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Background: US-based Latinos have lower education and income combined with higher health risks than non-Latino whites, but often 'paradoxically' evidence better health-related outcomes. Less work has investigated this paradox for cognitive-related outcomes despite nativity diversity. Objective: We evaluated cognitive aging within older Latinos of diverse nativity currently living in the US and participating in Rush Alzheimer's Disease Center studies. Methods: Participants without baseline dementia, who completed annual neuropsychological assessments (in English or Spanish) were grouped by US-born (nâ=â117), Mexico-born (nâ=â173), and born in other Latin American regions (LAr-bornâ=â128). Separate regression models examined associations between nativity and levels of (Nâ=â418) or change in (nâ=â371; maximum follow-up â¼16 years) global and domain-specific cognition. Results: Demographically-adjusted linear regression models indicated that foreign-born nativity was associated with lower levels of global cognition and select cognitive domains compared to US-born Latinos. No associations of nativity with cognitive decline emerged from demographically-adjusted mixed-effects models; however, Mexico-born nativity appeared associated with slower declines in working memory compared to other nativity groups (p-values ≥ 0.051). Mexico-born Latinos had relatively higher vascular burden and lower education levels than other nativity groups; however, this did not alter results. Conclusions: Nativity differences in baseline cognition may be due, in part, to accumulated stressors related to immigration and acculturation experienced by foreign-born Latinos which may hasten meeting criteria for dementia later in life. In contrast, Mexico-born participants' slower working memory declines, taken in the context of other participant characteristics including vascular burden, suggests the Hispanic Paradox may relate to factors with the potential to affect cognition.
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Cognição , Disfunção Cognitiva , Hispânico ou Latino , Testes Neuropsicológicos , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cognição/fisiologia , Envelhecimento Cognitivo/psicologia , Disfunção Cognitiva/etnologia , Disfunção Cognitiva/psicologia , Hispânico ou Latino/psicologia , Hispânico ou Latino/estatística & dados numéricos , México/etnologia , Testes Neuropsicológicos/estatística & dados numéricos , Estados Unidos/epidemiologia , Estados Unidos/etnologia , América Latina/etnologiaRESUMO
This study investigates how mediating (e.g. history of health conditions) and moderating (e.g. self-rated health) factors are associated with nativity status on depression and anxiety in Mexican immigrants. Using data from the 2019 National Health Interview Survey (NHIS), results found a significant direct association between nativity status and anxiety and depression. Additionally, the association between nativity status and mental health was mediated by the history of health conditions, and self-rated health was a significant moderator in both mediation models. Study findings are discussed within the context of barriers to care, current literature, and strengths-based interventions. Future research can expand upon these findings by examining the specific types of physical and mental health conditions that may support the Hispanic Paradox, as well as how self-efficacy and internal locus of control are associated with the paradox within this population.
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Although Mexican immigrants to the United States (US) have historically held health and mortality advantages over US-born groups, evolving population dynamics in Mexico paired with shifts in Mexico-US immigration patterns and policy regimes have raised new concerns about the metabolic health of recent cohorts of Mexican immigrants. Using a nationally representative sample of adults aged 20-years and older (n = 10,833) from the National Health and Nutrition Examination Study (NHANES, 1999-2016), we assess and seek to explain differences in metabolic syndrome (MetS) risk by race-ethnicity, country of origin, and duration of residence in the US and evaluate whether recent Mexican immigrants continue to exhibit a metabolic health advantage. We decompose the difference in MetS prevalence between US-born whites (45.5%) and recent Mexican immigrants (29.5%) to determine how demographic, socioeconomic, and health behavior characteristics contribute to the patterning of metabolic health. Findings reveal that recent Mexican immigrants hold a metabolic health advantage over all groups, which is accounted for by their younger age structure. Yet recent Mexican immigrants would retain a sizable age-adjusted MetS advantage if they were to achieve parity with US-born whites on education, income, and food security. To ensure that newly-arrived Mexican immigrants continue to experience historically favorable health and mortality prospects, modest policy changes could offer health-promoting protections in the form of increased economic and food security, as well as improved educational opportunities for younger immigrants.
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Genetic variability influences the susceptibility to and severity of complex diseases; there is a lower risk of COPD in Hispanics than in non-Hispanic Caucasians. In this study, we included 830 Mexican-Mestizo subjects; 299 were patients with COPD secondary to tobacco smoking, and 531 were smokers without COPD. We employed a customized genotyping array of single nucleotide polymorphisms (SNPs). The population structure was evaluated by principal component analysis and allele association through a logistic regression model and haplotype identification. In this study, 118 individuals were identified with a high Caucasian component and 712 with a high Amerindian component. Independent of the ancestral contribution, two SNPs were associated with a reduced risk (p ≤ 0.01) of developing COPD in the CYP2A6 (rs4105144) and CYP2B6 (rs10426235) genes; however, a haplotype was associated with an increased risk of COPD (p = 0.007, OR = 2.47) in the CHRNA5-CHRNA3 loci among smokers with a high Caucasian component. In Mexican-Mestizo smokers, there are SNPs in genes that encode proteins responsible for the metabolism of nicotine associated with a lower risk of COPD; individuals with a high Caucasian component harboring a haplotype in the CHRNA5-CHRNA3 loci have a higher risk of suffering from COPD.
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The contribution of genetic ancestry on chronic obstructive pulmonary disease (COPD) predisposition remains unclear. To explore this relationship, we analyzed the associations between 754,159 single nucleotide polymorphisms (SNPs) and risk of COPD (n = 214 cases, 193 healthy controls) in Talca, Chile, considering the genetic ancestry and established risk factors. The proportion of Mapuche ancestry (PMA) was based on a panel of 45 Mapuche reference individuals. Five PRDM15 SNPs and two PPP1R12B SNPs were associate with COPD risk (p = 0.05 to 5×10-4) in those individuals with lower PMA. Based on linkage disequilibrium and sliding window analyses, an adjacent PRDM15 SNPs were associated with COPD risk in the lower PMA group (p = 10-3 to 3.77×10-8). Our study is the first to report an association between PPP1R12B and COPD risk, as well as effect modification between ethnicity and PRDM15 SNPs in determining COPD risk. Our results are biologically plausible given that PPP1R12B and PRDM15 are involved in immune dysfunction and autoimmunity, providing mechanistic evidence for COPD pathogenesis and highlighting the importance to conduct more genome wide association studies (GWAS) in admixed populations with Amerindian descent.
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OBJECTIVE: To determine if child physical abuse hospitalization rates vary across urban-rural regions overall and after accounting for race/ethnicity and poverty demographics. STUDY DESIGN: This was a retrospective cross-sectional study of black, Hispanic, and non-Hispanic white children <5 years of age living in all US counties. US counties were classified as central metro, fringe/small metro, and rural. Incidence rates were calculated using child physical abuse hospitalization counts from the 2012 Kids' Inpatient Database and population statistics from the 2012 American Community Survey. Counties' race/ethnicity demographics and percent of children living in poverty were used to adjust rates. RESULTS: We identified 3082 child physical abuse hospitalizations occurring among 18.2 million children. Neither crude nor adjusted overall rates of child physical abuse hospitalizations varied significantly across the urban-rural spectrum. When stratified by race/ethnicity, crude child physical abuse hospitalization rates decreased among black children 29.1% (P = .004) and increased among white children 25.6% (P = .001) from central metro to rural counties. After adjusting for poverty, only rates among black children continued to vary significantly, decreasing 34.8% (P = .001) from central metro to rural counties. Rates were disproportionately higher among black children compared with white children and their disproportionality increased with population density, even after poverty adjustment. Rates among Hispanic children were disproportionately lower compared with white children in nearly all urban-rural categories. CONCLUSIONS: Our results suggest that urban black children have unique exposures, outside of poverty, increasing their risk for child physical abuse hospitalization. Identifying and addressing these unique urban exposures may aid in reducing black-white disproportionalities in child physical abuse.
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Maus-Tratos Infantis/etnologia , Etnicidade/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Abuso Físico/etnologia , População Rural , População Urbana , Maus-Tratos Infantis/estatística & dados numéricos , Pré-Escolar , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Incidência , Masculino , Abuso Físico/estatística & dados numéricos , Pobreza , Estudos Retrospectivos , Estados Unidos/epidemiologiaRESUMO
ABSTRACT Background: Although the leading cause of death among Hispanics living in the United States (US) is cardiovascular disease (CVD), the association between Hispanic ethnicity and CVD has been scarcely explored. Objective: To examine whether being Hispanic is associated with an increased risk of CVD compared with the non-Hispanic US adult population in 2013. Methods: Secondary data analysis of a cross-sectional 2013 Behavioral Risk Factor Surveillance System survey in 2013 (n=486,905). The main exposure variable was Hispanic ethnicity (Mexican, Puerto Rican, Cuban or Spanish origin) and the main outcome variable was self-reported CVD (myocardial infarction/coronary artery disease/angina). The main covariates were sex, age, education, income, healthcare access, exercise, body mass index, current smoking, heavy drinking, diabetes, hypertension and hyperlipidemia. Unadjusted and adjusted logistic regressions were used to assess the effect between ethnicity and self-reported CVD. Odds ratios (OR) and 99% confidence intervals (CI) were calculated. Results: In total, 12% of the study participants were Hispanic (n=57,257). Approximately 24% of Hispanics were 25-34 y/o while (21%) of non-Hispanic were >65 y/o. After adjustment, Hispanics were 30% less likely to report CVD compared with non-Hispanics (OR=0.7; 99%; CI=0.6-0.8). Compared with men, women had a 40% decreased risk of having CVD (OR=0.60; 99% CI=0.5-0.6). Advanced age, lower educational attainment, income <$15,000/year, lack of exercise, smoking, non-heavy drinking, diabetes, hypertension and hyperlipidemia increased statistically significantly the likelihood of reporting CVD. Conclusion: The findings suggest that, in general, Hispanics residing in the US are significantly less likely to self-declare if they had a CVD compared with non-Hispanic Americans. These data suggest that although Hispanics are generally poorer and have less access to education and health services, their self-perceived health is better than in non-Hispanic residents of the US.
Resumen Introducción: Aunque la enfermedad cardiovascular (ECV) es una de las mayores causas de defunción entre los hispanos que viven en los EE. UU, la asociación entre la etnia hispana y la ECV apenas se ha explorado. Objetivo: Examinar si ser hispano se asocia con un mayor riesgo de padecer ECV en comparación con la población adulta no Hispana de los EE. UU, basados en los datos de la encuesta nacional sobre factores de riesgo conductuales del 2013. Métodos: Se realizó un análisis de datos secundario de la información obtenida del Sistema de Vigilancia del Factor de Riesgo Conductual (BRFSS) para estudiar la asociación entre origen étnico (hispanos: mexicano, puertorriqueño, cubano o de origen español vs. no hispanos) y la ECV en los encuestados a través del sistema BRFSS. Utilizamos una regresión logística para obtener modelos ajustados y no ajustados para evaluar el efecto de las características de la población seleccionada en participantes que informaron tener o no ECV. Resultados: En este estudio se incluyeron 486905 adultos, (48% hombres) y 57257 (11,8%) que se autodefinieron como hispanos. Aproximadamente el 24% de los hispanos tenían entre 25 y 34 años, mientras que un 21% de los no hispanos tenían más de 65 años. Después del ajuste de variables, los hispanos tenían un 30% menos de probabilidades de reportar una ECV en comparación con los no hispanos (OR = 0.7, 99% CI = 0.6-0.8); las mujeres mostraron un 40% menos de probabilidades de presentar una ECV (OR = 0,60; IC del 99% = 0,5-0,6). Tener más edad, menos nivel de educación formal, ganar menos de <$ 15000 / año, el sedentarismo, el tabaquismo, el consumo excesivo de alcohol, la diabetes, la hipertensión y la hiperlipidemia aumentaron significativamente la probabilidad de presentar una ECV. Conclusiones: Los hallazgos sugieren que en general, los hispanos que residen en los EE. UU, especialmente mujeres, tuvieron una probabilidad significativamente menor de autoreportar que tuvieron una ECV en comparación con los norteamericanos no hispanos.
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Recent empirical findings have suggested the existence of a twist in the Hispanic paradox, in which Mexican and other Hispanic foreign-born migrants living in the United States experience shallower socioeconomic status (SES) health disparities than those in the U.S. POPULATION: In this article, we seek to replicate this finding and test conjectures that could explain this new observed phenomenon using objective indicators of adult health by educational attainment in several groups: (1) Mexican-born individuals living in Mexico and in the United States, (2) U.S.-born Mexican Americans, and (3) non-Hispanic American whites. Our analytical strategy improves upon previous research on three fronts. First, we derive four hypotheses from a general framework that has also been used to explain the standard Hispanic paradox. Second, we study biomarkers rather than self-reported health and related conditions. Third, we use a binational data platform that includes both Mexicans living in Mexico (Mexican National Health and Nutrition Survey 2006) and Mexican migrants to the United States (NHANES 1999-2010). We find steep education gradients among Mexicans living in Mexico's urban areas in five of six biomarkers of metabolic syndrome (MetS) and in the overall MetS score. Mexican migrants living in the United States experience similar patterns to Mexicans living in Mexico in glucose and obesity biomarkers. These results are inconsistent with previous findings, suggesting that Mexican migrants in the United States experience significantly attenuated health gradients relative to the non-Hispanic white U.S. POPULATION: Our empirical evidence also contradicts the idea that SES-health gradients in Mexico are shallower than those in the United States and could be invoked to explain shallower gradients among Mexicans living in the United States.
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Emigrantes e Imigrantes/estatística & dados numéricos , Nível de Saúde , Americanos Mexicanos/estatística & dados numéricos , Adulto , Fatores Etários , Biomarcadores , Glicemia , Pressão Sanguínea , Índice de Massa Corporal , Pesos e Medidas Corporais , Feminino , Disparidades nos Níveis de Saúde , Humanos , Estilo de Vida , Lipídeos/sangue , Masculino , Síndrome Metabólica/etnologia , México/etnologia , Pessoa de Meia-Idade , Características de Residência/estatística & dados numéricos , Fatores Sexuais , Apoio Social , Fatores Socioeconômicos , Estados Unidos/epidemiologia , População Branca/estatística & dados numéricosRESUMO
OBJECTIVES: To examine predictors of mortality in aging Mexican Americans (MAs) and European Americans (EAs). DESIGN: Longitudinal, observational cohort study. SETTING: Socioeconomically diverse neighborhoods in San Antonio, Texas. PARTICIPANTS: Community-dwelling adults aged 65 and older (394 MA; 355 EA) who completed the baseline examination (1992-96) of the San Antonio Longitudinal Study of Aging (SALSA) and for whom vital status was ascertained over an average 8.2 years of follow-up. MEASUREMENTS: Ethnic group was classified using a validated algorithm. Hazard ratios (HRs) for mortality were estimated using Cox proportional hazards models with age, sex, ethnic group, education, income, frailty, diabetes mellitus with and without complications, comorbidity, cognition, depressive symptoms, and body mass index included as predictors in sequential models. RESULTS: At baseline, MAs had a higher prevalence of diabetes mellitus and frailty and lower socioeconomic status (SES) than EAs. The age- and sex-adjusted ethnic HR (MA vs EA) for mortality was 1.54 (95% confidence interval (CI) = 1.17-2.03). After adjusting for SES, the ethnic HR was no longer significant (HR = 1.16, 95% CI = 0.83-1.61). In the final model, comorbidity, diabetes mellitus with complications, depressive symptoms, and cognitive impairment were significant independent risk factors for mortality. CONCLUSION: Contrary to the Hispanic paradox, MAs were at greater risk of mortality than EAs. SES differences largely explained this ethnic disparity. Significant independent predictors of mortality, regardless of ethnic group, were diabetes mellitus with complications, comorbidity, depressive symptoms, and cognitive impairment. Mortality reduction in older MAs requires attention to socioeconomic disparities and disease factors.