Explaining Chronic Illness and Self-Rated Health Among Immigrants of Five Hispanic Ethnicities

Deep-Structure Attitudes and Reasons Toward Healthy Eating and Self-Rated Diet and Health in Ethnically Diverse U.S.-Hispanics/Latinos

Little is known about deep-structure (i.e., embedded) cultural attitudes toward healthy eating among Hispanics/Latinos in the United States. This study aimed to identify ethnic-specific dietary attitudes of Latino adults and evaluate their associations with self-rated diet and health. Participants (n = 200) were community-based Latinos (25-65 y/o) living in the Boston, Massachusetts metro area who completed a survey assessing agreement with 20 statements on attitudes toward healthy eating (eight positive and 12 negative) and 15 statements on reasons for healthy eating across seven constructs. Multinomial logistic regression models tested the association of sum scores of positive or negative attitudes and reasons for healthy eating with self-rated diet or self-rated health for participants of Caribbean versus Non-Caribbean backgrounds. Most participants of both backgrounds agreed that healthy eating would keep them healthy and make them look good, and that families should eat together. Differences by background were noted in statements regarding eating at special occasions, cost of healthy foods, self-efficacy (i.e., cravings), and cultural beliefs. Negative attitudes were associated with lower odds of better self-rated health for Caribbean, but not for non-Caribbean, participants. Positive attitudes were associated with 1.85 (95% CI [1.10, 3.12]) odds of better self-rated diet for Caribbean participants and 3.13 (95% CI [1.26, 7.81]) for non-Caribbean participants. Non-Caribbean participants were more likely to self-rate very good/excellent diet with higher reasons for healthy eating. Latinos have shared and ethnic-specific deep-structure attitudes toward healthy eating related to their perceived diet quality and health. Programs promoting healthy eating for Latino adults should be deeply tailored by ethnicity.

Self-Rated Health and Medically Diagnosed Chronic Disease Association among Adults in Puerto Rico

Introduction

Latinos report lower self-rated health (SRH) than non-Hispanic White persons. However, the association between SRH and medically diagnosed chronic diseases (MDCDs) remains understudied in Latino populations. This study assessed the relationship between a single-item SRH indicator and MDCD status among predominantly Latino adults in Puerto Rico.

Methods

Participants (30-75 years; n=965) of the Puerto Rico Observational Study of Psychosocial, Environmental, and Chronic Disease Trends (PROSPECT) reported SRH (excellent/very good, good, or fair/poor) and MDCD (ever vs never). We performed multivariate logistic regressions to evaluate the association between SRH and MDCD, which adjusted for key socioeconomic, demographic, and behavioral confounders.

Results

Twenty-seven percent of participants reported excellent/very good SRH, 39% good, and 34% fair/poor. Participants with fair/poor SRH (vs excellent/very good) were more likely to report MDCD for painful inflammation (odds ratio [OR]=4.95 [95% CI, 3.27-7.48]), kidney disease (4.64 [2.16-9.97]), sleep disorder (4.47 [2.83-7.05]), migraine headaches (4.07 [2.52-6.58]), overweight/obesity (3.84 [2.51-5.88]), depression (3.61 [2.28-5.74]), hypertension (3.59 [2.43-5.32]), high blood sugar (3.43 [2.00-5.89]), cardiovascular disease (3.13 [2.01-4.87]), anxiety (2.87 [1.85-4.44]), arthritis (2.80 [1.83-4.30]), diabetes (2.46 [1.57-3.83]), respiratory problems (2.45 [1.59-3.79]), stomach problems (2.44 [1.57-3.81]), eye disease (2.42 [1.44-4.06]), gallbladder disease (2.34 [1.35-4.05]), liver disease (2.26 [1.38-3.70]), heartburn (2.25 [1.55-3.26]), hyperlipidemia (2.10 [1.44-3.06]), and thyroid conditions (2.04 [1.30-3.21]).

Conclusions

SRH may reflect MDCD burden and serve as a valid screener to efficiently identify Latino individuals in high need of clinical services. This is relevant in Puerto Rico, where chronic disease rates remain high amid limited, disparate access to health care.

The relationship between political efficacy and self-rated health: An analysis of Mexican, Puerto Rican, and Cuban subgroups compared to non-Latinx whites in the United States

Latinx represent a growing population in the United States (US) that continue to experience a disproportionate burden of disease. However, health disparities vary across Latinx subgroups, including Mexican, Puerto Rican, and Cuban communities, particularly when assessing self-rated health. Given the nature of political exclusion in the US, these differences may be associated with underexplored political factors, or political determinants of health, within the social environment that distinctly shape health among racial and ethnic minorities. To explore potential pathways that connect the political environment to individual-level health outcomes among Latinx subgroups, political efficacy (or one's perceptions about one's power to influence political affairs) was assessed as a correlate of self-rated health. We used secondary data from the 2016 Collaborative Multiracial Post-election Survey to conduct ordered logistic regression analysis to determine whether two domains of political efficacy, internal and external political efficacy, were correlates of self-rated health among Mexican, Puerto Rican, and Cuban subgroups as compared to non-Latinx whites in the US. We also tested for differential associations across Latinx subgroups as compared to non-Latinx whites. The sample consisted of 3156 respondents (1486 Mexicans, 484 Puerto Ricans, 159 Cubans and 1027 non-Latinx whites). Among Puerto Ricans, results revealed that lower levels of internal political efficacy were associated with higher levels of self-rated health. Conversely, among other subgroups, positive associations between internal political efficacy and self-rated health were observed. This study provides empirical evidence of a relationship between internal political perceptions and health perceptions that has not previously been established within the Latinx health disparities literature. Future investigations should continue to examine pathways that connect political determinants to individual-level health outcomes, particularly among communities that disproportionately experience political exclusion.

Mental Health and its Influencing Factors Among Immigrants with Chronic Diseases in China

Immigrants are a special group in society, and their health is of great concern. Few studies have targeted this population in China. A cross-sectional descriptive correlational study was conducted from July to August 2018 in Hubei Province, China. Chi-square tests, Z-tests and multivariable linear regression analysis were performed to analyze the data using SPSS 24.0. A total of 1068 questionnaires were distributed. The results showed that the variables that affected the mental health of the immigrants with chronic diseases included gender, annual income, life events (L), negative emotion (NE), negative coping styles (NC) and objective support (OS) (p ≤ 0.05). Future research should focus on the physical and mental health of different immigrant groups and design effective, individualized interventions to improve the health status of immigrants, especially those with chronic diseases.

Ethnicity and Self-reported Depression Among Hispanic Immigrants in the U.S

Viewed to be healthier than ethnic Hispanics born in the United States, Hispanic immigrants represent numerous subgroups with clearly heterogeneous geographic, cultural, structural, and social origins. This study asked how the factors length of U.S. residency, social status, lifestyle, and health care might explain self-reported depression within 5 large, discrete subgroups comprising immigrants from, in turn, Mexico, Puerto Rico, Cuba, the Dominican Republic, and other nations in Central and South America. The study also examined ethnicity's potential role moderating self-reported depression's associations. With pooled data from National Health Interview Surveys 1999-2015, it evaluated each ethnic group separately. Self-reported depression was associated generally with lengthening residence in the U.S., with being female, with poverty, with unemployment, with lack of education, and with lifestyle and health-care factors. These associations were not uniform across ethnic groups, however. Where self-reported depression is concerned, descriptive results suggest the proverbial health advantage may largely accrue specifically to Hispanic immigrants of Cuban and of Central/South American origin.

Particulate Matter Exposure across Latino Ethnicities

The Hispanic/Latino health paradox is the well-known health advantage seen across the Hispanic/Latino racial category in the US. However, this racial category collapses several distinct ethnic groups with varying spatial distributions. Certain populations, such as Dominicans and Cubans, are concentrated in specific areas, compared to more dispersed groups such as Mexicans. Historical peculiarities have brought these populations into contact with specific types of environmental exposures. This paper takes a first step towards unraveling these diverse exposure profiles by estimating how exposure to particulate matter varies across demographic groups and narrows down which types of industries and chemicals are contributing the most to air toxins. Exposure to particulate matter is estimated for 72,271 census tracts in the continental US to evaluate how these exposures correlate with the proportion of the population classified within the four largest groups that make up the Hispanic population in the US: Mexican, Puerto Rican, Cuban, and Dominican. Using linear mixed models, with the state nested within US Environmental Protection Agency regulatory region, and controls for population density, we find that the Dominican population is significantly less exposed to PM_2.5 and PM₁₀ compared to non-Hispanic Whites. Moreover, those tracts with a higher proportion of Cuban residents are significantly less exposed to PM_2.5. However, those tracts with a higher proportion of foreign-born, Mexicans, and Puerto Ricans had significantly higher levels of exposure to all sizes of particulate matter. We discuss the need to consider the chemical components of these particles to better understand the risk of exposure to air pollution.