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Alvarez VHA, Amboree TL, Mitchell P, Badr HJ, Montealegre JR. Nativity Disparities in Colorectal Cancer Screening Among Hispanics in the United States. J Immigr Minor Health 2024:10.1007/s10903-024-01590-w. [PMID: 38635108 DOI: 10.1007/s10903-024-01590-w] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2024] [Indexed: 04/19/2024]
Abstract
Hispanics in the United States (U.S.) have previously exhibited lower guideline-concordant colorectal cancer (CRC) screening uptake than non-Hispanic (NH) Whites, with disparities accentuated in foreign-born Hispanics, however it is unclear whether nativity-related CRC screening disparities have changed in the last two decades and whether these disparities are attenuated after adjusting for socioeconomic and demographic characteristics. We evaluated CRC screening adherence in foreign- and U.S.-born Hispanics compared to U.S.-born NH Whites. We used 2019 National Health Interview Survey data to compare the prevalence of up-to-date CRC screening per the 2019 U.S. Preventive Services Task Force recommendations among Hispanic nativity subgroups (i.e., foreign- and U.S.-born) and U.S.-born NH Whites using unadjusted and adjusted weighted log-linked binomial regression. Foreign- and U.S.-born Hispanics had a significantly lower unadjusted prevalence of up-to-date screening than U.S.-born NH Whites (47.18% and 64.18% versus 70.70%; p < 0.0001 and p = 0.0109, respectively). After adjusting for socioeconomic and demographic differences, the prevalence of up-to-date screening was lower in foreign-born Hispanics compared to U.S.-born NH Whites [adjusted prevalence ratio 0.80 (95% confidence interval 0.70-0.91)]; however, no statistically significant difference was observed between U.S.-born Hispanics and NH Whites. Our results suggest a low screening uptake in foreign-born Hispanics independent of socioeconomic and demographic differences. Future interventions should target foreign-born Hispanics to address disparities and promote early detection and prevention of CRC regardless of socioeconomic factors.
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Affiliation(s)
- Victor H Albornoz Alvarez
- Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Health Shreveport, Shreveport, LA, USA
| | - Trisha L Amboree
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Parker Mitchell
- School of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Hoda J Badr
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Jane R Montealegre
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Adzrago D, Walker TJ, Williams F. Reliability and validity of the Patient Health Questionnaire-4 scale and its subscales of depression and anxiety among US adults based on nativity. BMC Psychiatry 2024; 24:213. [PMID: 38500115 PMCID: PMC10949792 DOI: 10.1186/s12888-024-05665-8] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 03/06/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND The burdens of anxiety and depression symptoms have significantly increased in the general US population, especially during this COVID-19 epidemiological crisis. The first step in an effective treatment for anxiety and depression disorders is screening. The Patient Health Questionnaire-4 (PHQ-4, a 4-item measure of anxiety/depression) and its subscales (PHQ-2 [a 2-item measure of depression] and Generalized Anxiety Disorder [GAD-2, a 2-item measure of anxiety]) are brief but effective mass screening instruments for anxiety and depression symptoms in general populations. However, little to no study examined the psychometric properties (i.e., reliability and validity) of the PHQ-4 and its subscales (PHQ-2 and GAD-2) in the general US adult population or based on US nativity (i.e., foreign-born vs. the US-born). We evaluated the psychometric properties of the PHQ-4 and its subscales in US adults, as well as the psychometric equivalence of the PHQ-4 scale based on nativity. METHODS We conducted a cross-sectional survey of 5,140 adults aged ≥ 18 years. We examined the factorial validity and dimensionality of the PHQ-4 with confirmatory factor analysis (CFA). A multiple-group confirmatory factor analysis (MCFA) was used to evaluate the comparability of the PHQ-4 across nativity groups. Reliability indices were assessed. Also, the scales' construct validities were assessed by examining the associations of both the PHQ-4 and its subscales' scores with the sociodemographic characteristics and the 3-item UCLA Loneliness scale. RESULTS The internal consistencies were high for the PHQ-4 scale (α = 0.92) and its subscales of PHQ-2 (α = 0.86) and GAD-2 (α = 0.90). The CFA fit indices showed evidence for the two-factor structure of the PHQ-4. The two factors (i.e., anxiety and depression) were significantly correlated (r = 0.92). The MCFA demonstrated measurement invariance of the PHQ-4 across the nativity groups, but the model fits the data better in the foreign-born group. There were significant associations of the PHQ-4 scale and its subscales' scores with the sociodemographic characteristics and the UCLA Loneliness scale (all p < 0.001). CONCLUSIONS The PHQ-4 and its subscales are reliable and valid measures to screen anxiety and depression symptoms in the general US adult population, especially in foreign-born individuals during the COVID-19 pandemic.
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Affiliation(s)
- David Adzrago
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, 11545 Rockville Pike, 20852, Rockville, MD, USA.
| | - Timothy J Walker
- Center for Health Promotion and Prevention Research, The University of Texas School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, 11545 Rockville Pike, 20852, Rockville, MD, USA.
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Adzrago D, Thapa K, Rajbhandari-Thapa J, Sulley S, Williams F. Influence of biopsychosocial factors on self-reported anxiety/depression symptoms among first-generation immigrant population in the U.S. BMC Public Health 2024; 24:819. [PMID: 38491362 PMCID: PMC10941619 DOI: 10.1186/s12889-024-18336-w] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 03/12/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Despite increasing studies on mental health among immigrants, there are limited studies using nationally representative samples to examine immigrants' mental health and its potential biopsychosocial contributing factors, especially during the COVID-19 pandemic. We explored and estimated the influence of life satisfaction, social/emotional support, and other biopsychosocial factors on self-reported anxiety/depression symptoms among a nationally representative sample of first-generation immigrants in the U.S. METHODS We conducted a secondary data analysis using the 2021 National Health Interview Survey among first-generation adults aged ≥ 18 years (n = 4295). We applied survey weights and developed multivariable logistic regression model to evaluate the study objective. RESULTS The prevalence of daily, weekly, or monthly anxiety/depression symptoms was 10.22% in the first-generation immigrant population. There were 2.04% daily, 3.27% weekly, and 4.91% monthly anxiety/depression among the population: about 8.20%, 9.94%, and 9.60% experienced anxiety symptoms, whereas 2.49%, 3.54%, and 5.34% experienced depression symptoms daily, weekly, and monthly, respectively. The first-generation population aged 26-49 years were less likely to experience anxiety/depression daily, weekly, or monthly compared to those aged 18-25. Females (versus males) were more likely to experience anxiety/depression daily, weekly, or monthly. Those who identified as gay/lesbian had higher odds of experiencing anxiety/depression daily, weekly, or monthly compared to heterosexual persons. Relative to non-Hispanic White individuals, non-Hispanic Asian, Black/African American, and Hispanic individuals had lower odds, while other/multi-racial/ethnic groups were more likely to experience anxiety/depression daily, weekly, or monthly. A higher life satisfaction score was associated with lower odds of experiencing anxiety/depression daily, weekly, or monthly. Having social/emotional support sometimes/rarely or using healthcare within the past one/two years was associated with experiencing anxiety/depression daily, weekly, or monthly. CONCLUSIONS The findings reveal significant burden of anxiety and depression among first-generation population in the U.S., with higher risks among subgroups like young adults, females, sexual minorities, and non-Hispanic White and other/multi-racial individuals. Additionally, individuals with lower life satisfaction scores, limited social/emotional support, or healthcare utilization in the past one or two years present increased risk. These findings highlight the need for personalized mental health screening and interventions for first-generation individuals in the U.S. based on their diversity and health-related risks.
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Affiliation(s)
- David Adzrago
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, 20852, Bethesda, MD, USA.
| | - Kiran Thapa
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, GA, USA
| | | | - Saanie Sulley
- National Healthy Start Association, Washington, DC, USA
| | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, 20852, Bethesda, MD, USA
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Arizpe A, Navarro S, Ochoa-Dominguez CY, Rodriguez C, Kim SE, Farias AJ. Nativity differences in socioeconomic barriers and healthcare delays among cancer survivors in the All of Us cohort. Cancer Causes Control 2024; 35:203-214. [PMID: 37679534 PMCID: PMC10787892 DOI: 10.1007/s10552-023-01782-z] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 08/21/2023] [Indexed: 09/09/2023]
Abstract
PURPOSE We aimed to assess whether nativity differences in socioeconomic (SES) barriers and health literacy were associated with healthcare delays among US cancer survivors. METHODS "All of Us" survey data were analyzed among adult participants ever diagnosed with cancer. A binary measure of healthcare delay (1+ delays versus no delays) was created. Health literacy was assessed using the Brief Health Literacy Screen. A composite measure of SES barriers (education, employment, housing, income, and insurance statuses) was created as 0, 1, 2, or 3+. Multivariable logistic regression model tested the associations of (1) SES barriers and health literacy with healthcare delays, and (2) whether nativity modified this relationship. RESULTS Median participant age was 64 years (n = 10,020), with 8% foreign-born and 18% ethnic minorities. Compared to survivors with no SES barriers, those with 3+ had higher likelihood of experiencing healthcare delays (OR 2.18, 95% CI 1.84, 2.58). For every additional barrier, the odds of healthcare delays were greater among foreign-born (1.72, 1.43, 2.08) than US-born (1.27, 1.21, 1.34). For every 1-unit increase in health literacy among US-born, the odds of healthcare delay decreased by 9% (0.91, 0.89, 0.94). CONCLUSION We found that SES barriers to healthcare delays have a greater impact among foreign-born than US-born cancer survivors. Higher health literacy may mitigate healthcare delays among US cancer survivors. Healthcare providers, systems and policymakers should assess and address social determinants of health and promote health literacy as a way to minimize healthcare delays among both foreign- and US-born cancer survivors.
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Affiliation(s)
- Angel Arizpe
- Keck School of Medicine of the University of Southern California, 2001 N. Soto St., Suite 318B, Los Angeles, CA, 90032, USA
| | - Stephanie Navarro
- Keck School of Medicine of the University of Southern California, 2001 N. Soto St., Suite 318B, Los Angeles, CA, 90032, USA
| | | | | | - Sue E Kim
- Keck School of Medicine of the University of Southern California, 2001 N. Soto St., Suite 318B, Los Angeles, CA, 90032, USA
| | - Albert J Farias
- Keck School of Medicine of the University of Southern California, 2001 N. Soto St., Suite 318B, Los Angeles, CA, 90032, USA.
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Hagopian GS, Bapat AC, Dottino PR, Lieber M, Kemeny MM, Li X, Kaplowitz E, Beddoe A. The impact of nativity on uterine cancer survival in the public hospital system of Queens, New York. Gynecol Oncol 2024; 181:133-140. [PMID: 38163383 DOI: 10.1016/j.ygyno.2023.12.018] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 12/17/2023] [Accepted: 12/19/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE We studied cis-women with uterine cancer presenting to the two Public Hospitals in Queens, New York from 2006 to 2015 to examine the relationship between nativity (birthplace) and survival. METHODS A retrospective review of tumor registries identified women diagnosed with uterine cancer between January 1, 2006, and December 31, 2015. Data from 259 women were available for this analysis. RESULTS Most women were born outside the United States (US) (76% versus 24%). The majority of US-born women were black (68%). Seventy-seven women (30%) were born in Latin America, 76 in the Caribbean Islands (29%) and 44 in Asia/South Asia (17%). Most women presented with stage I/II disease (70%) and endometrioid/mucinous histology (68%) with no significant differences observed among nativity groups. Kaplan-Meier estimated survival curves stratified by birthplace demonstrated significant differences in survival distributions among the groups using the log-rank test (P < 0.0001). The most favorable survival curves were observed among all foreign-born women, whereas the least favorable survival was demonstrated in US-born women. Time to death was analyzed using the Cox proportional hazards model. Adjusting for age of diagnosis, insurance status, stage, and treatment modality, Latin American and Asia/South Asia birthplace was significantly associated with increased survival time. CONCLUSION An immigrant health paradox was defined for foreign-born Latin American and Asian/South Asian women presenting to the two Public Hospitals of Queens, New York, as women born in these geographic regions were less likely to die at any given time compared to those born in the United States.
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Affiliation(s)
- George S Hagopian
- Department of Obstetrics and Gynecology, Elmhurst Hospital Center, Elmhurst, Queens, NY, USA; Department of Obstetrics and Gynecology, Queens Hospital Center, Jamaica, Queens, NY, USA; Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Queens Cancer Center, Queens Hospital Center, Jamaica, Queens, NY, USA.
| | - Alka Chintamani Bapat
- Department of Obstetrics and Gynecology, Queens Hospital Center, Jamaica, Queens, NY, USA
| | - Peter R Dottino
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Molly Lieber
- Division of Global Health, Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - M Margaret Kemeny
- Queens Cancer Center, Queens Hospital Center, Jamaica, Queens, NY, USA; Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Xilian Li
- Department of Radiation Oncology, Queens Hospital Center, Jamaica, Queens, NY, USA; Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Elianna Kaplowitz
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Annmarie Beddoe
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Division of Global Health, Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Datta BK, Coughlin SS, Majeed B. Inequities in routine preventive care utilization among persons with overweight/obesity in the United States: An analysis of nativity, racial and ethnic identity, and socioeconomic status. Dialogues Health 2023; 2:100125. [PMID: 37377782 PMCID: PMC10292657 DOI: 10.1016/j.dialog.2023.100125] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 03/06/2023] [Accepted: 03/10/2023] [Indexed: 06/29/2023]
Abstract
Extant literature documented various health disparities among immigrants and racial and ethnically marginalized individuals in the United States. However, health disparities in the intersection of nativity and race are generally less visited. This cross-sectional study assessed utilization of routine preventive care among adults with overweight/obesity at the junction of their nativity, racial/ethnic identity, and socioeconomic status (i.e., income and education). Pooling data on 120,184 adults with overweight/obesity from the 2013-2018 waves of the National Health Interview Survey (NHIS), we estimated modified Poisson regressions with robust standard errors to obtain adjusted prevalence rates of preventive care visit, receiving flu shot, and having blood pressure, cholesterol and blood glucose screened. We found that immigrant adults with overweight/obesity had lower rates of utilization of all five preventive care services. However, these patterns varied by racial and ethnic sub-populations. While White immigrants had comparable rates of cholesterol and blood glucose screening, they had 2.7%, 2.9%, and 14.5% lower rates of preventive care visit, blood pressure screening, and getting a flu shot respectively, compared to native-born Whites. These patterns were similar for Asian immigrants as well. Black immigrants, on the other hand, had comparable rates of getting a flu shot and blood glucose screening, and had 5.2%, 4.9%, and 4.9% lower rates of preventive care visit, blood pressure screening, and cholesterol screening respectively. Lastly, the rates of utilization among Hispanic immigrants were significantly lower (ranging from 9.2% to 20%) than those of their native-born counterparts for all five preventive care services. These rates further varied by education, income, and length of stay in the US, within the racial and ethnic subgroups. Our findings thus suggest a complex relationship between nativity and racial/ethnic identity in relation to preventive care utilization among adults with overweight/obesity.
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Affiliation(s)
- Biplab Kumar Datta
- Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA
- Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Steven S. Coughlin
- Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA
- Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Ban Majeed
- Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA
- Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA
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Liu J, Lin Z. Race/Ethnicity, Nativity, and Gender Disparities in Mental Health Trajectories from Mid- to Later-Life: A Life Course-Intersectional Approach. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01808-x. [PMID: 37755686 DOI: 10.1007/s40615-023-01808-x] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/29/2023] [Accepted: 09/18/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND Numerous studies have highlighted mental health disparities based on race/ethnicity, nativity, and gender across different life stages. However, few have investigated how the intersectionality of these factors influences mental health trajectories during midlife to late life. This study fills this gap by adopting a life course-intersectional approach, viewing mental health trajectories as dynamic processes shaped by the combined influences of race/ethnicity, nativity, and gender. It explores social, psychological, and physiological pathways contributing to these disparities. DESIGN Using data from the Health and Retirement Study (2006-2018; N = 38,049 observations) and growth curve models, this study examines how intra-individual trends in depressive symptoms (measured as CES-D scale, 07) are influenced by the intersection of race/ethnicity, nativity, and gender. It also investigates the impact of objective and subjective social isolation and physical health on group disparities in mental health trajectories. RESULTS The findings reveal that, during mid- to early late-life, most Black and Hispanic Americans experience higher levels of depressive symptoms compared to their White counterparts (disparities ranging from 0.184 to 0.463 for men and 0.117 to 0.439 for women). However, this disadvantage diminishes for US-born Hispanic men and US-born Black women (0.014-0.031 faster decrease rates compared to US-born White), while it intensifies for Hispanic immigrants (0.017-0.018 slower decrease rates compared to US-born White) in advanced ages. Mediation analysis demonstrates that both social isolation and physical health contribute to these disparities, with physical health explaining a larger portion, particularly in differences between immigrant Hispanic women and US-born Whites. CONCLUSION This study underscores the importance of a life course-intersectional approach in understanding mental health disparities. It emphasizes the need for improved social welfare systems and community-level interventions targeting the specific challenges faced by older Hispanic immigrants, especially women who encounter multiple forms of oppression.
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Affiliation(s)
- Jingwen Liu
- Department of Sociology, University of Maryland, 3834 Campus Dr., Parren Mitchell Art-Sociology Building, College Park, MD, 20742, USA.
| | - Zhiyong Lin
- Department of Sociology, University of Texas at San Antonio, One UTSA Circle, MS 4.02.66, San Antonio, TX, 78249, USA
- Population Research Center, University of Texas at Austin, 305 E. 23rd Street, Stop G1800, Austin, TX, 78712, USA
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Carson SA. Biological Differences between Late 19 th and Early 20 th Century Urban and Rural Residence. J Biosoc Sci 2023; 55:812-852. [PMID: 36814332 DOI: 10.1017/s0021932022000372] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Communities urbanize when the net benefits to urbanization exceed rural areas. Body mass, height, and weight are biological welfare measures that reflect the net difference between calories consumed and calories required for work and to withstand the physical environment. Individuals of African-decent had greater BMIs, heavier weights, and shorter statures. Urban farmers had lower BMIs, shorter statures, and lower weight than rural farmers. Over the late 19th and early 20th centuries, urban and rural BMIs, height, and weight were constant, and rural farmers had greater BMIs, taller statures, and heavier weights than urban farmers and workers in other occupations.
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Affiliation(s)
- Scott Alan Carson
- University of Texas, Permian Basin, 4901 East University, Odessa, TX 79762
- Research Fellow, University of Münich and CESifo, Shackstrasse 4, 80539 Münich, Germany
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Amboree TL, Parker SL, Bulsara S, Anderson ML, Schmeler KM, Chiao EY, Montealegre JR. Cervical cancer screening among English- and Spanish-speaking Hispanic women in an urban safety net health system, 2015-2020. BMC Womens Health 2023; 23:309. [PMID: 37316815 DOI: 10.1186/s12905-023-02448-3] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 05/19/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND The Hispanic population is heterogeneous with differences in health behaviors across subgroups by nativity and preferred language. We evaluated cervical cancer screening adherence among English- and Spanish-speaking Hispanic patients receiving care at a safety net health system. METHODS Electronic health records were used to identify 46,094 women aged 30-65. Up to date (UTD) screening was defined based on date of last Pap test, human papillomavirus (HPV) test, or Pap/HPV co-test. RESULTS Overall, 81.5% of 31,297 Hispanic women were UTD. English-speaking Hispanic women had a lower prevalence of being UTD when compared to Spanish-speaking Hispanic women (aPR: 0.94, 95% CI: 0.93 - 0.96). Further, those with indigent healthcare plans had a higher prevalence of being UTD when compared to those with private insurance (aPR: 1.10, 95% CI: 1.09 - 1.12), while all other health insurance plans were associated with lower UTD screening when compared to private insurance. CONCLUSIONS These findings suggest screening differences within the Hispanic population, highlighting the need for disaggregated research assessing heterogeneity within racial/ethnic groups, specifically among Hispanic populations.
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Affiliation(s)
- Trisha L Amboree
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1330, Houston, TX, 77030, USA.
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
| | - Susan Lackey Parker
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1330, Houston, TX, 77030, USA
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
- Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA
| | - Shaun Bulsara
- Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA
| | - Matthew L Anderson
- Division of Gynecologic Oncology, University of South Florida Morsani School of Medicine and Tampa General Hospital Cancer Institute, Tampa, FL, USA
| | - Kathleen M Schmeler
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Elizabeth Y Chiao
- Departments of Epidemiology and Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jane R Montealegre
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1330, Houston, TX, 77030, USA
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
- Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA
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Carr T, Gillum R. Immigration and use of preventive aspirin by Hispanics and non-Hispanic whites and non-Hispanic blacks in the US. J Natl Med Assoc 2023:S0027-9684(23)00037-8. [PMID: 37024312 DOI: 10.1016/j.jnma.2023.03.002] [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] [Received: 10/25/2022] [Revised: 02/08/2023] [Accepted: 03/14/2023] [Indexed: 04/08/2023]
Abstract
BACKGROUND In the US, little is known about aspirin use as a preventive measure for cardiovascular disease by immigration status. METHODS Combined data from the National Health and Nutrition Examination Survey (NHANES) 2015-2016 and 2017- March 2020 (pre-pandemic data) were analyzed. Persons were asked about demographics including country of birth and those aged 40 years and older were asked about current use of aspirin to prevent cardiovascular disease (CVD). RESULTS Among 2,321 born in the US, preventive aspirin use was significantly more prevalent (39.6%) than among 910 others (27.5%, p < 0.01). However, after stratifying by race/ethnicity and history of CVD, the difference was significant only in Hispanics with CVD. In logistic regression analyses in Hispanics controlling for age, gender and education, the US born had significantly higher odds of aspirin use in those with or without CVD. DISCUSSION Among US Hispanics, use of aspirin for prevention of CVD was more prevalent in those born in the US than in others.
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Affiliation(s)
- Tyler Carr
- MSII, Howard University College of Medicine, 520 W St NW, Washington, DC 20059, USA.
| | - Richard Gillum
- Professor, Department of Medicine, Howard University College of Medicine, Washington, DC 20059 USA.
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Garcia S, Hopfer S, Amaro H, Tanjasiri S. HPV vaccine delay and refusal among unvaccinated Mexican American young adult women: a qualitative investigation of Mexican-born and US-born HPV vaccine decision narratives. J Behav Med 2023; 46:88-99. [PMID: 35610490 PMCID: PMC9130004 DOI: 10.1007/s10865-022-00326-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 03/29/2022] [Indexed: 12/23/2022]
Abstract
Low HPV vaccination rates among Latina young adults perpetuate HPV-associated cancer disparities. Using qualitative methods, this study explored individual, interpersonal, and community factors that influence HPV vaccine delay and refusal among Mexican- and U.S.-born Mexican American young adult women. Participants (N = 30) between 18 and 26 years old were purposively sampled from two federally qualified health centers in Orange County, California. The National Institute on Minority Health and Health Disparities research framework and narrative engagement theory guided semi-structured phone interviews coded inductively and deductively. Participants primarily attributed vaccine status to individual and interpersonal reasons. Emerging themes included low HPV vaccine knowledge, insufficient provider communication, negative perceptions about HPV and the vaccine, motherhood responsibilities, mother's communication about HPV, cultural family norms, health care access, and misinformation. Compared to U.S.-born Latinas, Mexican-born participants more frequently expressed avoiding health care discussions with family. HPV vaccine recommendations for young Mexican American women should include socioculturally tailored messages that may improve HPV vaccination acceptance and uptake.
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Affiliation(s)
- Samantha Garcia
- Department of Health, Society, and Behavior, Program in Public Health, University of California, 653 E. Peltason Drive, AIRB, Room 2020D, Irvine, CA 92697-3957 USA
| | - Suellen Hopfer
- Department of Health, Society, and Behavior, Program in Public Health, University of California, 653 E. Peltason Drive, AIRB, Room 2020D, Irvine, CA 92697-3957 USA
| | - Hortensia Amaro
- Herbert Wertheim College of Medicine and Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St, AHC4 Room 419, Miami, FL 33199 USA
| | - Sora Tanjasiri
- Department of Epidemiology and Biostatistics, Program in Public Health, University of California, 653 E. Peltason Drive, AIRB, Room 3072, Irvine, CA 92697-3957 USA
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12
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Ventura J, Downer B, Li CY, Snih SA. Nativity differences in the relationship between handgrip strength and cognitive impairment in older Mexican Americans over 20 years of follow-up. Arch Gerontol Geriatr 2023; 107:104903. [PMID: 36584560 PMCID: PMC9974812 DOI: 10.1016/j.archger.2022.104903] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 12/01/2022] [Accepted: 12/12/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE To examine nativity differences in the relationship between handgrip strength (HGS) and cognitive impairment among Mexican Americans aged ≥ 65 years with normal or high cognitive function at baseline over a 20-year period. METHODS Prospective cohort study of 2,155 non-institutionalized Mexican Americans aged ≥ 65 years from the Hispanic Established Population for the Epidemiological Study of the Elderly) who scored ≥ 21 in the Mini Mental State Examination (MMSE) at baseline. Measures included socio-demographics, body mass index, medical conditions, depressive symptoms, physical function, disability, HGS quartiles (sex-adjusted), and MMSE. We used generalized estimating equation models to estimate the odds ratio (OR) and 95% Confidence Interval (CI) of cognitive impairment (MMSE < 21) as a function of HGS quartile by nativity and adjusted for covariates. RESULTS US-born and foreign-born participants in the 4th quartile (highest) of HGS at baseline had lower odds of cognitive impairment over time compared with those in the 1st (lowest) HGS quartile (OR=0.95, 95% CI=0.90-0.99 and OR=0.93, 95% CI=0.89-0.98, respectively), after controlling for all covariates. When we analyzed HGS quartiles as time-varying, we found that US-born participants in the 3rd and 4th HGS quartile had 25% and 30% lower odds of cognitive impairment, respectively, while foreign-born participants in the 3rd and 4th HGS quartile had 27% and 49% lower odds of cognitive impairment over time, respectively, after controlling for all covariates. CONCLUSION Foreign-born older Mexican Americans who performed high in HGS experienced 7% lower odds of cognitive impairment over time compared with US-born older Mexican Americans.
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Affiliation(s)
- Juan Ventura
- John Sealy School of Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Brian Downer
- Department of Population Health and Health Disparities/School of Public and Population Health, University of Texas Medical Branch, Galveston, TX, USA
| | - Chih-Ying Li
- Department of Occupational Therapy/School of Health Professions, University of Texas Medical Branch, Galveston, TX, USA
| | - Soham Al Snih
- Department of Population Health and Health Disparities/School of Public and Population Health, University of Texas Medical Branch, Galveston, TX, USA; Division of Geriatrics & Palliative Medicine/Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA; Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, USA.
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13
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Almeida J, Belanoff C, Erbetta KF, Black A. Ethnic, Nativity and Country of Origin Inequities in Preterm Birth Among Hispanic and Non-Hispanic Whites in New York City: What's Stress Got to Do With It? J Immigr Minor Health 2023; 25:406-414. [PMID: 35960400 DOI: 10.1007/s10903-022-01392-y] [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: 07/26/2022] [Indexed: 11/30/2022]
Abstract
Hispanic populations experience good birth outcomes despite their socioeconomic disadvantage, a phenomenon referred to as the Hispanic paradox. This health advantage, however, deteriorates over time and understanding of this pattern is limited. Using data from the 2009-2013 New York City (NYC) PRAMS survey linked with birth certificate data, we tested whether stressful life events (SLEs) partially accounted for differences in preterm birth (PTB) between birthing parents across ethnicity, nativity and country of foreign birth (CFB). Experiencing 3+ SLEs in the prenatal period was associated with increased odds of PTB (OR = 1.49, 95% CI 1.13, 1.97). However, stressors were not associated with greater risk of PTB among US-born Hispanic participants, or differences across CFB. SLEs are associated with increased odds of PTB after a threshold of 3+, but do not explain greater PTB among US-born, or some Hispanic subgroups, despite differences in SLEs across ethnicity and CFB among Hispanic birthing parents.
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Affiliation(s)
- Joanna Almeida
- School of Social Work, Simmons University, 300 The Fenway, Office M430-D, Boston, MA, 02115, USA.
| | - Candice Belanoff
- School of Public Health, Boston University, 715 Albany Street, Boston, MA, 02118, USA
| | - Kristin F Erbetta
- School of Social Work, Simmons University, 300 The Fenway, Office M430-D, Boston, MA, 02115, USA
| | - Adriana Black
- Pritzker School of Medicine, University of Chicago, 924 E. 57th Street, Suite 104, Chicago, IL, 60637, USA
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14
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Kim S, Williams AD. Roles of Income and Acculturation in the Hispanic Paradox: Breastfeeding Among Hispanic Women. Matern Child Health J 2023; 27:1070-1080. [PMID: 36988791 DOI: 10.1007/s10995-023-03643-2] [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: 03/17/2023] [Indexed: 03/30/2023]
Abstract
OBJECTIVES Despite Hispanics' high prevalence of breastfeeding compared to other racial/ethnic groups, contributing factors remain unclear. This study examines the complex relationship among Hispanic nativity, acculturation, income, and breastfeeding. METHODS The Fragile Families Child Wellbeing Study baseline (1998-2000) and Year 1 data (1999-2001) were used, including 4,077 women (933 non-Hispanic white, 2,046 non-Hispanic Black, 352 US-born Mexicans [USM], 299 US-born other Hispanics [USH], 302 foreign-born Mexicans [FBM], and 145 foreign-born other Hispanics [FBH]). Logistic regression estimated odds ratios(OR) and 95% confidence intervals(CI) for associations between Hispanic nativity and breastfeeding initiation and 4-month and 6-month breastfeeding, accounting for acculturation (Spanish language use, cultural engagement, religiosity, and traditional gender role attitudes), demographics, income, and health factors. Models were run for the overall sample and stratified by low vs. high income (above median: $21,600). RESULTS FBM(OR:2.35, 95%CI 1.33,4.15) and FBH(OR:2.28, 95%CI 1.23,4.24) had higher odds, while USM(OR:0.55, 95%CI 0.41,0.73) and USH(OR:0.50, 95%CI 0.37,0.67) had lower odds of breastfeeding initiation, compared to white women. USM had lower odds of 4-month(OR:0.53, 95%CI 0.36,0.80) and 6-month breastfeeding(OR:0.38, 95%CI 0.23,0.63), as did USH for 4-month(OR:0.64, 95%CI 0.42,0.99) and 6-month breastfeeding(OR:0.50, 95%CI 0.30,0.85). In stratified models, low-income (vs. high-income) FBH had higher odds of breastfeeding initiation(OR:3.73 95%CI 1.43,9.75) and 4-month(OR:3.01 95%CI 1.12,8.04) and 6-month breastfeeding(OR:3.08 95%CI 1.07,8.88), yet effects of acculturation across income strata are inconsistent. CONCLUSIONS FOR PRACTICE The Hispanic paradox operates differentially due to nativity, income, and acculturation. Breastfeeding intervention and promotion may require tailored approaches to Hispanic subgroups.
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Affiliation(s)
- Soojung Kim
- Department of Communication, University of North Dakota, Columbia Hall, Room 2370, 501 N Columbia Rd. Stop 7169, Grand Forks, ND, 58202-7169, USA
| | - Andrew D Williams
- Public Health Program, Department of Population Health, UND School of Medicine and Health Sciences, University of North Dakota, Room E162, 1301 North Columbia Road Stop 9037, Grand Forks, ND, 58202-9037, USA.
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15
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Teng Y, Hanibuchi T, Machida M, Nakaya T. Psychological determinants of COVID-19 vaccine acceptance: A comparison between immigrants and the host population in Japan. Vaccine 2023; 41:1426-30. [PMID: 36702692 DOI: 10.1016/j.vaccine.2023.01.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 01/12/2023] [Accepted: 01/14/2023] [Indexed: 01/24/2023]
Abstract
This study explored the differences in COVID-19 vaccination readiness based on the 7C model and its association with vaccine acceptance among foreign-born immigrants, Japan-born immigrants, and locals in Japan. A cross-sectional survey was conducted in October 2021 (n = 3,690). Our results show that COVID-19 vaccination readiness, acceptance, and their relationship differ according to migratory status and nativity. Immigrant participants reported higher general vaccination readiness and acceptability for vaccination against COVID-19 than the Japanese participants, but had lower vaccination coverage, particularly among those born in Japan. The psychological determinants of Japan-born immigrants were more similar to those of Japanese participants than those of foreign-born immigrants. The effects of confidence, complacency, and constraints on COVID-19 vaccine acceptance were strong among all three groups. However, the role of collective responsibility and conspiracy varied by migratory status. This study highlighted the importance of culturally tailored interventions in vaccine delivery to immigrants.
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16
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Labaran RS, Johnson S, Johnson DA. The association of stress and work hours with sleep duration and insomnia symptoms among U.S.-born and Foreign-born Black adults. Sleep Health 2023; 9:56-63. [PMID: 36402727 PMCID: PMC9991989 DOI: 10.1016/j.sleh.2022.09.011] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 09/12/2022] [Accepted: 09/26/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To examine associations between stress and work hours with sleep duration and insomnia symptoms among U.S.-born and Foreign-born Black adults. DESIGN A cross-sectional analysis of the National Health Interview Survey. PARTICIPANTS Black adults (N = 16,315) with a mean age of 40 ± 0.1 years, mostly women (52.7%), college graduates (40.7%), and U.S.-born (82.5%). MEASUREMENTS Participants self-reported sleep duration, insomnia symptoms, frequent stress (yes/no), and work hours in the prior week (1-39 hours, 40 hours, ≥41 hours). Poisson regression with robust variance was used to test associations overall and by nativity. RESULTS Working ≥41 hours, frequent stress, and short sleep duration (<7 hours) were reported by 22%, 24.9%, and 43% of participants, respectively. U.S.-born and Foreign-born Black adults who reported frequent stress and working ≥41 hours vs. 40 hours had 60% and 19% higher prevalence of short sleep duration (adjusted prevalence ratio [aPR] = 1.60, 95% confidence interval [CI]: 1.47, 1.74 and aPR = 1.19, 95% CI: 1.12, 1.25, respectively). Foreign-born Black adults who worked 1-39 hours vs. 40 hours, had higher prevalence of short sleep duration, aPR = 1.18, 95% CI: 1.01, 1.37. U.S.-born Black adults who worked ≥41 hours vs. 40 hours had higher prevalence of insomnia symptoms (trouble falling asleep: aPR = 1.33 [95% CI: 1.13, 1.56], trouble staying asleep: aPR = 1.33 [95% CI: 1.16, 1.53]). CONCLUSION Frequent stress and working ≥41 hours are likely salient determinants of sleep health for U.S. and Foreign-born Black individuals. Further, less work hours (Foreign-born) while longer work hours (U.S.-born) were associated with short sleep duration. Stress and work hours may be factors for sleep health interventions among Black adults.
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Affiliation(s)
- Rukkayya S Labaran
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Sheroi Johnson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Dayna A Johnson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
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17
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Vásquez E, Gadgil MA, Zhang W, Angel JL. Diabetes, disability, and dementia risk: Results from the Hispanic Established Populations for the Epidemiologic Studies of the Elderly (H-EPESE). Int J Soc Psychiatry 2022; 68:1462-1469. [PMID: 34369183 DOI: 10.1177/00207640211037722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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] [Indexed: 11/16/2022]
Abstract
BACKGROUND Emerging research has elucidated pathophysiological relationships among diabetes, disability, cognitive impairment, and incident dementia. However, the relationships between diabetes, disability, and dementia have been largely underexamined in Latino populations, which have a disproportionate prevalence of diabetes and its complications. AIMS This study examines diabetes as a risk factor for subsequent disability and dementia risk in a Mexican-origin older adult sample. METHODS The data are drawn from eight waves (1993-2013) of the Hispanic Established Populations for the Epidemiologic Study of the Elderly (HEPESE; N = 3,050, mean age at baseline = 73.6 (±6.8)). Respondents' diabetes status at baseline was ascertained by self-report. Disability was assessed using eight functional domains assessed through the Lawton Instrumental Activities of Daily Living (IADL) Scale. Dementia risk was assessed using a Mini-Mental Status Exam (MMSE) score below 18 and the need for aid with at least two IADLs. We used multivariable Cox proportional hazards models to predict the relation between diabetes and time to disability, cognitive impairment, and incident dementia, adjusting for age at migration, socioeconomic status, acculturation, and health status. RESULTS At baseline, diabetes prevalence was 28.1%, and 37.7% had IADL disability. Diabetes was associated with a higher risk of developing dementia (Hazard Ratio (HR) = 1.22, p < .001) over the approximetely 20 year study period. In addition, immigrants who migrated at age 50 or older had a higher dementia risk (HR = 1.35, p = .01) when compared to their US-born counterpart. CONCLUSION Our results highlight the importance of better characterizing the role of diabetes and nativity in the co-occurrence of disability and dementia risk.
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Affiliation(s)
- Elizabeth Vásquez
- School of Public Health, University at Albany (SUNY), NY, USA.,Department of Population and Health, Dell Medical School, University of Texas at Austin, USA
| | - Meghana A Gadgil
- Division of Hospital Medicine, University of California San Francisco, USA.,Division of Health Policy & Management, School of Public Health, University of California Berkeley, USA
| | - Weihui Zhang
- School of Public Health, University at Albany (SUNY), NY, USA
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18
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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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19
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Zheng H, Yu WH. Do Immigrants' Health Advantages Remain After Unemployment? Variations by Race-Ethnicity and Gender. J Soc Issues 2022; 78:691-716. [PMID: 36278121 PMCID: PMC9580995 DOI: 10.1111/josi.12463] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 06/07/2021] [Indexed: 06/16/2023]
Abstract
Immigrants tend to display more favorable health outcomes than native-born co-ethnics. At the same time, they face considerable employment instability. It is unclear whether immigrants' job conditions may compromise their health advantage. Using U.S. National Health Interview Survey data, this study shows that the experience of unemployment reduces immigrants' health advantage, but unemployed foreign-born Blacks, White women, and Asian women still have lower mortality rates than their native-born employed counterparts. Overall, unemployment is less detrimental to immigrants than to natives, and immigrants' "survival advantage after unemployment" persists as their duration of residence extends. We further find substantial heterogeneity in the unemployment effect within immigrants. Asian immigrants display a much sharper gender difference in the mortality consequence of unemployment than other immigrants. Asian men's worse general health and substantially higher smoking rate, especially among the unemployed, lead them to fare much worse than Asian women following unemployment.
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Affiliation(s)
- Hui Zheng
- The Ohio State University, Department of Sociology, 1885 Neil Ave Mall, 106 Townshend Hall, Columbus OH 43210
| | - Wei-Hsin Yu
- Department of Sociology, UCLA, Los Angeles, California, USA
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20
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Osborn B, Albrecht SS, Fleischer NL, Ro A. Food insecurity, diabetes, and perceived diabetes self-management among Latinos in California: Differences by nativity and duration of residence. Prev Med Rep 2022; 28:101856. [PMID: 35711286 PMCID: PMC9194646 DOI: 10.1016/j.pmedr.2022.101856] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 05/14/2022] [Accepted: 06/06/2022] [Indexed: 11/23/2022] Open
Abstract
We examined associations between food security (FS) status and type 2 diabetes (T2D) prevalence and perceived T2D self-management by nativity and US duration of residence among Latinos living in California. We used the California Health Interview Survey (2012-2017) and included Latinos who lived below 200% of the federal poverty line (n = 16,254) and for our management outcome, those with T2D (n = 2284). Latinos with low FS (OR = 1.44, 95% CI 1.14-1.83) or very low FS (OR = 1.87, 95% CI 1.33-2.61) had a higher odds of T2D compared to their food-secure counterparts. When stratified by nativity/duration in the US, US-born Latinos and Latino immigrants with >10 years duration had a higher odds of T2D if they reported low FS (US-born: OR = 1.60, 95% CI 1.02-2.52; >10 yrs: OR = 1.48, 95% CI 1.12-1.97) or very low FS (US-born: OR = 2.37, 95% CI 1.45-3.86; >10 yrs: OR = 1.78, 95% CI 1.15-2.76) compared to their food-secure counterparts. There was no association among immigrants with <10 years duration. For perceived T2D self-management, those with low or very low FS had lower odds of reporting proper management (OR = 0.56, 95% CI 0.36-0.86; OR = 0.46, 95% CI 0.26-0.83) compared to their food-secure counterparts. When stratified by nativity, the US-born did not differ in their perceived self-management by FS status, while immigrants with low or very FS had lower odds of perceived self-management (OR = 0.54, 95% CI 0.34-0.86; OR = 0.36, 95% CI 0.17-0.74), compared to their food-secure counterparts. Food insecurity may be an important contributor to T2D prevalence and perceived T2D self-management for Latino immigrants.
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Affiliation(s)
- Brandon Osborn
- Program in Public Health, University of California, Irvine, Anteater Instruction and Research Building (AIRB), Room 2030, 653 E. Peltason Road, Irvine, CA 92697-3957, United States
| | - Sandra S. Albrecht
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, Room 703, New York, NY 10032, United States
| | - Nancy L. Fleischer
- Center for Social Epidemiology and Population Health, Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109-2029, United States
| | - Annie Ro
- Program in Public Health, University of California, Irvine, Anteater Instruction and Research Building (AIRB), Room 2030, 653 E. Peltason Road, Irvine, CA 92697-3957, United States
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Cano M, Sparks CS. Drug overdose mortality by race/ethnicity across US-born and immigrant populations. Drug Alcohol Depend 2022; 232:109309. [PMID: 35077954 DOI: 10.1016/j.drugalcdep.2022.109309] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 11/03/2021] [Revised: 01/14/2022] [Accepted: 01/14/2022] [Indexed: 12/22/2022]
Abstract
BACKGROUND The present study examined racial/ethnic differences in US drug overdose mortality among US-born and foreign-born men and women. METHODS In this cross-sectional analysis of 2010-2019 data from the National Center for Health Statistics, Bayesian hierarchical models predicted drug overdose mortality based on the interaction of race/ethnicity, nativity, and sex, adjusting for age, for 518,553 drug overdose deaths among individuals ages 15-74 identified as Non-Hispanic (NH) White, NH Black, Hispanic, or NH Asian/Pacific Islander (PI). Rate ratios with 95% Highest Posterior Density Intervals (HPDIs) were examined by race/ethnicity and nativity. RESULTS In the US-born population, 2017-2019 estimated overdose mortality rates were higher for NH Black than NH White men (ratio 1.48 [95% HPDI 1.28-1.72]), similar between NH Black and NH White women (ratio 1.03 [95% HPDI 0.89-1.20]), similar between Hispanic and NH White men (ratio 0.96 [95% HPDI 0.82-1.10]), and lower for NH Asian/PI than NH White men and women. In the foreign-born population, both for men and women, estimated overdose mortality rates were lower in every racial/ethnic group relative to the NH White group. For men and women of all racial/ethnic groups examined, estimated overdose mortality rates were higher in US-born than foreign-born subpopulations, yet the extent of this nativity differential was least pronounced in the NH White group. CONCLUSIONS In the US-born population, NH Black men experienced the highest recent rates of overdose mortality; in the foreign-born population, the highest rates of overdose mortality were observed among NH White men and women.
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Affiliation(s)
- Manuel Cano
- Department of Social Work, The University of Texas at San Antonio, 501W. César E. Chávez Blvd., San Antonio, TX 78207, USA.
| | - Corey S Sparks
- Department of Demography, The University of Texas at San Antonio, One UTSA Circle, San Antonio, TX 78249, USA.
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22
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Galan J, Mydam J, Collins JW Jr. Infant Mortality Rates Among US-Born and Foreign-Born Latinx Women: The Effect of Black Race. Matern Child Health J 2022. [PMID: 35199230 DOI: 10.1007/s10995-021-03366-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To determine the extent to which Black race is associated with the infant mortality rate (< 365 day, IMR) of births to US-born and foreign-born Latinx women. METHODS Stratified and multivariable binominal log-linear regression analyses were performed on the 2010-2013 National Center for Health Statistics linked birth-death certificate files of singleton infants. RESULTS The IMR of births to US-born Black Latinx women (N = 54,542) exceeded that of births to US-born White Latinx women (N = 1,320,084): 5.7/1000 vs 4.2/1000, RR = 1.4 (1.2, 1.5). In contrast, the IMR of births to foreign-born Black Latinx women (N = 35,544) approximated that of births to foreign-born White Latinx women (N = 1,372,172): 3.8/1000 vs 3.6/1000, RR = 1.0 (0.9, 1.2) The adjusted (controlling for maternal age, education, prenatal care, high parity, and region of residence) RR of infant mortality for births to US-born and foreign-born Black (versus non-Latinx White) Latinx women equaled 1.4 (1.2, 1.6) and 1.0 (0.8, 1.2), respectively. The adjusted RR of infant mortality for births to US-born and foreign-born White (versus non-Latinx White) Latinx women equaled 1.0 (0.9, 1.0) and 0.8 (0.7, 0.8), respectively. CONCLUSIONS Black race is associated with a 1.4-fold higher IMR among births to US-born Latinx women. A similar phenomenon does not occur among foreign-born Latinx women. These intriguing findings highlight that the social construct of Black race across the life-course of Latinx women are detrimental to infant outcome.
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Garcia BY, Dongarwar D, Salihu HM. Hispanic Ethnicity, Nativity and the Risk of Stillbirth. J Immigr Minor Health 2022. [PMID: 35044554 DOI: 10.1007/s10903-022-01332-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2022] [Indexed: 10/19/2022]
Abstract
The objective of this study was to examine stillbirth risk by nativity and Hispanic ethnicity. We analyzed births and fetal deaths among women of Hispanic origin within gestational ages of 20-42 weeks from the 2014-2019 Birth and Fetal Death. Foreign-born Hispanic mothers were 8% less likely (HR 0.92, 95% CI 0.90-0.95) to experience stillbirth than their counterparts. Stratified by ethnicity, foreign-born Mexican and Central/South American women had a lower risk of stillbirth (HR 0.85, 95% CI 0.81-0.88 and HR 0.68, 95% CI 0.63-0.75, respectively) while foreign-born Puerto Rican women were more likely to experience stillbirth (HR 1.37, 95% CI 1.24-1.51) than their native-born counterparts. While overall foreign-born Hispanic mothers were less likely to experience stillbirth than native-born Hispanic mothers, this differed depending on ethnicity. Counseling regarding risk of stillbirth among Hispanic women should take into consideration nativity and country of origin as influential factors.
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Belanoff C, Alade MO, Almeida J. Preterm Birth Among US and Foreign-Born Non-Hispanic Black Birthing Parents in Massachusetts: Variation by Nativity, Region, and Country of Origin. Matern Child Health J 2022; 26:834-844. [PMID: 34982341 DOI: 10.1007/s10995-021-03368-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Foreign-born non-Hispanic Black (NHB) birthing parents are less likely to have a preterm birth (PTB) than US-born NHBs. There is further variation by region and country of origin. We update previous studies by examining PTB rates by nativity, region and country of origin among NHBs in Massachusetts, a state with a heterogeneous population of foreign-born NHBs, including communities excluded from previous studies. METHODS Using 2011-2015 natality data from the three largest metropolitan areas in Massachusetts, we documented associations between nativity, region, and 18 individual countries of origin and PTB, using multivariable logistic regression to adjust for individual-level risk factors. RESULTS PTB was highest among US-born NHBs (9.4%) and lowest among those from Sub-Saharan Africa (SSA) (6.6%). Country-specific rates ranged from 4.0% among Angolans to 12.6% among those from Barbados and Trinidad and Tobago. While NHBs from SSA had significantly lower odds of PTB, risk among those from the Caribbean and Brazil was not different from US-born NHBs. The significantly lower risk among foreign-born NHBs and SSAs, in particular, remained robust in adjusted models. DISCUSSION Individual-level factors do not explain observed variation among NHB birthing parents. Future research should investigate explanations for lower PTB risk among SSAs, and congruent risk among foreign-born Caribbeans, Brazilians and US-born NHBs. Exposure to racism, a known risk factor for PTB, likely contributes to these inequities in PTB and merits further exploration. Prenatal care providers should assess place of birth among foreign-born NHBs, as well as exposure to racial discrimination among all NLB birthing parents.
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Affiliation(s)
- Candice Belanoff
- Boston University School of Public Health, Boston University, 715 Albany Street, Boston, MA, 02118, USA
| | - Mayowa Oluwatosin Alade
- Boston University School of Public Health, Boston University, 801 Massachusetts Avenue, Boston, MA, 02118, USA
| | - Joanna Almeida
- Simmons School of Social Work, Simmons University, 300 The Fenway, Office P412-B, Boston, MA, 02115, USA.
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McRoy L, Epané J, Ramamonjiarivelo Z, Zengul F, Weech-Maldonado R, Rust G. Examining the relationship between self-reported lifetime cancer diagnosis and nativity: findings from the National Health and Nutrition Examination Survey (NHANES) 2011-2018. Cancer Causes Control 2021; 33:321-329. [PMID: 34708322 DOI: 10.1007/s10552-021-01514-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 03/31/2020] [Accepted: 10/18/2021] [Indexed: 02/07/2023]
Abstract
PURPOSE Cancer incidence in the USA remains higher among certain groups, regions, and communities, and there are variations based on nativity. Research has primarily focused on specific groups and types of cancer. This study expands on previous studies to explore the relationship between country of birth (nativity) and all cancer site incidences among USA and foreign-born residents using a nationally representative sample. METHODS This is a cross-sectional study of (unweighted n = 22,554; weighted n = 231,175,933) participants between the ages of 20 and 80 from the National Health and Nutrition Examination Survey (NHANES) 2011-2018. Using weighted logistic regressions, we analyzed the impact of nativity on self-reported cancer diagnosis controlling for routine care, smoking status, overweight, race/ethnicity, age, and gender. We ran a partial model, adjusting only for age as a covariate, a full model with all other covariates, and stratified by race/ethnicity. RESULTS In the partial and full models, our findings indicate that US-born individuals were more likely to report a cancer diagnosis compared to their foreign-born counterparts (OR 2.34, 95% CI [1.93; 2.84], p < 0.01) and (OR 1. 39, 95% CI [1.05; 1.84], p < 0.05), respectively. This significance persisted only among non-Hispanic Blacks when stratified by race. Non-Hispanic Blacks who were US-born were more likely to report a cancer diagnosis compared to their foreign-born counterparts (OR 2.30, 95% [CI 1.31; 4.02], p < 0.05). CONCLUSION A variety of factors may reflect lower self-reported cancer diagnosis in foreign-born individuals in the USA other than a healthy immigrant advantage. Future studies should consider the factors behind the differences in cancer diagnoses based on nativity status, particularly among non-Hispanic Blacks.
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Affiliation(s)
| | | | | | - Ferhat Zengul
- University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - George Rust
- Florida State University College of Medicine, Tallahassee, FL, USA
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Giorgi J, Boertien D. The potential impact of co-residence structures on socio-demographic inequalities in COVID-19 mortality. Genus 2021; 77:20. [PMID: 34511631 PMCID: PMC8422957 DOI: 10.1186/s41118-021-00124-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 05/11/2021] [Indexed: 12/13/2022] Open
Abstract
During the COVID-19 pandemic, confinement measures were adopted across the world to limit the spread of the virus. In France, these measures were applied between March 17 and May 10. Using high-quality population census data and focusing on co-residence structures on French territory, this article analyzes how co-residence patterns unevenly put different socio-demographic groups at risk of being infected and dying from COVID-19. The research ambition is to quantify the possible impact of co-residence structures heterogeneity on socio-economic inequalities in mortality stemming from within-household transmission of the virus. Using a simulation approach, the article highlights the existence of theoretical pronounced inequalities of vulnerability to COVID-19 related to cohabitation structures as well as a reversal of the social gradient of vulnerability when the age of the infected person increases. Among young age categories, infection is simulated to lead to more deaths in the less educated or foreign-born populations. Among the older ones, the inverse holds with infections having a greater potential to provoke deaths through the transmission of the virus within households headed by a highly educated or a native-born person. Demographic patterns such as the cohabitation of multiple generations and the survival of both partners of a couple help to explain these results. Even though inter-generational co-residence and large households are more common among the lower educated and foreign born in general, the higher educated are more likely to still live with their partner at higher ages.
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Affiliation(s)
- Julien Giorgi
- National Institute of Statistics and Economic Studies, Montrouge, 92120 France
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Bhattacharya M, Xiong S, McRee AL. Nativity Differences in Awareness and Knowledge About HPV Infection and Vaccination Among U.S. Adults: Findings from a National Population-Based Sample. J Immigr Minor Health 2021; 24:794-798. [PMID: 34455520 DOI: 10.1007/s10903-021-01268-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 08/21/2021] [Indexed: 10/20/2022]
Abstract
Foreign-born populations in the United States suffer multiple disparities related to human papillomavirus, including higher cervical cancer mortality and lower HPV vaccination. No nationally based studies have examined the relationship between nativity with HPV and HPV vaccination awareness and knowledge, especially examining acculturation, an immigration-specific process affecting health-related behaviors. We assessed nativity differences in HPV awareness and knowledge, and awareness of HPV vaccination using data from a population-based sample of adults in the U.S. (n = 2415). Among foreign-born respondents, we also assessed the association of acculturation with outcomes. Awareness of HPV and HPV vaccination were lower among foreign-born respondents compared to U.S.-born respondents. Knowledge of HPV was similar between populations. Acculturation was not associated with any of the assessed outcomes. Findings suggest HPV-related awareness deficits among foreign-born U.S. residents, highlighting a need for culturally-appropriate HPV prevention efforts.
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Affiliation(s)
- Manami Bhattacharya
- Department of Health Management and Policy, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Serena Xiong
- Department of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Annie-Laurie McRee
- Department of Pediatrics, University of Minnesota Medical School, 717 Delaware St SE #386, Minneapolis, MN, 55414, USA.
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Saggi S, Carmen GD, Chen YW, Udelsman BV, Goldstone RN, Chang DC. The Paradoxical Protective Effect of Immigration on Colorectal Cancer Survivals. J Surg Res 2021; 267:586-592. [PMID: 34265602 DOI: 10.1016/j.jss.2021.06.005] [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] [Received: 02/16/2021] [Revised: 05/01/2021] [Accepted: 06/08/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND It is unknown whether the place of birth would affect colon cancer survival. METHODS An observational study of colon cancer patient data using the SEER database from 1973 to 2010 was performed. Patients with more than one primary cancer in their lifetime or patients who were under age 18 were excluded. The primary outcome was cancer-specific survival. Cox proportional hazards analyses were performed, adjusting for patient demographics and oncological characteristics. RESULTS A total of 262,618 colon cancer patients were analyzed, with the majority (86.0%) born in the US. The overall 5-year cancer-specific survival rate was 51.4% and was significantly lower for US-born than non-US born patients (50.4% vs 58.1%). This difference persisted in local/regional disease and in cases with distant metastasis, and across racial groups. On adjusted analysis, US-born patients had worse disease-specific survivals (HR 1.28, 95% CI 1.24-1.33), and this effect persisted in all racial groups except in Asians. CONCLUSION US-born patients have worse survivals than non-US born patients. This is paradoxical given known disparities in quality of care delivered to immigrant populations. It may be useful to consider including geographical histories in patient interviews.
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Affiliation(s)
- Soren Saggi
- Yale University, New Haven, CT; Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Gabriel Del Carmen
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA; McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX
| | - Ya-Wen Chen
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Brooks V Udelsman
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Robert N Goldstone
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - David C Chang
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
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Escobar B, Amboree TL, Sonawane K, Deshmukh AA, McGee LU, Rodriguez AM, Jibaja-Weiss ML, Montealegre JR. Human papillomavirus awareness among foreign- and US-born Hispanics, United States, 2017-2018. Prev Med Rep 2021; 22:101379. [PMID: 33996392 PMCID: PMC8102157 DOI: 10.1016/j.pmedr.2021.101379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 03/23/2021] [Accepted: 03/28/2021] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Human papillomavirus (HPV) and HPV vaccine knowledge and awareness are known to be lower among Hispanics compared to non-Hispanic whites. However, Hispanics in the US are a non-homogenous population, with significant differences by nativity, particularly between the US-and foreign-born individuals. We examined HPV and HPV vaccine awareness among foreign-born Hispanics, US-born Hispanics, and US-born non-Hispanic whites. METHODS We analyzed data from the Health Information National Trends Survey (HINTS) 5, cycles 1 (2017) and 2 (2018), the most recent HINTS datasets including nativity information. We used descriptive statistics and multivariable regression to compare awareness of HPV and the HPV vaccine among ethnicity/nativity subgroups. RESULTS Over 50% of foreign-born Hispanics had not heard of HPV, compared to 32% of US-born Hispanics (P < 0.01) and 33% of non-Hispanic whites (p < 0.01). Lack of HPV vaccine awareness among foreign-born Hispanics was not significantly different from US-born Hispanics (52% vs. 44%, p = 0.12), but was significantly lower compared to non-Hispanic whites (52% vs. 32%, p < 0.01). In multivariable analyses, non-Hispanic whites had over twice the odds of having heard of HPV than foreign-born Hispanics (p < 0.05), while US-born Hispanics had 75% higher odds (p < 0.05). Regarding HPV awareness, non-Hispanic whites had 95% higher odds of having heard of the HPV vaccine than foreign-born Hispanics (p < 0.05), while differences between US and foreign-born Hispanics were not significant. CONCLUSION There are significant nativity-related differences in HPV and HPV vaccine awareness and knowledge among US-born Hispanics. Over 50% of foreign-born Hispanic adults are unaware of HPV and the HPV vaccine.
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Affiliation(s)
- Betsy Escobar
- Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, United States
| | - Trisha L. Amboree
- Department of Epidemiology, UTHealth School of Public Health, Houston, TX, United States
| | - Kalyani Sonawane
- Department of Management, Policy and Community Health, UTHealth School of Public Health, Houston, TX, United States
| | - Ashish A. Deshmukh
- Department of Management, Policy and Community Health, UTHealth School of Public Health, Houston, TX, United States
| | - Lindy U. McGee
- Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, United States
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
| | - Ana M. Rodriguez
- Department of Obstetrics and Gynecology, The University of Texas Medical Branch, Galveston, TX, United States
| | - Maria L. Jibaja-Weiss
- Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, United States
- School of Health Professions, Baylor College of Medicine, Houston, TX, United States
| | - Jane R. Montealegre
- Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, United States
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
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Niño MD. Poverty, Material Hardship, and Telomere Length Among Latina/o Children. J Racial Ethn Health Disparities 2021; 9:1315-1324. [PMID: 34047997 PMCID: PMC8162160 DOI: 10.1007/s40615-021-01072-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/20/2021] [Accepted: 05/24/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Despite increased attention on the links between poverty and the health and wellbeing of youth, few have attempted to understand the physiological consequences associated with different forms of economic disadvantage among Latina/o children. The present study begins to address this gap by (1) examining whether different forms of economic disadvantage were related to telomere length for Latina/o children and (2) determining whether parents' nativity shapes economic disadvantage-telomere length relationships. METHODS Data were drawn from the Fragile Families and Child Wellbeing Study, a longitudinal, stratified multistage probability sample of couples and children in 20 large US cities. The sample consisted of 417 Latina/o children and their parents that were followed from birth to age 9. Ordinary least squares regressions were used to examine relationships between economic disadvantage and telomere length. RESULTS Findings revealed that poverty status was not significantly related to telomere length, whereas some forms of material hardship were shown to play a role in the risk of premature cellular aging. More specifically, medical hardship and difficulty paying bills were associated with shorter telomere length at age 9. Results also provide minimal evidence economic disadvantage-telomere length patterns varied by parents' nativity. Only medical hardship was related to shorter telomere length at age 9 for children with at least one foreign-born parent. CONCLUSION Overall, results indicate that the risk of premature cellular aging depends on the measure of economic disadvantage under investigation. Findings from this study can inform targeted strategies designed to reduce the deleterious consequences associated with economic deprivation.
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Affiliation(s)
- Michael D Niño
- Department of Sociology and Criminology, University of Arkansas, Fayetteville, AR, 72701, USA.
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Garcia MA, Downer B, Chiu CT, Saenz JL, Ortiz K, Wong R. Educational Benefits and Cognitive Health Life Expectancies: Racial/Ethnic, Nativity, and Gender Disparities. Gerontologist 2021; 61:330-340. [PMID: 32833008 DOI: 10.1093/geront/gnaa112] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [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: 01/15/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND AND OBJECTIVES To examine racial/ethnic, nativity, and gender differences in the benefits of educational attainment on cognitive health life expectancies among older adults in the United States. RESEARCH DESIGN AND METHODS We used data from the Health and Retirement Study (1998-2014) to estimate Sullivan-based life tables of cognitively healthy, cognitively impaired/no dementia, and dementia life expectancies by gender for older White, Black, U.S.-born Hispanic, and foreign-born Hispanic adults with less than high school, high school, and some college or more. RESULTS White respondents lived a greater percentage of their remaining lives cognitively healthy than their minority Black or Hispanic counterparts, regardless of level of education. Among respondents with some college or more, versus less than high school, Black and U.S.-born Hispanic women exhibited the greatest increase (both 37 percentage points higher) in the proportion of total life expectancy spent cognitively healthy; whereas White women had the smallest increase (17 percentage points higher). For men, the difference between respondents with some college or more, versus less than high school, was greatest for Black men (35 percentage points higher) and was lowest for U.S.-born Hispanic men (21 percentage points higher). DISCUSSION AND IMPLICATIONS Our results provide evidence that the benefits of education on cognitive health life expectancies are largest for Black men and women and U.S.-born Hispanic women. The combination of extended longevity and rising prevalence of Alzheimer's disease points to the need for understanding why certain individuals spend an extended period of their lives with poor cognitive health.
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Affiliation(s)
- Marc A Garcia
- Department of Sociology and Institute for Ethnic Studies, University of Nebraska-Lincoln
| | - Brian Downer
- Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston
| | - Chi-Tsun Chiu
- Institute of European and American Studies, Academia Sinica, Taipei, Taiwan
| | - Joseph L Saenz
- Davis School of Gerontology, University of Southern California, Los Angeles
| | - Kasim Ortiz
- Department of Sociology & Criminology, University of New Mexico, Albuquerque
| | - Rebeca Wong
- Department of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston
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Abstract
Objective To evaluate the relationship between metabolic risk (MR) and depression in a sample of older Mexican Americans and examine whether the association differs by age at migration. Methods Longitudinal study using data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly (HEPESE) (N=807, mean age = 84.3). The analytical sample was compiled from wave 6 (2007) to wave 7 (2010-2011) of HEPESE. Random-effect logistic regression examined the association between MR and depression and tested the model stratified by nativity status and age at migration. Results MR was associated with higher odds of depression for US-born Mexican Americans after controlling for potential confounders. Similarly, among Mexican Americans who migrated before age 20, MR was associated with higher odds of depression. Conclusion The findings highlight the importance of age at migration when evaluating the health of foreign-born Mexican Americans from a life-course perspective. Particularly among Mexican Americans who migrated before age 20, those with MR were more vulnerable to depression than their counterparts without MR.
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Affiliation(s)
- Weihui Zhang
- University at Albany, Department of Sociology (SUNY), Albany, NY
| | | | - Anda Botoseneanu
- University of Michigan, Department of Health & Human Services and Institute of Gerontology, Dearborn, MI
| | - Recai Yucel
- Temple University, Department of Epidemiology and Biostatistics, Philadelphia, PA
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Abstract
This study examines the prevalence of several types of hardship (e.g., bill paying and housing hardships) among immigrants by race and ethnicity in the United States using data from the 2008 and 2014 panels of the Survey of Income and Program Participation and logistic regressions. I find that Blacks, and to some extent Hispanics, are more likely to report hardships than Whites and Asians, who are about equally likely to report hardships. Exploring results by nativity and citizenship status, I find that immigrants who became U.S. citizens are less likely than the native-born population to report some kinds of hardship. Undocumented immigrants, however, are more likely to report some kinds of hardships, particularly in the 2008 panel conducted at the time of the Great Recession, which hit immigrants especially hard; this relationship, however, is explained by the lower incomes of undocumented immigrant households in the 2008 panel. Results within racial and ethnic groups are generally in the same direction but are less frequently statistically significant. Overall, these findings suggest that immigrants are not particularly prone to hardship, especially when other characteristics are controlled for. In fact, the lower likelihood of some hardships among foreign-born citizens suggests that they are positively selected: they may have unobserved characteristics that are protective, such as better health, stronger social networks, or money management skills. Because the foreign-born are less likely to be disadvantaged vis-à-vis the native-born when hardship rather than the official income poverty measure is used, this study highlights the importance of using multiple measures when assessing the well-being of immigrants.
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Affiliation(s)
- John Iceland
- Department of Sociology, Penn State University, University Park, PA, USA
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Garcia E, Eckel SP, Chen Z, Li K, Gilliland FD. COVID-19 mortality in California based on death certificates: disproportionate impacts across racial/ethnic groups and nativity. Ann Epidemiol 2021; 58:69-75. [PMID: 33746033 PMCID: PMC8005258 DOI: 10.1016/j.annepidem.2021.03.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 03/10/2021] [Accepted: 03/10/2021] [Indexed: 12/22/2022]
Abstract
Purpose To examine characteristics of coronavirus disease 2019 (COVID-19) decedents in California (CA) and evaluate for disproportionate mortality across race/ethnicity and ethnicity/nativity. Methods COVID-19 deaths were identified from death certificates. Age-adjusted mortality rate ratios (MRR) were compared across race/ethnicity. Proportionate mortality rates (PMR) were compared across race/ethnicity and by ethnicity/nativity. Results We identified 10,200 COVID-19 deaths in CA occurring February 1 through July 31, 2020. The most frequently observed characteristics among decedents were age 65 years or above, male, Hispanic, foreign-born, and educational attainment of High School or below. MRR indicated elevated COVID-19 morality rates among Asian/Pacific Islander, Black, and Hispanic groups compared with the White group, with Black and Hispanic groups having the highest MRR at 2.75 (95%CI: 2.54–2.97) and 4.18 (95%CI: 3.99–4.37), respectively. Disparities were larger at younger ages. Similar results were observed with PMR, and patterns of age-racial/ethnic disparities remained in analyses stratified by education. Elevated PMR were observed in all ethnicity/nativity groups, especially foreign-born Hispanic individuals, relative to U.S.-born non-Hispanic individuals. These were generally larger at younger ages and persisted after stratifying by education. Conclusions Differential COVID-19 mortality was observed in California across racial/ethnic groups and by ethnicity/nativity groups with evidence of greater disparities among younger age groups. Identifying COVID-19 disparities is an initial step toward mitigating disease impacts in vulnerable communities.
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Affiliation(s)
- Erika Garcia
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA.
| | - Sandrah P Eckel
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA
| | - Zhanghua Chen
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA
| | - Kenan Li
- Spatial Sciences Institute, University of Southern California, Los Angeles, CA
| | - Frank D Gilliland
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA
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Niño MD, Chavez YZ. Stress and Allostatic Load Among Latina/os: Evidence from the Hispanic Community Health Study/Study of Latina/os. J Immigr Minor Health 2021; 23:895-903. [PMID: 33666779 DOI: 10.1007/s10903-021-01175-x] [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: 02/22/2021] [Indexed: 12/01/2022]
Abstract
We investigated associations between measures of environmental and psychological stress (i.e., chronic stress and perceived stress) and allostatic load across gender. We also tested whether other important intersectional factors, such as ethnic background and nativity, moderated stress-allostatic load relationships. Data were drawn from the Hispanic Community Health Study/ Study of Latina/os, a representative, multi-ethnic sample of Latina/os living in four urban communities. The final analytic sample consisted of 3848 Latina/os from five ethnic groups: Cuban, Puerto Rican, Dominican, Mexican, and South/ Central American. Findings indicate greater chronic and perceived stress were significantly associated with allostatic load for males but not for females. We also find, in some cases, ethnic background and nativity moderated relationships between types of stress and allostatic load for males. Findings suggest that environmental and psychological stressors can potentially shape health profiles of Latino males, with important differences across ethnic background and nativity.
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Affiliation(s)
- Michael D Niño
- Department of Sociology and Criminology, 1 University of Arkansas, Fayetteville, AR, 72701, USA.
| | - Yolanda Z Chavez
- Department of Sociology and Criminology, 1 University of Arkansas, Fayetteville, AR, 72701, USA
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Yusuf KK, Dongarwar D, Maiyegun SO, Ikedionwu C, Ibrahimi S, Salihu HM. Impact of Maternal Age on the Foreign-Born Paradox. J Immigr Minor Health 2021; 23:1198-1205. [PMID: 33575978 DOI: 10.1007/s10903-021-01157-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 01/30/2021] [Indexed: 11/28/2022]
Abstract
To examine the effect of maternal age on the risk of preterm birth and its phenotypes in foreign-born compared to native-born mothers. The 2014-2017 US Birth and Fetal Death data were analyzed (N = 14,867,880). Log-binomial regression models were used to estimate adjusted prevalence ratios (APR), quantifying the association between mother's nativity and preterm birth and its phenotypes, stratified by maternal age. Foreign-born mothers had a 13% lower probability of preterm birth compared to their native-born counterparts (APR, 0.87 [95% CI 0.86-0.87]). This protective effect persisted across all preterm phenotypes. Stratification by maternal age showed a slightly elevated risk in preterm and moderate-to-late preterm for adolescent mothers. Our study supports the existence of the "foreign-born paradox" whereby foreign-born mothers experienced lower levels of preterm birth despite the disadvantages of living in an alien socio-cultural environment. This favorable birth outcome was present primarily in foreign-born mothers aged ≥ 20 years.
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Affiliation(s)
- Korede K Yusuf
- College of Nursing and Public Health, Adelphi University, Garden City, New York, USA.
| | - Deepa Dongarwar
- Center of Excellence in Health Equity, Training and Research, Baylor College of Medicine, Houston, TX, USA
| | | | - Chioma Ikedionwu
- Center of Excellence in Health Equity, Training and Research, Baylor College of Medicine, Houston, TX, USA
| | - Sahra Ibrahimi
- College of Nursing and Public Health, Adelphi University, Garden City, New York, USA
| | - Hamisu M Salihu
- Center of Excellence in Health Equity, Training and Research, Baylor College of Medicine, Houston, TX, USA.,Family and Community Medicine, Baylor College of Medicine, Houston, TX, USA
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Akhtar S, Alroughani R. Evaluation of disparities in multiple sclerosis risk by age, sex, and nativity in Kuwait:1980-2019. Mult Scler Relat Disord 2021; 47:102676. [PMID: 33316627 DOI: 10.1016/j.msard.2020.102676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 11/07/2020] [Accepted: 12/03/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVE This cross-sectional cohort study quantified the disparities in MS risk by age, sex, nativity from 1980 to 2019 in Kuwait. METHODS Age-standardized MS incidence rate (ASIR) (per 100,000 person-years) overall and by subcohorts defined by cross-classification of the period (5-year groups) of diagnosis, age at onset, sex (female or male) and nativity (Kuwaiti or non-Kuwaiti) were computed and analyzed using multivariable negative binomial model. RESULTS Overall MS ASIR (per 100,000 person-years) was 3.41 (95% CI: 1.61, 5.21), which exponentially increased from 1980 to 2014 before drifting downward in 2015-2019 period. Compared with adults (age ≥ 40 years), males, non-Kuwaiti residents respectively, young adults (20-39 years), females and Kuwaiti nationals were significantly (p < 0.05) more likely to develop MS after adjusting for the period effect. CONCLUSIONS A high overall MS ASIR (per 100,000 person-years) was recorded with substantial temporal variation between 1980 and 2019. Young adults (20-39 years), females and Kuwaiti nationals constituted MS high-risk groups. The knowledge of underlying interface pathways between genetic and environmental factors may provide insights into MS pathogenesis and leads for future research.
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Lee JR, Maruthur NM, Yeh HC. Nativity and prevalence of cardiometabolic diseases among U.S. Asian immigrants. J Diabetes Complications 2020; 34:107679. [PMID: 32900593 PMCID: PMC9078065 DOI: 10.1016/j.jdiacomp.2020.107679] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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] [Received: 07/22/2019] [Revised: 07/08/2020] [Accepted: 07/13/2020] [Indexed: 11/17/2022]
Abstract
AIMS Acculturation has been shown to be an important factor for immigrants' health in the United States. We investigate whether nativity is associated with a greater risk for cardiometabolic diseases among Asian Americans (Asians) vs. non-Hispanic whites (whites). METHODS Based on data from the U.S. National Health Interview Survey in 2006-2015, 146,862 Asians and whites aged ≥30 years were evaluated. Nativity as a proxy for acculturation was defined using a combination of birthplace and the duration of U.S. residency. Cardiometabolic diseases were defined based on self-reported diagnoses of diabetes, prediabetes, or cardiovascular diseases (CVD). Using 10-year pooled data accounting for complex sampling designs and weights, multiple logistic regression models were used to assess associations. Four Asian subgroups, including Chinese, Filipinos, Asian Indians and other Asians, were evaluated in subgroup analyses. RESULTS Compared to U.S.-born whites, prevalent type 2 diabetes and prediabetes were higher among Asians depending on nativity. However, the prevalence of CVD was lower among Asians than among whites regardless of nativity (OR≥15 years = 0.5 [95% CI:0.5-0.6], ORU.S-born = 0.7 [95% CI:0.6-0.8]). In addition, compared to U.S.-born whites, prevalent type 2 diabetes and prediabetes increased with an increasing length of U.S. residency for foreign-born Asians among Asians overall (≥15 years: ORdiabetes = 1.5 [95% CI:1.3-1.7]; ORprediabetes = 1.3 [95% CI:1.2-1.6]) and Asian Indians and Filipinos. Furthermore, a significant graded association between prediabetes and length of U.S. residency was found among foreign-born Asians. CONCLUSIONS The prevalence of diabetes and prediabetes is higher among Asian immigrants who have spent more years in the U.S., than those in U.S.-born whites. Monitoring and prevention efforts for diabetes should target this group.
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Affiliation(s)
- Jiwon R Lee
- Samsung Health Research Institute, Samsung Electronics Co., Ltd., Hwaseong 18448, Republic of Korea.
| | - Nisa M Maruthur
- Department of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA; Department of Epidemiology, Johns Hopkins University, Baltimore, MD 21205, USA.
| | - Hsin-Chieh Yeh
- Department of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA; Department of Epidemiology, Johns Hopkins University, Baltimore, MD 21205, USA.
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Hyder A, Barnett KS. Low Birth Weight and Preterm Birth Among Arab-American Women in Ohio. Matern Child Health J 2020; 25:574-583. [PMID: 33247418 DOI: 10.1007/s10995-020-03095-y] [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: 11/08/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE There is limited evidence about prevalence and odds of adverse birth outcomes among Arab American women in the United States. We estimated the prevalence of low birth weight (LBW < 2500 g) and preterm birth (PTB < 37 completed weeks' gestation) among Arab American women in Ohio and studied the association between ethnicity, Arab American nativity (foreign or US born) and odds of LBW and PTB. METHODS We identified Arab American women based on birth certificate data from live singleton births from 2007-2010 to 2013-2015 and a name algorithm. We compared the prevalence of LBW and PTB by ethnicity (Arab American vs. non-Hispanic White) and by nativity (foreign-born Arab American vs. US-born Arab American). Logistic regression models were used to estimate the unadjusted and adjusted effects of ethnicity and mother's nativity on study outcomes. RESULTS 31,744 Arab American women (2.5% of all births in Ohio) were identified over a 7-year period. 24,129 Arab American women with complete data were included in the analysis after applying exclusion criteria. Prevalence of LBW was 5.2% (non-Hispanic White), 6.1% (Arab American), 6.4% (US-born Arab American) and 5.6% (foreign-born Arab American). Prevalence of PTB was 7.2% (non-Hispanic White), 7.0% (Arab American), 7.3% (US-born Arab American), and 5.4% (foreign-born Arab American). In adjusted models, which controlled for mother demographics, health behaviors, and pregnancy risk factors, Arab Americans had 33% higher odds of LBW (odds ratio [OR] 1.33; 95% Confidence Intervals[CI] 1.26-1.41) than non-Hispanic Whites. Foreign born Arab American women had 15% lower odds of PTB (OR 0.85; 95% CI 0.75-0.95) than US-born Arab Americans. CONCLUSIONS FOR PRACTICE Our main findings were that LBW is influenced by Arab ethnicity while PTB is influenced by nativity among Arab American women. These findings may be informative for developing and implementing strategies for adverse birth outcomes for a growing US ethnic minority population.
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Affiliation(s)
- Ayaz Hyder
- College of Public Health, Translational Data Analytics Institute, The Ohio State University, 1841 Neil Ave., Cunz Hall, Room 380D, Columbus, OH, 43210, USA.
| | - Kierra S Barnett
- College of Public Health, Kirwan Institute for the Study of Race and Ethnicity, The Ohio State University, 33 W 11th Avenue, Columbus, OH, 43201, USA
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McElfish PA, Narcisse MR, Felix HC, Cascante DC, Nagarsheth N, Teeter B, Faramawi MF. Race, Nativity, and Sex Disparities in Human Papillomavirus Vaccination Among Young Adults in the USA. J Racial Ethn Health Disparities 2020; 8:1260-1266. [PMID: 33033889 PMCID: PMC9753349 DOI: 10.1007/s40615-020-00886-5] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/24/2020] [Accepted: 09/28/2020] [Indexed: 11/26/2022]
Abstract
Research has demonstrated that the human papillomavirus (HPV) vaccine is a safe and effective way to decrease HPV-related cervical cancers; however, the vaccination rate in the USA is suboptimal. The current study examined racial and ethnic disparities in HPV vaccination among a nationally representative sample, including Native Hawaiian and Pacific Islanders (NHPI). This study also investigated the associations between nativity and vaccination, and sex differences between race/ethnicity and vaccination and nativity and vaccination. A cross-sectional study was conducted with a sample of adults aged 18-26 years drawn from the 2014 NHPI National Health Interview Survey (n = 2590) and the general 2014 National Health Interview Survey (n = 36,697). Log-binomial models were fitted to examine differences in vaccination. There was a statistically significant racial/ethnic difference in HPV vaccination (p = 0.003). More women than men were vaccinated (41.8% vs. 10.1%) (p < 0.001). There was a significant difference in HPV vaccination based on nativity: 27.4% of adults aged 18 to 26 years who were born in the USA and 27.7% born in a US territory received the HPV vaccine compared with 14.3% among those not born in the USA or a US territory (p < 0.001). The association of HPV vaccination with nativity and race/ethnicity differed by sex and showed several nuanced differences. Overall, the prevalence of HPV vaccination was low. The study's findings demonstrate the need for public health strategies to increase vaccination rates among all populations, with the critical need to identify strategies that are effective for men, racial/ethnic minorities, and immigrant women born outside the USA.
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Affiliation(s)
- Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N College Ave, Fayetteville, AR, 72703, USA.
| | - Marie-Rachelle Narcisse
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N College Ave, Fayetteville, AR, 72703, USA
| | - Holly C Felix
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA
| | - Diana C Cascante
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, 72703, USA
| | - Nirav Nagarsheth
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N College Ave, Fayetteville, AR, 72703, USA
| | - Ben Teeter
- College of Pharmacy, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA
| | - Mohammed F Faramawi
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA
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Scott KA, Chambers BD, Baer RJ, Ryckman KK, McLemore MR, Jelliffe-Pawlowski LL. Preterm birth and nativity among Black women with gestational diabetes in California, 2013-2017: a population-based retrospective cohort study. BMC Pregnancy Childbirth 2020; 20:593. [PMID: 33023524 PMCID: PMC7541301 DOI: 10.1186/s12884-020-03290-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 09/27/2020] [Indexed: 02/08/2023] Open
Abstract
Background Despite the disproportionate prevalence of gestational diabetes (GDM) and preterm birth (PTB) and their associated adverse perinatal outcomes among Black women, little is known about PTB among Black women with GDM. Specifically, the relationship between PTB by subtype (defined as indicated PTB and spontaneous PT labor) and severity, GDM, and nativity has not been well characterized. Here we examine the risk of PTB by severity (early < 34 weeks, late 34 to 36 weeks) and early term birth (37 to 38 weeks) by nativity among Black women with GDM in California. Methods This retrospective cohort study used linked birth certificate and hospital discharge data for 8609 of the 100,691 self-identifying non-Hispanic Black women with GDM who had a singleton live birth between 20 and 44 weeks gestation in California in 2013–2017. Adjusted odds ratios (aOR) and 95% confidence intervals (CIs) were examine risks for PTB, by severity and subtype, and early term birth using multivariate regression modeling. Results Approximately, 83.9% of Black women with GDM were US-born and 16.1% were foreign-born. The overall prevalence of early PTB, late PTB, and early term birth was 3.8, 9.5, and 29.9%, respectively. Excluding history of prior PTB, preeclampsia was the greatest overall risk factor for early PTB (cOR = 6.7, 95%, CI 5.3 to 8.3), late PTB (cOR = 4.3, 95%, CI 3.8 to 5.0), and early term birth (cOR = 1.8, 95%, CI 1.6 to 2.0). There was no significant difference in the prevalence of PTB by subtypes and nativity (p = 0.5963). Overall, 14.2% of US- compared to 8.9% of foreign-born women had a PTB (early PTB: aOR = 0.56, 95%, CI 0.38 to 0.82; late PTB: aOR = 0.57, 95%, CI 0.45 to 0.73; early term birth: aOR = 0.67, 95%, CI 0.58 to 0.77). Conclusions Foreign-born status remained protective of PTB, irrespective of severity and subtype. Preeclampsia, PTB, and GDM share pathophysiologic mechanisms suggesting a need to better understand differences in perinatal stress, chronic disease, and vascular dysfunction based on nativity in future epidemiologic studies and health services research.
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Affiliation(s)
- Karen A Scott
- Department of Obstetrics, Gynecology & Reproductive Sciences, School of Medicine, University of California San Francisco, 2356 Sutter Street, J-140, San Francisco, CA, 94143, USA.
| | - Brittany D Chambers
- California Preterm Birth Initiative, University of California San Francisco, 3333 California Street, Suite 285, San Francisco, CA, 94118, USA.,Department of Epidemiology and Biostatistics, School of Medicine, University of California San Francisco, 560 16th Street, Second Floor, San Francisco, CA, 94158, USA
| | - Rebecca J Baer
- Department of Obstetrics, Gynecology & Reproductive Sciences, School of Medicine, University of California San Francisco, 2356 Sutter Street, J-140, San Francisco, CA, 94143, USA.,California Preterm Birth Initiative, University of California San Francisco, 3333 California Street, Suite 285, San Francisco, CA, 94118, USA.,Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, Building 3, La Jolla, CA, 92161, USA
| | - Kelli K Ryckman
- Department of Epidemiology, University of Iowa College of Public Health, 145 N. Riverside Drive, Office S435 CPHB, Iowa City, IA, 52242, USA
| | - Monica R McLemore
- Family Health Care Nursing Department, School of Nursing, University of California, 2 Koret Way, N431H, San Francisco, San Francisco, CA, 94143, USA
| | - Laura L Jelliffe-Pawlowski
- California Preterm Birth Initiative, University of California San Francisco, 3333 California Street, Suite 285, San Francisco, CA, 94118, USA.,Department of Epidemiology and Biostatistics, School of Medicine, University of California San Francisco, 560 16th Street, Second Floor, San Francisco, CA, 94158, USA
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Herbach EL, Weeks KS, O'Rorke M, Novak NL, Schweizer ML. Disparities in breast cancer stage at diagnosis between immigrant and native-born women: A meta-analysis. Ann Epidemiol 2020; 54:64-72.e7. [PMID: 32950654 DOI: 10.1016/j.annepidem.2020.09.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 06/01/2020] [Revised: 07/10/2020] [Accepted: 09/13/2020] [Indexed: 01/15/2023]
Abstract
PURPOSE To synthesize existing observational evidence to identify disparities in stage at breast cancer diagnosis between foreign- and native-born women. We hypothesized immigrant women would be less likely than natives to be diagnosed at a localized stage. METHODS Systematic searches for studies detailing stage at breast cancer diagnosis by birthplace in PubMed, Embase, and Web of Science yielded 11 relevant cohort studies from six countries. Odds ratios were pooled using random effects models. RESULTS Foreign-born women were 12% less likely to be diagnosed with breast cancer at a localized stage than natives (OR 0.88, 95% CI 0.82-0.95). A similar disadvantage was observed in immigrants from Asia, Eastern Europe, Latin America and the Caribbean, and developing or in transition nations; immigrants from developed countries experienced the least disparity. CONCLUSIONS This meta-analysis confirmed the presence of significant differences in breast cancer stage at diagnosis as per nativity. Across diverse immigrant groups and host countries, foreign-born women were significantly less likely to be diagnosed with localized breast cancer than native women; the magnitude of the disparity varied by region and economic condition of immigrants' birthplace.
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Affiliation(s)
- Emma L Herbach
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City.
| | - Kristin S Weeks
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City
| | - Michael O'Rorke
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City
| | - Nicole L Novak
- Department of Community and Behavioral Health, University of Iowa, Iowa City
| | - Marin L Schweizer
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City; Center for Access & Delivery Research and Evaluation, Iowa City Veterans Affairs Health Care System, Iowa City, IA
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Araneta MRG, Baer RJ, Muglia LJ, Ryckman KK, Ryu J, Sidelinger DE, Jeliffe-Powlowski LL, Chambers CD. Health Advantages and Disparities in Preterm Birth Among Immigrants Despite Disparate Sociodemographic, Behavioral, and Maternal Risk Factors in San Diego, California. Matern Child Health J 2020; 24:153-164. [PMID: 31838667 DOI: 10.1007/s10995-019-02836-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Reproductive health advantages have been reported among selected immigrants, but few studies have included new immigrants and refugees, nor simultaneously adjusted for socioeconomic, behavioral, and medical disparities. METHODS We examined the risk of preterm birth (PTB, < 37 weeks' gestation) among singleton live births in San Diego County from 2007 to 2012. Multivariable regression was used to compare PTB (1) by nativity within racial/ethnic groups and (2) among immigrants compared to United States (US) born Whites, while adjusting for sociodemographic, behavioral, reproductive and medical variables. RESULTS Among 230,878 singleton live births, overall PTB prevalence was highest among parturient women who were US-born Blacks (10.9%), Philippine (10.8%) and US-born Filipinas (10.7%), and US-born Asians (8.6%) despite differences in socioeconomic and maternal risk factors, and lowest among Somali (5.5%) migrants. Blacks born in Somalia or outside of the US, had significantly lower overall PTB prevalence compared to US-born Blacks (5.5% vs 7.6% vs 10.9%). Compared to US-born Whites, spontaneous PTB risk was significantly lower among Somali migrants (4.8% vs 3.7%, adjusted relative risk, aRR 0.7 [95% Confidence Intervals 0.5-0.9]), but higher among Philippine migrants (4.8% vs 7.7%, aRR 1.4 [1.3-1.6]). The strongest risk factor for overall PTB among nulliparous US-born Blacks was preexisting diabetes (aRR 3.81 [2.05-7.08]), and preexisting hypertension among Filipinas (aRR: 3.27 [2.36-4.54] and US-born Asians (aRR: 3.64 [1.61-8.24]). CONCLUSION Black migrants had lower PTB prevalence compared to US-born Blacks, but this immigrant advantage was not observed in other racial/ethnic groups. Compared to US-born Whites, Somali migrants had significantly lower risk of spontaneous PTB while Filipinas had elevated risk.
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Affiliation(s)
- Maria Rosario G Araneta
- Department of Family Medicine and Public Health, University of California San Diego, 9500 Gilman Drive MC-0606, La Jolla, CA, 92093-0606, USA.
| | - Rebecca J Baer
- Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
- California Preterm Birth Initiative, University of California San Francisco, San Francisco, CA, USA
| | - Louis J Muglia
- Center for Prevention of Preterm Birth, Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Kelli K Ryckman
- Departments of Epidemiology and Pediatrics, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Julie Ryu
- Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
- Rady Children's Hospital, San Diego, CA, USA
| | - Dean E Sidelinger
- County of San Diego Health and Human Services Agency, Medical Care Services Division, San Diego, CA, USA
| | - Laura L Jeliffe-Powlowski
- California Preterm Birth Initiative, University of California San Francisco, San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Christina D Chambers
- Department of Family Medicine and Public Health, University of California San Diego, 9500 Gilman Drive MC-0606, La Jolla, CA, 92093-0606, USA
- Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
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Arias E, Johnson NJ, Vera BT. Racial disparities in mortality in the adult hispanic population. SSM Popul Health 2020; 11:100583. [PMID: 32346598 PMCID: PMC7180162 DOI: 10.1016/j.ssmph.2020.100583] [Citation(s) in RCA: 6] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 04/01/2020] [Accepted: 04/02/2020] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE We addressed three research questions: (1) Are there racial mortality disparities in the adult Hispanic population that resemble those observed in the non-Hispanic population in the US? (2) Does nativity mediate the race-mortality relationship in the Hispanic population? and (3) What does the Hispanic mortality advantage relative to the non-Hispanic white population look like when Hispanic race is considered? METHODS We estimated a series of parametric hazard models on eight years of mortality follow-up data and calculated life expectancy estimates using the Mortality Disparities in American Communities database. RESULTS Hispanic white adults experience lower mortality than their Hispanic black, American Indian and Alaska Native, Some Other Race, and multiple race counterparts. This Hispanic white advantage is found mostly among the US born. The Hispanic advantage relative to the non-Hispanic white population operates for most Hispanic race groups among the foreign born but either disappears or converts to a disadvantage for most of the non-white Hispanic groups among the US born. CONTRIBUTION Our study extends the literature on the Hispanic Mortality Paradox by revealing that the adult Hispanic population experiences racial mortality disparities that closely resemble those observed in the non-Hispanic population. The Hispanic mortality advantage is mediated not only by nativity but by race. These results indicate that race is a critical factor that should be considered in any study with the goal of understanding the health and mortality profiles of the Hispanic population in the US.
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Affiliation(s)
- Elizabeth Arias
- Mortality Statistics Branch, Division of Vital Statistics, National Center for Health Statistics, 3311 Toledo Road, Hyattsville, 20782, MD, United States
| | - Norman J. Johnson
- Mortality Research Branch, Center for Economic Studies, U.S. Census Bureau, 4600 Silver Hill Road, Room 5K127, Suitland, MD, 20746, United States
| | - Betzaida Tejada Vera
- Mortality Statistics Branch, Division of Vital Statistics, National Center for Health Statistics, 3311 Toledo Road, Hyattsville, 20782, MD, United States
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Assari S, Perez MU, Johnson N, Williams NR, Carrillo E, Garcia L, Hollis XT. Education Level and Self-rated Health in the United States: Immigrants' Diminished Returns. Int J Travel Med Glob Health 2020; 8:116-123. [PMID: 32905455 DOI: 10.34172/ijtmgh.2020.20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 12/15/2022] Open
Abstract
Introduction Although education is among the major socioeconomic status (SES) resources that influence populations' and individuals' health, social marginalization may reduce the health gain that follows access to SES indicators such as education, a pattern called marginalization-related diminished return (MDR). The literature on MDRs, however, has been mainly derived from studies that have defined marginalization based on race, ethnicity, and sexual orientation. Thus, more research is needed on MDRs that may follow as a result of immigration. To extend what is known on immigration status related MDRs, this study compared a national sample of immigrants and non-immigrants for the effect of education on the poor self-rated health (SRH) of adults in the United States. Methods With a cross-sectional design, this study employed data from the 2015 National Health Interview Survey (NHIS), a survey that had enrolled 33,654 adults who were either immigrants (n = 6225; 18.5%) or non-immigrants (n = 27 429; 81.5%). The independent variable was education level, treated as a categorical variable. The dependent variable was SRH treated as a dichotomous variable. Race, ethnicity, age, gender, marital status, and region were the confounders. Immigration (nativity) was the moderator. Logistic regression was used for data analysis. Results Higher education credentials were associated with better SRH in the pooled sample; however, immigration showed a significant statistical interaction with education level (college graduation) on the outcome. This interaction was indicative of a smaller protective effect of college graduation on poor SRH among immigrants than non-immigrant adults. Conclusion In line with the MDRs framework, the effect of education on SRH is weaker for immigrants than for non-immigrant adults. There is a need to help highly educated immigrants to mobilize their human capital to secure their best health outcomes, similar to non-immigrants. Such strategies may require bold and innovative policy solutions to reduce discrimination against immigrants, so they can more effectively translate their education and human capital into tangible outcomes such as health.
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Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, USA
| | - Maryver U Perez
- Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, USA
| | - Nay'Air Johnson
- Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, USA
| | - Nikesha R Williams
- Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, USA
| | - Esmeralda Carrillo
- Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, USA
| | - Leslye Garcia
- Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, USA
| | - Xiaxiang T Hollis
- Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, USA
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Doamekpor LA, Gleason JL, Opara I, Amutah-Onukagha NN. Nativity and Cardiovascular Dysregulation: Evidence from the 2001-2016 National Health and Nutrition Examination Survey. J Racial Ethn Health Disparities 2021; 8:136-46. [PMID: 32410072 DOI: 10.1007/s40615-020-00765-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 03/14/2020] [Accepted: 04/22/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To examine nativity-based differences in 3 cardiovascular biomarkers commonly used to assess cardiovascular dysregulation. METHODS Data was pooled from the 2001-2016 National Health and Nutrition Examination Survey to compare biomarker risk scores for the US-born (n = 4693) and foreign-born (n = 2968) Black adults. We used multivariable-adjusted logistic regression to assess the association between nativity and cardiovascular biomarkers, controlling for gender, age, health behaviors, and socioeconomic status. RESULTS In the full model, a foreign-born health advantage was not observed in all 3 cardiovascular biomarkers. In fact, foreign-born Blacks were almost twice as likely to have high mean diastolic blood pressure compared with the US-born individuals (OR = 1.82; 95% CI = 1.15, 2.88) and had an increased risk of high 60-s pulse. Foreign-born individuals living in the USA for less than 5 years were 62% less likely to have high mean systolic blood pressure than individuals living in the USA for 20 years or more. CONCLUSIONS The foreign-born health advantage among Blacks was not observed in the cardiovascular biomarkers under study, suggesting that the commonly cited Healthy Immigrant Effect may need to be reassessed.
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Affiliation(s)
- R Dionigi
- University of Insubria, Varese, Italy
| | - F Trimarchi
- Accademia Peloritana dei Pericolanti at the University of Messina, Messina, Italy
| | - G Dionigi
- Division for Endocrine and Minimally Invasive Surgery, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University Hospital G. Martino, University of Messina, Via C. Valeria 1, 98125, Messina, Italy.
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Abstract
Growing costs of prescription medication are leading to increased purchases of prescriptions abroad. Yet there is a research gap of factors associated with this practice by nativity and race/ethnicity. We analyzed the 2017 National Health Interview Survey (n = 26,488). The outcome was whether the respondent purchased prescription medications from another country to save money in the past 12 months. Predictors were drawn from Andersen's healthcare utilization model. We used logistic regression models to examine factors associated with purchases by nativity and race/ethnicity. Foreign-born and Hispanic respondents showed a higher rate of purchasing medications abroad compared to their US-born and non-Hispanic white counterparts. Foreign-born respondents who are uninsured, who have no usual place of healthcare, who have difficulty finding a doctor, and who have lived in the US for less than 10 years were more likely to buy medications abroad. Different racial/ethnic groups differed on associated enabling factors. Need factor was significantly associated only with Hispanics' purchase of medications abroad. Our research reveals the need for health education regarding the safety and the illegality of this behavior, especially among recent and Hispanic immigrants.
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Affiliation(s)
- Sou Hyun Jang
- Sungkyunkwan University, 25-2 Sungkyunkwan-ro, Jongno-gu, Seoul, South Korea.
| | - Linda K Ko
- University of Washington & The Fred Hutch Cancer Research Center, 1100 Fairview Ave N., Mail Stop M3-B232, Seattle, WA, USA
| | - Hendrika Meischke
- University of Washington, H-675, Health Sciences Building, 1959 NE Pacific Street, Seattle, WA, USA
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Cuevas AG, Ortiz K, Ransome Y. The moderating role of race/ethnicity and nativity in the relationship between perceived discrimination and overweight and obesity: results from the National Epidemiologic Survey on Alcohol and Related Conditions. BMC Public Health 2019; 19:1458. [PMID: 31694587 PMCID: PMC6833296 DOI: 10.1186/s12889-019-7811-0] [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] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 10/21/2019] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The overweight/obesity epidemic is a public health issue in the United States (US), that disproportionately affect certain racial/ethnic minority groups. Perceived discrimination has been implicated as a health risk factor. However, research on race/ethnicity, perceived discrimination, and obesity has been mixed. Researchers suggest that perceptions of discrimination may be dependent upon nativity status. This study evaluated the role that nativity status and race/ethnicity play in the relationship between perceived discrimination and overweight/obesity. METHODS We used Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (2004-2005) [N = 33,319]). Multinomial logistic regression assessed a three-way interaction (perceived discrimination × race/ethnicity × nativity) on overweight and obesity, adjusting for sociodemographic factors and health-related behaviors. RESULTS The three-way interaction was significant for overweight [F (17, 49) = 3.35; p < 0.001] and obesity [F (17, 49) = 5.05; p < 0.001]. Among US-born individuals, US-born non-Hispanic Blacks had a decreased risk of being obese compared to US-born non-Hispanic Whites at mean levels of perceived discrimination [aRRR = 0.71; 95% CI (0.51-0.98); p = 0.04). Among foreign-born individuals, foreign-born South Americans had an increased risk of being overweight at mean levels of perceived discrimination compared to foreign-born non-Hispanic Whites [aRRR = 8.07; 95% CI (1.68-38.77); p = 0.01], whereas foreign-born Dominicans had a decreased risk of being obese compared to foreign-born non-Hispanic Whites [aRRR = 0.05; 95% CI (0.01-0.20); p < 0.001]. CONCLUSION Perceived racial discrimination is a risk factor for overweight/obesity for certain groups. Race/ethnicity and nativity may play important roles in the relationship between perceived discrimination and overweight/obesity. Future research is needed to identify the behavioral and psychological pathways that link perceived discrimination and overweight/obesity.
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Affiliation(s)
- Adolfo G Cuevas
- Department of Community Health, Tufts University, 574 Boston Ave, Suite 208, Medford, MA, 02155, USA.
| | - Kasim Ortiz
- Department of Sociology & Criminology, University of New Mexico, MSC05 3080, 1915 Roma NE Ste. 1103, Albuquerque, NM, 8713, USA
| | - Yusuf Ransome
- Department of Social & Behavioral Sciences, Yale School of Public Health, 60 College Street, LEPH Building, New Haven, CT, 06510, USA
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Schlumbrecht M, Bussies P, Huang M, Kobetz E, George S. Endometrial cancer among a cohort of urban Haitian immigrants. World J Clin Oncol 2019; 10:340-349. [PMID: 31799149 PMCID: PMC6885451 DOI: 10.5306/wjco.v10.i10.340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 08/22/2019] [Accepted: 09/22/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Black women are known to have a higher risk of aggressive endometrial cancers. Little data exist about the role of nativity as a determinant of survival outcomes in women with this disease.
AIM Our objective was to evaluate a population of Haitian immigrants with endometrial cancer in an urban setting using the Florida Cancer Data System (FCDS).
METHODS A search of FCDS identified 107 women born in Haiti and who received treatment for invasive endometrial cancer in Miami-Dade County between 1989 and 2013. Clinicopathologic data were extracted to describe the cohort and assess associations with overall survival. Statistical analyses were performed using Cox proportional hazards models, the log-rank test, and the Kaplan-Meier method, with significance set at P ≤ 0.05.
RESULTS Median age at diagnosis was 65 years. 63.9% of the patients had a type II, high-grade, histology, and 52.6% presented with extrauterine metastatic disease. Nearly three quarters had health insurance. Within the entire cohort, only presence of extrauterine disease was associated with worse overall survival [Hazard ratio (HR) = 2.70, 95% confidence interval (CI): 1.31-5.57, P = 0.007]. However, after stratification by histologic grade, both age (HR = 0.88, 95%CI: 0.81-0.96, P = 0.002) and extrauterine disease (HR = 2.49, 95%CI: 1.01-6.21, P = 0.049) were independently associated with worse survival, but only in women with type II malignancies.
CONCLUSION Urban Haitian women with endometrial cancer have a high burden of aggressive histologies. Additional investigation to explain the etiology of these findings is needed.
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Affiliation(s)
- Matthew Schlumbrecht
- Division of Gynecologic Oncology, Sylvester Comprehensive Cancer center, University of Miami Miller School of Medicine, Miami, FL 33139, United States
- Department of Obstetrics, Gynecology, and Reproductive Science, University of Miami Miller School of Medicine, Miami, FL 33139, United States
| | - Parker Bussies
- Department of Obstetrics, Gynecology, and Reproductive Science, University of Miami Miller School of Medicine, Miami, FL 33139, United States
| | - Marilyn Huang
- Division of Gynecologic Oncology, Sylvester Comprehensive Cancer center, University of Miami Miller School of Medicine, Miami, FL 33139, United States
- Department of Obstetrics, Gynecology, and Reproductive Science, University of Miami Miller School of Medicine, Miami, FL 33139, United States
| | - Erin Kobetz
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33139, United States
| | - Sophia George
- Division of Gynecologic Oncology, Sylvester Comprehensive Cancer center, University of Miami Miller School of Medicine, Miami, FL 33139, United States
- Department of Obstetrics, Gynecology, and Reproductive Science, University of Miami Miller School of Medicine, Miami, FL 33139, United States
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