RESUMO
OBJECTIVE: This secondary data analysis examined associations among perceived neighborhood environmental factors, physical activity (PA), and the presence of metabolic syndrome (MS) in Mexican-American (MA) adults. Seventy-five MA adults (mean age of 37.9 ± 9.3 years) provided anthropometric, biomarker, and survey data. The Neighborhood Scales Questionnaire evaluated six perceived neighborhood factors: walking environment, aesthetic quality, safety, violence, social cohesion, and activities with neighbors. The Rapid Assessment of PA questionnaire assessed PA. MS was determined according to ATP III criteria. RESULTS: PA was significantly associated with MS (OR = .338, CI .204-.738). Neighborhood factors of safety (B = .255, p = .024), walking environment (B = .384, p = .001), and social cohesion (B = .230, p = .043) were positively associated with PA. No other neighborhood factors were significantly related to PA. Analyses examining whether neighborhood factors moderated the relationship between PA and MS were not significant.
Assuntos
Exercício Físico , Síndrome Metabólica/etnologia , Americanos Mexicanos/estatística & dados numéricos , Características de Residência/estatística & dados numéricos , Adulto , Arizona/etnologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Little research has been conducted that integrates, in one explanatory model, the multitude of factors potentially leading to disparities among Latino children. PURPOSE: A longitudinal, observational study tested an explanatory model for disparities in asthma control between Mexican and Puerto Rican children with persistent asthma requiring daily controller medication use. METHODS: Mexican and Puerto Rican children aged 5-12 years (n = 267) and their caregivers (n = 267) were enrolled and completed interviews and child spirometry at baseline and 3, 6, 9, and 12 months postenrollment. A 12 month retrospective children's medical record review was completed. Participants were recruited from two school-based health clinics and the Breathmobile in Phoenix, AZ, and two inner-city hospital asthma clinics in the Bronx, NY. RESULTS: Statistically significant differences in the social/contextual predictors of asthma illness representations (IRs) were noted between Mexican and Puerto Rican caregivers. The structural equation model results revealed differences in asthma control over time by ethnicity. This model accounted for 40%-48% of the variance in asthma control test scores over 12 months. Caregivers' IRs aligned with the professional model of asthma management were associated with better children's asthma control across 1 year. These results also supported the theoretical notion that IRs change over time impacting caregivers' treatment decisions and children's asthma control. CONCLUSIONS: These findings extend a previous cross-sectional model test using a more comprehensive model and longitudinal data and highlight the importance of considering within-group differences for diagnosis and treatment of children coming from the vastly heterogeneous Latino umbrella group. TRIAL REGISTRATION: Trial number NCT01099800.
Assuntos
Asma/etnologia , Asma/enfermagem , Cuidadores/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Hispânico ou Latino/estatística & dados numéricos , Arizona/etnologia , Criança , Pré-Escolar , Feminino , Humanos , Estudos Longitudinais , Masculino , Americanos Mexicanos/estatística & dados numéricos , Modelos Estatísticos , Cidade de Nova Iorque/etnologia , Porto Rico/etnologia , Estudos RetrospectivosRESUMO
Neighborhood Latino ethnic concentration, above and beyond or in combination with mothers' and fathers' ethnic socialization, may have beneficial implications for minority adolescents' ethnic attitude and identity development. These hypotheses, along with two competing hypotheses, were tested prospectively (from x¯age = 12.79-15.83 years) in a sample of 733 Mexican-origin adolescents. Neighborhood ethnic concentration had beneficial implications for ethnic identity processes (i.e., ethnic exploration and perceived peer discrimination) but not for ethnic attitudes. For Mexico-born adolescents, high maternal ethnic socialization compensated for living in neighborhoods low on ethnic concentration. Findings are discussed vis-à-vis the ways in which they address major gaps in the neighborhood effects literature and the ethnic and racial identity development literature.
Assuntos
Americanos Mexicanos/psicologia , Pais , Características de Residência , Identificação Social , Socialização , Adolescente , Arizona/etnologia , Criança , Feminino , Humanos , Masculino , México/etnologiaRESUMO
BACKGROUND: This study examines the association between perceived neighborhood violence, perceived neighborhood collective efficacy, and binge drinking among Mexican Americans residing on the U.S.-Mexico border. METHODS: Data were collected from a multistage cluster sample of adult Mexican Americans residing in the U.S.-Mexico border areas of California, Arizona, New Mexico, and Texas (N = 1,307). The survey weighted response rate was 67%. Face-to-face interviews lasting approximately 1 hour were conducted in respondents' homes in English or Spanish. Path analysis was used to test whether collective efficacy mediated the impact of perceived neighborhood violence on binge drinking. RESULTS: Among 30+-year-old women, perceived neighborhood collective efficacy mediated the effects of perceived neighborhood violence on binge drinking in a theoretically predicted way: Lower perceptions of violence predicted an increased perception of collective efficacy, which in turn, predicted less binge drinking. Direct effects of violence perceptions on binge were nonsignificant. Younger 18- to 29-year-old women showed a similar (but nonsignificant) pattern of effects. Perceived collective efficacy also mediated the effects of perceived violence on binge drinking among men, but in opposite ways for older and younger men. Older men showed the same mediating effect as older women, but the effect reversed among younger men due to a strong, positive relation between collective efficacy and binge drinking. There were also age differences in the direct effect of violence perceptions on binge drinking: Perceptions of violence predicted more binge drinking among young men, but less among older men. CONCLUSIONS: These results highlight the complexity of people's responses to neighborhood characteristics in regard to their drinking. Young men in particular seem to react very differently to perceptions of collective efficacy than other groups. However, among both men and women, collective efficacy may come to play an increasingly important protective role in health outcomes with age.
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Consumo Excessivo de Bebidas Alcoólicas/diagnóstico , Consumo Excessivo de Bebidas Alcoólicas/etnologia , Americanos Mexicanos/etnologia , Percepção , Características de Residência , Adulto , Arizona/etnologia , Consumo Excessivo de Bebidas Alcoólicas/psicologia , California/etnologia , Análise por Conglomerados , Feminino , Humanos , Masculino , Americanos Mexicanos/psicologia , México/etnologia , Pessoa de Meia-Idade , New Mexico/etnologia , Texas/etnologia , Adulto JovemRESUMO
BACKGROUND: Hepatitis A (HAV) incidence has decreased in the United States, yet regional disparities persist. The role of international travel has become increasingly important in HAV transmission. We compared the relative burden of HAV in border and non-border regions in Arizona and examined the role of travel in sustaining HAV transmission. METHODS: HAV vaccination coverage was calculated by age and region, using Arizona State Immunization Information System data. Incidence, demographics, and risk factors of cases reported through Arizona's infectious disease surveillance system between 2006 and 2011 were analyzed. RESULTS: Hepatitis A incidence was higher in the border region of Arizona. Compared with the rest of Arizona, one-dose coverage in children<15 years was lower in the border region until 2008. Second dose coverage was lower in the border region, particularly among Spanish speakers. International travel among cases was generally high; however, in the border region cases were more likely to visit Mexico or South/Central America (94% vs. 80%, P value = 0.01) and be Hispanic (68% vs. 42%, P value = 0.0003). CONCLUSIONS: Rates of HAV continue to be higher in the Arizona border region; the risk appears particularly high among Hispanics with recent travel in the Americas. Border surveillance should be emphasized, along with vaccination of all travelers, to continue to decrease and control HAV.
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Etnicidade/etnologia , Vacinas contra Hepatite A/administração & dosagem , Hepatite A/etnologia , Hepatite A/prevenção & controle , Viagem , Vacinação , Adolescente , Adulto , Idoso , Arizona/etnologia , Criança , Pré-Escolar , Bases de Dados Factuais/tendências , Feminino , Humanos , Incidência , Lactente , Masculino , México/etnologia , Pessoa de Meia-Idade , Fatores de Risco , Viagem/tendências , Estados Unidos/etnologia , Vacinação/tendências , Adulto JovemRESUMO
PURPOSE: This study describes the epidemiology of epilepsy on the Arizona-Mexico border. METHODS: Households in Southern Arizona were identified using two strategies. County-wide random digit dialing telephone surveys were supplemented with door-to-door recruitment in three Arizona border communities. Utilizing a two-step screening process, individuals with a seizure disorder or epilepsy were identified. A consensus diagnosis was arrived at after reviewing results from the detailed interview, medical records and clinical examination. RESULTS: A total of 15,738 household individuals were surveyed. Two hundred and three individuals were identified as having had epilepsy at some point in their life; 25% of them were previously not diagnosed. The sex and age-adjusted prevalence estimate was 14.3 per 1000 (95% CI: 12.5-16.1) for lifetime epilepsy, and 11.8 per 1000 (CI: 10.2-13.5) for active epilepsy (seizures in the past 5 years or currently taking antiseizure medications). Non-Hispanic Whites were two times more likely to have active epilepsy than Hispanics. The majority of individuals with lifetime history of epilepsy had idiopathic or cryptogenic epilepsy; most were localization-related epilepsy although the exact location could not be determined for the majority. Although most individuals with epilepsy report receiving care from a neurology specialist, they were more likely to have visited a non-specialist in the past 3 months. SIGNIFICANCE: The lower prevalence of epilepsy among Hispanics compared to non-Hispanics supports previous survey findings in the Southwest US and may be due to language, acculturation factors, stigma, or a reflection of the "healthy immigrant effect". The surprisingly high proportion of previously un-diagnosed individuals shows a need for further investigation as well as a need to increase community awareness.
Assuntos
Aculturação , Epilepsia/diagnóstico , Epilepsia/etnologia , Inquéritos Epidemiológicos/métodos , Hispânico ou Latino/etnologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Arizona/etnologia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , México/etnologia , Pessoa de Meia-Idade , Prevalência , Adulto JovemRESUMO
BACKGROUND: Acculturation to life in the United States is a known predictor of Hispanic drinking behavior. We compare the ability of 2 theoretical models of this effect-sociocultural theory and general stress theory-to account for associations between acculturation and drinking in a sample of Mexican Americans. Limitations of previous evaluations of these theoretical models are addressed using a broader range of hypothesized cognitive mediators and a more direct measure of acculturative stress. In addition, we explore nonlinearities as possible underpinnings of attenuated acculturation effects among men. METHODS: Respondents (N = 2,595, current drinker N = 1,351) were interviewed as part of 2 recent multistage probability samples in a study of drinking behavior among Mexican Americans in the United States. The ability of norms, drinking motives, alcohol expectancies, and acculturation stress to account for relations between acculturation and drinking outcomes (volume and heavy drinking days) were assessed with a hierarchical linear regression strategy. Nonlinear trends were assessed by modeling quadratic effects of acculturation and acculturation stress on cognitive mediators and drinking outcomes. RESULTS: Consistent with previous findings, acculturation effects on drinking outcomes were stronger for women than men. Among women, only drinking motives explained acculturation associations with volume or heavy drinking days. Among men, acculturation was linked to increases in norms, and norms were positive predictors of drinking outcomes. However, adjusted effects of acculturation were nonexistent or trending in a negative direction, which counteracted this indirect normative influence. Acculturation stress did not explain the positive associations between acculturation and drinking. CONCLUSIONS: Stress and alcohol outcome expectancies play little role in the positive linear association between acculturation and drinking outcomes, but drinking motives appear to at least partially account for this effect. Consistent with recent reports, these results challenge stress models of linear acculturation effects on drinking outcomes and provide (partial) support for sociocultural models. Inconsistent mediation patterns-rather than nonlinearities-represented a more plausible statistical description of why acculturation-drinking associations are weakened among men.
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Aculturação , Consumo de Bebidas Alcoólicas/etnologia , Americanos Mexicanos/etnologia , Adulto , Consumo de Bebidas Alcoólicas/psicologia , Arizona/etnologia , California/etnologia , Estudos Transversais , Feminino , Humanos , Masculino , Americanos Mexicanos/psicologia , New Mexico/etnologia , Cidade de Nova Iorque/etnologia , Pennsylvania/etnologia , Texas/etnologia , Estados Unidos/etnologiaRESUMO
INTRODUCTION: Diabetes is a growing worldwide problem, characterized by considerable ethnic variation and being particularly common in modernizing populations. Modernization is accompanied by a variety of stressful sociocultural changes that are believed to increase the risk of diabetes. Unfortunately, there is little accurate knowledge about impact of stress on the risk of diabetes in the US-Mexico border area. METHODS: Literature searches were performed in PubMed and Google Scholar to identify anthropological studies on stress and diabetes. Snowball and opportunistic sampling were used to expand the identified literature. In total, 30 anthropological studies were identified concerning the role of stress and modernization on diabetes among Indigenous peoples. This article reviews the available information regarding stress and diabetes in different populations from various anthropological perspectives. RESULTS: Four different concepts of stress were indentified: physiological, psychological, psychosocial and nutritional stress. Unlike physiological and nutritional theories of diabetes, psychological and psychosocial theories of stress and disease lack etiological specificity. No study addressed all four concepts of stress and few studies addressed more than two concepts. Most studies concerned nutritional stress and the developmental origins of diabetes. Most studies were conducted on the Pima Indians of Arizona and Mexico. All four stress concepts have some evidence as determinants of diabetes. CONCLUSION: These theoretical concepts and ethnographic results can provide the basis for developing comprehensive research protocols and public health intervention targeted at diabetes. A comprehensive view of stress can potentially explain the high prevalence of diabetes in developing countries and among Indigenous peoples. These results can be used to inform public health interventions aimed at reducing diabetes in the US-Mexico border region or similar areas, help identify at-risk individuals, and guide health education and promotion.