RESUMO
Mexican return migrant population is increasing, yet our knowledge about their lives after resettlement in Mexico remains fragmentary. Using 2001-2012 longitudinal data from the Mexican Health and Aging Study, we investigate difference in household composition for older migrants who returned from the United States compared to nonmigrants. Furthermore, we fit a Cox proportional hazards model to assess the relationship between household composition and health and functional trajectories of return migrants and nonmigrants. The results indicate that return migrants with long duration of U.S. stay have different household composition than nonmigrants or short-term migrants: On average, they have smaller household size, including fewer females who may be available to offer assistance to older adults. Presence of middle-age females in the household has positive effects on health and functional trajectories. We highlight implications of this research for policy makers in Mexico and the United States.
Assuntos
Envelhecimento/etnologia , Emigração e Imigração , Características da Família/etnologia , Família/etnologia , Feminino , Nível de Saúde , Humanos , Masculino , Americanos Mexicanos , México/etnologia , Pessoa de Meia-IdadeRESUMO
This study seeks to identify risk factors for psychiatric disorders that may explain differences in nativity effects among adult Latinos in the USA. We evaluate whether factors related to the processes of acculturation and enculturation, immigration factors, family stressors and supports, contextual factors, and social status in the US account for differences in 12-month prevalence of psychiatric disorders for eight subgroups of Latinos. We report results that differentiate Latino respondents by country of origin and age at immigration (whether they were US-born or arrived before age 6: In-US-as-Child [IUSC]; or whether they arrived after age 6: later-arrival immigrants [LAI]). After age and gender adjustments, LAI Mexicans and IUSC Cubans reported a significantly lower prevalence of depressive disorders than IUSC Mexicans. Once we adjust for differences in family stressors, contextual factors and social status factors, these differences are no longer significant. The risk for anxiety disorders appears no different for LAI compared to IUSC Latinos, after age and gender adjustments. For substance use disorders, family factors do not offset the elevated risk of early exposure to neighborhood disadvantage, but coming to the US after age 25 does offset it. Family conflict and burden were consistently related to the risk of mood disorders. Our findings suggest that successful adaptation into the US is a multidimensional process that includes maintenance of family harmony, integration in advantageous US neighborhoods, and positive perceptions of social standing. Our results uncover that nativity may be a less important independent risk factor for current psychiatric morbidity than originally thought.
Assuntos
Hispânico ou Latino/psicologia , Transtornos Mentais/etiologia , Meio Social , Aculturação , Cuba/etnologia , Emigração e Imigração , Feminino , Humanos , Modelos Logísticos , Masculino , Transtornos Mentais/epidemiologia , México/etnologia , Modelos Psicológicos , Porto Rico/etnologia , Fatores de Risco , Inquéritos e Questionários , Estados Unidos/epidemiologiaRESUMO
It is reported that Latin Americans describe culturally normative experiences or express putative psychotic symptoms in medical and mental health treatment settings that complicate the diagnostic process. Previous research reported that Latinos were more likely than European Americans and African Americans to have their diagnoses changed from schizophrenia to other disorders. This study describes the prevalence and likelihood of putative psychotic symptoms being expressed independent of any psychiatric disorder or co-occurring with common disorders such as depression or anxiety within a Mexican American population sample. Epidemiologic data of the Mexican American Prevalence and Services Survey (N = 3012) were used to contrast rates and patterns of putatively psychotic features among adults by demographic variables and diagnostic status using DSM-III-R criteria and receipt of treatment. Putative psychotic symptoms were reported by 17% of US-born and 7% of immigrants without disorders, and by 38% of US-born and 28% of immigrants with lifetime disorders, totaling 18% lifetime prevalence for the entire study population of Mexican Americans. First-rank Schneiderian symptoms were higher in those with a disorder compared with those without a disorder for both sexes. The results of this study indicate that putative psychotic symptoms are common among Mexican Americans, and their presence is a strong precautionary signal for evaluating clinicians to correctly distinguish whether putative psychotic symptoms are indicators of nonorganic psychoses or other psychiatric disorders, or are simply cultural expressions. Research is needed to identify the determinants of misdiagnosis in clinical practice, and guidelines are needed to assist clinicians.
Assuntos
Características Culturais , Transtornos Mentais/epidemiologia , Americanos Mexicanos/estatística & dados numéricos , Transtornos Psicóticos/diagnóstico , Transtornos Psicóticos/epidemiologia , Adolescente , Adulto , California/epidemiologia , Comorbidade , Erros de Diagnóstico , Manual Diagnóstico e Estatístico de Transtornos Mentais , Emigração e Imigração/estatística & dados numéricos , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Transtornos Mentais/diagnóstico , Transtornos Mentais/etnologia , Americanos Mexicanos/psicologia , Pessoa de Meia-Idade , Prevalência , Escalas de Graduação Psiquiátrica , Transtornos Psicóticos/etnologia , Esquizofrenia/diagnóstico , Esquizofrenia/epidemiologia , Psicologia do Esquizofrênico , Fatores SexuaisRESUMO
The burden of disease attributable to mental illnesses has major costs and human services implications in the United States. Mexican Americans compose two thirds of the nation's largest and fastest-growing minority group, Latinos. We report 12-month DSM-III-R psychiatric disorder rates among Mexican Americans derived from a population survey of immigrants and US-born adults of Mexican origin conducted in rural and urban areas of central California. Rates of 12-month total mood, anxiety, and substance disorders were 14.2% for immigrant women, 12.6% for immigrant men, 27.8% for US-born women, and 27.2% for US-born men. For immigrants, younger age of entry and longer residence in the United States were associated with increased rates of psychiatric disorders. Three dominant explanations are reviewed to explain these differences: selection, social assimilation and stress, and measurement artifact. Our results and other research studies collectively support a social assimilation explanation based on aversive impact on health behaviors and protective resources such as families. Greater social assimilation increases psychiatric morbidity, with rates for subjects who are US-born of Mexican origin approximately the same as rates for the US general population.
Assuntos
Transtornos Mentais/epidemiologia , Americanos Mexicanos/estatística & dados numéricos , Aculturação , Adolescente , Adulto , Distribuição por Idade , Fatores Etários , California/epidemiologia , Coleta de Dados/estatística & dados numéricos , Manual Diagnóstico e Estatístico de Transtornos Mentais , Emigração e Imigração/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Grupos Populacionais/estatística & dados numéricos , Prevalência , Escalas de Graduação Psiquiátrica , Fatores de Risco , Fatores Socioeconômicos , Fatores de Tempo , Estados Unidos/epidemiologiaRESUMO
We examined co-occurrence of (comorbid) alcohol, drug, and non-substance use psychiatric disorders in a population sample of Mexican-origin adults from rural and urban areas of central California. Co-occurring lifetime rates of alcohol or other drug disorders with non-substance use psychiatric disorders, or both, were 8.3% for men and 5.5% for women and were 12.3% for the US born and 3.5% for immigrants. Alcohol abuse or dependence with co-occurring psychiatric disorders is a primary disorder among Mexican-origin adult males (7.5% lifetime prevalence). US-born men and women are almost equally likely to have co-occurring disorders involving substances. Cobormidity is expected to increase in the Mexican-origin population owing to acculturation effects of both sexes.
Assuntos
Diagnóstico Duplo (Psiquiatria) , Transtornos Mentais/etnologia , Americanos Mexicanos/psicologia , Transtornos Relacionados ao Uso de Substâncias/etnologia , Adulto , Alcoolismo/complicações , Alcoolismo/etnologia , California/epidemiologia , Análise por Conglomerados , Comorbidade , Feminino , Humanos , Masculino , Transtornos Mentais/complicações , Americanos Mexicanos/estatística & dados numéricos , Pessoa de Meia-Idade , Prevalência , Saúde da População Rural/estatística & dados numéricos , Fatores Socioeconômicos , Transtornos Relacionados ao Uso de Substâncias/complicações , Saúde da População Urbana/estatística & dados numéricosRESUMO
OBJECTIVE: This study examines the reciprocal relationship of social assimilation and four parental behavioral risk factors in the intergenerational development of alcohol abuse or dependence (AAD) among adults of Mexican origin in the United States. Whereas many studies have shown U.S. nativity and English language use are markers for enhanced risk of AAD among Mexican Americans, such studies have not examined the extent to which predisposing biobehavioral factors are conditioned by social assimilation in the United States. METHOD: Language use patterns as a proxy of cultural assimilation and length of time in the U.S. as a proxy for social assimilation were used to compare the distribution of parental behavioral factors (alcohol, drug abuse, depression and anxiety) and the influence of these factors on AAD onset in adult children of Mexican immigrants. Data were obtained from an epidemiologic field survey in Central California of 3,012 Mexican origin adults. RESULTS: Complex effects structured by gender were found: parental behavioral risk factors predicted AAD onset; Mexican American adults born in the U.S. were much more likely than were immigrants to report parents with behavioral risk factors; women were more susceptible to the effects of parent risk factors in the context of social and cultural assimilation. Women required more total risk factor exposure, including parent risk factors, for AAD onset. CONCLUSIONS: Reciprocal influences of parent risk factors on assimilation were found, suggesting that parental behavioral factor effects on AAD in adult children of Mexican Americans are subordinate to social and cultural assimilation.