The Intersections Between Sexual Orientation, Latine Ethnicity, Social Determinants of Health, and Lifetime Suicide Attempts in a Sample Being Assessed for Entry to Co-Occurring Mental Health and Substance Use Disorder Treatment

PURPOSE

Few studies have examined the relationship between the intersections of lesbian, gay, and bisexual (LGB) sexual orientation, Latine ethnicity, and lifetime suicide attempts in Latine individuals with substance use disorder. This study examines this intersection and controls for social determinants of health, mental health disorder symptoms, and substance use disorder symptoms in a sample of Latine adults entering treatment for co-occurring disorders.

METHOD

Bivariate statistics and multivariate logistic regression were used to analyze assessment data (n = 360) from a bilingual/bicultural integrated behavioral health system serving Latine communities in Massachusetts to examine the relationship between sexual orientation, Latine ethnicity, and history of lifetime suicide attempts. We controlled for social determinants of health, mental health disorders, and substance use disorder (SUD) factors significantly associated with lifetime suicide attempts at the bivariate level.

RESULTS

Over 27% of the sample and 35% of Puerto Ricans (PR) reported lifetime suicide attempts. The logistic regression identified that PR clients were 78% more likely to have attempted suicide in a lifetime compared to non-PR clients. Clients identifying as LGB were 3.2 times more likely to report having attempted suicide in their lifetime compared to heterosexual clients. Unemployed clients were 2.4 times more likely to report having attempted suicide in their lifetime compared to employed clients.

CONCLUSION

Findings identify high rates of lifetime suicide attempts among LGBs and PRs entering SUD treatment. Targeted outreach and treatment efforts designed to address intersectionality for this underserved population are needed.

Pre-hurricane linkages between poverty, families, and migration among Puerto Rican-origin children living in Puerto Rico and the United States

Puerto Rican children comprise a historically vulnerable group that has garnered little attention from academics and policy makers. Then, Hurricanes Irma and Maria devastated the already impoverished island of Puerto Rico in 2017. It is imperative to understand the demographic, social, and economic patterns of Puerto Ricans in the past decade, in order to assess the true impact of the destructive 2017 hurricanes on Puerto Rican children and their families, and identify ways to address current population needs. This study fills this gap in the literature by providing recent pre-hurricane socioeconomic outcomes of Puerto Rican-origin children in Puerto Rico and the United States. It applies an origin-destination framework by relying on American Community Survey and Puerto Rico Community Survey data from 2012 to 2016. The analyses consider the linkages among family migration experiences, children's living arrangements, and household poverty levels. The findings are evaluated regarding prior research.

Understanding Generational Differences in Early Fertility: Proximate and Social Determinants

Although US rates of early fertility have declined, they remain high relative to other high-income countries, and disparities by population group persist. The share of the US youth population with immigrant parents has expanded greatly, yet relatively little is known about generational variations in early fertility. This study used Add Health data to investigate: (1) differences by generational status in the risk of early childbearing; (2) to what extent observed differences reflected timing of sexual onset versus post-onset proximate determinants like contraceptive use; and (3) the influence of individual-, family-, and neighborhood-level social factors. Foreign-born and second-generation young women initiated both sexual activity and childbearing later than those with US-born parents. Sequential hazard models revealed the importance of later sexual onset in explaining delayed fertility among the foreign-born, and of family attributes for their later sexual onset. Post-onset behaviors were central to the delayed childbearing observed among the second generation.

Childbearing after Migration: Fertility Patterns of Foreign-born Women in Sweden

The present study provides an investigation of patterns in childbearing among foreign-born women in Sweden from the 1960s to the 1990s. Event-history techniques are applied to longitudinal population register data on childbearing and migration of 446,000 foreign-born women who had ever lived in Sweden before the end of 1999. Period trends in parity-specific fertility appear to be quite similar for Swedish- and foreign-born women, but important differences exist in levels of childbearing propensities between women from different countries of origin. Most immigrant groups tend to display higher levels of childbearing shortly after immigration. We conclude that migration and family building in many cases are interrelated processes and that it is always important to account for time since migration when fertility of immigrants is studied.

The Intergenerational Assimilation of Completed Fertility: Comparing the Convergence of Different Origin Groups

Recent studies have highlighted the need for new research on intergenerational assimilation and how it varies for different origin groups. This article responds by studying the intergenerational assimilation of completed fertility in the United Kingdom. The results provide evidence of assimilation for some origins, in particular for women from Ireland and Jamaica. Yet results also show evidence against assimilation for second-generation Pakistanis and Bangladeshis. The ability of the method used to distinguish between origin groups highlights the importance of a robust statistical approach that takes account of heterogeneity, an approach that can also be used to study outcomes other than fertility.

Adolescent Latino Reproductive Health: A Review of the Literature

Latino adolescent reproductive health has become an increasingly important topic because of the growth in the numbers of Latino youth and because Latino youth are at high risk for negative reproductive health outcomes. Latinas now have the highest teen birth rates, and Latinos have disproportionately high rates of HIV/AIDS. These trends highlight the need for greater understanding of the sexual and reproductive health and behavior of Latino youth. This overview provides an introduction to key aspects of the Latino population. It then examines and synthesizes the existing literature by domains useful to the study of Latinos. Areas that receive in-depth coverage are socioeconomic status, family, national origin, peers and partners, and acculturation. Based on the current state of knowledge and the issues facing young Latinos, suggestions for future research and uses for existing data and past research are included.

Contraceptive Use among Women Migrants in Nang Rong, Thailand: An Exploratory Study

Understanding the dynamics of contraceptive use among women migrants is considered important, especially to a country like Thailand that is undergoing many changes, and an increasingly female-dominated migration during the last few decades. Using survey data collected in 2000, this study seeks to examine the determinants of modern contraceptive use among women migrants in Nang Rong, Thailand. The study found that several demographic and socioeconomic factors are significant predictors of contraceptive use among women migrants and the magnitude of such effects varies across different migrant types.

The Causal Effects of Rural-to-Urban Migration on Children's Wellbeing in China

China's rural-to-urban migration has affected 12.6 million school-age rural children who have migrated with their parents and another 22 million who have been left behind by their migrant parents. Not enough is known, either theoretically or empirically, about the causal impact of migration on the wellbeing of this large number of Chinese children affected by migration. Propensity score matching methods are applied to estimate the effects of migration in children 10-15 years old from a 2010 national survey (N = 2,417). Children's migration has significant positive effects on their objective wellbeing but no negative effects on their subjective wellbeing. There is little difference between the left-behind and non-migrant children across multiple life domains. The Rosenbaum bounds tests indicate that the causal effects of child migration are sensitive to hidden bias for certain outcomes, but not for others.

Nicaraguan migration and the prevalence of adolescent childbearing in Costa Rica

This study describes the dynamics of adolescent childbearing of Nicaraguan-born and Costa Rican-born adolescents in Costa Rica and examines the association between socio-demographic factors and adolescent childbearing in the country. We studied Nicaraguan-born and Costa Rican adolescents using the data of the 2000 Census. Multivariate logistic regression was used to analyze the association between country of origin and adolescent childbearing, while controlling for socio-demographic factors (age, education, union, urbanization and poverty). 26% of Nicaraguan-born migrants and 9.5% of Costa Ricans had given birth during adolescence. The migrants' increased odds of pregnancy decreased from 3.34 (CI 3.21, 3.48) to 1.88 (CI 1.79, 1.97) when controlling for socio-demographic factors. Age, low educational attainment, urban residence, poverty and union were all significant predictors of adolescent pregnancy. Nicaraguan-born status is associated with adolescent childbearing in Costa Rica. Further research is needed to understand what factors, other than socio-demographic indicators, contribute to the differing prevalence of adolescent childbearing in Costa Rica.

Suicidal ideation and suicide attempts among Hispanic subgroups in the United States: 1991-1992 and 2001-2002

OBJECTIVE

To compare the prevalence of suicidal ideation/attempts among Hispanic subgroups in the US in 1991-1992 and 2001-2002, and identify high-risk groups.

METHOD

Data were drawn from the 1991-1992 National Longitudinal Alcohol Epidemiologic Survey (NLAES, n = 42,862) and the 2001-2002 National Epidemiological Survey on Alcohol and Related Conditions (NESARC, n = 43,093), two nationally representative surveys of individuals aged 18 years and older.

RESULTS

1) Puerto Ricans are the Hispanic ethnic subgroup with the highest rates of suicide attempts; 2) 45- to 64-year-old Puerto Rican women are a high-risk group for suicide attempts; 3) Over the 10 year period between the two surveys, the lifetime prevalence of suicide attempts significantly increased among 18- to 24-year-old Puerto Rican women and Cuban men, and among 45- to 64-year-old Puerto Rican men.

CONCLUSION

Hispanics in the US are not a homogeneous group. We identify high-risk groups among Hispanics. Specific interventions for subgroups of Hispanics at high risk for suicidal behaviors may be required.

The relationship between psychosocial status, acculturation and country of origin in mid-life Hispanic women: data from the Study of Women's Health Across the Nation (SWAN)

METHOD

To test the hypothesis that psychosocial symptomatology differs by country of origin and acculturation among Hispanic women, we examined 419 women, aged 42-52 years at baseline, enrolled in the New Jersey site of the Study of Women's Health Across the Nation (SWAN). Women were categorized into six groups: Central (CA, n = 29) or South American (SA, n = 106), Puerto Rican (PR, n = 56), Dominican (D, n = 42), Cuban (Cu, n = 44) and non-Hispanic Caucasian (NHC, n = 142). Acculturation, depressive symptoms, hostility/cynicism, mistreatment/discrimination, sleep quality, social support, and perceived stress were assessed at baseline. Physical functioning, trait anxiety and anger were assessed at the fourth annual follow-up. Comparisons between Hispanic and non-Hispanic Caucasians used χ², t test or non-parametric alternatives; ANOVA or Kruskal-Wallis testing examined differences among the five Hispanic sub-groups. Multivariable regression models used PR women as the reference group.

RESULTS

Hispanic women were overall less educated, less acculturated (p < 0.001 for both) and reported more depressive symptoms, cynicism, perceived stress, and less mistreatment/discrimination than NHCs. Along with D women, PR women reported worse sleep than Cu women (p < 0.01) and more trait anxiety than SA and Cu women (p < 0.01). Yet, PR women were most acculturated (21.4% highly acculturated vs. CA (0.0%), D (4.8%), SA (4.8%) and Cu (2.3%) women; p < 0.001). In regression models, PR women reported depressive symptoms more frequently than D, Cu, or SA women, and reported trait anxiety more frequently than Cu or SA women. Greater acculturation was associated with more favorable psychosocial status, but PR ethnicity was negatively related to psychosocial status.

CONCLUSION

Psychosocial symptomatology among Hispanic women differs by country of origin and the relatively adverse profile of Puerto Rican women is not explained by acculturation.

Immigration measures and reproductive health among Hispanic youth: findings from the national longitudinal survey of youth, 1997-2003

PURPOSE

To explore relationships between immigration measures and risk of reproductive and sexual events among U.S. Hispanic adolescents.

METHODS

We examined generation status, language in the home and country of origin in relation to sexual activity, contraception, and childbearing among 1614 Hispanic adolescents, using nationally representative 1997-2003 longitudinal data. Multivariable analyses controlled for potentially confounding variables. Tests for effect modification by gender and Mexican origin were conducted.

RESULTS

Fewer first generation adolescents transitioned to sexual intercourse before age 18 (odds ratio [OR]=.80, 95% confidence interval [CI]=.66-.98) and fewer first and second generation sexually active teens used contraceptives consistently at age 17 (OR=.32, 95% CI=.17-.60 and OR=.50, 95% CI=.31-.80, respectively) than third-generation teens. Language was similarly associated with the transition to sexual intercourse and contraceptive practices. Versus teens of Mexican origin, teens of Puerto Rican origin and origins other than Cuba and Central/South America had greater odds of becoming sexually active; youth of all origins except Central/South America had fewer multiple live births (OR=.14-.31). Gender modified the effects of generation on consistent use of contraceptives and condoms at age 17. Gender also modified the effect of country of origin on transitioning to sexual intercourse before age 18 years.

CONCLUSIONS

Results expand on previous observations that generation, language, and country of origin are predictors of reproductive and sexual risks for Hispanic adolescents. These immigration measures may therefore be useful in targeting community and clinical preventive services.

IS ASSIMILATION THEORY DEAD? THE EFFECT OF ASSIMILATION ON ADOLESCENT WELL-BEING

The relationship between assimilation and the well-being of immigrant children has been the focus of debate in the recent sociological literature. Much of this work has questioned whether classical theories of immigrant adaptation, which assumed assimilation to be an integral part of the process of upward mobility for immigrants, are still applicable to today's immigrant children. This study reevaluates the applicability of classical assimilation theory with a comprehensive empirical assessment of the relationship between assimilation and the well-being of Hispanic and Asian immigrant adolescents. Using Add Health data, we examine the effect of different aspects of assimilation on educational achievement, psychological well-being, and at-risk behaviors. We find that the effect of assimilation varies greatly depending on the ethnic group and outcome under consideration, but that it is generally related to both greater academic achievement and more at-risk behavior. We conclude that assimilation theory is still relevant, but suggest an interpretation that emphasizes a process of decreasing differences between groups rather than either detrimental or beneficial effects of assimilation.

Lower rates of preterm birth in women of Arab ancestry: an epidemiologic paradox--Michigan, 1993-2002

OBJECTIVE

Preterm birth (PTB), <37 weeks gestation, occurs in 12.1% of live births annually and is associated with significant morbidity and mortality in the United States. Racial/ethnic subgroups are disproportionately affected by PTB. Michigan is home to one of the largest Arab-American communities in the country; however, little is known about PTB in this population. This study examined the maternal demographic profile and risk factors of preterm birth (PTB) among foreign-born and US-born women of Arab ancestry relative to US-born Whites in Michigan.

METHODS

Using Michigan Vital Statistics data, we examined correlates of PTB for primiparous U.S.-born white (n = 205,749), U.S.-born Arab (n=1,697), and foreign-born Arab (n=5,997) women who had had a live-born singleton infant during 1993-2002. We examined variables commonly reported to be associated with PTB, including mother's age and education; insurance type; marital status of parents; receipt of prenatal care; mother's chronic hypertension, diabetes, and tobacco use; and infant sex.

RESULTS

Foreign-born Arabs are less educated and more likely to be on Medicaid, and they receive less prenatal care than US-born Whites. Prevalence of PTB was 8.5, 8.0, and 7.5% for US-born Whites, US-born Arabs, and foreign-born Arabs, respectively. Pregnancy-related hypertension was the only predictor of PTB that these three groups had in common: Adjusted Odds Ratio (AOR)=2.1 (95% Confidence Interval (CI)=1.99, 2.21), AOR=2.6 (95% CI=1.24, 5.51), and AOR=2.6 (95% CI=1.55, 4.31) for US-born whites, US-born Arabs, and foreign-born Arabs, respectively.

CONCLUSIONS

Foreign-born Arab women in Michigan have a higher-risk maternal demographic profile than that of their US-born white counterparts; however, their prevalence of PTB is lower, which is consistent with the epidemiologic paradox reported among foreign-born Hispanic women.

Declining fertility on the frontier: the Ecuadorian Amazon

This paper examines farm and household characteristics associated with a rapid fertility decline in a forest frontier of the Ecuadorian Amazon. The Amazon basin and other rainforests in the tropics are among the last frontiers in the ongoing global fertility transition. The pace of this transition along agricultural frontiers will likely have major implications for future forest transitions, rural development, and ultimately urbanization in frontier areas. The study here is based upon data from a probability sample of 172 women who lived on the same farm in 1990 and 1999. These data are from perhaps the first region-wide longitudinal survey of fertility in an agricultural frontier. Descriptive analyses indicate that fertility has plummeted in the region, which is surprising since it had remained high and unchanging among migrant colonists up to 1990. Thus only half of the women in our sample reported having a birth during the 1990-1999 time period, and most women report in 1999 that they do not want to have any more children. Analyses, controlling for women's age, corroborate hypotheses about land-fertility relations. For example, women from households with a legal land title had fewer than half as many children as those from households without a title. Large cattle (pasture) holdings and hiring laborers to work on the farm (which may replace household labor) are both related to socio-economic status that is traditionally associated with lower fertility. Similarly, distance to the nearest community center is positively related to fertility. Factors negatively related to fertility include increasing temporary out-migration of adult men or women from the household, asset accumulation, and access to electricity.

Mapping Gender and Migration in Sociological Scholarship: Is It Segregation or Integration?

A review of the sociological research about gender and migration shows the substantial ways in which gender fundamentally organizes the social relations and structures influencing the causes and consequences of migration. Yet, although a significant sociological research has emerged on gender and migration in the last three decades, studies are not evenly distributed across the discipline. In this article, we map the recent intellectual history of gender and migration in the field of sociology and then systematically assess the extent to which studies on engendering migration have appeared in four widely read journals of sociology (American Journal of Sociology, American Sociological Review, Demography, and Social Forces). We follow with a discussion of these studies, and in our conclusions, we consider how future gender and migration scholarship in sociology might evolve more equitably.

From austerity to prosperity? Migration and child poverty among mainland and island Puerto Ricans

Analyses of migrants’ economic circumstances typically use the native-born in the destination as a comparison group. We use the 1990 Census Public Use Microdata Samples for the United States and Puerto Rico to demonstrate the benefits of a comparative approach that includes data from both the origin and the destination. Specifically, the primary objective is to determine how and why the risk of child poverty is associated with migration from Puerto Rico to the United States. The results show that migration reduces the risk of child poverty, partly because better jobs are available on the mainland. Employment, human capital, family structure, and public assistance cannot completely explain observed differences. The results also show that the economic benefits of migration continue for the native-born on the mainland and that return migration to Puerto Rico is associated with impoverishment.