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Hawkins MM, Holliday DD, Weinhardt LS, Florsheim P, Ngui E, AbuZahra T. Barriers and facilitators of health among older adult immigrants in the United States: an integrative review of 20 years of literature. BMC Public Health 2022; 22:755. [PMID: 35421979 PMCID: PMC9008931 DOI: 10.1186/s12889-022-13042-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 03/09/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
There are over seven million older adult immigrants in the United States, and that number is expected to increase. Older adult immigrants in the United States have unique factors that influence their health.
Methods
In this integrative review, we systematically review 20 years of peer-reviewed literature on the barriers (i.e. isolation, lack of English Language Proficiency, low health literacy, lack of SES resources, discrimination) and facilitators (i.e. English Language Proficiency and maintaining ones native language, social support, culturally sensitive providers, healthcare access) of health among older adult immigrants in the United States.
Results
We found differing uses of the term ‘older adult’, emphasis on the lack of homogeneity among older adult immigrants, social support and isolation as significant barriers and facilitators of older adult immigrant health, and inconsistencies in uses and definitions of acculturation. We also examined relevant theories in the literature. Based on the literature review, focusing on Acculturation Theory, Social Cognitive Theory, and Successful Aging Theory, combining these three theories with findings from the literature to create the Older Adult Immigrant Adapted Model for Health Promotion.
Conclusions
Public health strives to promote health and prevent adverse health outcomes. Our integrative review not only systematically and thoroughly explicates 20 years of literature, but the Older Adult Immigrant Adapted Model for Health Promotion, provides guidance for future research and interventions.
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Alkaid Albqoor M, Chen JL, Weiss S, Waters C, Choi JW. Serious psychological distress: A national study of Middle Eastern immigrants. J Psychiatr Ment Health Nurs 2021; 28:163-173. [PMID: 32363710 DOI: 10.1111/jpm.12646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/09/2020] [Accepted: 04/23/2020] [Indexed: 11/30/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: There is very limited literature on the health of Middle Eastern immigrants in the United States, and the available studies were mostly conducted on small convenient samples in local communities. There is also a need to understand changes in the rates of serious psychological distress (SPD) during the 15 years after 2001, as there were negative effects on Arabs' health since the September 2001 aftermath. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: The study examined the rates of SPD, the risk of SPD and its associated factors in a national sample of Middle Eastern immigrants in the United States from 2001 to 2015. The study found that serious psychological distress rate was high among Middle Eastern immigrants. Being a female and having obesity were associated with a higher risk of reporting serious psychological distress among this population. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: These outcomes necessitate mental health nursing interventions that provide culturally sensitive mental health care to immigrants For example, developing community-based prevention programmes is required to address risk factors of psychological distress and to increase awareness about psychological distress among Middle Eastern immigrants. ABSTRACT: Introduction While Middle Eastern immigrants are a fast-growing population in the United States, there is very limited literature on their mental health. Most of the available studies were conducted on small convenient samples in local communities. Aims To examine rates of serious psychological distress (SPD) and its associated factors among Middle Eastern immigrants in the United States, compared with US-born, non-Hispanic Whites. Methods Data from the National Health Interview Survey (NHIS) from 2001 to 2015 were analysed. The survey included 1,246 Middle Eastern immigrants and 232,392 US-born, non-Hispanic Whites. SPD was measured by the Kessler-6 psychological distress scale. Survey analysis procedures, sampling weights and variance estimates were conducted. Descriptive statistics and regression analyses were employed to examine differences and factors associated with SPD. Results SPD rate was the highest among Middle Eastern immigrants (5.99%) between 2006 and 2010. Among Middle Eastern immigrants, being female and obese were significantly associated with a higher risk of SPD. Discussion Middle Eastern immigrants in the United States suffered high rates of SPD. Gender and obesity were factors associated with SPD risk. Implications These outcomes indicate the need for mental health nursing interventions that provide culturally sensitive mental health care to immigrants, such as developing community-based prevention programmes.
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Affiliation(s)
- Maha Alkaid Albqoor
- Department of Community Health Nursing, University of Jordan University of Jordan, Amman, Jordan
| | - Jyu-Lin Chen
- Department of Family Health Care Nursing, University of California San Francisco, San Francisco, CA, USA
| | - Sandra Weiss
- Department of Community Health Systems, University of California San Francisco, San Francisco, CA, USA
| | - Catherine Waters
- Department of Community Health Systems, University of California San Francisco, San Francisco, CA, USA
| | - Ji-Won Choi
- Institute for Health Aging, University of California San Francisco, San Francisco, CA, USA
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Fund N, Green A, Chodick G, Orin M, Koren G, Shalev V, Dagan Y. The epidemiology of sleep disorders in Israel: results from a population-wide study. Sleep Med 2020; 67:120-127. [PMID: 31918117 DOI: 10.1016/j.sleep.2019.10.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 08/13/2019] [Accepted: 10/18/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND Studies on the prevalence of sleep disorders have found great variability due to different data collection methods and case definitions. We aimed at assessing the prevalence of sleep disorders in a large, unselected population using validated clinical patient records. To the best of our knowledge, this is the first large clinically based study on sleep disorders. METHODS This retrospective study used the computerized data of 2.3 million members of Maccabi Healthcare Services (MHS) public mandated health provider. Among enrolled MHS members alive in June 2018, electronic medical records were searched from January 2010 for sleep disorders using diagnosis codes, sleep medications, and recorded sleep studies. RESULTS A total of 195,201 patients (9% of the total MHS population) were identified. Patients were 48.3% men and the average age at diagnosis was 50.4 years (SD = 20.9). Prevalence increased with age; 3.2% in children under 10 years, 5.2% in young adults, and 22.3% among seniors aged 75 or older. The two most prevalent disorders were insomnia (7.4%), and sleep-related breathing disorders (2%). Less prevalent disorders included central disorders of hypersomnolence (100 per 100,000), circadian rhythm sleep-wake disorders (49 per 100,000), parasomnias (140 per 100,000), and sleep-related movement disorders (20 per 100,000). CONCLUSIONS The overall prevalence of sleep disorders including insomnia and sleep related breathing disorders in Israel were similar to other western countries despite stressful life events of ongoing war and terrorism. The large sample size allowed us to calculate the prevalence of more rare sleep disorders, which have been generally less known.
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Affiliation(s)
- Naama Fund
- Institute of Research and Innovation, Maccabi Healthcare Services, Israel.
| | - Amit Green
- The Sleep and Fatigue Institute, Assuta Medical Center, Israel; The Research Institute of Applied Chronobiology, The Academic College of Tel-Hai, Israel
| | - Gabriel Chodick
- Institute of Research and Innovation, Maccabi Healthcare Services, Israel; Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Melanie Orin
- Institute of Research and Innovation, Maccabi Healthcare Services, Israel
| | - Gideon Koren
- Institute of Research and Innovation, Maccabi Healthcare Services, Israel
| | - Varda Shalev
- Institute of Research and Innovation, Maccabi Healthcare Services, Israel; Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Yaron Dagan
- Institute of Research and Innovation, Maccabi Healthcare Services, Israel; The Sleep and Fatigue Institute, Assuta Medical Center, Israel; The Research Institute of Applied Chronobiology, The Academic College of Tel-Hai, Israel
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Affiliation(s)
- Tari Haahtela
- Department of Allergy, Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland.
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Van Son CR, Gileff TY. Relying on what they know: older Slavic emigres managing chronic health conditions. QUALITATIVE HEALTH RESEARCH 2013; 23:1660-1671. [PMID: 24132306 DOI: 10.1177/1049732313508842] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
As the U.S. population ages and becomes increasingly diverse, health care professionals need to recognize the role of culture and life course in managing chronic health conditions. Older émigrés, in particular, face daunting challenges learning to navigate a new language, country, and health care system. In this focused ethnography, data collection included 16 months of participant observation and interviews with 28 Slavic participants (older émigrés, family caregivers, and key informants). Participants shared beliefs about the causes of chronic conditions, described treatments used, identified barriers to care, and expressed their expectations of U.S. health care providers. The findings provide insight into older émigrés' explanatory models of health, which can be used by health care providers to improve health care delivery to this underserved population.
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Grandner MA, Petrov MER, Rattanaumpawan P, Jackson N, Platt A, Patel NP. Sleep symptoms, race/ethnicity, and socioeconomic position. J Clin Sleep Med 2013; 9:897-905; 905A-905D. [PMID: 23997702 PMCID: PMC3746717 DOI: 10.5664/jcsm.2990] [Citation(s) in RCA: 209] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
STUDY OBJECTIVES Growing evidence indicates sleep is a major public health issue. Race/ethnicity and socioeconomics may contribute to sleep problems. This study assessed whether sleep symptoms were more prevalent among minorities and/or the socioeconomically disadvantaged. DESIGN Cross-sectional. SETTING Epidemiologic survey. PATIENTS OR PARTICIPANTS 2007-2008 National Health and Nutrition Examination Survey (N = 4,081). INTERVENTIONS None. MEASUREMENTS AND RESULTS Sociodemographics included age, sex, race/ethnicity, marital status, and immigration. Socioeconomics included poverty, education, private insurance, and food insecurity. Sleep symptoms assessed were sleep latency > 30 min, difficulty falling asleep, sleep maintenance difficulties, early morning awakenings, non-restorative sleep, daytime sleepiness, snorting/gasping, and snoring. Decreased reported problems for most symptoms were found among minorities, immigrants, and lower education levels. In general, in fully adjusted models, long sleep latency was associated with female gender, being black/African American, lower education attainment, no private insurance, and food insecurity. Difficulty falling asleep, sleep maintenance difficulties, early morning awakenings, and non-restorative sleep were also associated with female gender and food insecurity. Daytime sleepiness was seen in female and divorced respondents. Snorting/gasping was more prevalent among male, other-Hispanic/Latino, and 9(th)- to 11(th)-grade-level respondents. Snoring was prevalent among male, other-Hispanic/Latino, less-educated, and food-insecure respondents. CONCLUSIONS Sleep symptoms were associated with multiple sociodemographic and economic factors, though these relationships differed by predictor and sleep outcome. Also, reports depended on question wording.
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Affiliation(s)
- Michael A Grandner
- Center for Sleep and Circadian Neurobiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
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Haahtela T, Holgate S, Pawankar R, Akdis CA, Benjaponpitak S, Caraballo L, Demain J, Portnoy J, von Hertzen L. The biodiversity hypothesis and allergic disease: world allergy organization position statement. World Allergy Organ J 2013; 6:3. [PMID: 23663440 PMCID: PMC3646540 DOI: 10.1186/1939-4551-6-3] [Citation(s) in RCA: 200] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Accepted: 01/17/2013] [Indexed: 12/21/2022] Open
Abstract
Biodiversity loss and climate change secondary to human activities are now being associated with various adverse health effects. However, less attention is being paid to the effects of biodiversity loss on environmental and commensal (indigenous) microbiotas. Metagenomic and other studies of healthy and diseased individuals reveal that reduced biodiversity and alterations in the composition of the gut and skin microbiota are associated with various inflammatory conditions, including asthma, allergic and inflammatory bowel diseases (IBD), type1 diabetes, and obesity. Altered indigenous microbiota and the general microbial deprivation characterizing the lifestyle of urban people in affluent countries appear to be risk factors for immune dysregulation and impaired tolerance. The risk is further enhanced by physical inactivity and a western diet poor in fresh fruit and vegetables, which may act in synergy with dysbiosis of the gut flora. Studies of immigrants moving from non-affluent to affluent regions indicate that tolerance mechanisms can rapidly become impaired in microbe-poor environments. The data on microbial deprivation and immune dysfunction as they relate to biodiversity loss are evaluated in this Statement of World Allergy Organization (WAO). We propose that biodiversity, the variability among living organisms from all sources are closely related, at both the macro- and micro-levels. Loss of the macrodiversity is associated with shrinking of the microdiversity, which is associated with alterations of the indigenous microbiota. Data on behavioural means to induce tolerance are outlined and a proposal made for a Global Allergy Plan to prevent and reduce the global allergy burden for affected individuals and the societies in which they live.
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Affiliation(s)
- Tari Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital, PO Box 160, 00029, Helsinki, HUCH, Finland
| | - Stephen Holgate
- School of Medicine, University of Southampton, Southampton, UK
| | | | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research, University of Zurich, Davos, Switzerland
| | - Suwat Benjaponpitak
- Department of Pediatrics, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Luis Caraballo
- Institute for Immunological Research, University of Cartagena, Cartagena, Colombia
| | - Jeffrey Demain
- Allergy, Asthma & Immunology Center of Alaska, Dept of Pediatrics, University of Washington, Washington, USA
| | - Jay Portnoy
- University of Missouri-Kansas City School of Medicine, Missouri, USA
| | - Leena von Hertzen
- Skin and Allergy Hospital, Helsinki University Hospital, PO Box 160, 00029, Helsinki, HUCH, Finland
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Li Y, Zhang S, Zhu J, Du X, Huang F. Sleep disturbances are associated with increased pain, disease activity, depression, and anxiety in ankylosing spondylitis: a case-control study. Arthritis Res Ther 2012; 14:R215. [PMID: 23058191 PMCID: PMC3580527 DOI: 10.1186/ar4054] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2011] [Accepted: 10/11/2012] [Indexed: 01/08/2023] Open
Abstract
Introduction Literature data suggest that sleep disturbances are prevalent among patients with ankylosing spondylitis (AS) and have a close correlation with pain. Other studies indicate that sleep disturbances are constantly accompanied by depression and anxiety in AS, but their interrelations are poorly understood. This study was designed to evaluate sleep disturbances and their association with demographic variables, pain, disease-specific variables, functional status, covering depression and anxiety in AS patients. Methods The 314 patients with AS and age- and sex-matched controls took part in the study, completed a battery of questionnaires, and participated in long-term follow-up. Blood samples were taken to measure C-reactive protein (CRP) and the erythrocyte sedimentation rate (ESR). The association among sleep, pain, disease activity, functional status, depression, and anxiety were assessed by using Pearson/Spearman correlations and multiple regression analysis. Results The Pittsburgh Sleep Quality Index (PSQI) score of the Chinese version was significantly higher in the AS group than in the control group (P = 0.020). Of the 314 patients with AS, 184 (58.6%) had a high risk for sleep disturbances. The PSQI score was associated with age, years of education, ESR, CRP, overall assessment of health, pain, morning stiffness, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), depression, and anxiety (all P < 0.001), but were not associated with disease duration, fingertip-to-floor distance, and Bath Ankylosing Spondylitis Metrology Index (BASMI) (P > 0.05). In hierarchic multiple regression analysis, the medical and psychological variables contributed significantly to the variance in sleep-disturbances scores, adding an additional 23.9% to the overall R2 beyond that accounted for by demographic variables (R-square, 8.5%), resulting in a final R2of 42.6%. Multiple stepwise regression analysis revealed that anxiety was the maximal statistical contribution in predicting sleep disturbances (standardized coefficients, 0.287). Conclusions The prevalence of sleep disturbances in AS patients is higher than it is generally thought to be. Depression, anxiety, nocturnal pain, and total back pain are the major contributors of sleep disturbances in AS.
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Bakr IM, Elaziz KMA, Ezz NFAE, Fahim HI. Insomnia in institutionalized older people in Cairo, Egypt: Prevalence and risk factors associated. Eur Geriatr Med 2012. [DOI: 10.1016/j.eurger.2012.02.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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von Hertzen L, Hanski I, Haahtela T. Natural immunity. Biodiversity loss and inflammatory diseases are two global megatrends that might be related. EMBO Rep 2011; 12:1089-93. [PMID: 21979814 DOI: 10.1038/embor.2011.195] [Citation(s) in RCA: 158] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2011] [Accepted: 09/15/2011] [Indexed: 02/02/2023] Open
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