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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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Quesada O, Crousillat D, Rodriguez F, Bravo-Jaimes K, Briller J, Ogunniyi MO, Mattina DJ, Aggarwal NR, Rodriguez CJ, De Oliveira GMM, Velarde G. Cardiovascular Disease in Hispanic Women: JACC Review Topic of the Week. J Am Coll Cardiol 2024; 83:1702-1712. [PMID: 38658109 DOI: 10.1016/j.jacc.2024.02.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 01/29/2024] [Accepted: 02/05/2024] [Indexed: 04/26/2024]
Abstract
Cardiovascular disease affects 37% of Hispanic women and is the leading cause of death among Hispanic women in the United States. Hispanic women have a higher burden of cardiovascular risk factors, are disproportionally affected by social determinants of health, and face additional barriers related to immigration, such as discrimination, language proficiency, and acculturation. Despite this, Hispanic women show lower rates of cardiovascular disease and mortality compared with non-Hispanic White women. However, this "Hispanic paradox" is challenged by recent studies that account for the diversity in culture, race, genetic background, country of origin, and social determinants of health within Hispanic subpopulations. This review provides a comprehensive overview of the cardiovascular risk factors in Hispanic women, emphasizing the role of social determinants, and proposes a multipronged approach for equitable care.
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Affiliation(s)
- Odayme Quesada
- Women's Heart Center, The Christ Hospital Heart and Vascular Institute, Cincinnati, Ohio, USA; The Carl and Edyth Lindner Center for Research and Education, The Christ Hospital, Cincinnati, Ohio, USA.
| | - Daniela Crousillat
- Division of Cardiovascular Sciences, Department of Medicine, Department of Obstetrics and Gynecology, University of South Florida Morsani College of Medicine, Tampa, Florida, USA
| | - Fatima Rodriguez
- Division of Cardiovascular Medicine and the Cardiovascular Institute, Stanford University School of Medicine, Stanford, California, USA
| | - Katia Bravo-Jaimes
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida, USA
| | - Joan Briller
- Division of Cardiology, Department of Medicine, University of Illinois Chicago, Chicago, Illinois, USA; Department of Obstetrics and Gynecology, University of Illinois Chicago, Chicago, Illinois, USA
| | - Modele O Ogunniyi
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA; Grady Health System, Atlanta, Georgia, USA
| | - Deirdre J Mattina
- Department of Cardiovascular Medicine, Cleveland Clinic, Beachwood, Ohio, USA
| | - Niti R Aggarwal
- Department of Cardiovascular Disease, Mayo Clinic, Rochester, Minnesota, USA
| | | | | | - Gladys Velarde
- Division of Cardiology, Department of Medicine, University of Florida College of Medicine, Jacksonville, Florida, USA
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Vo V, Lopez G, Malay S, Roman YM. Cardiovascular Risk Factors Among Asian Americans: Perspectives on the Role of Acculturation in Cardiovascular Diseases Health Disparities. J Immigr Minor Health 2024; 26:409-420. [PMID: 37222869 DOI: 10.1007/s10903-023-01489-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2023] [Indexed: 05/25/2023]
Abstract
The growing prevalence of cardiovascular diseases in the United States (US) has disproportionately affected minority populations more than their white counterparts. A population that is often overlooked is the Asian American population, particularly Southeastern Asian immigrants. Despite having relatively favorable socioeconomic indicators compared to the general US population, Asian Americans, specifically Southeast Asian individuals, face a significant burden of traditional cardiovascular risk factors and are considered a high cardiovascular disease risk group. In addition, most studies have aggregated Asian populations into one major racial group rather than analyzing the different ethnicities among the Asian categorization. While some studies suggest that the acculturation process has some degree of impact on cardiovascular health, there has not been a widely-used tool to measure or ascertain the totality of acculturation. Instead, multiple proxies have been used to measure acculturation, and prior studies have argued for more culturally-tailored acculturation proxies. This paper aims to assess the implications of different acculturation measures on cardiovascular health among Asian Americans, particularly Southeastern Asian immigrants. The following proxies were expanded on in this paper: English spoken at home, length of stay in the US, religiosity and spirituality, and admixed family structures. Previous studies showed that as the length of stay in the US increases, the burden of cardiovascular risk factors increases. However, the impact of English spoken at home, religiosity, and admixed family structure are still inconclusive given the extent of current studies. While most studies suggest that an increase in acculturation increases the risk of cardiovascular disease, it is critical to note that acculturation is a multifaceted process. Therefore, more studies are necessary to appropriately examine the implications of various acculturation processes on cardiovascular risk factors in Asians, specifically Southeastern Asian individuals in the US.
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Affiliation(s)
- Victoria Vo
- Pharmacotherapy and Outcomes Science, Virginia Commonwealth University School of Pharmacy, Richmond, VA, 23298, USA
| | - Glydel Lopez
- Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USA
| | - Shravani Malay
- Pharmacotherapy and Outcomes Science, Virginia Commonwealth University School of Pharmacy, Richmond, VA, 23298, USA
| | - Youssef M Roman
- Pharmacotherapy and Outcomes Science, Virginia Commonwealth University School of Pharmacy, Richmond, VA, 23298, USA.
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Guadamuz JS. Sociodemographic inequities in COVID-19 vaccination among adults in the United States, 2022. J Am Pharm Assoc (2003) 2024:102064. [PMID: 38432482 DOI: 10.1016/j.japh.2024.102064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 02/24/2024] [Accepted: 02/24/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Despite the availability of COVID-19 vaccines since December 2020, sociodemographic inequities in vaccination and preventable COVID-related deaths persist. To inform efforts for equitable COVID-19 vaccination campaigns, a comprehensive national evaluation of existing inequities is necessary. OBJECTIVE To examine sociodemographic inequities in COVID-19 vaccination receipt using data from the 2022 National Health Interview Survey (NHIS). METHODS This secondary data analysis used cross-sectional nationally-representative data from the 2022 NHIS to assess vaccination inequities among 27,126 adults. Separate Poisson regressions adjusted for clinical factors (e.g., age, sex, high-risk health conditions) were used to evaluate vaccination inequities across sociographic factors (e.g., race/ethnicity, poverty, health insurance). RESULTS In 2022, 79.6% of adults received at ≥ 1 vaccine dose, 75.0% received ≥ 2 doses ("fully vaccinated"), 45.7% received ≥ 3 doses (≥ 1 booster), and 17.2% received ≥ 4 doses (≥ 2 boosters). Marked inequities were evident in COVID-19 vaccination across primary and booster doses, especially receipt of at least 1 booster dose (≥ 3 doses). Black (35.7%, prevalence ratio [PR] 0.78 [95% CI 0.74-0.83]) and Latinx (35.5%, PR 0.82 [CI 0.78-0.86]) adults were less likely to receive ≥ 3 doses than Asian (66.5%, PR 1.41 [CI 1.35-1.48]) and White (48.8%) adults. Poverty (31.1% [PR 0.65 {CI 0.61-0.69}] vs. 50.7%) and food insecurity (27.1% [PR 0.63 {CI 0.58-0.68}] vs. 47.3%) were negatively associated with receipt of ≥ 3 vaccine doses. Adults without usual source of care (24.9%, PR 0.61 [CI 0.57-0.65]) or health insurance (17.4%, PR 0.40 [CI 0.36-0.45]) had much lower rates of ≥ 3 doses than those with appropriate health care access (48.7% and 51.9%, respectively). CONCLUSION As of 2022, 1-in-5 U.S. adults remain unvaccinated, and more than half have not received any recommended booster doses. Economically/socially marginalized populations-including Black and Latinx adults and those with structural barriers such as poverty, food insecurity, and poor health care access-were less likely to receive a booster. Addressing these vaccination inequities is crucial to achieve equitable COVID-19 protection and reduce preventable deaths among economically/socially marginalized populations.
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Datta BK, Coughlin SS, Majeed B. Inequities in routine preventive care utilization among persons with overweight/obesity in the United States: An analysis of nativity, racial and ethnic identity, and socioeconomic status. DIALOGUES IN HEALTH 2023; 2:100125. [PMID: 37377782 PMCID: PMC10292657 DOI: 10.1016/j.dialog.2023.100125] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 03/06/2023] [Accepted: 03/10/2023] [Indexed: 06/29/2023]
Abstract
Extant literature documented various health disparities among immigrants and racial and ethnically marginalized individuals in the United States. However, health disparities in the intersection of nativity and race are generally less visited. This cross-sectional study assessed utilization of routine preventive care among adults with overweight/obesity at the junction of their nativity, racial/ethnic identity, and socioeconomic status (i.e., income and education). Pooling data on 120,184 adults with overweight/obesity from the 2013-2018 waves of the National Health Interview Survey (NHIS), we estimated modified Poisson regressions with robust standard errors to obtain adjusted prevalence rates of preventive care visit, receiving flu shot, and having blood pressure, cholesterol and blood glucose screened. We found that immigrant adults with overweight/obesity had lower rates of utilization of all five preventive care services. However, these patterns varied by racial and ethnic sub-populations. While White immigrants had comparable rates of cholesterol and blood glucose screening, they had 2.7%, 2.9%, and 14.5% lower rates of preventive care visit, blood pressure screening, and getting a flu shot respectively, compared to native-born Whites. These patterns were similar for Asian immigrants as well. Black immigrants, on the other hand, had comparable rates of getting a flu shot and blood glucose screening, and had 5.2%, 4.9%, and 4.9% lower rates of preventive care visit, blood pressure screening, and cholesterol screening respectively. Lastly, the rates of utilization among Hispanic immigrants were significantly lower (ranging from 9.2% to 20%) than those of their native-born counterparts for all five preventive care services. These rates further varied by education, income, and length of stay in the US, within the racial and ethnic subgroups. Our findings thus suggest a complex relationship between nativity and racial/ethnic identity in relation to preventive care utilization among adults with overweight/obesity.
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Affiliation(s)
- Biplab Kumar Datta
- Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA
- Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Steven S. Coughlin
- Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA
- Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Ban Majeed
- Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA
- Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA
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Guadamuz JS, Wang X, Ryals CA, Miksad RA, Snider J, Walters J, Calip GS. Socioeconomic status and inequities in treatment initiation and survival among patients with cancer, 2011-2022. JNCI Cancer Spectr 2023; 7:pkad058. [PMID: 37707536 PMCID: PMC10582690 DOI: 10.1093/jncics/pkad058] [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: 04/27/2023] [Revised: 07/25/2023] [Accepted: 08/09/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Lower neighborhood socioeconomic status (SES) is associated with suboptimal cancer care and reduced survival. Most studies examining cancer inequities across area-level socioeconomic status tend to use less granular or unidimensional measures and pre-date the COVID-19 pandemic. Here, we examined the association of area-level socioeconomic status on real-world treatment initiation and overall survival among adults with 20 common cancers. METHODS This retrospective cohort study used electronic health record-derived deidentified data (Flatiron Health Research Database, 2011-2022) linked to US Census Bureau data from the American Community Survey (2015-2019). Area-level socioeconomic status quintiles (based on a measure incorporating income, home values, rental costs, poverty, blue-collar employment, unemployment, and education information) were computed from the US population and applied to patients based on their mailing address. Associations were examined using Cox proportional hazards models adjusted for diagnosis year, age, sex, performance status, stage, and cancer type. RESULTS This cohort included 291 419 patients (47.7% female; median age = 68 years). Patients from low-SES areas were younger and more likely to be Black (21.9% vs 3.3%) or Latinx (8.4% vs 3.0%) than those in high-SES areas. Living in low-SES areas (vs high) was associated with lower treatment rates (hazard ratio = 0.94 [95% confidence interval = 0.93 to 0.95]) and reduced survival (median real-world overall survival = 21.4 vs 29.5 months, hazard ratio = 1.20 [95% confidence interval = 1.18 to 1.22]). Treatment and survival inequities were observed in 9 and 19 cancer types, respectively. Area-level socioeconomic inequities in treatment and survival remained statistically significant in the COVID-19 era (after March 2020). CONCLUSION To reduce inequities in cancer outcomes, efforts that target marginalized, low-socioeconomic status neighborhoods are necessary.
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Affiliation(s)
- Jenny S Guadamuz
- Flatiron Health, New York, NY, USA
- Division of Health Policy and Management, University of California, Berkeley, School of Public Health, Berkeley, CA, USA
- Program on Medicines and Public Health, University of Southern California School of Pharmacy, Los Angeles, CA, USA
| | | | | | - Rebecca A Miksad
- Flatiron Health, New York, NY, USA
- Department of Hematology and Oncology, Boston University School of Medicine, Boston, MA, USA
| | | | | | - Gregory S Calip
- Flatiron Health, New York, NY, USA
- Program on Medicines and Public Health, University of Southern California School of Pharmacy, Los Angeles, CA, USA
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Elias S, Turkson‐Ocran R, Koirala B, Byiringiro S, Baptiste D, Himmelfarb CR, Commodore‐Mensah Y. Heterogeneity in Cardiovascular Disease Risk Factors Among Latino Immigrant Subgroups: Evidence From the 2010 to 2018 National Health Interview Survey. J Am Heart Assoc 2023; 12:e027433. [PMID: 37158060 PMCID: PMC10227289 DOI: 10.1161/jaha.122.027433] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 03/10/2023] [Indexed: 05/10/2023]
Abstract
Background The Latino population is a growing and diverse share of the US population. Previous studies have examined Latino immigrants as a homogenous group. The authors hypothesized that there would be heterogeneity in cardiovascular disease risk factors among Latino immigrant subgroups (from Mexico, Puerto Rico, Cuba, Dominican Republic, Central America, or South America) compared with non-Latino White adults. Methods and Results A cross-sectional analysis of the 2010 to 2018 National Health Interview Survey (NHIS) among 548 739 individuals was performed. Generalized linear models with Poisson distribution were fitted to compare the prevalence of self-reported hypertension, overweight/obesity, diabetes, high cholesterol, physical inactivity, and current smoking, adjusting for known confounders. The authors included 474 968 non-Latino White adults and 73 771 Latino immigrants from Mexico (59%), Puerto Rico (7%), Cuba (6%), Dominican Republic (5%), Central America (15%), and South America (9%). Compared with White adults, Mexican immigrants had the highest prevalence of overweight/obesity (prevalence ratio [PR], 1.17 [95% CI, 1.15-1.19]); Puerto Rican individuals had the highest prevalence of diabetes (PR, 1.63 [95% CI, 1.45-1.83]); individuals from Central America had the highest prevalence of high cholesterol (PR, 1.16 [95% CI, 1.04-1.28]); and individuals from the Dominican Republic had the highest prevalence of physical inactivity (PR, 1.25 [95% CI, 1.18-1.32]). All Latino immigrant subgroups were less likely to be smokers than White adults. Conclusions The authors observed advantages and disparities in cardiovascular disease risk factors among Latino immigrants. Aggregating data on Latino individuals may mask differences in cardiovascular disease risk and hinder efforts to reduce health disparities in this population. Study findings provide Latino group-specific actionable information and targets for improving cardiovascular health.
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Affiliation(s)
| | - Ruth‐Alma Turkson‐Ocran
- Division of General MedicineBeth Israel Deaconess Medical Center and Harvard Medical SchoolBostonMA
| | | | | | | | - Cheryl R. Himmelfarb
- Johns Hopkins School of NursingBaltimoreMD
- Johns Hopkins Bloomberg School of Public HealthBaltimoreMD
- Johns Hopkins School of MedicineBaltimoreMD
| | - Yvonne Commodore‐Mensah
- Johns Hopkins School of NursingBaltimoreMD
- Johns Hopkins Bloomberg School of Public HealthBaltimoreMD
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Carr T, Gillum R. Immigration and use of preventive aspirin by Hispanics and non-Hispanic whites and non-Hispanic blacks in the US. J Natl Med Assoc 2023:S0027-9684(23)00037-8. [PMID: 37024312 DOI: 10.1016/j.jnma.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 02/08/2023] [Accepted: 03/14/2023] [Indexed: 04/08/2023]
Abstract
BACKGROUND In the US, little is known about aspirin use as a preventive measure for cardiovascular disease by immigration status. METHODS Combined data from the National Health and Nutrition Examination Survey (NHANES) 2015-2016 and 2017- March 2020 (pre-pandemic data) were analyzed. Persons were asked about demographics including country of birth and those aged 40 years and older were asked about current use of aspirin to prevent cardiovascular disease (CVD). RESULTS Among 2,321 born in the US, preventive aspirin use was significantly more prevalent (39.6%) than among 910 others (27.5%, p < 0.01). However, after stratifying by race/ethnicity and history of CVD, the difference was significant only in Hispanics with CVD. In logistic regression analyses in Hispanics controlling for age, gender and education, the US born had significantly higher odds of aspirin use in those with or without CVD. DISCUSSION Among US Hispanics, use of aspirin for prevention of CVD was more prevalent in those born in the US than in others.
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Affiliation(s)
- Tyler Carr
- MSII, Howard University College of Medicine, 520 W St NW, Washington, DC 20059, USA.
| | - Richard Gillum
- Professor, Department of Medicine, Howard University College of Medicine, Washington, DC 20059 USA.
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Association of Acculturation with Cardiovascular Risk Factors in Asian-American Subgroups. Am J Prev Cardiol 2022; 13:100437. [PMID: 36545389 PMCID: PMC9761380 DOI: 10.1016/j.ajpc.2022.100437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 11/23/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022] Open
Abstract
Objective This cross-sectional study aims to better understand the heterogeneous associations of acculturation level on CV risk factors among disaggregated Asian subgroups. We hypothesize that the association between acculturation level and CV risk factors will differ significantly by Asian subgroup. Methods We used the National Health Interview Survey (NHIS), a nationally representative US survey, years 2014-18. Acculturation was defined using: (a) years in the US, (b) US citizenship status, and (c) level of English proficiency. We created an acculturation index, categorized into low vs. high (scores of 0-3 and 4, respectively). Self-reported CV risk factors included diabetes, high cholesterol, hypertension, obesity, tobacco use, and sufficient physical activity. Rao-Scott Chi Square was used to compare age-standardized, weighted prevalence of CV risk factors between Asian subgroups. We used logistic regression analysis to assess associations between acculturation and CV risk factors, stratified by Asian subgroup. Results The study sample consisted of 6,051 adults ≥ 18 years of age (53.9% female; mean age 46.6 [SE 0.33]). The distribution by race/ethnicity was Asian Indian 26.9%, Chinese 22.8%, Filipino 18.1%, and other Asian 32.3%. The association between acculturation and CV risk factors differed by Asian subgroups. From multivariable adjusted models, high vs. low acculturation was associated with: high cholesterol amongst Asian Indian (OR=1.57, 95% CI: 1.11, 2.37) and other Asian (OR=1.48, 95% CI: 1.10, 2.01) adults, obesity amongst Filipino adults (OR= 1.62, 95% CI: 1.07, 2.45), and sufficient physical activity amongst Chinese (OR= 1.54, 95% CI: 1.09, 2.19) and Filipino adults (OR=1.58, 95% CI: 1.10, 2.27). Conclusion This study demonstrates that acculturation is heterogeneously associated with higher prevalence of CV risk factors among Asian subgroups. More studies are needed to better understand these differences that can help to inform targeted, culturally specific interventions.
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Coronado G, Chio-Lauri J, Cruz RD, Roman YM. Health Disparities of Cardiometabolic Disorders Among Filipino Americans: Implications for Health Equity and Community-Based Genetic Research. J Racial Ethn Health Disparities 2022; 9:2560-2567. [PMID: 34837163 PMCID: PMC9248953 DOI: 10.1007/s40615-021-01190-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/19/2021] [Accepted: 11/10/2021] [Indexed: 12/29/2022]
Abstract
Health disparities are well-documented among different racial and ethnic minority groups in the United States. Filipino Americans (FAs) are the third-largest Asian-American group in the USA and are commonly grouped under the Asian categorization. FAs have a higher prevalence of cardiometabolic disorders than non-Hispanic Whites and other Asian subgroups with rates comparable to African Americans. Although no major epidemiological studies have ascertained the prevalence of cardiometabolic diseases in FAs, limited reports suggest that FAs have a higher prevalence of dyslipidemia, hypertension, diabetes, metabolic syndrome, hyperuricemia, and gout than non-FAs. A recent genetic study has shown that FAs could have the highest prevalence of a genetic polymorphism strongly associated with the development of gout and gout-related comorbidities. While developing cardiometabolic disorders is a heterogeneous and multifaceted process, the overall prevalence of certain cardiometabolic disorders parallel the prevalence of population-level risk factors, including genetics, dietary lifestyles, health beliefs, and social determinants of health. Therefore, assessment of the Filipino cuisine, health behaviors among Filipinos, socio-cultural factors, and acculturation to living in the USA are equally critical. Ascertaining the contribution of the biological causes to disease onset and the different psychosocial factors that could modulate disease risk or disease management are needed. Ultimately, a multilevel research approach is critical to assess the role of biological and non-biological risk factors of cardiometabolic disorders in FAs to inform culturally appropriate health promotion, disease prevention strategies, and a personalized approach to health.
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Affiliation(s)
- Gerald Coronado
- School of Medicine, Virginia Commonwealth University, Richmond, VA 23298, USA
| | | | - Rosheanne Dela Cruz
- School of Pharmacy, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Youssef M. Roman
- School of Pharmacy, Virginia Commonwealth University, Richmond, VA 23298, USA
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Gupta K, Al Rifai M, Hussain A, Minhas AMK, Patel J, Kalra D, Samad Z, Virani SS. South Asian ethnicity: What can we do to make this risk enhancer a risk equivalent? Prog Cardiovasc Dis 2022; 75:21-32. [PMID: 36279943 DOI: 10.1016/j.pcad.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022]
Abstract
South Asians account for around 25% of the global population and are the fastest-growing ethnicity in the US. This population has an increasing burden of atherosclerotic cardiovascular disease (ASCVD) which is also seen in the diaspora. Current risk prediction equations underestimate this risk and consider the South Asian ethnicity as a risk-enhancer among those with borderline-intermediate risk. In this review, we discuss why the South Asian population is at a higher risk of ASCVD and strategies to mitigate this increased risk.
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Affiliation(s)
- Kartik Gupta
- Department of Medicine, Henry Ford Hospital, Detroit, MI, USA
| | - Mahmoud Al Rifai
- Section of Cardiology and Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Aliza Hussain
- Section of Cardiology and Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | | | - Jaideep Patel
- Pauley Heart Center, Division of Cardiology, Virginia Commonwealth University Medical Center, Richmond, VA, USA; Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, MD, USA
| | - Dinesh Kalra
- Rudd Heart & Lung Center, University of Louisville School of Medicine, Louisville, KY, USA
| | - Zainab Samad
- Department of Medicine, Aga Khan University, Karachi, Pakistan
| | - Salim S Virani
- Section of Cardiology and Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA; Health Policy, Quality & Informatics Program, Health Services Research and Development Center for Innovations in Quality, Effectiveness, and Safety (IQuESt), Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA; Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA.
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De Ramos IP, Auchincloss AH, Bilal U. Exploring inequalities in life expectancy and lifespan variation by race/ethnicity and urbanicity in the United States: 1990 to 2019. SSM Popul Health 2022; 19:101230. [PMID: 36148325 PMCID: PMC9485214 DOI: 10.1016/j.ssmph.2022.101230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 09/06/2022] [Accepted: 09/10/2022] [Indexed: 11/18/2022] Open
Abstract
Background/Objective Investigating trends in life expectancy and lifespan variation can highlight disproportionate mortality burdens among population subgroups. We examined inequalities in life expectancy and lifespan variation by race/ethnicity and by urbanicity in the US from 1990 to 2019. Methods Using vital registration data for 322.0 million people in 3,141 counties from the National Center for Health Statistics, we obtained life expectancy at birth and lifespan variation for 16 race/ethnicity-gender-urbanicity combinations in six 5-year periods (1990-1994 to 2015-2019). Race/ethnicity was categorized as Hispanic, and non-Hispanic White, Black, and Asian/Pacific Islander. Urbanicity was categorized as metropolitan vs nonmetropolitan areas, or in six further detailed categorizations. Life expectancy and lifespan variation (coefficient of variation) were computed using life tables. Results In 2015-2019, residents in metropolitan areas had higher life expectancies than their nonmetropolitan counterparts (79.6 years compared to 77.0 years). The widest inequality in life expectancy occurred between Asian/Pacific Islander women and Black men, with a 17.7-year gap for residents in metropolitan areas and a 16.9-year gap for residents in nonmetropolitan areas. Nonmetropolitan areas had greater dispersion around average age at death. Black individuals had the highest lifespan variations in both metropolitan and nonmetropolitan areas. Until the mid-2010s, life expectancy increased while lifespan variation decreased; however, recent trends show stagnation in life expectancy and increases in lifespan variation. Metropolitan-nonmetropolitan inequalities in both life expectancy and lifespan variation widened over time. Conclusion Despite previous improvements in longevity, life expectancy is now stagnating while lifespan variation is increasing. Our results highlight that early-life deaths (i.e., young- and middle-age mortality) disproportionately affect Black individuals, who not only live the shortest lifespans but also have the most variability with respect to age at death.
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Affiliation(s)
- Isabel P. De Ramos
- Urban Health Collaborative, Drexel Dornsife School of Public Health, Philadelphia, PA, USA
- Department of Epidemiology and Biostatistics, Drexel Dornsife School of Public Health, Philadelphia, PA, USA
| | - Amy H. Auchincloss
- Urban Health Collaborative, Drexel Dornsife School of Public Health, Philadelphia, PA, USA
- Department of Epidemiology and Biostatistics, Drexel Dornsife School of Public Health, Philadelphia, PA, USA
| | - Usama Bilal
- Urban Health Collaborative, Drexel Dornsife School of Public Health, Philadelphia, PA, USA
- Department of Epidemiology and Biostatistics, Drexel Dornsife School of Public Health, Philadelphia, PA, USA
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Morey BN, Ryu S, Shi Y, Park HW, Lee S. Acculturation and Cardiometabolic Abnormalities Among Chinese and Korean Americans. J Racial Ethn Health Disparities 2022:10.1007/s40615-022-01347-x. [PMID: 35705844 PMCID: PMC9200372 DOI: 10.1007/s40615-022-01347-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 05/16/2022] [Accepted: 05/31/2022] [Indexed: 11/26/2022]
Abstract
Background Studies generally show that higher acculturation is associated with greater cardiovascular disease (CVD) risk among immigrants in the United States (US). However, few studies have compared how proxies of acculturation are differentially associated with metabolic abnormalities measured using objective biomarkers, self-reported diagnosis, and medication use, particularly among East Asian Americans. Methods Survey data and biomarker measurements collected from random (non-fasting) blood samples of Chinese and Korean immigrants in the US (n = 328) were used to examine the associations between two proxies for acculturation (years living in the US and English speaking proficiency) with three cardiometabolic abnormalities (high triglyceride levels, diabetes, and hypercholesterolemia). Poisson regression models estimated prevalence ratios adjusted for demographic characteristics, socioeconomic factors, and body mass index. Gender, Asian subgroup, and household income were tested as potential effect modifiers. Results Living longer in the US was associated with greater likelihood of having high triglycerides. In addition, living longer in the US was associated with greater likelihood of diabetes for people with lower household income and greater likelihood of hypercholesterolemia for people with higher household income. Higher level of English proficiency was less consistently associated with higher cardiometabolic risk, although there was a significant association with greater likelihood of hypercholesterolemia. Conclusions Longer time lived in the US is associated with higher risk of cardiometabolic abnormalities among Chinese and Korean Americans. Future studies of acculturation and cardiometabolic risk should carefully consider potential mechanisms and what proxy measures of acculturation capture. Trial Registration Number NCT03481296, date of registration: 3/29/2018.
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Affiliation(s)
- Brittany N Morey
- Program in Public Health, Department of Health, Society, & Behavior, University of California, Irvine, 653 E. Peltason Dr., Anteater Instruction and Research Building (AIRB) 2022, Irvine, CA, 92697-3957, USA.
| | - Soomin Ryu
- School of Public Policy, University of Maryland, College Park, MD, USA
| | - Yuxi Shi
- Department of Medicine, School of Medicine, University of California, Irvine, Irvine, CA, USA
| | - Hye Won Park
- Department of Medicine, School of Medicine, University of California, Irvine, Irvine, CA, USA
| | - Sunmin Lee
- Department of Medicine, School of Medicine, University of California, Irvine, Irvine, CA, USA
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Guadamuz JS, Durazo-Arvizu RA, Morales JF, Qato DM. Citizenship Status and Mortality Among Young Latino Adults in the U.S., 1998‒2015. Am J Prev Med 2022; 62:777-781. [PMID: 35459453 DOI: 10.1016/j.amepre.2021.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 11/13/2021] [Accepted: 11/16/2021] [Indexed: 01/14/2023]
Abstract
INTRODUCTION Although Latino immigrants, especially noncitizens, endure structural factors that may increase their risk of death at younger ages, little is known about their risk of death in young adulthood. This study evaluates mortality differences across citizenship status among young Latino adults (aged 18-44 years) in the U.S. METHODS This study used the National Health Interview Survey (1998-2014) with mortality follow-up through 2015. Cox regression models adjusted for age and sex were used to determine baseline differences in mortality. Models adjusted for socioeconomic factors (i.e., English proficiency, education, poverty, and health insurance) were used to determine whether socioeconomic conditions attenuate mortality differences. RESULTS Participants included noncitizens (n=48,388), naturalized citizens (n=16,241), and U.S.-born citizens (n=63,388). Noncitizens (hazard ratio [HR]=1.40, 95% CI=1.31, 1.51), but not naturalized citizens (HR=1.04, 95% CI=0.94, 1.16), were at greater risk of all-cause death than U.S.-born citizens. Both noncitizens (HR=2.46, 95% CI=2.07, 2.92) and naturalized citizens (HR=1.76, 95% CI=1.40, 2.21) were more likely to die of cancer. Noncitizens were also at a greater risk of death because of cardiometabolic diseases (HR=1.46, 95% CI=1.20, 1.78) and accidents (HR=1.33, 95% CI=1.14, 1.55). Socioeconomic factors attenuated differences in all-cause, cardiometabolic, and accidental deaths, but not differences in cancer mortality. CONCLUSIONS Contrary to the long-held notion of the healthy migrant, young Latino immigrants, especially noncitizens, are at increased risk of death than their U.S.-born counterparts. Efforts to reduce these disparities should focus on improving their socioeconomic conditions and healthcare access early in adulthood.
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Affiliation(s)
- Jenny S Guadamuz
- Program on Medicines and Public Health, Titus Family Department of Clinical Pharmacy, University of Southern California School of Pharmacy, Los Angeles, California; Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, California.
| | - Ramon A Durazo-Arvizu
- Department of Pediatrics, Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Josefina Flores Morales
- California Center for Population Research, University of California, Los Angeles, Los Angeles, California
| | - Dima M Qato
- Program on Medicines and Public Health, Titus Family Department of Clinical Pharmacy, University of Southern California School of Pharmacy, Los Angeles, California; Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, California
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15
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Burns SD, Baker EH, Sheehan CM. Disability and Self-Rated Health: Exploring Foreign- and U.S.-Born Differences Across Adulthood. J Migr Health 2022; 6:100112. [PMID: 35620793 PMCID: PMC9126965 DOI: 10.1016/j.jmh.2022.100112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 04/22/2022] [Accepted: 05/03/2022] [Indexed: 11/25/2022] Open
Abstract
There is limited inquiry regarding how immigrant status intersects with disability to influence health across adulthood. As the U.S. population continues to age, especially immigrants, understanding how disability influences health is imperative. Using 2010–2018 National Health Interview Survey data (n = 461,010) and logistic regression models, we investigate how differences in reporting Activity of Daily Living (ADL) disability influence reports of self-rated health (SRH) between foreign- and U.S.-born respondents (ages 25+) by race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic, and non-Hispanic Asian) by age group (25–64 and 65+). Among those ages 25–64, foreign-born respondents generally report lower or similar rates of fair/poor SRH and ADL disability when compared to their U.S.-born peers. Among those ages 65+, we find that foreign-born respondents are at greater risk of fair/poor SRH compared to their U.S.-born peers. Additionally, while having ADL disability greatly increases the likelihood of fair/poor SRH, the impact of this association differs by race/ethnicity/nativity and age. Among those 25–64, having ADL disability appears to be especially, negatively impactful for SRH among foreign-born groups, particularly Hispanics and non-Hispanic Whites. However, among those ages 65+, having ADL disability is less impactful on the SRH of foreign-born respondents, especially non-Hispanic Blacks and Hispanics. Our findings shed new light on marginalization-related diminished returns by showing how ADL disability influences SRH differently between foreign-born groups across adulthood.
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Shah NS, Wang MC, Kandula NR, Carnethon MR, Gunderson EP, Grobman WA, Khan SS. Gestational Diabetes and Hypertensive Disorders of Pregnancy by Maternal Birthplace. Am J Prev Med 2022; 62:e223-e231. [PMID: 34893385 PMCID: PMC8940631 DOI: 10.1016/j.amepre.2021.10.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 10/02/2021] [Accepted: 10/05/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Gestational diabetes mellitus and hypertensive disorders of pregnancy increase the risk for future adverse health outcomes in the pregnant woman and baby, and disparities exist in the rates of gestational diabetes mellitus and hypertensive disorders of pregnancy by race/ethnicity. The objective of this study is to identify the differences in gestational diabetes mellitus and hypertensive disorders of pregnancy rates by maternal place of birth within race/ethnicity groups. METHODS In women aged 15-44 years at first live singleton birth in U.S. surveillance data between 2014 and 2019, age-standardized rates of gestational diabetes mellitus and hypertensive disorders of pregnancy and the rate ratios of gestational diabetes mellitus and hypertensive disorders of pregnancy in women born outside versus those born in the U.S. were evaluated, stratified by race/ethnicity. Analyses were conducted in 2021. RESULTS Of 8,574,264 included women, 6,827,198 were born in the U.S. (mean age=26.2 [SD 5.7] years), and 1,747,066 were born outside the U.S. (mean age=28.2 [SD=5.8] years). Overall, the gestational diabetes mellitus rate was higher in women born outside than in those born in the U.S. (70.3, 95% CI=69.9, 70.7 vs 53.2, 95% CI=53.0, 53.4 per 1,000 live births; rate ratio=1.32, 95% CI=1.31, 1.33), a pattern observed in most race/ethnic groups. By contrast, the overall hypertensive disorders of pregnancy rate was lower in those born outside than in those born in the U.S. (52.5, 95% CI=52.2, 52.9 vs 90.1, 95% CI=89.9, 90.3 per 1,000 live births; rate ratio=0.58, 95% CI=0.58, 0.59), a pattern observed in most race/ethnic groups. CONCLUSIONS In the U.S., gestational diabetes mellitus rates were higher and hypertensive disorders of pregnancy rates were lower in women born outside the U.S. than in those born in the U.S. in most race/ethnicity groups.
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Affiliation(s)
- Nilay S Shah
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois;; Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
| | - Michael C Wang
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Namratha R Kandula
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois;; Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Mercedes R Carnethon
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Erica P Gunderson
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - William A Grobman
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois;; Department of Obstetrics & Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Sadiya S Khan
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois;; Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Sebastian SA, Avanthika C, Jhaveri S, Carrera KG, Camacho L GP, Balasubramanian R. The Risk of Cardiovascular Disease Among Immigrants in Canada. Cureus 2022; 14:e22300. [PMID: 35350529 PMCID: PMC8933291 DOI: 10.7759/cureus.22300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2022] [Indexed: 11/05/2022] Open
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Hussain M, Howell JL, Peek MK, Stowe RP, Zawadzki MJ. Psychosocial stressors predict lower cardiovascular disease risk among Mexican-American adults living in a high-risk community: Findings from the Texas City Stress and Health Study. PLoS One 2021; 16:e0257940. [PMID: 34618834 PMCID: PMC8496861 DOI: 10.1371/journal.pone.0257940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 09/14/2021] [Indexed: 12/02/2022] Open
Abstract
The objective of this study was to examine the link between systemic and general psychosocial stress and cardiovascular disease (CVD) risk in a group of U.S. Latinos as a function of acculturation and education within the blended guiding conceptual framework of the biopsychosocial model of the stress process plus the reserve capacity model. We analyzed data from self-identifying Mexican-origin adults (n = 396, 56.9% female, Mage = 58.2 years, 55.5% < 12 years of education, 79% U.S.-born) from the Texas City Stress and Health Study. We used established measures of perceived stress (general stress), neighborhood stress and discrimination (systemic stress) to capture psychosocial stress, our primary predictor. We used the atherosclerotic CVD calculator to assess 10-year CVD risk, our primary outcome. This calculator uses demographics, cholesterol, blood pressure, and history of hypertension, smoking, and diabetes to compute CVD risk in the next 10 years. We also created an acculturation index using English-language use, childhood interaction, and preservation of cultural values. Participants reported years of education. Contrary to expectations, findings showed that higher levels of all three forms of psychosocial stress, perceived stress, neighborhood stress, and perceived discrimination, predicted lower 10-year CVD risk. Acculturation and education did not moderate the effects of psychosocial stress on 10-year CVD risk. Contextualized within the biopsychosocial and reserve capacity framework, we interpret our findings such that participants who accurately reported their stressors may have turned to their social networks to handle the stress, thereby reducing their risk for CVD. We highlight the importance of examining strengths within the sociocultural environment when considering cardiovascular inequities among Latinos.
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Affiliation(s)
- Maryam Hussain
- Department of Psychological Sciences, University of California-Merced, Merced, California, United States of America
| | - Jennifer L. Howell
- Department of Psychological Sciences, University of California-Merced, Merced, California, United States of America
| | - M. Kristen Peek
- Department of Preventive Medicine and Population Health, University of Texas Medical Branch-Galveston, Galveston, Texas, United States of America
| | - Raymond P. Stowe
- Microgen Laboratories, La Marque, Texas, United States of America
| | - Matthew J. Zawadzki
- Department of Psychological Sciences, University of California-Merced, Merced, California, United States of America
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Cainzos-Achirica M, Bilal U. Continúa el éxito en la reducción de la mortalidad por cardiopatía isquémica en España: contexto, paradojas y oportunidades para seguir mejorando. Rev Esp Cardiol (Engl Ed) 2021. [DOI: 10.1016/j.recesp.2021.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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20
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Cainzos-Achirica M, Bilal U. Further improvements in coronary heart disease mortality in Spain: context, paradoxes, and pathways forward. ACTA ACUST UNITED AC 2021; 74:823-826. [PMID: 34158261 DOI: 10.1016/j.rec.2021.05.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 04/20/2021] [Indexed: 01/15/2023]
Affiliation(s)
- Miguel Cainzos-Achirica
- Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston, Texas, United States; Center for Outcomes Research, Houston Methodist, Houston, Texas, United States; Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States.
| | - Usama Bilal
- Department of Epidemiology and Biostatistics, Drexel Dornsife School of Public Health, Philadelphia, Pennsylvania, United States; Urban Health Collaborative, Drexel Dornsife School of Public Health, Philadelphia, Pennsylvania, United States
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Gomez-Aguinaga B, Dominguez MS, Manzano S. Immigration and Gender as Social Determinants of Mental Health during the COVID-19 Outbreak: The Case of US Latina/os. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6065. [PMID: 34199895 PMCID: PMC8200095 DOI: 10.3390/ijerph18116065] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 05/26/2021] [Accepted: 05/29/2021] [Indexed: 01/16/2023]
Abstract
While men and women make up a similar number of COVID-19 cases, and are equally likely to know someone who has become ill due to the virus, the gendered and systemic implications of immigration during public health emergencies among minority groups in the United States are empirically underexplored. Using the SOMOS COVID-19 Crisis National Latino Survey, we conduct a series of intersectional analyses to understand the extent to which personal experiences with COVID-19, gendered structural factors, and spillover effects of US immigration policies impact the mental health of US Latina/os during a public health emergency. The results show that among Latinas, knowing an undocumented immigrant and someone ill with COVID-19 increases the probability of reporting worse mental outcomes by 52 percent. Furthermore, being a woman increases the probability of reporting the highest level of mental health problems by 30 percent among Hispanic people who know someone with COVID-19 and an undocumented immigrant. These findings indicate that the effects of the COVID-19 outbreak among US Latinas and Latinos are entrenched in gendered and systemic inequalities.
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