cause of death, VietAms exhibited lower mortality compared to both aggregated Asians and NHWs. Over the course of the study period, VietAms witnessed an increase in mortality in every leading cause. This effect was mostly driven by foreign-born, male VietAms. CONCLUSIONS AND RELEVANCE While VietAms have lower overall mortality from leading causes of death compared to aggregated Asians and NHWs, these advantages have eroded markedly between 2005 and 2020. These data emphasize the importance of racial disaggregation in the reporting of public health measures.
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Affiliation(s)
- Khoa Tran
- Department of Humanities, New York University, Abu Dhabi, United Arab Emirates
| | - HyeYuong Shon
- Department of Psychology, University of California, Berkeley, CA, United States of America
| | - Jonathan Phan
- Department of Bioengineering, University of California, Los Angeles, CA, United States of America
| | - Tina Cheng
- Center for Asian Health Research and Education, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Gloria S. Kim
- Center for Asian Health Research and Education, Stanford University School of Medicine, Stanford, CA, United States of America
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Armaan Jamal
- Center for Asian Health Research and Education, Stanford University School of Medicine, Stanford, CA, United States of America
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Malathi Srinivasan
- Center for Asian Health Research and Education, Stanford University School of Medicine, Stanford, CA, United States of America
- Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Latha P. Palaniappan
- Center for Asian Health Research and Education, Stanford University School of Medicine, Stanford, CA, United States of America
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Linda Nguyen
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Robert J. Huang
- Center for Asian Health Research and Education, Stanford University School of Medicine, Stanford, CA, United States of America
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, United States of America
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Shokeen D, Wang N, Nguyen NP, Bakal E, Tripathi O, Palaniappan LP, Huang RJ. The association between local area immigrant fraction and prevalence of cardiovascular diseases in the United States: an observational study. LANCET REGIONAL HEALTH. AMERICAS 2023; 27:100613. [PMID: 37860751 PMCID: PMC10582736 DOI: 10.1016/j.lana.2023.100613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 09/14/2023] [Accepted: 09/18/2023] [Indexed: 10/21/2023]
Abstract
Background Local area immigrant fraction is strongly and positively correlated with local life expectancy in the United States. The aim of the study was to determine the relationship between local area immigrant fraction and local prevalence of coronary heart disease (CHD) and stroke. Methods Cross-sectional study design, with ZIP code as the unit of observation. Demographic data was obtained from the American Community Survey, and linked to indicators of health access (e.g., insurance, annual check-ups, cholesterol screening), obesity, behavior (smoking, exercise), and cardiovascular outcomes data from the 2020 Population Level Analysis and Community Estimates. Multivariable regression and path analyses were used to assess both direct and indirect relationships among variables. Findings CHD prevalence was lower in the second (3.9% relative difference, 95% CI: 3.1-4.5%), third (6.5%, 95% CI: 5.8-7.1%), and fourth (14.8%, 95% CI: 14.1-15.8%) quartiles of immigrant fraction compared to the lowest (p-trend <0.001). These effects remained robust in multivariable analysis following adjustment for indicators of access, obesity, and behavioral variables (p-trend <0.0001). For stroke, only the highest quartile demonstrated a significant difference in prevalence (2.1%, 95% CI: 1.2-3.0% with full adjustment). In CHD path analysis, ∼45% of the association of immigrant fraction was direct, and ∼55% was mediated through lower prevalence of deleterious behaviors (e.g., smoking). In stroke path analysis, the effect was entirely mediated through indirect effects. Interpretation In the United States, ZIP codes with higher immigrant fractions have lower prevalence of cardiovascular diseases. These associations are partially mediated through differences in health behaviors at the community level. Funding NIH (K08CA252635, P30AG0059304, K24HL150476), Stanford University, Rutgers University.
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Affiliation(s)
- Deepa Shokeen
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, USA
| | - Natalie Wang
- University of California Los Angeles, Los Angeles, CA, USA
| | - Ngan P. Nguyen
- Department of Psychology, Fulbright University Vietnam, Vietnam
| | - Ethan Bakal
- New York University College of Arts and Sciences, New York, USA
| | - Osika Tripathi
- The Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, USA
- San Diego State University School of Public Health, San Diego, CA, USA
| | - Latha P. Palaniappan
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Robert J. Huang
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, USA
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