Increasing risk of hepatocellular carcinoma with successive generations in the United States among Mexican American adults: The Multiethnic Cohort

BACKGROUND

US-born Latinos have a higher incidence of hepatocellular carcinoma (HCC) than foreign-born Latinos. Acculturation to unhealthy lifestyle behaviors and an immigrant self-selection effect may play a role. In this study, the authors examined the influence of generational status on HCC risk among Mexican American adults.

METHODS

The analytic cohort included 31,377 self-reported Mexican Americans from the Multiethnic Cohort Study (MEC). Generational status was categorized as: first-generation (Mexico-born; n = 13,382), second-generation (US-born with one or two parents born in Mexico; n = 13,081), or third-generation (US-born with both parents born in the United States; n = 4914). Multivariable Cox proportional hazards regression was performed to examine the association between generational status and HCC incidence.

RESULTS

In total, 213 incident HCC cases were identified during an average follow-up of 19.5 years. After adjusting for lifestyle and neighborhood-level risk factors, second-generation and third-generation Mexican Americans had a 37% (hazard ratio [HR], 1.37; 95% confidence interval [CI], 0.98-1.92) and 66% (HR, 1.66; 95% CI, 1.11-2.49) increased risk of HCC, respectively, compared with first-generation Mexican Americans (p for trend = 0.012). The increased risk associated with generational status was mainly observed in males (second-generation vs. first-generation: HR, 1.60 [95% CI, 1.05-2.44]; third-generation vs. first-generation: HR, 2.08 [95% CI, 1.29-3.37]).

CONCLUSIONS

Increasing generational status of Mexican Americans is associated with a higher risk of HCC. Further studies are needed to identify factors that contribute to this increased risk.

Prevalence and management of type 2 diabetes among Chinese Americans

AIMS

: This study examines: (a) the prevalence rate of type 2 diabetes mellitus (T2DM) in Chinese Americans (CAs); (b) the influence of acculturative status (i.e. generational status and linguistic fluency) on T2DM prevalence; (c) and differences in diabetes management between CAs and Non-Hispanic Whites (NHWs).

METHODS

: We used 2011-2018 data from the California Health Interview Survey (CHIS) to analyze the prevalence rate and management of diabetes among the CAs. Chi-squares, linear regressions, and logistic regressions were used to analyze the data.

RESULTS

: After controlling for demographic, socioeconomic, and health behaviors, there were no significant differences in the T2DM prevalence rate between CAs overall or of varying acculturative statuses compared with NHWs. However, there were differences in diabetes management, with first-generation CAs being less likely to exam glucose daily, have medical care plans developed by medical providers, or have confidence in controlling diabetes compared to NHWs. CAs with limited English proficiency (LEP) were less likely to perform self-monitoring of blood glucose or have confidence in managing their diabetes care compared to NHWs. Finally, non-first generation CAs were also more likely to take diabetes medication compared to NHWs.

CONCLUSIONS

: Although the prevalence rate of T2DM was found to be similar between CAs and NHWs, significant differences were found in diabetes care and management. Specifically, those who were less acculturated (e.g. first generation and those with LEP) were less likely to actively manage and have confidence in managing their T2DM. These results highlight the importance of targeting immigrants with LEP in prevention and intervention efforts.

COVID‐19 related distress and sleep health among trauma‐exposed South Asians: Does generational status matter?

The COVID-19 pandemic has resulted in substantial changes in individual and socio-economic factors that may negatively impact sleep health. We examined associations between COVID-19 related distress and sleep among trauma-exposed South Asian adults in the United States. Since a health advantage among foreign-born individuals has been previously noted in the literature (the 'immigrant paradox'), we also explored if generational status (number of generations one's family has been in the U.S.) moderated associations between COVID-19 related distress and sleep health. Participants were 196 trauma-exposed South Asian adults residing in the U.S. (54% male, 63% U.S.-born citizens, average age = 34.51 years), who completed measures of generational status, COVID-19 related distress, trauma exposure, sleep-related impairment (SRI), and sleep disturbances. Greater COVID-19 distress was associated with more sleep disturbances (b = 0.15, p < 0.001) and SRI (b = 0.24, p < 0.001). Generational status was not associated with sleep, nor did it modify associations between COVID-19 distress and sleep. Findings highlight the potential importance of developing interventions to reduce stress and sleep difficulties during the pandemic. Our results did not support the immigration paradox. Future studies are needed to better understand the role of generational status on sleep health across immigrant subgroups.

Parent-child relationships in Latinx families: The role of immigrant concentration, residential stability, and generational status

Prior research links neighborhood immigrant concentration and residential stability to individual health outcomes. It remains unclear how neighborhood social organization extend to family functioning among immigrant families. Expanding the scope of research on neighborhoods and family relationships, this study draws on data from 1417 Latinx families (M_{youth age}  = 10.19 years, SD_{youth age}  = 3.34) to: (1) examine associations between neighborhood immigrant concentration, residential stability, and parent-child warmth and conflict in Latinx families, and (2) test whether associations vary by family generational status. Multilevel mod3els revealed that associations between immigrant concentration and parent-child relationships were contingent on residential stability, and that the association differed according to generational status. In general, stable neighborhoods with larger immigrant populations were associated with more warmth and less conflict for first- and second-generation families relative to foreign-born families. Discussion centers on the conditional role of neighborhood structural characteristics for family relationships among Latinx families and advances directions for future research on neighborhoods and families.

Emphasizing the "Cultural" in Sociocultural: A Systematic Review of Research on Thin-Ideal Internalization, Acculturation, and Eating Pathology in US Ethnic Minorities

A large body of research suggests that thin-ideal internalization is a robust predictor of eating pathology in women and, to some degree, in men. Recent research is exploring the relationships between thin-ideal internalization and culture-specific factors that may be salient to women and men who live in the US but are marginalized based on racial or ethnic background, such as acculturation. This systematic review summarizes published articles examining the relationships among thin-ideal internalization, acculturation-related constructs (including assimilation, marginalization, biculturalism, and acculturative stress), and eating pathology in US adults. Following the PRISMA method, 15 empirical studies met inclusion criteria. Although existing literature was sparse and conflicting in large part due to heterogeneity in acculturation measures, results yielded some support for positive correlational relationships between acculturative stress, thin-ideal internalization, and eating pathology for both men and women (in 4 out of 5 relevant studies). Research on other aspects of acculturation (eg, integration, assimilation) is mixed, with some existing research suggesting a positive relationship and other research finding no statistically significant relationship. Future research would particularly benefit from a gold-standard, multidimensional transcultural measure of acculturation to examine how the acculturation process relates to thin-ideal internalization and eating pathology in ethnic and racial minorities in the US.

The double burden of food insecurity and obesity among Latino youth: Understanding the role of generational status

BACKGROUND

Obesity is linked to food insecurity and generational status; however, little is known about how both impact obesity risk among Latino youth.

OBJECTIVE

To investigate the joint effect of generational status and food insecurity on obesity prevalence among Latino youth.

METHODS

We pooled data from the 2011 to 2017 waves of the National Health Interview Survey to derive a sample Latino youth aged 12 to 17 (N = 7532). Four generational categories were constructed: first generation (foreign-born children); second generation (US-born child; foreign-born parent[s]); 2.5 generation (US-born child; one foreign-born parent and one US-born parent); third generation (US-born child; U.S.-born parent[s]). Food insecurity was defined by monthly instances of food scarcity over the past year. Obesity was measured using age- and sex-specific body mass index percentile cut-offs. Log-binomial multivariable regression models estimated the association between generational status and food insecurity categories on obesity.

RESULTS

Obesity percentages among food-insecure households ranged from 12.8% in the first generation, 15.8% in the second, 24.3% in the 2.5, and 19.2% in the third. In fully adjusted models, 2.5 generation food secure youth had the highest prevalence of obesity (aPR: 1.53; 95% CI, 1.09-2.16) when compared with first generation food secure youth, followed by third generation food insecure youth (aPR: 1.49; 95% CI, 1.01-2.20).

CONCLUSIONS

Food security status is associated with increased obesity prevalence among Latino youth across the generations. Given that obesity is a risk factor for top causes of mortality and morbidity, growing rates among this population is of public health and clinical importance.

The Perceived Payoff of Education: Do Generational Status and Racial Discrimination Matter?

The purpose of this study was to examine the associations among racial discrimination, generational status, and perceptions of the economic value of education among Latina/o youth. Participants were 400 urban, low-income, Latina/o students from a large Midwestern U.S. city who completed surveys in both 9th and 10th grades. Results revealed that more perceived racial discrimination was associated with more perceived economic limitations of education. When analyzed by generational status, more racial discrimination in 9th grade was significantly related to lower perceived economic value of education in 10th grade for third-generation and later participants, but not for first- or second-generation participants. The results provide evidence for the diverse experiences of racial discrimination and perceived economic value of education across generational groups.

Interrelationship between family history of alcoholism and generational status in the prediction of alcohol dependence in US Hispanics

BACKGROUND

Both a family history of alcoholism and migration-related factors like US v. foreign nativity increase the risk for developing alcohol use disorders in Hispanic Americans. For this study, we integrated these two lines of research to test whether the relationship between familial alcoholism and alcohol dependence changes with successive generations in the United States.

METHOD

Data were from the waves 1 and 2 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Subjects self-identified Hispanic ethnicity (N = 4122; n = 1784 first, n = 1169 second, and n = 1169 third or later generation) and reported ever consuming ⩾12 drinks in a 1-year period. A family history of alcoholism was assessed in first- and second-degree relatives. Analyses predicting the number of alcohol dependence symptoms were path models.

RESULTS

Alcohol dependence symptoms were associated with a stronger family history of alcoholism and later generational status. There was a significant interaction effect between familial alcoholism and generational status; the relationship of familial alcoholism with alcohol dependence symptoms increased significantly with successive generations in the United States, more strongly in women than men. Acculturation partially mediated the interaction effect between familial alcoholism and generational status on alcohol dependence, although not in the expected direction.

CONCLUSIONS

Familial alcoholism interacted with generational status in predicting alcohol dependence symptoms in US Hispanic drinkers. This relationship suggests that heritability for alcoholism is influenced by a higher-order environmental factor, likely characterized by a relaxing of social restrictions on drinking.

Evaluating the invariance of the Multigroup Ethnic Identity Measure across foreign-born, second-generation and later-generation college students in the United States

OBJECTIVES

Past research has established that the Multigroup Ethnic Identity Measure (MEIM) exhibits measurement invariance across diverse ethnic groups. However, relatively little research has evaluated whether this measure is invariant across generational status. Thus, the present study evaluates the invariance of the MEIM across foreign-born, second-generation, and later-generation respondents.

METHOD

A large, ethnically diverse sample of college students completed the MEIM as part of an online survey (N = 9,107; 72.8% women; mean age = 20.31 years; SD = 3.38).

RESULTS

There is evidence of configural and metric invariance, but there is little evidence of scalar invariance across generational status groups.

CONCLUSIONS

This study suggests that the MEIM has an equivalent factor structure across generation groups, indicating it is appropriate to compare the magnitude of associations between the MEIM and other variables across foreign-born, second-generation, and later-generation individuals. However, the lack of scalar invariance suggests that mean-level differences across generational status should be interpreted with caution. (PsycINFO Database Record

School Belonging, Generational Status, and Socioeconomic Effects on Mexican-Origin Children's Later Academic Competence and Expectations

This study examined factors that relate to academic competence and expectations from elementary to middle school for 674 fifth grade students (50% boys; M_age = 10.86 years) of Mexican origin. Models predicting academic competence and expectations were estimated using a Structural Equation Modeling (SEM) framework, with longitudinal data from fifth to eighth grades. School belonging (i.e., social and emotional connectedness to school) predicted greater academic competence and expectations over time. Findings indicate that student feelings of belonging in school may act as a resource that promotes academic competence and expectations. Furthermore, family income, parent education, and generational status had direct effects on academic competence and expectations to some degree, suggesting the importance of contextual factors in this process.

Educational Achievement Gaps between Immigrant and Native Students in Two "New Immigration Countries": Italy and Spain in comparison

We use PISA 2009 data to determine how immigrant children in Italy and Spain compare with native students in reading and mathematics skills. Drawing on the vast empirical literature in traditional immigration countries, we test the extent to which the most well-established patterns and hypotheses of immigrant/native educational achievement gaps also apply to these new immigration countries. Findings show that both first- and second-generation immigrant students underperform natives in both countries. Although socioeconomic background and language skills contribute to the explanation of achievement gaps, significant differences remain within countries. While modeling socioeconomic background reduces the observed gaps to a very similar extent in the two countries, language spoken at home is more strongly associated with achievement in Italy. School-type differentiation, such as tracking in Italy and school ownership in Spain, do not reduce immigrant/native gaps, although in Italy tracking is strongly associated with students' test scores.