RESUMO
Extant literature on Urge Urinary Incontinence (UUI) focuses on women and non-Hispanic Whites and little is known about ethnic minority men. We analyzed 700 Mexican-American men aged 75 and older from the fifth Wave (2004/5) of the Hispanic Established Population for the Epidemiologic Study of the Elderly. Logistic regression analyses examined risk factors for self-reported UUI and the impact of UUI on mental health and social support. Twenty-nine percent reported having difficulty holding their urine until they could get to a toilet. Men with more co-morbid conditions and men with prostate problems were more likely to report UUI symptoms. Men with UUI were less likely to report having a confidant and had a higher risk of high depressive symptoms. This study is the first to examine risk factors for and consequences of self-reported UUI among older Mexican-American men using a large community-based survey.
Assuntos
Americanos Mexicanos , Autorrelato , Incontinência Urinária de Urgência/etiologia , Incontinência Urinária de Urgência/psicologia , Idoso , Idoso de 80 Anos ou mais , Humanos , Masculino , Análise de Regressão , Fatores de Risco , Sudoeste dos Estados Unidos/epidemiologia , Incontinência Urinária de Urgência/epidemiologia , Incontinência Urinária de Urgência/etnologiaRESUMO
OBJECTIVES: To determine the prevalence of current hormone replacement therapy (HRT) use and describe its correlates among community-dwelling, Mexican-American women aged 67 and older. DESIGN: A population-based survey of older Mexican-Americans conducted in 1995/1996. SETTING: Five Southwestern states: Texas, New Mexico, California, Arizona, and Colorado. PARTICIPANTS: An area probability sample of 1,424 noninstitutionalized Mexican-American women aged 67 and older (mean age = 75.1) completed the survey instrument via a 90-minute in-home interview, which included examination and recording of all medications taken. MEASUREMENTS: Current use of HRT. RESULTS: In this sample of older Mexican-American women, 4.7% were current users of HRT. Controlling for sociodemographic characteristics (age, marital status, living arrangements, years of education, income, language of interview), current HRT use is significantly related to years of education (per each year) (odds ratio (OR) = 1.13; 95% confidence interval (CI) = 1.05-1.20), having had a hysterectomy (OR = 4.37; 95% CI 2.50-7.64), a diagnosis of osteoporosis (OR = 3.40, 95% CI = 1.58-7.33), age at menopause (per each year) (OR = 1.07; 95% CI = 1.03-1.12), ever having a mammogram (OR = 3.72; 95% CI = 1.66-8.37), ever having a Pap test/pelvic examination (OR = 2.11; 95% CI = 1.08-4.12), having spoken with a pharmacist within the past year regarding health conditions (OR = 1.96; 95% CI = 1.06-3.65), and having Medicare plus private insurance (OR = 2.13; 95% CI = 1.14-3.97). CONCLUSION: The prevalence of HRT use is lower than that reported in the older non-Hispanic white female population. In general, these findings indicate that access to and utilization of the traditional U.S. health care system are indicators of HRT use.
Assuntos
Terapia de Reposição de Estrogênios/estatística & dados numéricos , Americanos Mexicanos/estatística & dados numéricos , Pós-Menopausa , Atividades Cotidianas , Idoso , Idoso de 80 Anos ou mais , Feminino , Acessibilidade aos Serviços de Saúde , Nível de Saúde , Humanos , México/etnologia , Razão de Chances , Fatores Socioeconômicos , Sudoeste dos Estados UnidosRESUMO
Mini-Mental State Examination data from the Hispanic Established Population for the Epidemiologic Study of the Elderly baseline survey, a population-based study of community-dwelling Mexican Americans aged 65 and older, were used to examine the relationship between cognitive impairment, sociodemographics, and health-related characteristics. The rate of cognitive impairment found in this group of older Mexican Americans, using the conventional cut point of 23/24 on the MMSE, was 36.7%. Using a more conservative cut point of 17/18 indicated an overall rate of severe cognitive impairment of 6.7%. Rates of impairment varied significantly with age, education, literacy, marital status, language of interview, and immigrant status and were associated with high and moderate levels of depressive symptoms, and history of stroke. Importantly, although education was strongly related to poor cognitive performance, it was not a significant predictor of severe cognitive impairment. Multivariate analyses further indicated that as a screen for cognitive impairment in older Mexican Americans, the MMSE is strongly influenced by these noncognitive factors. Scores may reflect test bias, secondary to cultural differences or the level of education in this population.
Assuntos
Transtornos Cognitivos/diagnóstico , Testes de Inteligência , Americanos Mexicanos , Idoso , Idoso de 80 Anos ou mais , Transtornos Cognitivos/etnologia , Transtornos Cognitivos/psicologia , Escolaridade , Feminino , Humanos , Masculino , Valor Preditivo dos Testes , Vigilância de Evento Sentinela , Fatores Socioeconômicos , Estados Unidos/epidemiologiaRESUMO
OBJECTIVES: The prevalence and health burden of self-reported adult-onset diabetes mellitus were examined in older Mexican Americans. METHODS: Data from the Hispanic Established Populations for Epidemiologic Studies of the Elderly were used to assess the prevalence of self-reported diabetes and its association with other chronic conditions, disability, sensory impairments, health behaviors, and health service use in 3050 community-dwelling Mexican Americans 65 years and older. RESULTS: The prevalence of self-reported diabetes in this sample was 22%, and there were high rates of obesity, diabetes-related complications, and diabetic medication use. Myocardial infarction, stroke, hypertension, angina, and cancer were significantly more common in diabetics than in nondiabetics, as were high levels of depressive symptoms, low perceived health status, disability, incontinence, vision impairment, and health service use. Many of the rate differences found in this sample of older Mexican Americans were higher than those reported among other groups of older adults. CONCLUSIONS: Our findings indicate that the prevalence and health burden of diabetes are greater in older Mexican Americans than in older non-Hispanic Whites and African Americans, particularly among elderly men.
Assuntos
Idoso/estatística & dados numéricos , Efeitos Psicossociais da Doença , Diabetes Mellitus Tipo 2/etnologia , Americanos Mexicanos/estatística & dados numéricos , Idoso de 80 Anos ou mais , Comorbidade , Diabetes Mellitus Tipo 2/complicações , Pessoas com Deficiência/estatística & dados numéricos , Feminino , Comportamentos Relacionados com a Saúde/etnologia , Serviços de Saúde/estatística & dados numéricos , Inquéritos Epidemiológicos , Humanos , Masculino , México/etnologia , Vigilância da População , Prevalência , Distribuição por Sexo , Sudoeste dos Estados Unidos/epidemiologia , Inquéritos e QuestionáriosRESUMO
OBJECTIVES: The aim of this work was to examine changes in the smoking behavior of elderly Mexican Americans in the southwestern United States from the early 1980s to the early 1990s. METHODS: Data from the 1993-1994 Hispanic EPESE study (n = 2,809) on persons ages 65 to 74 and 75 to 84 residing in the five southwestern states were compared with data from the 1982-1984 Hispanic HANES study (n = 753, persons ages 55 to 74), which included a Mexican American sample from the same five southwestern states. RESULTS: Rates of current smoking in 1993-1994 for persons ages 65 to 74 were approximately half the rates for persons of the same age a decade earlier. Smoking rates for persons ages 75 to 84 in 1993-1994 were significantly lower than rates for persons ages 65 to 74 a decade earlier. Finally, rates for persons ages 65 to 74 in 1993-1994 were significantly lower than those for persons ages 55 to 64 in 1982-1984. CONCLUSIONS: Although some of the declines in smoking in recent years represent aging effects (including declines due to greater mortality among smokers), the much lower rates for same-age people (65 to 74) over the 10-year period are more significant in that they represent cohort differences. It appears that the broader public health message that is causing the general population to quit smoking is reaching the elderly Mexican American population of the Southwest.
Assuntos
Idoso/estatística & dados numéricos , Americanos Mexicanos/estatística & dados numéricos , Fumar/etnologia , Fumar/tendências , Idoso/psicologia , Estudos de Coortes , Feminino , Educação em Saúde , Conhecimentos, Atitudes e Prática em Saúde , Inquéritos Epidemiológicos , Humanos , Masculino , Americanos Mexicanos/psicologia , Pessoa de Meia-Idade , Vigilância da População , Fumar/psicologia , Sudoeste dos Estados Unidos/epidemiologiaRESUMO
OBJECTIVES: Self-reports of past heavy drinking correlate with the current drinking practices and with risk of mortality in non-Hispanic males. The prevalence of past heavy drinking has not been reported in Hispanic populations. METHODS: Using data from the Hispanic Health and Nutrition Examination Survey (HHANES) we (1) report on the prevalence, duration and severity of past heavy drinking in three Hispanic groups, (2) compare the current alcohol consumption patterns among past heavy drinkers and those who do not report a history of past heavy drinking and (3) compare the risk factor profiles and health indicators in these two groups. RESULTS: The prevalence of past heavy drinking among Mexican American and Puerto Rican males ranged from 28-35% while the rates for Cuban American males ranged from 7-16%. The rates for Hispanic women were much lower (1-8%). The average years of past heavy drinking ranged from 2.3-14.9 years, while the alcohol consumption during the past heavy drinking period ranged from 24.4-44.0 drinks per week. Past heavy drinkers tended to consume more alcohol at present than did never heavy drinkers with the greatest differences found for Mexican American females. Comparisons of the risk factors and health indicators by drinking status revealed a higher prevalence of smoking among past heavy drinkers (50-60%) versus never heavy drinkers (34-43%). Past heavy drinking Mexican American females also reported significantly more chronic conditions and depressive symptoms than did never heavy drinkers. CONCLUSIONS: Prevalence rates of past heavy drinking among Mexican American and Puerto Rican males are approximately three times higher than rates reported for non-Hispanic male populations.
Assuntos
Alcoolismo/etnologia , Hispânico ou Latino/estatística & dados numéricos , Adulto , Idoso , Cuba/etnologia , Feminino , Florida/epidemiologia , Indicadores Básicos de Saúde , Hispânico ou Latino/psicologia , Humanos , Masculino , México/etnologia , Pessoa de Meia-Idade , Cidade de Nova Iorque/epidemiologia , Vigilância da População , Prevalência , Porto Rico/etnologia , Fatores de Risco , Índice de Gravidade de Doença , Distribuição por Sexo , Fumar/etnologia , Sudoeste dos Estados Unidos/epidemiologia , Inquéritos e QuestionáriosRESUMO
We examined the relationship of self-reported functional status to common medical conditions using a probability sample of 3050 noninstitutionalized Mexican-American men and women aged 65 or older and residing in the Southwestern United States (Arizona, California, Colorado, New Mexico, and Texas). All subjects were interviewed in person (n = 2,873) or by proxy (n = 177) in their homes during late 1993 and early 1994. The questionnaire obtained information on self-reported functional status and prevalence of arthritis, cancer, diabetes, stroke, heart attack, and hip fracture. The prevalence of medical conditions ranged from 4.1% for hip fracture to 40.8% for arthritis. Prevalence of impairments in seven activities of daily living ranged from 5.4% for eating to 11.7% for bathing, while 25.1% could not walk up and down stairs, and 28.9% could not walk a half mile without help. In multiple logistic regression analyses, previous diagnoses of stroke and hip fracture were most predictive of functional limitations, though all conditions examined (arthritis, cancer, diabetes, stroke, heart attack, and hip fracture) were independently associated with increased odds of impairment in some activities of daily living. In general, the odds for functional impairment associated with specific medical conditions were higher than those previously published for non-Hispanic white populations. The fact that Mexican-American elderly who live in the community and who have medical conditions, especially stroke and hip fracture, are at high risk for functional impairment probably reflects the low rate of institutionalization in this population and has implications for the provision of community-based long-term care services for Mexican-American elderly.
Assuntos
Atividades Cotidianas , Avaliação Geriátrica , Americanos Mexicanos , Idoso , Idoso de 80 Anos ou mais , Doença Crônica , Avaliação da Deficiência , Métodos Epidemiológicos , Feminino , Humanos , Modelos Logísticos , Masculino , Fatores Socioeconômicos , Sudoeste dos Estados Unidos/etnologiaRESUMO
This study examined the effects of religious attendance on three dimensions of psychological well-being using panel data from a three-generations study of Mexican Americans from Texas (N = 624). Well-being dimensions included life satisfaction (the 13-item LSIA), and respective seven- and four-item depressed and positive affect subscales of the CES-D. Two-wave path analyses revealed a cross-sectional association between religious attendance and life satisfaction in the two oldest generations, and a salutary longitudinal effect of religious attendance on subsequent depressed affect in the youngest generation. Findings for life satisfaction and depressed affect withstood controlling for health and five sociodemographic correlates of religious attendance and well-being.
Assuntos
Aculturação , Adaptação Psicológica , Envelhecimento/psicologia , Americanos Mexicanos/psicologia , Religião e Psicologia , Adulto , Idoso , Depressão/psicologia , Feminino , Humanos , Relação entre Gerações , Masculino , Pessoa de Meia-Idade , Satisfação Pessoal , Determinação da Personalidade , TexasRESUMO
Previous research has shown that interpersonal conflict and depression are cross-sectionally associated with hostility. Our objective was to determine whether hostility is longitudinally predictive of interpersonal distress and depression and to replicate previous research that suggests that hostility is a risk factor for other health behaviors (e.g., smoking and excessive alcohol use) and psychosocial health problems. We use data from the youngest generation of a three-generation, 11-year follow-up study of Mexican Americans, that represent 251 Mexican Americans between the ages of 18 and 42 years. Our indicator of hostility was the irritability subscale from the Buss-Durkee Hostility Inventory. After statistically controlling for marital status, language acculturation, education, age, and sex, irritability was found to predict subsequent heavy drinking, somatic symptoms associated with depression, psychosomatic symptoms, infectious disease, divorce, marital separation, ending a serious nonmarital relationship, not being married at the follow-up, and more negative feelings associated with divorce, marital separation, and ending a serious relationship. Our research supports theory and research suggesting that hostility is predictive of physical symptoms, poor health habits, and interpersonal conflict.
Assuntos
Comportamentos Relacionados com a Saúde , Hostilidade , Americanos Mexicanos/psicologia , Adolescente , Adulto , Afeto , Consumo de Bebidas Alcoólicas/psicologia , Estudos Transversais , Feminino , Seguimentos , Humanos , Relação entre Gerações , Masculino , Estudos Prospectivos , FumarRESUMO
In this analysis, we employ data from the Hispanic Health and Nutrition Examination Survey to examine the association between level of acculturation into the larger society and rates of hypertension in Mexican Americans. Analyses conducted separately by gender in three broad age groups (ages 20 to 39, 40 to 59, and 60 to 74 years) fail to indicate a linear effect of acculturation on hypertension after controlling for age, education, marital status, employment, smoking, alcohol consumption, and body mass index. A nonlinear hypothesis was subsequently examined and found partial support among middle-aged men. Other things equal, middle-aged men at the middle of the acculturation continuum have significantly higher rates of hypertension than persons at the low end of the continuum. Lower rates are also observed among men at the high end of the acculturation continuum, but these rates are not significantly lower than those among men in the middle acculturation group when other variables are controlled. These findings for middle-aged men support an "acculturative stress" model that suggests that stress is higher at the middle of the acculturation continuum. Research on the influence of acculturation on health outcomes should go beyond simply examining linear effects to investigate the viability of nonlinear effects.
Assuntos
Aculturação , Hipertensão/etnologia , Americanos Mexicanos , Adulto , Idoso , Feminino , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Estresse Fisiológico/etnologiaRESUMO
Data from the Hispanic Health and Nutrition Examination Survey were employed to investigate the prevalence of hearing loss and hearing aid use in Mexican-American, Cuban-American, and Puerto Rican adults. Hearing loss was 6 to 14 times more prevalent in older (ages 54 to 74) vs younger (ages 20 through 34) subjects. Cuban Americans and Mexican Americans tended to have a similar prevalence of hearing loss, whereas Puerto Ricans had markedly lower rates. Mexican-American men had higher rates of hearing loss than Mexican-American women. The prevalence of hearing aid use among hearing-impaired individuals ranged from 2% to 11%. Implications for future research are discussed.
Assuntos
Auxiliares de Audição/estatística & dados numéricos , Transtornos da Audição/epidemiologia , Hispânico ou Latino/estatística & dados numéricos , Adulto , Idoso , Cuba/etnologia , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Americanos Mexicanos/estatística & dados numéricos , Pessoa de Meia-Idade , National Center for Health Statistics, U.S. , Prevalência , Porto Rico/etnologia , Estados Unidos/epidemiologiaRESUMO
BACKGROUND: This report presents findings from the Hispanic HANES on patterns and predictors of smoking in the Mexican-American subsample. Data are drawn from men and women ages 20-74 years who were administered the Adult Sample Person Questionnaire (N = 3,464). METHODS: Four smoking variables (current, ever, former, and daily consumption) are analyzed in relation to sociodemographic measures, including gender, age, marital status, employment status, occupational prestige, income, acculturation, co-workers' smoking, and presence of others in the home who smoke. All analyses were conducted separately for young, middle-age, and older age groups and for males and females. Multiple logistic and multiple regression analyses were performed, controlling for sociodemographic factors, to identify predictors of smoking. RESULTS: The most important factors found to be associated with smoking were the presence of other smokers in the immediate social environment (home and workplace) and the degree of acculturation (particularly among women). Associations with age, income, and marital status were inconsistent across age and gender groups. With minor exceptions, education, employment, and occupational prestige were unrelated to smoking. CONCLUSIONS: These findings support interventions on the basis of age categories, differential acculturation, and social influence, but overall the findings are more striking for their similarity to predictors of smoking in the general population than for their differences.
Assuntos
Hispânico ou Latino , Fumar , Adulto , Fatores Etários , Idoso , Escolaridade , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Casamento , México/etnologia , Pessoa de Meia-Idade , Fatores Sexuais , Classe Social , Meio Social , Estados UnidosRESUMO
Data from the Hispanic Health and Nutrition Examination Survey (HHANES) conducted by the National Center for Health Statistics in 1982-1984 were analyzed to document the type of barriers encountered which prevented Mexican Americans from obtaining health care, the sociodemographic subgroups most vulnerable to such barriers, and to examine the combined effects of predisposing, enabling, and need characteristics on these barriers. The findings suggest, in general, that low income groups, younger age groups, the less acculturated, those who lack health insurance coverage, those with functional limitations, and those in poorer perceived health status encounter more barriers than others, and are prevented by these barriers from obtaining health care for themselves.
Assuntos
Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Inquéritos Epidemiológicos , Americanos Mexicanos/estatística & dados numéricos , Adulto , Fatores Etários , Idoso , Criança , Cuidado da Criança , Feminino , Acessibilidade aos Serviços de Saúde/economia , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Análise de Regressão , Fatores Sexuais , Fatores Socioeconômicos , Meios de TransporteRESUMO
Data from the Southwest sample of the Hispanic Health and Nutrition Examination Survey (HHANES) were analyzed to examine whether the use of a curandero or other folk medicine practitioner hindered, enhanced, or did not affect the utilization of western health care services by Mexican Americans. Findings revealed that only 4.2 percent of the HHANES sample persons between the ages of 18-74 years reported consulting a curandero, herbalista, or other folk medicine practitioner within the 12 months prior to the survey. Income, self-perceived health status, the language of the interview, and dissatisfaction with modern medical care recently received independently predicted curandero utilization (adjusted OR 2.01 and 1.66, respectively). Low income and self-perceived health status were less strongly related to curandero utilization.
Assuntos
Inquéritos Epidemiológicos , Medicina Tradicional , Americanos Mexicanos/estatística & dados numéricos , Adulto , Idoso , Comportamento do Consumidor , Feminino , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Sudoeste dos Estados UnidosRESUMO
Data from the Southwestern sample of the Hispanic HANES are employed to evaluate the relationship of acculturation into the larger society with alcohol consumption. As in previous work, acculturation was not found to be related to alcohol consumption of Mexican American men, but was positively related to the consumption of younger Mexican American women. Among middle-aged women, acculturation was not important. However, we found evidence that middle-aged women might be turning to alcohol in response to marital disruption and poverty. In addition, middle-aged women who are not employed are less frequent drinkers but those who drink are heavier drinkers than employed women.
Assuntos
Aculturação , Consumo de Bebidas Alcoólicas/etnologia , Inquéritos Epidemiológicos , Americanos Mexicanos/estatística & dados numéricos , Adulto , Distribuição por Idade , Idoso , Consumo de Bebidas Alcoólicas/epidemiologia , Análise de Variância , Escolaridade , Feminino , Humanos , Masculino , Estado Civil , Pessoa de Meia-Idade , Análise de Regressão , Estudos de Amostragem , Distribuição por Sexo , Sudoeste dos Estados Unidos/epidemiologiaRESUMO
Smoking behavior was investigated with data from a three-generation study of Mexican Americans in San Antonio, Texas. Rates of smoking among the men were found to be higher than rates for other White men obtained in previous studies, while rates for women were slightly lower than those reported for other White women. However, the percentage of light smokers was considerably higher among Mexican Americans than among other groups. There was no evidence that acculturation was a consistent predictor of greater likelihood of smoking. However, there was evidence that the smoking behavior of younger Mexican Americans, particularly the women, was associated with the smoking behavior of their parents.
Assuntos
Família , Hispânico ou Latino , Fumar , Adolescente , Adulto , Fatores Etários , Idoso , Feminino , Humanos , Masculino , México/etnologia , Pessoa de Meia-Idade , Fatores Sexuais , TexasRESUMO
Sources of help and advice (other than one's spouse) and degree of intergenerational solidarity were investigated in a three-generation sample of Mexican Americans. It was found that elderly Mexican Americans are involved in strong helping networks with their children who rely a great deal on them for advice and help. In all three generations, there is a predominance of family as sources of support. Women are relied on for help regarding health matters and men regarding home repairs and upkeep. Help and advice regarding financial problems and personal problems fall primarily along same-sex lines. Scales measuring intergenerational solidarity, showed that all-female dyads have greater associational solidarity than all-male and cross-sex dyads. Few differences appear in affectual solidarity which was uniformly high. Finally, there appears to be minimum association and intergenerational helping between grandparents and grandchildren.
Assuntos
Família , Comportamento de Ajuda , Hispânico ou Latino , Adolescente , Adulto , Idoso , Características da Família , Feminino , Humanos , Masculino , México/etnologia , Pessoa de Meia-IdadeRESUMO
Determinants of physician utilization were examined using a three-generational sample of Mexican-Americans in San Antonio. A typical version of Andersen's causal behavioral model was moderately successful in predicting physician utilization in the middle and older generations and less successful in the younger generation. Consistent with the literature, need factors (health indicators) tended to affect utilization most directly. The authors also examined whether acculturation into the larger society positively influenced utilization regardless of need, as the literature suggested. While three separate measures of acculturation had no independent effects on physician utilization, acculturation did affect utilization indirectly via the need variables in the middle generation, although these effects were not consistently in the direction of greater utilization. Generational differences in determinants of physician utilization are discussed particularly in relation to the model's greater relevance for the middle and older generations.