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Rosas CE, Pirzada A, Durazo-Arvizu R, Gallo LC, Talavera GA, Elfassy T, Cai J, Llabre MM, Perreira KM, Wassertheil-Smoller S, Daviglus ML, Sanchez-Johnsen LAP. Associations of Anxiety Symptoms With 6-Year Blood Pressure Changes and Incident Hypertension: Results From the Hispanic Community Health Study/Study of Latinos. Ann Behav Med 2024:kaae026. [PMID: 38810223 DOI: 10.1093/abm/kaae026] [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] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND Despite the high burden of anxiety and hypertension in Hispanic/Latino adults, little is known about their association in this population. PURPOSE To examine the associations of anxiety symptoms with 6-year changes in blood pressure (BP) and incident hypertension in Hispanic/Latino adults. METHODS We examined data from a probability sample of 10,881 Hispanic/Latino persons aged 18-74 who attended visits 1 (V1; 2008-2011) and 2 (V2; 2014-2017) of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a prospective cohort study. Anxiety symptoms were assessed at V1 using the 10-item Spielberger Trait Anxiety Scale (M = 17.1; Range = 10-40) and dichotomized using a cut-point of 20, the highest quartile in this cohort. BP was measured at both visits using a standardized protocol. RESULTS Adults with elevated anxiety symptoms had a 1.02 mm Hg greater increase in systolic (p = .02) and a 0.75 mm Hg greater increase in diastolic BP (p = .02) over 6.1 years than those with lower symptoms, after adjusting for sociodemographic and clinical covariates. These associations differed by sex. Elevated anxiety was associated with a greater increase in systolic and diastolic BP in men only. Among persons without hypertension at V1 (N = 7,412), those with elevated anxiety symptoms at V1 had a 22% higher incidence of hypertension (p = .02) 6.1 years later. CONCLUSIONS Our findings underscore the importance of screening for and treating elevated anxiety symptoms to help prevent hypertension. Further research on the role of sex and underlying mechanisms is warranted.
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Affiliation(s)
- Carlos E Rosas
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
- South Bay Latino Research Center, San Diego State University, Chula Vista, California, USA
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Amber Pirzada
- Institute for Minority Health Research, University of Illinois Chicago, Chicago, Illinois, USA
- Department of Medicine, University of Illinois Chicago, Chicago, Illinois, USA
| | - Ramon Durazo-Arvizu
- Department of Neonatology, Children's Hospital Los Angeles - University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Linda C Gallo
- South Bay Latino Research Center, San Diego State University, Chula Vista, California, USA
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Gregory A Talavera
- South Bay Latino Research Center, San Diego State University, Chula Vista, California, USA
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Tali Elfassy
- Department of Medicine, Katz Family Division of Nephrology and Hypertension, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Jianwen Cai
- Department of Biostatistics, Collaborative Studies Coordinating Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Maria M Llabre
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Krista M Perreira
- Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Sylvia Wassertheil-Smoller
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Martha L Daviglus
- South Bay Latino Research Center, San Diego State University, Chula Vista, California, USA
- Department of Medicine, University of Illinois Chicago, Chicago, Illinois, USA
| | - Lisa A P Sanchez-Johnsen
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
- Department of Psychology, University of Illinois Chicago, Chicago, Illinois, USA
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Richard SL, Renn BN, Tran DMT, Kim J, Feng D. Metabolic Syndrome, Modifiable Lifestyle Factors, and Sleep-Disordered Breathing: The Hispanic Community Health Study. Ann Behav Med 2024; 58:179-191. [PMID: 38175927 PMCID: PMC10858308 DOI: 10.1093/abm/kaad071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND US Hispanics/Latinos are disproportionately susceptible to metabolic syndrome (MetS), attributed in part to systemic inequities related to health and lifestyle factors such as low physical activity (PA) levels, diet quality, alcohol use, tobacco use, and sleep disorder. Gender and heritage group differences are vastly understudied and need to be examined in this heterogeneous population. PURPOSE To examine the relationships between select health and lifestyle factors and MetS among Hispanic gender and heritage subgroups (Hypothesis 1) and determine whether gender and heritage moderate those relationships (Hypothesis 2). METHODS Participants included 14,155 Hispanic Americans aged 18-76 (59% female, mean age 45.92 ± 13.97) from seven heritage subgroups. This secondary analysis of cross-sectional data from the observational Hispanic Community Health Study/Study of Latinos (HCHS/SOL) dataset used hierarchical multinomial logistic regression to test Hypothesis 1; the dependent variable, MetS, included three categories delineating absence of MetS and presence of MetS with or without related medication use. Hayes' PROCESS macro tested Hypothesis 2. RESULTS Low PA and sleep-disordered breathing (SDB) each had significant (p < .001) predictive value of MetS group membership, whereas both low and high alcohol use (p < .001) were associated with decreased MetS risk. Cigarette pack-years were not significantly associated with MetS outcomes. Gender moderated the association between MetS and alcohol use (p < .001), cigarette pack-years (p < .001), and SDB (p < .001) such that the effects on MetS were higher in females than males. The association between MetS and diet quality (p < .001) was stronger among males than in females. CONCLUSIONS Gender and heritage differences were prominent among study variables.
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Affiliation(s)
- Shannon L Richard
- Department of Nursing, Department of Psychology, University of Nevada, 4505 S Maryland Pkwy, Las Vegas NV 89154, USA
| | - Brenna N Renn
- Department of Nursing, Department of Psychology, University of Nevada, 4505 S Maryland Pkwy, Las Vegas NV 89154, USA
| | - Dieu-My T Tran
- Department of Nursing, Department of Psychology, University of Nevada, 4505 S Maryland Pkwy, Las Vegas NV 89154, USA
| | - Jinyoung Kim
- Department of Nursing, Department of Psychology, University of Nevada, 4505 S Maryland Pkwy, Las Vegas NV 89154, USA
| | - Du Feng
- Department of Nursing, Department of Psychology, University of Nevada, 4505 S Maryland Pkwy, Las Vegas NV 89154, USA
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Roche KM, Ehrlich KB, Vaquera E, Little TD. Mental Health During Early Adolescence and Later Cardiometabolic Risk: A Prospective Study of US Latinx Youth. J Adolesc Health 2024; 74:71-77. [PMID: 37815772 PMCID: PMC10843259 DOI: 10.1016/j.jadohealth.2023.08.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 06/04/2023] [Accepted: 08/15/2023] [Indexed: 10/11/2023]
Abstract
PURPOSE Rising rates of cardiometabolic risk and mental health problems are serious public health concerns for US adolescents, particularly those of Latinx origin. This research examines how Latinx youth's internalizing symptoms during early adolescence are related to sleep problems, overweight/obesity, sedentary behavior, physical activity, healthy diet, and hypertension or diabetes risk during middle and late adolescence. METHODS Participants included 547 adolescents listed as "Hispanic" on 2017-18 middle school enrollment lists in a suburban Atlanta, GA school district. Survey data collected at baseline (2018) and four years later (2022) were analyzed using Structural Equation Model. Path estimates from baseline internalizing symptoms to later health behaviors and physical health outcomes adjusted for demographics, the follow-up measure of internalizing symptoms, and correlations among outcome variables. Missing data were handled using Full Information Maximum Likelihood. RESULTS At baseline, the 244 (44.6%) male and 303 (55.4%) female participants had a mean (standard deviation) age in years of 13.31 (0.97). Early adolescent internalizing symptoms were associated positively with later sleep problems (ß = 0.36 [95% confidence interval (CI), 0.24-0.48]), overweight/obesity (adjusted odds ratio, 2.57; 95% CI, 1.29-5.15), sedentary behavior (ß = 0.19 [95% CI, 0.09-0.30]), and internalizing symptoms (ß = 0.48 [95% CI, 0.39-0.56]) and inversely with later physical activity (ß = -0.16 [95% CI, -0.27 to -0.05]) and a healthy diet (ß = -0.21 [95% CI, -0.32 to -0.09]). DISCUSSION Latinx youth's internalizing symptoms during early adolescence not only track into later adolescence, but they also relate to health behaviors and outcomes underlying cardiometabolic risk during middle and late adolescence.
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Affiliation(s)
- Kathleen M Roche
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, D.C..
| | | | - Elizabeth Vaquera
- Department of Sociology and Trachtenberg School of Public Policy and Public Administration, George Washington University, NW, Washington, D.C
| | - Todd D Little
- Department of Educational Psychology and Leadership, Texas Tech University, Lubbock, Texas; School of Psychology and Cognitive Science, East China Normal University, Shanghai, China; Optentia Research Focus Area, North-West University, Vanderbijlpark, South Africa
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Pirzada A, Cai J, Cordero C, Gallo LC, Isasi CR, Kunz J, Thyagaragan B, Wassertheil-Smoller S, Daviglus ML. Risk Factors for Cardiovascular Disease: Knowledge Gained from the Hispanic Community Health Study/Study of Latinos. Curr Atheroscler Rep 2023; 25:785-793. [PMID: 37773246 DOI: 10.1007/s11883-023-01152-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2023] [Indexed: 10/01/2023]
Abstract
PURPOSE OF REVIEW The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) has made important contributions on the prevalence of and factors associated with cardiovascular disease (CVD) risk factors among diverse Hispanic/Latino adults in the US. This article summarizes the knowledge gained thus far on major CVD risk factors from this landmark study. RECENT FINDINGS HCHS/SOL demonstrated the sizeable burdens of CVD risk in all major Hispanic/Latino groups in the US, as well as the marked variations in prevalence of hypertension, hypercholesterolemia, diabetes, obesity, and smoking by sex and background. It also identified sociodemographic, lifestyle, and sociocultural characteristics associated with risk factors. HCHS/SOL has yielded an expanding body of literature on characteristics associated with adverse CVD risk factors in this population. Long-term follow-up of this cohort will shed further light on the observed heterogeneity in CVD risk across Hispanic/Latino groups and identify specific risk/protective factors driving these variations.
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Affiliation(s)
- Amber Pirzada
- Institute for Minority Health Research, University of Illinois Chicago, 1819 W. Polk Street, Suite 246, Chicago, IL, 60612, USA.
| | - Jianwen Cai
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Carmen R Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - John Kunz
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Bharat Thyagaragan
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
| | | | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois Chicago, 1819 W. Polk Street, Suite 246, Chicago, IL, 60612, USA
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5
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Richard SL, Renn BN, Kim J, Tran DMT, Feng D. Mental health is related to metabolic syndrome: The Hispanic community health study/ study of Latinos. Psychoneuroendocrinology 2023; 152:106085. [PMID: 36989563 PMCID: PMC10249587 DOI: 10.1016/j.psyneuen.2023.106085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 01/28/2023] [Accepted: 03/13/2023] [Indexed: 03/31/2023]
Abstract
OBJECTIVE Metabolic syndrome (MetS) is associated with common mental health conditions. Using cross-sectional data from the observational Hispanic Community Health Study / Study of Latinos (HCHS/SOL), this study examined the relationship between MetS and depression and anxiety in addition to testing moderating effects of gender and Hispanic heritage subgroups. METHODS Participants included 13,496 Hispanic Americans aged 18-74 (59% women, mean age 46.59 ± 13.65) from seven heritage subgroups. Depression was measured using the Center for Epidemiologic Studies Depression 10-item scale, and anxiety was assessed using the State-Trait Anxiety Inventory 10-item scale. A 3-level categorical variable was developed to assess the combined influence of depression and anxiety. The dependent variable is dichotomous, delineating the presence or absence of MetS as defined by the National Cholesterol Education Program Third Adult Treatment Panel. Logistic regression and Hayes' PROCESS macro assessed these relationships and the moderating effects of gender-heritage subgroups. RESULTS Results suggest depression (p < .001) and anxiety (p < .001) were associated with an increased likelihood of MetS. Puerto Ricans had the highest, and South Americans had the lowest, levels of depression and anxiety. Gender moderated the relationship between mental health and MetS, with women having a significant increase in the probability of MetS with depression (p < .001), anxiety (p < .001), or both (p < .001). CONCLUSION Elevated symptoms of depression and anxiety are associated with the presence of MetS in US Hispanic subgroups. Gender-heritage differences are present among the study variables. Strategies to manage psychological well-being must be employed to optimize cardiometabolic health in US Hispanics.
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Affiliation(s)
| | | | | | | | - Du Feng
- 4505 S Maryland Pky, Las Vegas, NV 89154, USA
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Stanaway IB, Wallace JC, Hong S, Wilder CS, Green FH, Tsai J, Knight M, Workman T, Vigoren EM, Smith MN, Griffith WC, Thompson B, Shojaie A, Faustman EM. Alteration of oral microbiome composition in children living with pesticide-exposed farm workers. Int J Hyg Environ Health 2023; 248:114090. [PMID: 36516690 PMCID: PMC9898171 DOI: 10.1016/j.ijheh.2022.114090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 08/30/2022] [Accepted: 11/30/2022] [Indexed: 12/14/2022]
Abstract
Our prior work shows that azinphos-methyl pesticide exposure is associated with altered oral microbiomes in exposed farmworkers. Here we extend this analysis to show the same association pattern is also evident in their children. Oral buccal swab samples were analyzed at two time points, the apple thinning season in spring-summer 2005 for 78 children and 101 adults and the non-spray season in winter 2006 for 62 children and 82 adults. The pesticide exposure for the children were defined by the farmworker occupation of the cohabitating household adult and the blood azinphos-methyl detection of the cohabitating adult. Oral buccal swab 16S rRNA sequencing determined taxonomic microbiota proportional composition from concurrent samples from both adults and children. Analysis of the identified bacteria showed significant proportional changes for 12 of 23 common oral microbiome genera in association with azinphos-methyl detection and farmworker occupation. The most common significantly altered genera had reductions in the abundance of Streptococcus, suggesting an anti-microbial effect of the pesticide. Principal component analysis of the microbiome identified two primary clusters, with association of principal component 1 to azinphos-methyl blood detection and farmworker occupational status of the household. The children's buccal microbiota composition clustered with their household adult in ∼95% of the households. Household adult farmworker occupation and household pesticide exposure is associated with significant alterations in their children's oral microbiome composition. This suggests that parental occupational exposure and pesticide take-home exposure pathways elicit alteration of their children's microbiomes.
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Affiliation(s)
- Ian B Stanaway
- Department of Environmental and Occupational Health Sciences, Institute for Risk Analysis and Risk Communication, University of Washington, Seattle, WA, USA
| | - James C Wallace
- Department of Environmental and Occupational Health Sciences, Institute for Risk Analysis and Risk Communication, University of Washington, Seattle, WA, USA
| | - Sungwoo Hong
- Department of Environmental and Occupational Health Sciences, Institute for Risk Analysis and Risk Communication, University of Washington, Seattle, WA, USA
| | - Carly S Wilder
- Department of Environmental and Occupational Health Sciences, Institute for Risk Analysis and Risk Communication, University of Washington, Seattle, WA, USA
| | - Foad H Green
- Department of Environmental and Occupational Health Sciences, Institute for Risk Analysis and Risk Communication, University of Washington, Seattle, WA, USA
| | - Jesse Tsai
- Department of Environmental and Occupational Health Sciences, Institute for Risk Analysis and Risk Communication, University of Washington, Seattle, WA, USA
| | - Misty Knight
- Department of Environmental and Occupational Health Sciences, Institute for Risk Analysis and Risk Communication, University of Washington, Seattle, WA, USA
| | - Tomomi Workman
- Department of Environmental and Occupational Health Sciences, Institute for Risk Analysis and Risk Communication, University of Washington, Seattle, WA, USA
| | - Eric M Vigoren
- Department of Environmental and Occupational Health Sciences, Institute for Risk Analysis and Risk Communication, University of Washington, Seattle, WA, USA
| | - Marissa N Smith
- Department of Environmental and Occupational Health Sciences, Institute for Risk Analysis and Risk Communication, University of Washington, Seattle, WA, USA
| | - William C Griffith
- Department of Environmental and Occupational Health Sciences, Institute for Risk Analysis and Risk Communication, University of Washington, Seattle, WA, USA
| | - Beti Thompson
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Ali Shojaie
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Elaine M Faustman
- Department of Environmental and Occupational Health Sciences, Institute for Risk Analysis and Risk Communication, University of Washington, Seattle, WA, USA.
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Baron S, Cuervo I, Winkel G, Flores D, Gonzalez A, Harari H. Employment Quality and Mental and Self-Reported Health Inequities among Latinx Housecleaners: The Safe and Just Cleaners Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15973. [PMID: 36498045 PMCID: PMC9741237 DOI: 10.3390/ijerph192315973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
Precarious employment, such as housecleaning, is one important structural contributor to health inequities. We used an employment quality (EQ) framework to characterize the impact of employment conditions on mental and self-reported ill-health among Latinx housecleaners in the New York City metropolitan area. Using a community-based participatory research approach, we collected cross-sectional survey data from 402 housecleaners between August 2019 and February 2020 to characterize housecleaners' EQ and its association with depression, perceived stress, and self-reported health. We also measured work-related irritant eye, skin, and respiratory symptoms, which have been shown in previous research to be associated with housecleaners' exposure to chemical components of cleaning products. Our housecleaner cohort was largely female and immigrant and most had worked at least five years. Survey items capturing the EQ dimensions of unbalanced interpersonal relations, low material resources, and violations of workers' rights were associated with increased odds of depression, perceived stress, and self-reported ill-health. Work-related irritant eye, skin, and respiratory symptoms were also independently associated with mental and self-reported ill-health and some of the effects of EQ on health were potentially partially mediated through their association with work-related irritant symptoms. Findings can inform directions for community-based educational and policy initiatives to improve housecleaners' employment quality.
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Affiliation(s)
- Sherry Baron
- Barry Commoner Center for Health and the Environment, Queens College, City University of New York, Queens, New York, NY 11367, USA
| | - Isabel Cuervo
- Barry Commoner Center for Health and the Environment, Queens College, City University of New York, Queens, New York, NY 11367, USA
| | - Gary Winkel
- Population Health Science and Policy Department, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | | | | | - Homero Harari
- Selikoff Centers for Occupational Health, Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
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Gutiérrez Á, Bravo RL, Tobin CT. Loneliness Exacerbates the Association Between Bodily Pain and Depressive Symptoms Among Middle-Aged and Older Latinx Adults. J Aging Health 2022; 34:1201-1212. [PMID: 36154318 DOI: 10.1177/08982643221127327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives: To investigate the associations between three bodily pain dimensions (intensity, frequency, severity) and depressive symptoms among middle-aged and older Latinxs ages 40-94 and to determine whether loneliness conditioned the pain-depressive symptoms associations. Methods: Data are from a community-based study of community-dwelling residents in Florida (N = 527). Multivariable linear regression models assessed the impact of each pain dimension on depressive symptoms, controlling for sociodemographic factors. Interactions determined whether loneliness moderated the pain-depressive symptoms relationships. Results: Each pain dimension was positively associated with depressive symptoms (p < .01). Loneliness modified the impact of pain frequency and pain severity on depressive symptoms. Those with moderate and high loneliness levels experienced an amplified pain-depressive symptoms association. Discussion: Findings underscore the synergistic effects of pain and loneliness in exacerbating depressive symptomatology among middle-aged and older Latinx adults. Loneliness is an important point of intervention to improve mental health among aging Latinxs.
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Affiliation(s)
- Ángela Gutiérrez
- Department of Social Medicine, Heritage College of Osteopathic Medicine, 1354Ohio University, Athens, OH, USA
| | - Rosana L Bravo
- Department of Health Sciences Education, College of Health Sciences, 6645Western University of Health Sciences, Pomona, CA, USA
| | - Courtney Thomas Tobin
- Department of Community Health Sciences, Fielding School of Public Health, 25808University of California, Los Angeles, CA, USA
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Roth KB, Sanchez E, Musci RJ. The differential relationship of common health comorbidities with acculturative experiences in United States Latinxs. SSM Popul Health 2022; 19:101179. [PMID: 35941995 PMCID: PMC9356214 DOI: 10.1016/j.ssmph.2022.101179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 07/08/2022] [Accepted: 07/18/2022] [Indexed: 11/26/2022] Open
Abstract
A novel conceptualization of acculturation and related experiences is related to comorbidity. Different patterns emerge in the relationship between acculturative experiences and health. Toxic stress and social support may play differential roles in the risk for health comorbidities.
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Castañeda SF, Gallo LC, Garcia ML, Mendoza PM, Gutierrez AP, Lopez-Gurrola M, Roesch S, Pichardo MS, Muñoz F, Talavera GA. Effectiveness of an integrated primary care intervention in improving psychosocial outcomes among Latino adults with diabetes: the LUNA-D study. Transl Behav Med 2022; 12:825-833. [PMID: 35776001 PMCID: PMC9385125 DOI: 10.1093/tbm/ibac042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVE To compare the effectiveness of usual care (UC) versus a culturally tailored integrated care model in improving mental health symptoms for Latino patients with Type 2 diabetes mellitus (T2DM). METHODS We conducted a two-arm randomized controlled trial from 2015 to 2019 at a federally qualified health center. Participants were 456 adults ages 23-80 years who had a previous diagnosis of T2DM and were not currently using insulin. Participants were randomly assigned to Integrated Care Intervention (ICI; including behavioral/mental healthcare, medical visits, health education and care coordination) or UC; standard of care including referrals for health education and behavioral/mental health care where appropriate. Intention-to-treat, multilevel models were used to compare group × time changes in depression and anxiety symptoms (PHQ-8; GAD-7) and perceived stress (PSS-10) across 6 months. RESULTS Participant mean age was 55.7 years, 36.3% were male, and 63.7% were primarily Spanish speaking. Baseline sociodemographic factors and mental health symptoms across study arms were balanced. Significant group × time interaction effects were observed for anxiety and depression symptoms (p < .05). Within the ICI and UC groups, mean depression symptom changes were -0.93 and -0.39 (p < .01); anxiety symptom changes were -0.97 (p < .01) and -0.11 (p = .35); and perceived stress changes were -1.56 and -1.27 (p < .01), respectively. CONCLUSIONS Although both ICI and UC showed decreases over time, the ICI group evidenced larger, statistically significant changes in both depression and anxiety. Adapted integrated models of behavioral and chronic disease management appear to be effective and could be considered for usual care practices. CLINICALTRIALS.GOV IDENTIFIER NCT03983499.
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Affiliation(s)
| | - Linda C Gallo
- South Bay Latino Research Center, Chula Vista, CA, USA,Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Melawhy L Garcia
- Center for Latino Community Health, Evaluation, and Leadership Training, Department of Health Science, California State University Long Beach, Long Beach, CA, USA
| | - Paulina M Mendoza
- South Bay Latino Research Center, Chula Vista, CA, USA,Department of Psychology, San Diego State University, San Diego, CA, USA
| | | | - Maria Lopez-Gurrola
- South Bay Latino Research Center, Chula Vista, CA, USA,Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Scott Roesch
- South Bay Latino Research Center, Chula Vista, CA, USA,Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Margaret S Pichardo
- College of Medicine, Howard University, Washington, D. C., USA,Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - Fatima Muñoz
- Department of Research, San Ysidro Health, San Diego, CA, USA
| | - Gregory A Talavera
- South Bay Latino Research Center, Chula Vista, CA, USA,Department of Psychology, San Diego State University, San Diego, CA, USA
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Alizadeh G, Gholipour K, Azami-Aghdash S, Dehnavieh R, JafarAbadi MA, Azmin M, Khodayari-Zarnaq R. Social, Economic, Technological, and Environmental Factors Affecting Cardiovascular Diseases: A Systematic Review and Thematic Analysis. Int J Prev Med 2022; 13:78. [PMID: 35706860 PMCID: PMC9188896 DOI: 10.4103/ijpvm.ijpvm_105_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 07/27/2020] [Indexed: 11/04/2022] Open
Abstract
Background Today, cardiovascular disease (CVD) is the leading cause of mortality in both sexes. There are several risk factors for heart diseases; some controllable, others not. However, socioeconomic, technological, and environmental factors can impact CVD as well as exclusive risk factors. Accurate identification and assessment of these factors are often difficult. In the present systematic review, we aimed to explore factors affecting CVD. Methods Multiple databases (MEDLINE, Scopus, ISI Web of Science, and Cochrane) and gray literature were searched. The included studies described at least one determinant of CVD. The framework method was applied to analyze the qualitative data. Results A total of 64 studies from 26 countries were included. The contextual determinants of CVD were categorized into 45 determinants, 15 factors, and 4 main social, economic, technological, and environmental categories. The 15 potentially reversible factors were identified as sociodemographic, violence, smoking, occupation, positive childhood experience, social inequalities, psychological distress, eating habits, neighborhood, family income, rapid technology, environmental pollution, living environments, noise, and disaster. Conclusions Devolution and more efficient health policies are required to achieve further sustained reduction in CVD mortality, increase life expectancy, and reduce its associated risk factors. Policymakers should fully address the value of social, economic, technological, and environmental factors. In fact, a prevention agenda should be developed and updated collaboratively in terms of the determinant factors.
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Affiliation(s)
- Gisoo Alizadeh
- Department of Health policy and Management, Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Kamal Gholipour
- Tabriz Health Services Management Research Center, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saber Azami-Aghdash
- Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Dehnavieh
- Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Asghari JafarAbadi
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehrdad Azmin
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Rahim Khodayari-Zarnaq
- Department of Health policy and Management, Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.,Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
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12
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Nmezi NA, Turkson-Ocran RA, Tucker CM, Commodore-Mensah Y. The Associations between Depression, Acculturation, and Cardiovascular Health among African Immigrants in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6658. [PMID: 35682247 PMCID: PMC9180644 DOI: 10.3390/ijerph19116658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/17/2022] [Accepted: 05/18/2022] [Indexed: 02/02/2023]
Abstract
Cardiovascular disease (CVD) is the leading cause of death both globally and in the United States (U.S.). Racial health disparities in cardiovascular health (CVH) persist with non-Hispanic Black adults having a higher burden of CVD morbidity and mortality compared to other racial groups. African immigrants represent an increasingly growing sub-population of the overall U.S. non-Hispanic Black adult population, however little is known about how specific psychological and social factors (i.e., depression and acculturation) influence the CVH of U.S. African immigrants. We sought to examine the association between severity of depression symptomology and CVH among African immigrants, and whether acculturation moderated the relationship between severity of depression symptoms and CVH. Study participants were those in the African Immigrant Health Study conducted in the Baltimore-Washington D.C. area. Severity of depression symptoms were assessed using the Patient Health Questionnaire-8 (PHQ-8). CVH was assessed using the American Heart Association Life's Simple 7 metrics and categorized as poor, intermediate, and ideal CVH. Acculturation measured as length of stay and acculturation strategy was examined as a moderator variable. Multivariable logistic regression was used to examine the association between depression and CVH and the moderating effect of acculturation adjusting for known confounders. In total 317 African immigrants participated in the study. The mean (±SD) age of study participants was 46.9 (±11.1) and a majority (60%) identified as female. Overall, 8.8% of study participants endorsed moderate-to-severe symptoms of depression. African immigrants endorsing moderate-to-severe levels of depression were less likely to have ideal CVH compared to those with minimal-to-mild symptoms of depression (Adjusted Odds Ratio [AOR]: 0.42, 95% CI: 0.17-0.99). Acculturation measured either as length of stay or acculturation strategy did not moderate the relationship between depression and CVH among study participants. Study participants exhibited elevated levels of symptoms of depression. Greater severity of depression symptoms was associated with worse CVH. Efforts to treat and prevent CVD among African immigrants should also include a focus on addressing symptoms of depression within this population.
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Affiliation(s)
- Nwakaego A. Nmezi
- Division of Rehabilitation Psychology and Neuropsychology, Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Ruth-Alma Turkson-Ocran
- Section for Research, Division of General Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA;
| | - Carolyn M. Tucker
- Department of Psychology, University of Florida, Gainesville, FL 32611, USA;
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González KA, Tarraf W, Wallace DM, Stickel AM, Schneiderman N, Redline S, Patel SR, Gallo LC, Mossavar-Rahmani Y, Daviglus ML, Zee PC, Talavera GA, Sotres-Alvarez D, González HM, Ramos A. Phenotypes of obstructive sleep apnea in the Hispanic Community Health Study/Study of Latinos. Sleep 2021; 44:zsab181. [PMID: 34272952 PMCID: PMC8664595 DOI: 10.1093/sleep/zsab181] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/08/2021] [Indexed: 11/14/2022] Open
Abstract
STUDY OBJECTIVES Recent work on US Whites from clinical samples used obstructive sleep apnea (OSA) symptoms to generate phenotypes for individuals with moderate-severe OSA which suggested 3 to 5 symptom classes. However, it is unknown whether similar classes generalize to diverse Hispanics/Latino adults. Therefore, we sought to fill this gap by empirically deriving sleep phenotypes among a large sample of diverse Hispanics/Latinos. METHODS We used data from The Hispanic Community Health Study/Study of Latinos (HCHS/SOL; 2008-2011), a prospective cohort study designed using a multisite multistage probability sample of adults 18-74 years old. The subpopulation of interest included participants with moderate-severe OSA symptoms (≥15 respiratory event index (REI) events per hour; n = 1,605). We performed latent class analysis for complex survey data using 15 common OSA symptoms (e.g. Epworth Sleepiness Scale) and 4 comorbidities to identify phenotype classes. RESULTS Average age was 52.4 ± 13.9 years and 34.0% were female. Mean REI was 33.8 ± 22.5 events per hour. Fit statistics and clinical significance suggested that a three-class solution provided the best fit to the data. The three phenotypes were: (1) Minimally Symptomatic (47.7%), (2) Excessive sleepiness (37.1%), and (3) Disturbed Sleep (15.2%). Sensitivity models were consistent with the main proposed solution. CONCLUSIONS Derived sleep phenotypes among diverse Hispanic/Latinos were consistent with recent findings from the Sleep Apnea Global Interdisciplinary Consortium, but we found notable differences in class prevalence relative to Whites. Further research is needed to link derived sleep phenotypes to health comorbidities in diverse populations.
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Affiliation(s)
- Kevin A González
- Department of Neurosciences and Shiley-Marcos Alzheimer’s Disease Research Center, University of California San Diego School of Medicine, San Diego, CA, USA
| | - Wassim Tarraf
- Department of Healthcare Sciences and Institute of Gerontology, Wayne State University, Detroit, MI, USA
| | - Douglas M Wallace
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Ariana M Stickel
- Department of Neurosciences and Shiley-Marcos Alzheimer’s Disease Research Center, University of California San Diego School of Medicine, San Diego, CA, USA
| | | | - Susan Redline
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Sanjay R Patel
- Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Linda C Gallo
- Department of Psychology and South Bay Latino Research Center, San Diego State University, San Diego, CA, USA
| | - Yasmin Mossavar-Rahmani
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago College of Medicine, Chicago, IL, USA
| | - Phyllis C Zee
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Gregory A Talavera
- Graduate School of Public Health, San Diego State University, San Diego, CA, USA
| | - Daniela Sotres-Alvarez
- Department of Biostatistics, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Hector M González
- Department of Neurosciences and Shiley-Marcos Alzheimer’s Disease Research Center, University of California San Diego School of Medicine, San Diego, CA, USA
| | - Alberto Ramos
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
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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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Poteat T, Gallo LC, Harkness A, Isasi CR, Matthews P, Schneiderman N, Thyagarajan B, Daviglus ML, Sotres-Alvarez D, Perreira KM. Influence of Stress, Gender, and Minority Status on Cardiovascular Disease Risk in the Hispanic/Latino Community: Protocol for a Longitudinal Observational Cohort Study. JMIR Res Protoc 2021; 10:e28997. [PMID: 33955843 PMCID: PMC8138714 DOI: 10.2196/28997] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 03/27/2021] [Accepted: 03/27/2021] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Hispanic/Latino sexual and gender minorities (SGM) are the fastest growing ethnic group of SGM in the United States. Cardiovascular disease (CVD) is a leading cause of morbidity and mortality among Hispanics/Latinos. SGM inequities in CVD risk have been identified as early as young adulthood, and minority stress has been identified as a potential mediator. Yet, the small number of ethnic or racial minority participants in SGM studies have precluded the examination of the intersections of sexual orientation, gender identity, and race and ethnicity. OBJECTIVE Minority stress models conceptualize relationships between stressors in minority groups and health outcomes. In this study, we will (1) examine the influence of sexual orientation and gender identity on CVD risk among all Hispanic Community Health Study/Study of Latinos (HCHS/SOL) participants at visit 3 (2021-2024; N~9300); (2) model pathways from sexual orientation and gender identity to CVD risk through stigma, discrimination, and stress in a 1:2 matched subcohort of SGM and non-SGM participants at visit 3 (n~1680); and (3) examine the influence of resilience factors on sexual orientation or gender identity and CVD risk relationships among subcohort participants at visit 3 (n~1680). METHODS This study will leverage existing data from the parent HCHS/SOL study (collected since 2008) while collecting new data on sexual orientation, gender identity, stigma, discrimination, stress, coping, social support, and CVD risk. Data analysis will follow the SGM minority stress model, which states that excess stigma against SGM populations leads to minority stress that increases CVD risk. In this model, coping and social support serve as resilience factors that can mitigate the impact of minority stress on CVD risk. Cross-sectional and longitudinal regression models as well as structural equation models will be used to test these relationships. RESULTS This study was funded by the National Heart, Lung, and Blood Institute in March 2020. Recruitment is scheduled to begin in the first quarter of 2021 and continue through 2024. CONCLUSIONS Understanding the influence of stigma-induced stress on CVD risk among Hispanic/Latino SGM has significant implications for the development of culturally specific CVD risk reduction strategies. Study findings will be used to build on identified Hispanic/Latino cultural strengths to inform adaptation and testing of family and community acceptance interventions. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/28997.
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Affiliation(s)
- Tonia Poteat
- Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, United States
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA, United States
| | - Audrey Harkness
- Department of Public Health Sciences, University of Miami, Miami, FL, United States
| | - Carmen R Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, NY, United States
| | - Phoenix Matthews
- Department of Population Health Nursing Science, University of Illinois Chicago, Chicago, IL, United States
| | - Neil Schneiderman
- Department of Psychology, University of Miami, Miami, FL, United States
| | - Bharat Thyagarajan
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, United States
| | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois College of Medicine, Chicago, IL, United States
| | - Daniela Sotres-Alvarez
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Krista M Perreira
- Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, United States
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Hu J, Amirehsani KA, McCoy TP, Coley SL, Wallace DC. Cardiovascular disease risk in Hispanic American women. Women Health 2021; 61:395-407. [PMID: 33941048 DOI: 10.1080/03630242.2021.1917476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Hispanic American women have an increased risk for the development of cardiovascular disease (CVD). This study examined CVD risk in a sample of immigrant Hispanic women using Framingham point scores and the Atherosclerotic Cardiovascular Disease (ASCVD) Risk Estimator for 10-year CVD risk and prevalence of metabolic syndrome. A cross-sectional study using baseline data from a diabetes self-management intervention study in a sample of 118 Hispanic American women was conducted. Data were c ollected with interviewer-administered surveys, and HbA1C and lipid profiles were obtained through capillary finger stick blood at clinics and churches in rural counties in central North Carolina. A majority (58%) of the women had type 2 diabetes and 61% had metabolic syndrome. Using the Framingham point scores for 10-year CVD risk, 2.5% were determined to have intermediate risk, compared to 7.6% at intermediate risk and 2.5% at high risk using the ASCVD 10-year risk estimator. High rates of CVD risk factors were found among this sample of Hispanic women. Early recognition of risk, mitigation of modifiable risk factors, and effective self-care programs are needed for Hispanic women. Hispanic American women may benefit from community-based CVD educational programs that have been culturally and linguistically tailored.
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Affiliation(s)
- Jie Hu
- College of Nursing, The Ohio State University, Columbus, Ohio, USA
| | - Karen A Amirehsani
- School of Nursing, The University of North Carolina, Greensboro, North Carolina, USA
| | - Thomas P McCoy
- School of Nursing, The University of North Carolina, Greensboro, North Carolina, USA
| | - Sheryl L Coley
- School of Nursing, The University of North Carolina, Greensboro, North Carolina, USA
| | - Debra C Wallace
- School of Nursing, The University of North Carolina, Greensboro, North Carolina, USA
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McCurley JL, Gutierrez AP, Bravin JI, Schneiderman N, Reina SA, Khambaty T, Castañeda SF, Smoller S, Daviglus ML, O’Brien MJ, Carnethon MR, Isasi CR, Perreira KM, Talavera GA, Yang M, Gallo LC. Association of Social Adversity with Comorbid Diabetes and Depression Symptoms in the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study: A Syndemic Framework. Ann Behav Med 2019; 53:975-987. [PMID: 30951585 PMCID: PMC6779072 DOI: 10.1093/abm/kaz009] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND U.S. Hispanics/Latinos experience high lifetime risk for Type 2 diabetes and concurrent psychological depression. This comorbidity is associated with poorer self-management, worse disease outcomes, and higher mortality. Syndemic theory is a novel social epidemiological framework that emphasizes the role of economic and social adversity in promoting disease comorbidity and health disparities. PURPOSE Informed by the syndemic framework, this study explored associations of socioeconomic and psychosocial adversity (low income/education, trauma history, adverse childhood experiences, ethnic discrimination, neighborhood problems [e.g., violence]) with comorbidity of diabetes and depression symptoms in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) and Sociocultural Ancillary Study. METHODS Participants were 5,247 Latino adults, aged 18-74, enrolled in four U.S. cities from 2008 to 2011. Participants completed a baseline physical exam and measures of depression symptoms and psychosocial adversity. Multinomial logistic regression analyses were conducted to examine associations of adversity variables with comorbid diabetes and high depression symptoms. RESULTS Household income below $30,000/year was associated with higher odds of diabetes/depression comorbidity (odds ratio [OR] = 4.61; 95% confidence interval [CI]: 2.89, 7.33) compared to having neither condition, as was each standard deviation increase in adverse childhood experiences (OR = 1.41; 95% CI: 1.16, 1.71), ethnic discrimination (OR = 1.23; 95% CI: 1.01, 1.50), and neighborhood problems (OR = 1.53; 95% CI: 1.30, 1.80). CONCLUSION Low household income, adverse childhood experiences, ethnic discrimination, and neighborhood problems are related to comorbid diabetes and depression in U.S. Latinos. Future studies should explore these relationships longitudinally.
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Affiliation(s)
- Jessica L McCurley
- Division of General Internal Medicine, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Angela P Gutierrez
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California San Diego, San Diego, CA, USA
| | - Julia I Bravin
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California San Diego, San Diego, CA, USA
| | - Neil Schneiderman
- Department of Psychology, University of Miami, Coral Gables, MA, USA
| | - Samantha A Reina
- Department of Psychology, University of Miami, Coral Gables, MA, USA
| | - Tasneem Khambaty
- Department of Psychology, University of Miami, Coral Gables, MA, USA
| | - Sheila F Castañeda
- Graduate School of Public Health, San Diego State University, San Diego, CA, USA
| | - Sylvia Smoller
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, NY, USA
| | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, USA
- Department of Preventive Medicine, Feinberg School of Medicine, Chicago, IL, USA
| | - Matthew J O’Brien
- Department of General Internal Medicine and Geriatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Mercedes R Carnethon
- Department of Preventive Medicine, Feinberg School of Medicine, Chicago, IL, USA
| | - Carmen R Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, NY, USA
| | - Krista M Perreira
- Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Greg A Talavera
- Graduate School of Public Health, San Diego State University, San Diego, CA, USA
| | - Mingan Yang
- Graduate School of Public Health, San Diego State University, San Diego, CA, USA
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA, USA
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Garcia ML, Castañeda SF, Allison MA, Elder JP, Talavera GA. Correlates of low-adherence to oral hypoglycemic medications among Hispanic/Latinos of Mexican heritage with Type 2 Diabetes in the United States. Diabetes Res Clin Pract 2019; 155:107692. [PMID: 30954512 PMCID: PMC9494711 DOI: 10.1016/j.diabres.2019.04.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 02/18/2019] [Accepted: 04/01/2019] [Indexed: 12/19/2022]
Abstract
AIMS We examined psychosocial- and social/economic factors related to low medication adherence, and sex differences, among 279 adults of Mexican heritage with Type 2 Diabetes. METHODS Self-report and health record data were used for cross-sectional analyses. Bivariate analyses tested the association of demographic, psychosocial (depression, anxiety, stress) and social/economic factors (insurance type, health literacy, social support) and medication adherence measured by proportion of days covered. Hierarchical regression analyses examined associations between demographic, psychosocial- and social/economic- related factors and low medication adherence stratified by sex. RESULTS More males than females demonstrated low adherence to hypoglycemic medications (75.0.% vs. 70.3%) (p < 0.05). We found significant differences between levels social support and medication adherence (p < 0.05). In hierarchical models, being US born and higher levels of social support were associated with low adherence among males (p < 0.05, and p < 0.001). CONCLUSIONS Approximately 72% of Mexican heritage adults demonstrated low adherence (PDC ≤ 0.50) to their hypoglycemic regimen, and gender differences exist. Interventions should address gender differences in preferences for social support to improve medication-taking behaviors among Mexican heritage males.
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Affiliation(s)
- Melawhy L Garcia
- Division of Health Promotion and Behavioral Science, School of Public Health, San Diego State University and Institute for Behavioral and Community Health, 9245 Sky Park Court, Suite 221 San Diego, CA 92123-4311, USA; Department of Family Medicine and Public Health, School of Medicine and Women's Cardiovascular Research Center, University of California San Diego, 8950 Villa La Jolla Drive, Suite A2016, La Jolla, CA 92307, USA.
| | - Sheila F Castañeda
- Division of Health Promotion and Behavioral Science, School of Public Health, San Diego State University and Institute for Behavioral and Community Health, 9245 Sky Park Court, Suite 221 San Diego, CA 92123-4311, USA
| | - Matthew A Allison
- Department of Family Medicine and Public Health, School of Medicine and Women's Cardiovascular Research Center, University of California San Diego, 8950 Villa La Jolla Drive, Suite A2016, La Jolla, CA 92307, USA
| | - John P Elder
- Division of Health Promotion and Behavioral Science, School of Public Health, San Diego State University and Institute for Behavioral and Community Health, 9245 Sky Park Court, Suite 221 San Diego, CA 92123-4311, USA
| | - Gregory A Talavera
- Division of Health Promotion and Behavioral Science, School of Public Health, San Diego State University and Institute for Behavioral and Community Health, 9245 Sky Park Court, Suite 221 San Diego, CA 92123-4311, USA
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19
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Fox RS, Carnethon MR, Gallo LC, Wiley JF, Isasi CR, Daviglus ML, Cai J, Davis SM, Giachello AL, Gonzalez P, McCurley JL, Schneiderman N, Penedo FJ. Perceived Discrimination and Cardiometabolic Risk Among US Hispanics/Latinos in the HCHS/SOL Sociocultural Ancillary Study. Int J Behav Med 2019; 26:331-342. [PMID: 31236872 PMCID: PMC7294575 DOI: 10.1007/s12529-019-09782-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Metabolic syndrome (MetS) is a group of cardiovascular risk factors including elevated blood pressure, elevated triglycerides, decreased high-density lipoprotein cholesterol, impaired fasting glucose, and abdominal obesity, which disproportionately affects Hispanics/Latinos. The present study examined associations between perceived discrimination and MetS in Hispanic/Latino adults from various background groups (i.e., Dominican, Central American, Cuban, Mexican, Puerto Rican, South American). METHODS Data were obtained from 5174 Hispanics/Latinos who participated in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Sociocultural Ancillary Study. MetS components and covariates were measured at a baseline examination, and perceived discrimination was assessed within 9 months of baseline. Path analysis modeled associations of perceived discrimination with MetS prevalence and each of the six components of MetS, controlling for age, sex, income, acculturation, physical activity, diet, smoking, and alcohol use. RESULTS Among the full cohort, perceived discrimination was not associated with MetS prevalence in any of the models evaluated. Higher perceived discrimination at work/school was associated with larger waist circumference. When examining background groups separately, higher perceived ethnicity-associated threat was related to increased MetS prevalence only among individuals of Central American background. Differential patterns of association between perceived discrimination and MetS components were found for different background groups. CONCLUSIONS Overall results suggested that perceived discrimination was not strongly or consistently associated with MetS among Hispanics/Latinos.
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Affiliation(s)
- Rina S Fox
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Mercedes R Carnethon
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA, USA
- SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Joshua F Wiley
- Monash Institute of Cognitive and Clinical Neurosciences and School of Psychological Sciences, Monash University, Melbourne, VIC, Australia
| | - Carmen R Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, NY, USA
| | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, USA
| | - Jianwen Cai
- Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sonia M Davis
- Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Aida L Giachello
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Patricia Gonzalez
- Graduate School of Public Health, San Diego State University, San Diego, CA, USA
| | - Jessica L McCurley
- SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | | | - Frank J Penedo
- Department of Psychology, University of Miami, Miami, FL, USA.
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20
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Welsh J, Korda RJ, Joshy G, Banks E. Primary Absolute Cardiovascular Disease Risk and Prevention in Relation to Psychological Distress in the Australian Population: A Nationally Representative Cross-Sectional Study. Front Public Health 2019; 7:126. [PMID: 31214558 PMCID: PMC6554659 DOI: 10.3389/fpubh.2019.00126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 05/07/2019] [Indexed: 01/14/2023] Open
Abstract
People who experience psychological distress have an elevated risk of incident cardiovascular disease (CVD). However, the extent to which traditional CVD prevention strategies could be used to reduce the CVD burden in this group is unclear because population-level data on CVD risk profiles and appropriate management of risk in relation to distress are currently not available. The aim of this study was to use nationally representative data to quantify variation in CVD risk and appropriate management of risk according to level of psychological distress in the Australian population. Data were from 2,618 participants aged 45-74 years without prior CVD who participated in the 2011-12 Australian Health Survey, a cross-sectional and nationally representative study of Australian adults. Age-and sex-adjusted prevalence of 5-year absolute risk of primary CVD (low <10%, moderate 10-15%, or high >15%), CVD risk factors, blood-pressure, and cholesterol assessments, and appropriate treatment (combined blood pressure- and lipid-lowering medication) if at high primary risk, were estimated. Prevalence ratios (PR) quantified variation in these outcomes in relation to low (Kessler-10 score: 10-<12), mild (12-<16), moderate (16-<22) and high (22-50) psychological distress, after adjusting for sociodemographic characteristics. The prevalence of high absolute risk of primary CVD for low, mild, moderate and high distress was 10.9, 12.3, 11.4, and 18.6%, respectively, and was significantly higher among participants with high compared to low distress (adjusted PR:1.62, 95%CI:1.04-2.52). The prevalence of CVD risk factors was generally higher in those with higher psychological distress. Blood pressure and cholesterol assessments were reported by the majority of participants (>85%) but treatment of high absolute risk was low (<30%), and neither were related to psychological distress. Our findings confirm the importance of recognizing people who experience psychological distress as a high risk group and suggest that at least part of the excess burden of primary CVD events among people with high psychological distress could be reduced with an absolute risk approach to assessment and improved management of high primary CVD risk.
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Affiliation(s)
- Jennifer Welsh
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - Rosemary J Korda
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - Grace Joshy
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - Emily Banks
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, ACT, Australia.,The Sax Institute, Ultimo, NSW, Australia
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21
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Tamez M, Ríos-Bedoya CF, Rodríguez-Orengo JF, Tucker KL, Mattei J. Sociodemographic and Lifestyle Factors, and Health Conditions of Dominican Adults Living in Puerto Rico. J Immigr Minor Health 2019; 20:1085-1093. [PMID: 28808807 DOI: 10.1007/s10903-017-0637-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Dominicans are the largest migrant community in Puerto Rico, yet understudied. We compared risk factors and health conditions of Dominicans versus Puerto Ricans (PRs). Cross-sectional survey of Dominicans (n = 55) and PRs (n = 310) aged 30-75 years, assessed with validated questionnaires and standardized anthropometric measurements. Significantly, more Dominicans than PRs had attained <8th grade education (37.7 vs. 8.0%), reported household income ≤$10,000 (76.1 vs. 56.9%), lacked health insurance (19.6 vs. 5.5%), and reported food insecurity (24.5 vs. 12.1%). They spent fewer hours/day watching television (2.9 vs. 3.8), and were less likely to smoke (7.6 vs. 19.6%). Medically-diagnosed depression was lower among Dominicans than PRs (9.6 vs. 23.0%); questionnaire-based high depressive symptomatology was similar (47.9 vs. 52.8%). Dominicans living in Puerto Rico had more socioeconomic risk factors but healthier lifestyle behaviors and lower prevalence of medically-diagnosed depression than PRs. Tailored approaches are needed to ameliorate disparities in each ethnic group.
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Affiliation(s)
- Martha Tamez
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 665 Huntington Ave, Bldg. 2, Boston, MA, 02115, USA
| | - Carlos F Ríos-Bedoya
- Fundación de Investigación de Puerto Rico, San Juan, PR, USA
- Department of Internal Medicine, Hurley Medical Center, Flint, MI, USA
| | - José F Rodríguez-Orengo
- Fundación de Investigación de Puerto Rico, San Juan, PR, USA
- Department of Biochemistry, School of Medicine, University of Puerto Rico, Río Piedras, PR, USA
| | - Katherine L Tucker
- Department of Biomedical & Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, USA
| | - Josiemer Mattei
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 665 Huntington Ave, Bldg. 2, Boston, MA, 02115, USA.
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22
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Lerman S, Jung M, Arredondo EM, Barnhart JM, Cai J, Castañeda SF, Daviglus ML, Espinoza RA, Giachello AL, Molina KM, Perreira K, Salgado H, Wassertheil-Smoller S, Kaplan RC. Religiosity prevalence and its association with depression and anxiety symptoms among Hispanic/Latino adults. PLoS One 2018; 13:e0185661. [PMID: 29415030 PMCID: PMC5802430 DOI: 10.1371/journal.pone.0185661] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 09/16/2017] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Religion plays an important role in the lives of people in the United States. We examined the prevalence of religiosity among Hispanic/Latinos in four regions of the United States and looked at its correlation to depression and anxiety symptoms. DESIGN The population-based Hispanic Community Health Study/ Study of Latinos enrolled a cohort of Hispanic/Latino adults (N = 16,415) ages 18-74 in four US cities from June 2008 to June 2011. Participants with complete data on religiosity (i.e., religious affiliation, frequency of attending religious activities and importance of religion), depression (assessed with the CESD-10), and trait anxiety (assessed with the STAI-10) were included in the present study. Distribution of religiosity is described by sociodemographic characteristics. Associations between religiosity with depression and anxiety were examined with logistic regression models controlling for sex, age group, education, Hispanic/Latino background, clinical center, and nativity. RESULTS The majority of the population (89.5%) reported having a religious affiliation. Weekly attendance at religious activities was reported by 41.6% of participants, while 20.6% did not attend any religious activities. Religion was very important to 63.9% and not at all important to 6.7% of the population. The CES-D scores and trait anxiety scores were not significantly related in the overall group to frequency of attending religious activity or perceived importance of religion. However, in age-stratified analyses, among older individuals (65+ years old) reporting "never" participating in religious activities compared to more than once per week was associated with an 80% higher likelihood of having high depressive symptomatology. Similarly, in the older age group, no religious affiliation or reporting that religion is "not at all important" was associated with greater anxiety symptomatology. CONCLUSION Religiosity varied by Hispanic/Latino background. Lack of religiosity was associated with elevated depressive or anxiety symptomology in older adults but not in young or middle-aged adults.
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Affiliation(s)
- Shir Lerman
- University of Massachusetts Medical School, Division of Preventive & Behavioral Medicine, Worcester, MA, United States of America
| | - Molly Jung
- Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY, United States of America
| | - Elva M. Arredondo
- San Diego State University, Graduate School of Public Health, Division of Health Promotion and Behavioral Science, San Diego, CA, United States of America
| | - Janice M. Barnhart
- Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY, United States of America
| | - Jianwen Cai
- University of North Carolina Gillings School of Global Public Health, Department of Biostatistics, Chapel Hill, NC, United States of America
| | - Sheila F. Castañeda
- San Diego State University, Graduate School of Public Health, Division of Health Promotion and Behavioral Science, San Diego, CA, United States of America
| | - Martha L. Daviglus
- University of Illinois at Chicago, Institute for Minority Health Research, Department of Medicine, Chicago, IL, United States of America
| | - Rebeca A. Espinoza
- San Diego State University, Graduate School of Public Health, Division of Health Promotion and Behavioral Science, San Diego, CA, United States of America
| | - Aida L. Giachello
- University of Illinois at Chicago, Department of Psychology, Chicago, IL, United States of America
| | - Kristine M. Molina
- University of Illinois at Chicago, Department of Psychology, Chicago, IL, United States of America
| | - Krista Perreira
- University of North Carolina Gillings School of Global Public Health, Department of Biostatistics, Chapel Hill, NC, United States of America
| | - Hugo Salgado
- San Diego State University, Graduate School of Public Health, Division of Health Promotion and Behavioral Science, San Diego, CA, United States of America
| | - Sylvia Wassertheil-Smoller
- Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY, United States of America
| | - Robert C. Kaplan
- Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY, United States of America
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23
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Chamik T, Viswanathan B, Gedeon J, Bovet P. Associations between psychological stress and smoking, drinking, obesity, and high blood pressure in an upper middle-income country in the African region. Stress Health 2018; 34:93-101. [PMID: 28586134 DOI: 10.1002/smi.2766] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 02/17/2017] [Accepted: 05/14/2017] [Indexed: 11/06/2022]
Abstract
The direction and magnitude of the associations between cardiovascular risk factors (CVRFs) and psychological stress continue to be debated, and no data are available from surveys in the African region. In this study, we examine the associations between CVRFs and psychological stress in the Seychelles, a rapidly developing small island state in the African region. A survey was conducted in 1,240 adults aged 25-64 years representative of the Seychelles. Participants were asked to rank psychological stress that they had experienced during the past 12 months in four domains: work, social life, financial situation, and environment around home. CVRFs (high blood pressure, tobacco use, alcohol drinking, and obesity) were assessed using standard procedures. Psychological stress was associated with age, sex, and socioeconomic status. Overall, there were only few consistent associations between psychological stress and CVRFs, adjusting for age, sex, and socioeconomic status. Social stress was associated with smoking, drinking, and obesity, and there were marginal associations between stress at work and drinking, and between financial stress, and smoking and drinking. Psychological stress was not associated with high blood pressure. These findings suggest that psychological stress should be considered in cardiovascular disease prevention and control strategies.
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Affiliation(s)
- Tanja Chamik
- Institute of Social and Preventive Medicine, University Hospital of Lausanne, Lausanne, Switzerland
| | | | - Jude Gedeon
- Ministry of Health, Victoria, Republic of Seychelles
| | - Pascal Bovet
- Institute of Social and Preventive Medicine, University Hospital of Lausanne, Lausanne, Switzerland
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24
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Camacho A, Tarraf W, Jimenez DE, Gallo LC, Gonzalez P, Kaplan RC, Lamar M, Khambaty T, Thyagarajan B, Perreira KM, Hernandez R, Cai J, Daviglus ML, Wassertheil-Smoller S, González HM. Anxious Depression and Neurocognition among Middle-Aged and Older Hispanic/Latino Adults: Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Results. Am J Geriatr Psychiatry 2018; 26:238-249. [PMID: 28684241 PMCID: PMC5752627 DOI: 10.1016/j.jagp.2017.06.002] [Citation(s) in RCA: 12] [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: 02/08/2017] [Revised: 06/01/2017] [Accepted: 06/01/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The purpose of this study is to examine the association between verbal learning, fluency, and processing speed with anxious depression symptomatology (ADS) among diverse Hispanics. We hypothesized an inverse association of anxious depression with neurocognition among Hispanics of different heritage. DESIGN Data are from the Hispanic Community Health Study/Study of Latinos. The sample included 9,311participants aged 45-74 years (mean: 56.5 years). A latent class analysis of items from the Center for Epidemiological Studies for Depression scale and the Spielberger Trait Anxiety Inventory was used to derive an anxious depression construct. Neurocognitive measures included scores on the Brief Spanish English Verbal Learning Test (B-SEVLT, learning and recall trials), Word Fluency (WF), Digit Symbol Substitution (DSS) test, and a Global Cognitive Score (GCS). We fit survey linear regression models to test the associations between anxious depression symptomatology and cognitive function. We tested for effect modification by sex, Hispanic heritage, and age groups. RESULTS Among men, 71.6% reported low, 23.3% moderate, and 5.1% high ADS. Among women, 55.1% reported low, 33.2% moderate, and 11.8% high ADS. After controlling for age, sex, sociodemographic characteristics, cardiovascular risk factors and disease, and antidepressant use, we found significant inverse associations between moderate and high anxious depression (ref:low) with B-SEVLT learning and recall, DSS and GCS. Moderate, but not high, anxious depression was inversely associated with WF. Associations were not modified by sex, Hispanic heritage, or age. CONCLUSIONS Increased anxious depression symptomatology is associated with decreased neurocognitive function among Hispanics. Longitudinal studies are needed to establish temporality and infer if negative emotional symptoms precede cognitive deficits.
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Affiliation(s)
- Alvaro Camacho
- Departments of Psychiatry, Family Medicine, and Public Health, University of California San Diego, San Diego, CA.
| | - Wassim Tarraf
- Institute of Gerontology and Department of Healthcare Sciences, Wayne State University, Detroit, MI
| | - Daniel E Jimenez
- Department of Psychiatry and Behavioral Sciences, Center of Aging, University of Miami, Miami, FL
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA
| | - Patricia Gonzalez
- Graduate School of Public Health, San Diego State University, San Diego, CA
| | - Robert C Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Melissa Lamar
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL
| | | | | | - Krista M Perreira
- Collaborative Studies Coordinating Center, University of North Carolina at Chapel Hill, NC
| | - Rosalba Hernandez
- School of Social Work, University of Illinois at Urbana-Champaign, Urbana, IL
| | - Jianwen Cai
- Collaborative Studies Coordinating Center, University of North Carolina at Chapel Hill, NC
| | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL
| | | | - Hector M González
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI
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25
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Genetic and Environmental Relationships Between Depressive and Anxiety Symptoms and Cardiovascular Risk Estimates Among Korean Twins and Families. Twin Res Hum Genet 2017; 20:533-540. [PMID: 28978361 DOI: 10.1017/thg.2017.54] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
We aimed to assess shared genetic correlations of depressive and anxiety symptoms with concurrent and future estimated cardiovascular risk (CVR) score in Korean twins and family members. For the relationship with Adult Treatment Panel III CVR estimate in subjects aged 30-74 years (n = 1,059, baseline and follow-up after 3.2 ± 1.2 years), Center for Epidemiological Studies Depression Scale (CES-D) and state and trait anxiety inventory (SAI and TAI) were measured at baseline. A mixed linear model for CVR scores at baseline and follow-up was applied to include depressive and anxiety symptoms, twin and family effects, income, education, alcohol use, exercise, body mass index, and baseline CVR score for follow-up analysis. Higher CES-D scores were associated with higher CVR score at baseline in men, while higher TAI score was associated with higher CVR score at follow-up in women. Heritabilities were 0.245~0.326 for CVR score, 0.320 for CES-D score, 0.367 for TAI score, and 0.482 for SAI score. There were significant common genetic correlations in the relationships of CES-D, TAI, and SAI scores with CVR scores at baseline and follow-up (after adjusting for baseline CV risk score). Shared common environmental correlations were observed in the relationships of CES-D and SAI scores with CVR score at baseline; and SAI score with CVR score at follow-up. In the within-monozygotic twin analysis, there were no associations between CES-D, TAI, and SAI scores, and CVR score. In conclusion, shared genetic and environmental influences were observed in the relationship between depressive and anxiety symptoms with concurrent and future CVR estimates.
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Human Oral Buccal Microbiomes Are Associated with Farmworker Status and Azinphos-Methyl Agricultural Pesticide Exposure. Appl Environ Microbiol 2016; 83:AEM.02149-16. [PMID: 27836847 PMCID: PMC5203616 DOI: 10.1128/aem.02149-16] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 10/24/2016] [Indexed: 12/24/2022] Open
Abstract
In a longitudinal agricultural community cohort sampling of 65 adult farmworkers and 52 adult nonfarmworkers, we investigated agricultural pesticide exposure-associated changes in the oral buccal microbiota. We found a seasonally persistent association between the detected blood concentration of the insecticide azinphos-methyl and the taxonomic composition of the buccal swab oral microbiome. Blood and buccal samples were collected concurrently from individual subjects in two seasons, spring/summer 2005 and winter 2006. Mass spectrometry quantified blood concentrations of the organophosphate insecticide azinphos-methyl. Buccal oral microbiome samples were 16S rRNA gene DNA sequenced, assigned to the bacterial taxonomy, and analyzed after "centered-log-ratio" transformation to handle the compositional nature of the proportional abundances of bacteria per sample. Nonparametric analysis of the transformed microbiome data for individuals with and without azinphos-methyl blood detection showed significant perturbations in seven common bacterial taxa (>0.5% of sample mean read depth), including significant reductions in members of the common oral bacterial genus Streptococcus Diversity in centered-log-ratio composition between individuals' microbiomes was also investigated using principal-component analysis (PCA) to reveal two primary PCA clusters of microbiome types. The spring/summer "exposed" microbiome cluster with significantly less bacterial diversity was enriched for farmworkers and contained 27 of the 30 individuals who also had azinphos-methyl agricultural pesticide exposure detected in the blood. IMPORTANCE In this study, we show in human subjects that organophosphate pesticide exposure is associated with large-scale significant alterations of the oral buccal microbiota composition, with extinctions of whole taxa suggested in some individuals. The persistence of this association from the spring/summer to the winter also suggests that long-lasting effects on the commensal microbiota have occurred. The important health-related outcomes of these agricultural community individuals' pesticide-associated microbiome perturbations are not understood at this time. Future investigations should index medical and dental records for common and chronic diseases that may be interactively caused by this association between pesticide exposure and microbiome alteration.
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