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Gonzalez TM, Murillo R, Isijola O, Sandoval J, Vásquez E, Echeverria SE. Fear of Job Loss and Hypertension Prevalence Among Working Latino Adults. J Immigr Minor Health 2022; 25:653-659. [PMID: 36318436 PMCID: PMC9628565 DOI: 10.1007/s10903-022-01417-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2022] [Indexed: 11/06/2022]
Abstract
Evidence indicates that stress increases cardiovascular disease risk. Latinos are disproportionately employed in precarious work conditions that can trigger hypertension risk. We examined if fear of job loss, a work stressor, was associated with hypertension among U.S. Latinos. We utilized 2015 National Health Interview Survey data from working Latino adults (n = 2683). In multivariate logistic regression models, we examined if fear of job loss was associated with hypertension, adjusting for age, sex, education, household income, and health insurance, and whether nativity status modified this relationship. Fear of job loss was significantly associated with increased probability of reporting hypertension among Latino workers in fully adjusted models (PR 1.55, 95% CI 1.18-2.03), compared with no fear of job loss. This relationship varied by nativity. These findings suggest that work-related conditions may contribute to cardiovascular disease risk among Latinos and public health initiatives should promote behavioral interventions in work settings.
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Affiliation(s)
- Tailisha M. Gonzalez
- CUNY Graduate School of Public Health and Health Policy, 55 West 125Th Street, 7Th Floor, New York, NY 10027 USA
- Lehman College, 250 Bedford Park Blvd West, 417B Gillet Hall, Bronx, NY 10468 USA
| | - Rosenda Murillo
- University of Houston, 3657 Cullen Boulevard, Room 491, Houston, TX 77204-5029 USA
- Health Research Institute, University of Houston, 1100 Health 2, 4849 Calhoun Rd., Houston, TX 77204 USA
| | - Oluwaseyi Isijola
- University of North Carolina Greensboro, 1400 Spring Garden Street, Greensboro, NC 27412 USA
| | - Jacqueline Sandoval
- University of North Carolina Greensboro, 1400 Spring Garden Street, Greensboro, NC 27412 USA
| | - Elizabeth Vásquez
- School of Public Health, University at Albany, State University of New York, 1400 Washington Ave, Albany, 12222 USA
| | - Sandra E. Echeverria
- University of North Carolina Greensboro, 1400 Spring Garden Street, Greensboro, NC 27412 USA
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2
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Borrell LN, Echeverria SE. The use of Latinx in public health research when referencing Hispanic or Latino populations. Soc Sci Med 2022; 302:114977. [PMID: 35504084 DOI: 10.1016/j.socscimed.2022.114977] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 04/09/2022] [Accepted: 04/11/2022] [Indexed: 10/18/2022]
Abstract
We provide a brief description of the demographics of the Hispanic or Latino population in the United States; point out the origin of the term Hispanic or Latino as standardized terminology in general including public health research; discuss the use of Latinx among the Hispanic or Latino population; and suggest recommendations for the use of Latinx in research including Hispanic or Latino populations. The Hispanic or Latino population is a heterogenous population familiar with name and/or labeling controversies since the introduction of the ethnicity category in the 1980 U.S. Census. Latinx, a term aiming to be gender-expansive, inclusive, and/or neutral, is being used to refer to the Hispanic or Latino population overall. However, only a small proportion of this population has heard or use the term. For research purposes, we recommend that 1) the population is referred to using the labels used during data collection for existing data; 2) when using Latinx, participants are explained the meaning of the term and other choices be provided; and 3) investigations using Latinx should interpret the results within the current context of the term and acknowledge the group (s) to which the findings apply. The latter will lead to accurately represent the Hispanic or Latino population. This correct identification is important to document and address health inequities across race and ethnicity in the U.S.
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Affiliation(s)
- Luisa N Borrell
- Department of Epidemiology & Biostatistics, Graduate School of Public Health & Health Policy, City University of New York, New York, NY, USA.
| | - Sandra E Echeverria
- Department of Public Health Education, School of Health and Human Sciences, The University of North Carolina at Greensboro, NC, USA.
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3
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Abraído-Lanza AF, Echeverria SE, Flórez KR, Mendoza-Grey S. Latina Women in Academia: Challenges and Opportunities. Front Public Health 2022; 10:876161. [PMID: 35558535 PMCID: PMC9087036 DOI: 10.3389/fpubh.2022.876161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 03/28/2022] [Indexed: 11/13/2022] Open
Abstract
Latina women and other ethnic and racial groups continue to be underrepresented in science, technology, engineering, and mathematics (STEM) fields, including public health. This underrepresentation of people from diverse backgrounds and lived experiences in academic public health and other scientific disciplines is a form of epistemic oppression, exclusion that hinders contribution to knowledge production and advancement. Our analysis of 2021 data from the Association of Schools and Programs of Public Health indicates that Latinos/as represented only 6.0% of all instructional faculty and 6.1% of all tenured faculty at schools and programs of public health. We discuss the ways in which sociopolitical contexts, family-level dynamics and gendered norms, and institutional contexts hamper Latinas' full participation in academia. We propose solutions such as redefining metrics for success, leadership accountability, equity analyses, cluster hiring initiatives, and instituting structured mentoring and leadership programs. Bold actions are needed if we are to advance the scientific enterprise and address the diversity and equity problem in public health.
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Affiliation(s)
- Ana F. Abraído-Lanza
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY, United States
| | - Sandra E. Echeverria
- Department of Public Health Education, School of Health and Human Sciences, The University of North Carolina at Greensboro, Greensboro, NC, United States
| | - Karen R. Flórez
- Department of Environmental, Occupational and Geospatial Sciences, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY, United States
| | - Sonia Mendoza-Grey
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, United States
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4
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Horlyck-Romanovsky MF, Huang TTK, Ahmed R, Echeverria SE, Wyka K, Leung MM, Sumner AE, Fuster M. Intergenerational differences in dietary acculturation among Ghanaian immigrants living in New York City: a qualitative study. J Nutr Sci 2021; 10:e80. [PMID: 34616551 PMCID: PMC8477345 DOI: 10.1017/jns.2021.69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 08/05/2021] [Accepted: 08/19/2021] [Indexed: 11/06/2022] Open
Abstract
Dietary acculturation may explain the increasing risk of diet-related diseases among African immigrants in the United States (US). We interviewed twenty-five Ghanaian immigrants (Youth n 13, Age (Mean ± sd) 20 y ± 5⋅4, Parents (n 6) and Grandparents (n 6) age 58⋅7 ± 9⋅7) living in New York City (NYC) to (a) understand how cultural practices and the acculturation experience influence dietary patterns of Ghanaian immigrants and (b) identify intergenerational differences in dietary acculturation among Ghanaian youth, parents and grandparents. Dietary acculturation began in Ghana, continued in NYC and was perceived as a positive process. At the interpersonal level, parents encouraged youth to embrace school lunch and foods outside the home. In contrast, parents preferred home-cooked Ghanaian meals, yet busy schedules limited time for cooking and shared meals. At the community level, greater purchasing power in NYC led to increased calories, and youth welcomed individual choice as schools and fast food exposed them to new foods. Global forces facilitated nutrition transition in Ghana as fast and packaged foods became omnipresent in urban settings. Adults sought to maintain cultural foodways while facilitating dietary acculturation for youth. Both traditional and global diets evolved as youth and adults adopted new food and healthy social norms in the US.
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Affiliation(s)
- Margrethe F. Horlyck-Romanovsky
- Department of Health and Nutrition Sciences, Brooklyn College, City University of New York, Brooklyn, NY, USA; Center for Systems and Community Design, New York, NY, USA
| | - Terry T.-K. Huang
- Department of Health Policy and Management, Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA; Center for Systems and Community Design, New York, NY, USA
| | | | - Sandra E. Echeverria
- Department of Public Health Education, The University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Katarzyna Wyka
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA
| | - May May Leung
- Nutrition Program, Hunter College, City University of New York, New York, NY, USA
| | - Anne E. Sumner
- Section on Ethnicity and Health, National Institute of Diabetes and Digestive and Kidney Diseases, and the National Institute of Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | - Melissa Fuster
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA; Center for Systems and Community Design, New York, NY, USA
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5
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Alam MT, Echeverria SE, DuPont-Reyes MJ, Vasquez E, Murillo R, Gonzalez T, Rodriguez F. Educational Attainment and Prevalence of Cardiovascular Health (Life's Simple 7) in Asian Americans. Int J Environ Res Public Health 2021; 18:ijerph18041480. [PMID: 33557415 PMCID: PMC7914420 DOI: 10.3390/ijerph18041480] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/25/2021] [Accepted: 02/02/2021] [Indexed: 11/16/2022]
Abstract
Asian Americans have a high burden of cardiovascular disease, yet little is known about the social patterning of cardiovascular health (CVH) in this population. We examined if education (<high school diploma, high school diploma, some college, and college degree+) was associated with CVH and if this varied by time in the United States (U.S.). Our study population included Asian Americans 20+ years of age sampled in the 2011-16 National Health and Nutrition Examination Survey (n = 1634). Ideal cardiovascular health was based on a composite score of adiposity, total cholesterol, blood pressure, blood glucose, smoking, physical activity, and diet. We fit sequential weighted multivariate logistic regression models for all analyses. The prevalence of ideal cardiovascular (CV) health was 17.1% among those living in the U.S. <10 years, 7.1% for those living in the U.S. >10+ years, and 15.9% for the U.S.-born. All models showed that low education compared to high education was associated with lower odds of having ideal CVH. This pattern remained in adjusted models but became non-significant when controlling for nativity (odds ratio = 0.34, 95% confidence interval: 0.10, 1.13). Models stratified by time in the U.S. were less consistent but showed similar education gradients in CVH. Low education is a risk factor for attaining ideal cardiovascular health among Asian Americans, regardless of time in the U.S.
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Affiliation(s)
- Md Towfiqul Alam
- Department of Public Health Education, University of North Carolina at Greensboro, Greensboro, NC 27412, USA;
- Correspondence:
| | - Sandra E. Echeverria
- Department of Public Health Education, University of North Carolina at Greensboro, Greensboro, NC 27412, USA;
| | - Melissa J. DuPont-Reyes
- Department of Epidemiology & Biostatistics, Texas A&M University, College Station, TX 77843, USA;
| | - Elizabeth Vasquez
- Department of Epidemiology & Biostatistics, University at Albany, Albany, NY 12144, USA;
| | - Rosenda Murillo
- Department of Psychological, Health, & Learning Sciences, University of Houston, Houston, TX 77204, USA;
| | - Tailisha Gonzalez
- Department of Community Health, CUNY Graduate School of Public Health & Health Policy, New York, NY 10027, USA;
| | - Fatima Rodriguez
- Division of Cardiovascular Medicine, Stanford University, Quarry Road, Falk CVRC, Stanford, CA 94305, USA;
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6
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Payton Foh E, Echeverria SE. Incorporating Health Equity and Community Perspectives During COVID-19: Commonalities with Cardiovascular Health Equity Research. Ethn Dis 2020; 30:421-424. [PMID: 32742144 DOI: 10.18865/ed.30.3.421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The COVID-19 pandemic is revealing the deeply entrenched structural inequities in health that exist in the United States. We draw parallels between the COVID-19 pandemic and our cardiovascular health equity research focused on physical activity and diabetes to highlight three common needs: 1) access to timely and disaggregated data; 2) how to integrate community-engaged approaches in telehealth; and 3) policy initiatives that explicitly integrate health equity and social justice principles and action. We suggest that a similar sense of urgency regarding COVID-19 should be applied to slow the burgeoning costs and suffering associated with cardiovascular disease overall and in marginalized communities specifically. We remain hopeful that the current crisis can serve as a guide for aligning our principles as a just and democratic society with a health agenda that explicitly recognizes that social inequities in health for some impacts all members of society.
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Affiliation(s)
- Erica Payton Foh
- Department of Public Health Education, University of North Carolina at Greensboro, NC
| | - Sandra E Echeverria
- Department of Public Health Education, University of North Carolina at Greensboro, NC
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7
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Orozco J, Echeverria SE, Armah SM, Dharod JM. Household Food Insecurity, Breastfeeding, and Related Feeding Practices in US Infants and Toddlers: Results From NHANES 2009-2014. J Nutr Educ Behav 2020; 52:588-594. [PMID: 32276879 DOI: 10.1016/j.jneb.2020.02.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 02/17/2020] [Accepted: 02/17/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To examine the relationships among food insecurity, breastfeeding, and other related feeding practices by race/ethnicity among US infants and toddlers. DESIGN National Health and Nutrition Examination Surveys 2009-2014, a nationally representative cross-sectional survey. PARTICIPANTS Infants and toddlers aged 0-24 months with complete data on household food security status (n = 2,069). MAIN OUTCOME MEASURES Initiation of breastfeeding (yes or no), duration of breastfeeding, and age of introduction to foods/drinks. ANALYSIS Differences in feeding practices by food security status were tested in survey-weighted, stratified multiple regression models. RESULTS Breastfeeding initiation rates among non-Hispanic whites, Hispanics, and non-Hispanic blacks were estimated at 80.0%, 77.5%, and 57.4%, respectively (P < .001). A total of 43% of infants and toddlers were introduced to foods/drinks before 4 months. After adjusting for household income, education, and other covariates, food insecurity was not a significant predictor of poor feeding behaviors. CONCLUSIONS AND IMPLICATIONS Racial/ethnic disparities existed, with non-Hispanic black infants at the highest risk for never being breastfed, nor to continue through the recommended period of breastfeeding. Food insecurity was not shown to affect breastfeeding and other infant feeding practices directly. Further investigation is needed to understand whether food insecurity, through stress and other sociostructural pathways, mediates poor infant feeding practices.
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Affiliation(s)
- Jovanna Orozco
- Department of Nutrition, University of North Carolina at Greensboro, Greensboro, NC
| | - Sandra E Echeverria
- Department of Public Health Education, University of North Carolina at Greensboro, Greensboro, NC
| | - Seth M Armah
- Department of Nutrition, University of North Carolina at Greensboro, Greensboro, NC
| | - Jigna M Dharod
- Department of Nutrition, University of North Carolina at Greensboro, Greensboro, NC.
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8
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Sterling MR, Echeverria SE, Commodore-Mensah Y, Breland JY, Nunez-Smith M. Health Equity and Implementation Science in Heart, Lung, Blood, and Sleep-Related Research: Emerging Themes From the 2018 Saunders-Watkins Leadership Workshop. Circ Cardiovasc Qual Outcomes 2019; 12:e005586. [PMID: 31610713 PMCID: PMC6812546 DOI: 10.1161/circoutcomes.119.005586] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Disparities in health outcomes for heart, lung, blood, and sleep-related health conditions are pervasive in the United States, with an unequal burden experienced among structurally disadvantaged populations. One reason for this disparity is that despite the existence of effective interventions that promote health equity, few have been translated and implemented consistently in the healthcare system. To achieve health equity, there is a dire need to implement and disseminate effective evidence-based interventions that account for the complex and multilayered social determinants of health among marginalized groups across healthcare settings. To that end, the National Heart, Lung, and Blood Institute's Center for Translation Research and Implementation Science invited early stage investigators to participate in the inaugural Saunders-Watkins Leadership Workshop in May of 2018 at the National Institutes of Health. The goals of the workshop were to: (1) present an overview of health equity research, including areas which require ongoing investigation; (2) review how the fields of health equity and implementation science are related; (3) demonstrate how implementation science could be utilized to advance health equity; and (4) foster early stage investigator career success in heart, lung, blood, and sleep-related research. Herein, we highlight key themes from the 2-day workshop and offer recommendations for the future direction of health equity and implementation science research in the context of heart, lung, blood, and sleep-related health conditions.
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Affiliation(s)
- Madeline R. Sterling
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, NY
| | - Sandra E. Echeverria
- Department of Public Health Education, The University of North Carolina at Greensboro, Greensboro, NC
| | - Yvonne Commodore-Mensah
- Johns Hopkins School of Nursing, Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, MD
| | - Jessica Y Breland
- Center for Innovation to Implementation, Veterans Affairs, Palo Alto Health Care System, Menlo Park, CA
| | - Marcella Nunez-Smith
- Equity Research and Innovation Center, Division of General Internal Medicine, Yale University School of Medicine, New Haven, CT
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9
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Sterling MR, Lin FR, Jannat-Khah DP, Goman AM, Echeverria SE, Safford MM. Hearing Loss Among Older Adults With Heart Failure in the United States: Data From the National Health and Nutrition Examination Survey. JAMA Otolaryngol Head Neck Surg 2019; 144:273-275. [PMID: 29372239 DOI: 10.1001/jamaoto.2017.2979] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Madeline R Sterling
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Frank R Lin
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.,The Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, Maryland.,Departments of Epidemiology, Geriatric Medicine, and Mental Health, Johns Hopkins University, Baltimore, Maryland
| | - Deanna P Jannat-Khah
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Adele M Goman
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.,The Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Sandra E Echeverria
- Department of Community Health and Social Sciences, City University of New York, Graduate School of Public Health and Health Policy, New York
| | - Monika M Safford
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medical College, New York, New York
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10
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McLeod MN, Heller D, Manze MG, Echeverria SE. Police Interactions and the Mental Health of Black Americans: a Systematic Review. J Racial Ethn Health Disparities 2019; 7:10-27. [PMID: 31482464 DOI: 10.1007/s40615-019-00629-1] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 08/07/2019] [Accepted: 08/11/2019] [Indexed: 10/26/2022]
Abstract
Black Americans comprise 13% of the US population, yet data suggests that they represent 23% of those fatally shot by police officers. Data on non-lethal encounters with police in the Black community is less available but can understandably result in emotional trauma, stress responses, and depressive symptoms. The aim of this systematic literature review is to assess if interactions with the police are associated with mental health outcomes among Black Americans. Following pre-defined inclusion criteria, 11 articles were reviewed. Using a quality assessment tool, eight studies received a fair quality rating, two studies a poor rating, and one study received a good rating. The types of police interaction reported among study participants included police use of force during arrest, police stops, police searches, exposure to police killings, and interactions with police in the court system and varied mental health outcomes. Most of the studies (6 of 11) reviewed found statistically significant associations between police interactions and mental health (psychotic experiences, psychological distress, depression, PTSD, anxiety, suicidal ideation and attempts), indicating a nearly twofold higher prevalence of poor mental health among those reporting a prior police interaction compared to those with no interaction. Although better quality studies are needed, findings suggest an association between police interactions and negative mental health outcomes. Changes in law enforcement policy, development and implementation of a validated instrument for police experiences, improved community outreach, a federally mandated review of policy and practice in police departments, and expanded police training initiatives could reduce the potential negative mental health impact of police interactions on Black Americans.
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Affiliation(s)
- Melissa N McLeod
- Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, 55 W 125th St, New York, NY, 10027, USA.
| | - Daliah Heller
- Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, 55 W 125th St, New York, NY, 10027, USA
| | - Meredith G Manze
- Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, 55 W 125th St, New York, NY, 10027, USA
| | - Sandra E Echeverria
- Department of Public Health Education, University of North Carolina Greensboro, 437-J Coleman Building, Greensboro, NC, 27412, USA
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11
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Flórez KR, Katic BJ, López-Cevallos DF, Murillo R, Cancel-Tirado D, Aponte-Soto L, Echeverria SE. The double burden of food insecurity and obesity among Latino youth: Understanding the role of generational status. Pediatr Obes 2019; 14:e12525. [PMID: 31022773 DOI: 10.1111/ijpo.12525] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 02/11/2019] [Accepted: 02/25/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND Obesity is linked to food insecurity and generational status; however, little is known about how both impact obesity risk among Latino youth. OBJECTIVE To investigate the joint effect of generational status and food insecurity on obesity prevalence among Latino youth. METHODS We pooled data from the 2011 to 2017 waves of the National Health Interview Survey to derive a sample Latino youth aged 12 to 17 (N = 7532). Four generational categories were constructed: first generation (foreign-born children); second generation (US-born child; foreign-born parent[s]); 2.5 generation (US-born child; one foreign-born parent and one US-born parent); third generation (US-born child; U.S.-born parent[s]). Food insecurity was defined by monthly instances of food scarcity over the past year. Obesity was measured using age- and sex-specific body mass index percentile cut-offs. Log-binomial multivariable regression models estimated the association between generational status and food insecurity categories on obesity. RESULTS Obesity percentages among food-insecure households ranged from 12.8% in the first generation, 15.8% in the second, 24.3% in the 2.5, and 19.2% in the third. In fully adjusted models, 2.5 generation food secure youth had the highest prevalence of obesity (aPR: 1.53; 95% CI, 1.09-2.16) when compared with first generation food secure youth, followed by third generation food insecure youth (aPR: 1.49; 95% CI, 1.01-2.20). CONCLUSIONS Food security status is associated with increased obesity prevalence among Latino youth across the generations. Given that obesity is a risk factor for top causes of mortality and morbidity, growing rates among this population is of public health and clinical importance.
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Affiliation(s)
- Karen R Flórez
- Department of Environmental, Occupational, and Geospatial Sciences, CUNY Graduate School of Public Health and Health Policy, New York, NY, USA
| | - Bozena J Katic
- Department of Environmental, Occupational, and Geospatial Sciences, CUNY Graduate School of Public Health and Health Policy, New York, NY, USA.,Department of Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Daniel F López-Cevallos
- School of Language, Culture, and Society, College of Liberal Arts, Oregon State University, Corvallis, OR, USA
| | - Rosenda Murillo
- Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, TX, USA
| | - Doris Cancel-Tirado
- Division of Health and Exercise Sciences, Western Oregon University, Monmouth, OR, USA
| | - Lisa Aponte-Soto
- Office of Community Based Practice, University of Illinois Cancer Center, University of Illinois at Chicago, Chicago, IL, USA
| | - Sandra E Echeverria
- Department of Public Health Education, University of North Carolina, Greenboro, NC, USA
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12
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13
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Divney AA, Murillo R, Rodriguez F, Mirzayi CA, Tsui EK, Echeverria SE. Diabetes Prevalence by Leisure-, Transportation-, and Occupation-Based Physical Activity Among Racially/Ethnically Diverse U.S. Adults. Diabetes Care 2019; 42:1241-1247. [PMID: 31221695 PMCID: PMC6609958 DOI: 10.2337/dc18-2432] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 04/20/2019] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Leisure-time physical activity (LTPA) has been shown to prevent or delay the development of diabetes. However, little research exists examining how other domains of PA (e.g., occupation based [OPA] and transportation based [TPA]) are associated with diabetes prevalence across diverse racial/ethnic groups. We examined associations between OPA, TPA, and LTPA and diabetes prevalence and whether associations differed by race/ethnicity. RESEARCH DESIGN AND METHODS Participants in the 2011-2016 National Health and Nutrition Examination Survey (NHANES) self-reported domain-specific PA. Diabetes status was determined by self-reported doctor/health professional-diagnosis of diabetes or a glycosylated hemoglobin (HbA1c) measurement of ≥6.5% (48 mmol/mol). Multivariable log binomial models examined differences in diabetes prevalence by PA level in each domain and total PA among Latinos (n = 3,931), non-Latino whites (n = 6,079), and non-Latino blacks (n = 3,659). RESULTS Whites reported the highest prevalence of achieving PA guidelines (64.9%), followed by Latinos (61.6%) and non-Latino blacks (60.9%; P < 0.0009). Participants achieving PA guidelines were 19-32% less likely to have diabetes depending on PA domain in adjusted models. Diabetes prevalence was consistently higher among non-Latino blacks (17.1%) and Latinos (14.1%) compared with non-Latino whites (10.7%; P < 0.0001), but interaction results showed the protective effect of PA was similar across PA domain and race/ethnicity-except within TPA, where the protective effect was 4% greater among non-Latino whites compared with Latinos (adjusted difference in risk differences 0.04, P = 0.01). CONCLUSIONS PA policies and programs, beyond LTPA, can be leveraged to reduce diabetes prevalence among all population groups. Future studies are needed to confirm potentially differential effects of transportation-based active living on diabetes prevalence across race/ethnicity.
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Affiliation(s)
- Anna A Divney
- Department of Community Health and Social Sciences, CUNY Graduate School of Public Health & Health Policy, New York, NY
| | - Rosenda Murillo
- Department of Psychological, Health, and Learning Sciences, College of Education, University of Houston, Houston, TX
| | - Fatima Rodriguez
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA
| | - Chloe A Mirzayi
- Department of Community Health and Social Sciences, CUNY Graduate School of Public Health & Health Policy, New York, NY
| | - Emma K Tsui
- Department of Community Health and Social Sciences, CUNY Graduate School of Public Health & Health Policy, New York, NY
| | - Sandra E Echeverria
- Department of Public Health Education, The University of North Carolina at Greensboro, Greensboro, NC
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14
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Horlyck-Romanovsky MF, Wyka K, Echeverria SE, Leung MM, Fuster M, Huang TTK. Foreign-Born Blacks Experience Lower Odds of Obesity but Higher Odds of Diabetes than US-Born Blacks in New York City. J Immigr Minor Health 2019; 21:47-55. [PMID: 29468517 DOI: 10.1007/s10903-018-0708-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Research is limited on the health of foreign-born Blacks (FBBs), who are often grouped with African Americans. This study compared obesity and diabetes odds in FBBs and US-born Blacks (USBBs) in NYC. Analyzing the 2009-2013 NYC Community Health Survey (3701 FBBs and 6297 USBBs), weighted multivariate logistic regression examined odds of obesity and diabetes, adjusting for age, gender, education, income, marital status, children < 18, BMI (for diabetes only) and duration of residence. FBBs had lower odds of obesity [OR 0.62 (95% CI 0.54, 0.72)] and greater odds of diabetes [OR 1.24 (95% CI 1.01, 1.52)] compared to USBBs. FBBs had 1.4 times the odds of diabetes at overweight status, compared to USBBs [OR 1.40 (95% CI 1.01, 1.95)]. Living in the US ≥ 10 years was not associated with odds of obesity and diabetes. Future research should seek to uncover unique risk profiles of sub-ethnic groups in the African diaspora.
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Affiliation(s)
- Margrethe F Horlyck-Romanovsky
- CUNY Graduate School of Public Health and Health Policy, New York, NY, USA. .,Department of Health and Nutrition Sciences, Brooklyn College, Brooklyn, NY, USA.
| | - Katarzyna Wyka
- CUNY Graduate School of Public Health and Health Policy, New York, NY, USA
| | | | - May May Leung
- School of Urban Public Health, Hunter College, New York, NY, USA
| | - Melissa Fuster
- Department of Health and Nutrition Sciences, Brooklyn College, Brooklyn, NY, USA
| | - Terry T-K Huang
- CUNY Graduate School of Public Health and Health Policy, New York, NY, USA
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15
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Horlyck-Romanovsky MF, Fuster M, Echeverria SE, Wyka K, Leung MM, Sumner AE, Huang TTK. Black Immigrants from Africa and the Caribbean Have Similar Rates of Diabetes but Africans Are Less Obese: the New York City Community Health Survey 2009-2013. J Racial Ethn Health Disparities 2019; 6:635-645. [PMID: 30725381 DOI: 10.1007/s40615-019-00562-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 01/17/2019] [Accepted: 01/17/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVE This study was designed to determine (a) whether the prevalence and odds of either obesity or diabetes differed in foreign-born black Africans and Caribbeans living in New York City (NYC) and (b) whether time in the United States (US) affected odds of either outcome. METHODS Data were obtained from NYC Community Health Survey 2009-13 for 380 African-born blacks and 2689 Caribbean-born blacks. Weighted logistic regression estimated odds of obesity and diabetes, adjusting for age, sex, education, income, marital status, children < 18, BMI (diabetes models only), and time in the US. RESULTS Obesity prevalence in Africans (60.2%, male; age, 46.0 ± 13.5 years, (mean ± SD); BMI, 27.3 ± 5.6 kg/m2) was 16.7 and 30.2% in Caribbeans (39.3%, male; age, 49.7 ± 14.7 years; BMI, 28.0 ± 5.8 kg/m2). Prevalence of diabetes was 10.5% in Africans and 14.7% in Caribbeans. Africans had lower adjusted odds of obesity (aOR = 0.60 (95% CI, 0.40-0.90); P = 0.015), but there was no difference in diabetes odds between groups. Obesity odds were higher in African (aOR = 2.35 (95% CI, 1.16-4.78); P = 0.018) and Caribbean women (aOR = 2.20 (95% CI, 1.63-2.98); P < 0.001) than their male counterparts. Odds of diabetes did not differ between sexes in either group. Time in the US did not affect odds of either obesity or diabetes. CONCLUSIONS Africans living in NYC are less obese than Caribbeans, but odds of diabetes do not differ. Time in the US does not affect odds of either obesity or diabetes. Hence, BMI and diabetes risk profiles in blacks differ by region of origin and combining foreign-born blacks into one group masks important differences.
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Affiliation(s)
- Margrethe F Horlyck-Romanovsky
- Graduate School of Public Health and Health Policy, Center for Systems and Community Design, City University of New York, New York, NY, USA. .,Graduate School of Public Health and Health Policy, Department of Community Health and Social Science, City University of New York, New York, NY, USA.
| | - Melissa Fuster
- Brooklyn College, Department of Health and Nutrition Sciences, City University of New York, Brooklyn, NY, USA
| | - Sandra E Echeverria
- Graduate School of Public Health and Health Policy, Department of Community Health and Social Science, City University of New York, New York, NY, USA
| | - Katarzyna Wyka
- Graduate School of Public Health and Health Policy, Center for Systems and Community Design, City University of New York, New York, NY, USA.,Graduate School of Public Health and Health Policy, Department of Epidemiology and Biostatistics, City University of New York, New York, NY, USA
| | - May May Leung
- Hunter College, Nutrition Program, City University of New York, New York, NY, USA
| | - Anne E Sumner
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD, USA.,National Institute of Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | - Terry T-K Huang
- Graduate School of Public Health and Health Policy, Center for Systems and Community Design, City University of New York, New York, NY, USA.,Graduate School of Public Health and Health Policy, Department of Community Health and Social Science, City University of New York, New York, NY, USA
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16
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Divney AA, Echeverria SE, Thorpe LE, Trinh-Shevrin C, Islam NS. Hypertension Prevalence Jointly Influenced by Acculturation and Gender in US Immigrant Groups. Am J Hypertens 2019; 32:104-111. [PMID: 30165394 DOI: 10.1093/ajh/hpy130] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 08/20/2018] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Latinos and Asians in the United States are disproportionately burdened by hypertension, a leading risk factor for cardiovascular disease. Few studies have used multicomponent measures of acculturation to compare cardiovascular risk factors across immigrant-origin groups. Additionally, little is known about how acculturation and gender shape hypertension risk among immigrants. METHODS We created an acculturation score composed of language use, nativity, and years in the United States and fit separate race/ethnicity log-binomial models examining associations with hypertension prevalence (≥130/80 mm Hg) among Latino (n = 4,267) and Asian (n = 2,142) National Health and Nutrition Examination Survey 2011-2016 participants aged 18+. Joint effect models tested the concept of "intersectionality" between acculturation and gender. RESULTS Adjusting for age, gender, and socioeconomic position, Latinos and Asians with high acculturation were 25% and 27% more likely to have hypertension, respectively, compared with low acculturation groups. Latino and Asian American men with high levels of acculturation were 74-79% more likely to have hypertension compared with women with low acculturation (adjusted prevalence ratios (aPR) for Latinos = 1.74, 95% confidence interval (CI): 1.49-2.03; aPR for Asians = 1.79, 95% CI: 1.42-2.25). The gradient of increasing hypertension with increasing acculturation was most apparent among Latino men (adjusted risk differences (aRD) = 12.0%, P < 0.001) and Asian women (aRD = 14.0%, P = 0.003) and nonsignificant among Latino women and Asian men when comparing high vs. low acculturation categories. CONCLUSIONS Our results correspond with prior literature demonstrating increased morbidity among immigrants with increasing acculturation but also suggest differing patterns by race/ethnicity and gender. Future research should explore how migration processes differentially influence hypertension among men and women.
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Affiliation(s)
- A A Divney
- Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, New York, New York, USA
- NYU-CUNY Prevention Research Center, New York, USA
| | - S E Echeverria
- Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, New York, New York, USA
- NYU-CUNY Prevention Research Center, New York, USA
| | - L E Thorpe
- NYU-CUNY Prevention Research Center, New York, USA
- NYU School of Medicine, Department of Population Health, New York, New York, USA
| | - C Trinh-Shevrin
- NYU-CUNY Prevention Research Center, New York, USA
- NYU School of Medicine, Department of Population Health, New York, New York, USA
| | - N S Islam
- NYU-CUNY Prevention Research Center, New York, USA
- NYU School of Medicine, Department of Population Health, New York, New York, USA
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17
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Romero D, Echeverria SE, Duffy M, Roberts L, Pozen A. Development of a wellness trust to improve population health: Case-study of a United States urban center. Prev Med Rep 2018; 10:292-298. [PMID: 29868382 PMCID: PMC5984219 DOI: 10.1016/j.pmedr.2018.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 03/11/2018] [Accepted: 03/14/2018] [Indexed: 11/18/2022] Open
Affiliation(s)
- Diana Romero
- Department of Community Health & Social Sciences, Affiliate, Center for Systems and Community Design, City University of New York (CUNY) Graduate School of Public Health and Health Policy, 55 W. 125th St, New York, NY 10027, United States
- Corresponding author at: Department of Community Health & Social Sciences, CUNY Graduate School of Public Health and Health Policy, 55 W. 125th St, New York, NY 10027, United States.
| | - Sandra E. Echeverria
- Department of Community Health & Social Sciences, Affiliate, Center for Systems and Community Design, City University of New York (CUNY) Graduate School of Public Health and Health Policy, 55 W. 125th St, New York, NY 10027, United States
| | - Madeline Duffy
- Department of Community Health & Social Sciences, City University of New York (CUNY) Graduate School of Public Health and Health Policy, 55 W. 125th St, New York, NY 10027, United States
| | - Lynn Roberts
- Department of Community Health & Social Sciences, City University of New York (CUNY) Graduate School of Public Health and Health Policy, 55 W. 125th St, New York, NY 10027, United States
| | - Alexis Pozen
- Department of Health Policy and Management, City University of New York (CUNY) Graduate School of Public Health and Health Policy, 55 W. 125th St, New York, NY 10027, United States
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18
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Vásquez E, Strizich G, Isasi CR, Echeverria SE, Sotres-Alvarez D, Evenson KR, Gellman MD, Palta P, Qi Q, Lamar M, Tarraf W, González HM, Kaplan R. Is there a relationship between accelerometer-assessed physical activity and sedentary behavior and cognitive function in US Hispanic/Latino adults? The Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Prev Med 2017; 103:43-48. [PMID: 28765082 PMCID: PMC5798874 DOI: 10.1016/j.ypmed.2017.07.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 06/01/2017] [Accepted: 07/24/2017] [Indexed: 01/08/2023]
Abstract
Normative changes in cognitive function are expected with increasing age. Research on the relationship between normative cognitive decline and moderate-to-vigorous physical activity (MVPA) and sedentary behavior (SED) needs further investigation in Hispanic/Latinos adults. We assessed the cross-sectional association between accelerometer assessed MVPA and SED with cognitive function in 7,478 adults aged 45-74years from the Hispanic Community Health Study/Study of Latinos. At baseline, cognitive tests included two executive function tests (Digit Symbol Substitution Test (DSST), a test of language (Word Fluency), and a test of memory (Spanish English Verbal Learning Test). Multiple regression models were used to examine associations of time spent in MVPA and SED with cognitive function by age groups, adjusted for age, education, sex, acculturation, and field center. Mean time spent in sedentary behaviors was 12.3h/day in females and 11.9 h/day in males (75% and 77% of accelerometer wear time, respectively). Higher SED, but not MVPA, was associated with lower DSST raw scores (β -0.03 with each 10-min increment in SED; P<0.05), indicating lower performance in executive function in all age groups. No associations were observed for MVPA and SED with tests of language or memory tests. Our findings suggest a distinct association of SED but not MVPA on executive functioning in middle-aged and older Latino adults. Longitudinal studies are needed to more conclusively determine causal links.
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Affiliation(s)
- Elizabeth Vásquez
- University at Albany (SUNY), Epidemiology and Biostatistics, 1 University place, 12144 Rensselaer, United States.
| | - Garrett Strizich
- University at Albany (SUNY), Epidemiology and Biostatistics, 1 University place, 12144 Rensselaer, United States
| | - Carmen R Isasi
- University at Albany (SUNY), Epidemiology and Biostatistics, 1 University place, 12144 Rensselaer, United States
| | - Sandra E Echeverria
- University at Albany (SUNY), Epidemiology and Biostatistics, 1 University place, 12144 Rensselaer, United States
| | - Daniela Sotres-Alvarez
- University at Albany (SUNY), Epidemiology and Biostatistics, 1 University place, 12144 Rensselaer, United States
| | - Kelly R Evenson
- University at Albany (SUNY), Epidemiology and Biostatistics, 1 University place, 12144 Rensselaer, United States
| | - Marc D Gellman
- University at Albany (SUNY), Epidemiology and Biostatistics, 1 University place, 12144 Rensselaer, United States
| | - Priya Palta
- University at Albany (SUNY), Epidemiology and Biostatistics, 1 University place, 12144 Rensselaer, United States
| | - Qibin Qi
- University at Albany (SUNY), Epidemiology and Biostatistics, 1 University place, 12144 Rensselaer, United States
| | - Melissa Lamar
- University at Albany (SUNY), Epidemiology and Biostatistics, 1 University place, 12144 Rensselaer, United States
| | - Wassim Tarraf
- University at Albany (SUNY), Epidemiology and Biostatistics, 1 University place, 12144 Rensselaer, United States
| | - Hector M González
- University at Albany (SUNY), Epidemiology and Biostatistics, 1 University place, 12144 Rensselaer, United States
| | - Robert Kaplan
- University at Albany (SUNY), Epidemiology and Biostatistics, 1 University place, 12144 Rensselaer, United States
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19
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Echeverria SE, Mustafa M, Pentakota SR, Kim S, Hastings KG, Amadi C, Palaniappan L. Social and clinically-relevant cardiovascular risk factors in Asian Americans adults: NHANES 2011-2014. Prev Med 2017; 99:222-227. [PMID: 28219784 DOI: 10.1016/j.ypmed.2017.02.016] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Revised: 12/24/2016] [Accepted: 02/17/2017] [Indexed: 12/17/2022]
Abstract
Little evidence exists examining cardiovascular risk factors among Asian Americans and how social determinants such as nativity status and education pattern risk in the United States (U.S.) context. We used the National Health and Nutrition Examination Survey, which purposely oversampled Asian Americans from 2011 to 2014, and examined prevalence of Type II diabetes, smoking and obesity for Asian Americans (n=1363) and non-Latino Whites (n=4121). We classified Asian Americans as U.S. or foreign-born and by years in the U.S. Obesity status was based on standard body mass index (BMI) cut points of ≥30kg/m2 and Asian-specific cut points (BMI≥25kg/m2) that may be more clinically relevant for this population. We fit separate logistic regression models for each outcome using complex survey design methods and tested for the joint effect of race, nativity and education on each outcome. Diabetes and obesity prevalence (applying Asian-specific BMI cut points) were higher among Asian Americans when compared to non-Latino Whites but smoking prevalence was lower. These patterns remained in fully adjusted models and showed small increases with longer duration in the U.S. Joint effects models showed higher odds of prevalent Type II diabetes and obesity (Asian-specific) for foreign-born Asians, regardless of years in the U.S. and slightly higher risk for low education, when compared to non-Latino Whites with high education. Smoking models showed significant interaction effects between race and education for non-Latino Whites only. Our study supports the premise that social as well as clinical factors should be considered when developing health initiatives for Asian Americans.
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Affiliation(s)
- Sandra E Echeverria
- CUNY Graduate School of Public Health and Health Policy, New York, NY, United States.
| | - Mehnaz Mustafa
- New Jersey Department of Health and Human Services, United States
| | - Sri Ram Pentakota
- Department of Surgery, Rutgers New Jersey Medical School, Newark, NY, United States.
| | - Soyeon Kim
- Department of Biostatistics, Rutgers School of Public Health, New Brunswick, NY, United States.
| | - Katherine G Hastings
- Division of General Medical Disciplines, Stanford University School of Medicine, Stanford, CA, United States.
| | - Chioma Amadi
- CUNY Graduate School of Public Health and Health Policy, New York, NY, United States.
| | - Latha Palaniappan
- Division of General Medical Disciplines, Stanford University School of Medicine, Stanford, CA, United States.
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20
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Mayne SL, Auchincloss AH, Moore KA, Michael YL, Tabb LP, Echeverria SE, Diez Roux AV. Cross-sectional and longitudinal associations of neighbourhood social environment and smoking behaviour: the multiethnic study of atherosclerosis. J Epidemiol Community Health 2016; 71:396-403. [PMID: 27885050 DOI: 10.1136/jech-2016-207990] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 09/18/2016] [Accepted: 11/07/2016] [Indexed: 11/03/2022]
Abstract
BACKGROUND Social features of neighbourhood environments may influence smoking by creating a stressful environment or by buffering stress through social cohesion. However, the association of the overall neighbourhood social environment (NSE) with smoking, and the association of specific neighbourhood social factors with change in smoking behaviour over time, has rarely been examined. METHODS This study included 5856 adults aged 45-84 years from the Multi-Ethnic Study of Atherosclerosis (2000-2012, average follow-up: 7.8 years). Outcomes included current smoking status and smoking intensity (average number of cigarettes smoked per day among baseline smokers). NSE was assessed as a composite score composed of aesthetic quality, safety and social cohesion scales (derived from neighbourhood surveys). Generalised linear mixed models evaluated the association of baseline NSE (composite score and individual scales) with current smoking (modified Poisson models) and smoking intensity (negative binomial models) cross-sectionally and longitudinally. RESULTS Each SD increase in baseline NSE composite score was associated with 13% lower prevalence of smoking at baseline (adjusted prevalence ratio (aPR) 0.87 (95% CI 0.78 to 0.98). Neighbourhood safety and aesthetic quality were similarly associated with lower smoking prevalence (aPR 0.87 (0.78 to 0.97) and aPR 0.87 (0.77 to 0.99), respectively) but the association with social cohesion was weaker or null. No significant associations were observed for smoking intensity among baseline smokers. Baseline NSE was not associated with changes in smoking risk or intensity over time. CONCLUSIONS Results suggest that neighbourhood social context influences whether older adults smoke, but does not promote smoking cessation or reduction over time.
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Affiliation(s)
- Stephanie L Mayne
- Department of Epidemiology and Biostatistics, School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Amy H Auchincloss
- Department of Epidemiology and Biostatistics, School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Kari A Moore
- Department of Epidemiology and Biostatistics, School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Yvonne L Michael
- Department of Epidemiology and Biostatistics, School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Loni Philip Tabb
- Department of Epidemiology and Biostatistics, School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Sandra E Echeverria
- Department of Community Health and Social Sciences, Graduate School of Public Health and Health Policy, City University of New York, New York, New York, USA
| | - Ana V Diez Roux
- Department of Epidemiology and Biostatistics, School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
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21
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Marcus AF, Echeverria SE, Holland BK, Abraido-Lanza AF, Passannante MR. The joint contribution of neighborhood poverty and social integration to mortality risk in the United States. Ann Epidemiol 2016; 26:261-6. [DOI: 10.1016/j.annepidem.2016.02.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 02/08/2016] [Accepted: 02/11/2016] [Indexed: 12/21/2022]
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22
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Marcus AF, Echeverria SE, Holland BK, Abraido-Lanza AF, Passannante MR. How Neighborhood Poverty Structures Types and Levels of Social Integration. Am J Community Psychol 2015; 56:134-144. [PMID: 26076667 DOI: 10.1007/s10464-015-9732-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Social integration is fundamental to health and well-being. However, few studies have explored how neighborhood contexts pattern types and levels of social integration that individuals experience. We examined how neighborhood poverty structures two dimensions of social integration: integration with neighbors and social integration more generally. Using data from the United States Third National Health and Nutrition Examination Survey, we linked study participants to percent poverty in their neighborhood of residence (N = 16,040). Social integration was assessed using a modified Social Network Index and neighborhood integration based on yearly visits with neighbors. We fit multivariate logistic regression models that accounted for the complex survey design. Living in high poverty neighborhoods was associated with lower social integration but higher visits with neighbors. Neighborhood poverty distinctly patterns social integration, demonstrating that contexts shape the extent and quality of social relationships.
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Affiliation(s)
- Andrea Fleisch Marcus
- Department of Nutritional Sciences, Rutgers School of Health Related Professions, 65 Bergen Street, Room 157, Newark, NJ, 07107, USA,
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23
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Samuel LJ, Dennison Himmelfarb CR, Szklo M, Seeman TE, Echeverria SE, Diez Roux AV. Social engagement and chronic disease risk behaviors: the Multi-Ethnic Study of Atherosclerosis. Prev Med 2015; 71:61-6. [PMID: 25524614 PMCID: PMC4329061 DOI: 10.1016/j.ypmed.2014.12.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Revised: 12/01/2014] [Accepted: 12/08/2014] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Although engagement in social networks is important to health, multiple different dimensions exist. This study identifies which dimensions are associated with chronic disease risk behaviors. METHODS Cross-sectional data on social support, loneliness, and neighborhood social cohesion from 5381 participants, aged 45-84 from the Multi-Ethnic Study of Atherosclerosis was used. RESULTS After adjusting for individual characteristics and all social engagement variables, social support was associated with lower smoking prevalence (PR=0.88, 95% CI: 0.82, 0.94), higher probability of having quit (PR=1.03, 95% CI: 1.01, 1.06) and a slightly higher probability of achieving physical activity recommendations (PR=1.03, 95% CI: 1.01, 1.06). Neighborhood social cohesion was associated with very slightly higher probability of achieving recommended (PR=1.03, 95% CI: 1.01, 1.05) or any regular (PR=1.0, 95% CI: 1.01, 1.04) physical activity, and a higher probability of consuming at least five daily fruit and vegetable servings (PR=1.05, 95% CI: 1.01, 1.09). CONCLUSIONS Both social support and neighborhood social cohesion, a less commonly considered aspect of social engagement, appear to be important for chronic disease prevention interventions and likely act via separate pathways.
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Affiliation(s)
- Laura J Samuel
- Johns Hopkins University, School of Nursing, 525 N Wolfe St., Baltimore, MD 21205, USA.
| | | | - Moyses Szklo
- Johns Hopkins University, Bloomberg School of Public Health, 615 North Wolfe Street, Room W6009, Baltimore, MD 21205, USA.
| | - Teresa E Seeman
- University of California, Los Angeles, David Geffen School of Medicine at UCLA, Department of Medicine, Division of Geriatrics, 10945 Le Conte Avenue, Suite 2339, Los Angeles, CA 90095, USA; University of California, Los Angeles, School of Public Health, 10945 Le Conte Avenue, Suite 2339, Los Angeles, CA 90095, USA.
| | - Sandra E Echeverria
- Rutgers School of Public Health, RWJMS Research and School of Public Health Bldg., 683 Hoes Lane West, Room 205, Piscataway, NJ 08854, USA.
| | - Ana V Diez Roux
- University of Michigan, School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48104, USA.
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24
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Janevic T, Borrell LN, Savitz DA, Echeverria SE, Rundle A. Ethnic enclaves and gestational diabetes among immigrant women in New York City. Soc Sci Med 2014; 120:180-9. [PMID: 25259656 DOI: 10.1016/j.socscimed.2014.09.026] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 09/12/2014] [Accepted: 09/15/2014] [Indexed: 01/25/2023]
Abstract
Previous research has shown that immigrants living in their own ethnic enclave are at decreased risk of poor health outcomes, but this question has not been studied in relation to gestational diabetes, an important early marker of lifecourse cardiovascular health. We ascertained gestational diabetes, census tract of residence, and individual-level covariates for Sub-Saharan African, Chinese, South Central Asian, Non-Hispanic Caribbean, Dominican, Puerto Rican, Mexican, and Central and South American migrant women using linked birth-hospital discharge data for 89,703 singleton live births in New York City for the years 2001-2002. Using 2000 census data, for each immigrant group we defined a given census tract as part of an ethnic enclave based on the population distribution for the corresponding ethnic group. We estimated odds ratios for associations between living in an ethnic enclave and risk of gestational diabetes adjusted for neighborhood deprivation, percent commercial space, education, age, parity, and insurance status, using multilevel logistic regression. Overall, we found no effect of ethnic enclave residence on gestational diabetes in most immigrant groups. Among South Central Asian and Mexican women, living in a residential ethnic enclave was associated with an increased odds of gestational diabetes. Several explanations are proposed for these findings. Mechanisms explaining an increased risk of gestational diabetes in South Central Asian and Mexican ethnic enclaves should be examined.
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Affiliation(s)
- T Janevic
- Department of Epidemiology, Rutgers School of Public Health, 683 Hoes Lane West, Piscataway, NJ 08854, USA.
| | - L N Borrell
- Department of Health Sciences, Graduate Program in Public Health, Lehman College, CUNY, 250 Bedford Park Boulevard West Bronx, NY 10468, USA.
| | - D A Savitz
- Departments of Epidemiology and Obstetrics and Gynecology, Brown University Box G-S121-2, Providence, RI 02912, USA.
| | - S E Echeverria
- Department of Epidemiology, Rutgers School of Public Health, 683 Hoes Lane West, Piscataway, NJ 08854, USA.
| | - A Rundle
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W. 168th St., New York, NY 10032, USA.
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Sterling MR, Echeverria SE, Merlin MA. The Effect of Language Congruency on the Out-of-Hospital Management of Chest Pain. World Medical & Health Policy 2013. [DOI: 10.1002/wmh3.46] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Delnevo CD, Gundersen DA, Hrywna M, Echeverria SE, Steinberg MB. Smoking-cessation prevalence among U.S. smokers of menthol versus non-menthol cigarettes. Am J Prev Med 2011; 41:357-65. [PMID: 21961462 DOI: 10.1016/j.amepre.2011.06.039] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2011] [Revised: 06/27/2011] [Accepted: 06/28/2011] [Indexed: 11/21/2022]
Abstract
BACKGROUND The Food and Drug Administration currently is assessing the public health impact of menthol cigarettes. Whether menthol cigarettes pose increased barriers to quitting is a critical issue because previous declines in smoking prevalence have stalled. PURPOSE To explore whether menthol cigarette smokers are less likely to quit than non-menthol smokers at the population level and whether this relationship differs by race/ethnicity. METHODS Cross-sectional analyses of the 2003 and 2006/2007 Tobacco Use Supplement to the Current Population Survey were conducted in 2010. Multiple logistic regressions were used to calculate the adjusted odds of cessation for menthol smoking relative to non-menthol smoking. Five different sample restrictions were used to assess the robustness of the findings. RESULTS In the broadest sample restriction, menthol smokers were less likely to have quit smoking (AOR=0.91, 95% CI=0.87, 0.96). This relationship holds among whites (AOR=0.93, 95% CI=0.88, 0.98) and blacks (AOR=0.81, 95% CI=0.67, 0.98). The magnitude of the relationship among Hispanics was similar to that among whites, but differed by Hispanic origin. Among those of Mexican origin, the AOR for menthol smokers was protective but not significant (AOR=1.29, 95% CI=0.99, 1.61), whereas among those of Puerto Rican origin, menthol smokers were less likely to have quit (AOR=0.57, 95% CI=0.37, 0.87). These findings were robust and significant in four of five sample restrictions. CONCLUSIONS Smoking menthol cigarettes is associated with decreased cessation at the population level, and this association is more pronounced among black and Puerto Rican smokers. These findings support the recent calls to ban menthol flavoring in cigarettes.
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Affiliation(s)
- Cristine D Delnevo
- Center for Tobacco Surveillance and Evaluation Research, School of Public Health, University of Medicine and Dentistry of New Jersey, New Brunswick, New Jersey, USA.
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Abstract
BACKGROUND Immigrant women are less likely to undergo cancer screening. However, few national studies have examined the role of citizenship status or acculturation. OBJECTIVE The objective of this study was to examine differences in Papanicolaou (Pap) smear and mammography screening among U.S.-born women and immigrants who are naturalized citizens or remained noncitizens. Among Latinas, we also determined if acculturation is related to screening after adjusting for covariates. RESEARCH DESIGN The authors conducted a cross-sectional analysis of the Adult Section of the 2000 National Health Interview Survey, a nationally representative sample. SUBJECTS A total of 18,342 women completed the survey, including 1445 who were not citizens. MEASURES For Pap smears, women age 18-65 were appropriately screened if they reported testing within the past 3 years. For mammograms, women age 50-70 were considered appropriately screened if they reported testing within the past 2 years. We determined acculturation using a modified version of the Marin scale. RESULTS After adjusting for age, education, family income, and marital status, noncitizens remained significantly less likely to report having a mammogram than U.S.-born women (14 percentage point difference; P < 0.01). However, after adjusting for health insurance coverage and a usual source of care, these disparities were markedly attenuated. For Pap smears, after adjusting for sociodemographics and access to care, disparities persisted (11 percentage points, P < 0.01). Among Latinas, differences in Pap smears between noncitizens and the U.S.-born disappeared after further controlling for acculturation. CONCLUSIONS Our study suggests that initiatives to diminish disparities in screening should prioritize improving access to care for noncitizens. Our study also lends support to culturally sensitive interventions aimed at improving Pap smear screening among noncitizens.
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Affiliation(s)
- Sandra E Echeverria
- Division of General Medicine, Columbia University Medical Center, New York, NY 10032, USA
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Abstract
The majority of studies examining the relation between neighborhood environments and health have used census-based indicators to characterize neighborhoods. These studies have shown that neighborhood socioeconomic characteristics are associated with a range of health outcomes. Establishing if these associations reflect causal relations requires testing hypotheses regarding how specific features of neighborhoods are related to specific health outcomes. However, there is little information on the reliability of neighborhood measures. The purpose of this study was to estimate the reliability of a questionnaire measuring various self-reported measures of the neighborhood environment of possible relevance to cardiovascular disease. The study consisted of a face-to-face and telephone interview administered twice to 48 participants over a 2-week period. The face-to-face and telephone portions of the interview lasted an average of 5 and 11 minutes, respectively. The questionnaire was piloted among a largely Latino and African American study sample recruited from a public hospital setting in New York City. Scales were used to assess six neighborhood domains: aesthetic quality, walking/exercise environment, safety from crime, violence, access to healthy foods, and social cohesion. Cronbach's alpha's ranged from .77 to .94 for the scales corresponding to these domains, with test-retest correlations ranging from 0.78 to 0.91. In addition, neighborhood indices for presence of recreational facilities, quality of recreational facilities, neighborhood participation, and neighborhood problems were examined. Test-retest reliability measures for these indices ranged from 0.73 to 0.91. The results from this study suggested that self-reported neighborhood characteristics can be reliably measured.
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Affiliation(s)
- Sandra E Echeverria
- Columbia University, Mailman School of Public Health, Department of Epidemiology, 622 West 168th Street, PH-9, Room 105, New York, NY 10032, USA.
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