How Education Shapes Indigenous Health Inequalities in the USA and Mexico.

Indigenous peoples around the world face significant health disparities relative to the dominant groups in their countries, yet the magnitude and patterns of health disparities vary across countries. We use data from the National Health Interview Survey and Mexican Family Life Survey to examine the health of Indigenous peoples in Mexico and American Indians and Alaska Natives in the USA and to evaluate how they fare relative to the majority populations in their countries (non-Indigenous Mexicans and non-Hispanic Whites, respectively). We assess disparities in self-rated health and activity limitations, with a focus on how Indigenous health disparities intersect with educational gradients in health. Regression analyses reveal three primary findings. First, Indigenous health disparities are larger in the USA than in Mexico. Second, differences in educational attainment account for most of the differences between Indigenous and non-Indigenous populations in Mexico, but less than half in the USA. Third, in both countries, health is moderated by educational attainment such that between-group disparities are largest at the highest levels of education. However, for Indigenous Mexicans there is a "cross-over" in which Indigenous Mexicans report better health at the lowest level of education. Overall, this study finds a weak relationship between education and Indigenous health, and raises the question about the validity of using traditional measures of SES in Indigenous contexts.

A longitudinal test of Mexican-origin teen mothers' cultural characteristics and children's Spanish vocabulary via mothers' Spanish language use.

OBJECTIVES: The present study examined whether teen mothers' adaptive cultural characteristics (i.e., familism values, language competency pressures, and involvement in Mexican culture and U.S. mainstream culture) when children were 3 years old (i.e., Wave 4; W4) informed mothers' Spanish language use with their children when children were 4 years old (W5) and, in turn, children's subsequent Spanish receptive vocabulary when children were 5 years old (W6). METHOD: The present study included 204 Mexican-origin children (58% male) and their mothers who entered parenthood during adolescence (M = 16.24, SD = .99 at W1). RESULTS: Five mediational processes were significant, such that mothers' higher familism values (i.e., emphasizing family support and obligations), Spanish competency pressure (i.e., stress associated with Spanish language competency), and involvement in U.S. mainstream culture at W4 were associated with mothers' lower Spanish language use with children at W5 and, in turn, children's lower levels of Spanish receptive vocabulary at W6. Mothers' greater involvement in Mexican culture and English competency pressure (i.e., stress associated with English language competency) at W4 were associated with mothers' greater Spanish language use with children at W5 and, in turn, children's greater Spanish receptive vocabulary at W6. Additionally, mothers' greater involvement in U.S. mainstream culture at W4 was directly associated with children's lower Spanish language abilities at W6. CONCLUSIONS: Findings highlight the importance of the family context in Mexican-origin children's Spanish language skills over time. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Vaya Con Dios: The Influence of Religious Constructs on Stressors around the Migration Process and U.S. Lived Experiences among Latina/o Immigrants.

This qualitative study explores the role of religious practices on the migration process and the U.S. lived experiences of Latina/o immigrants. We conducted semi-structured interviews with 20 Latino/a immigrant adults living in a southern state of the United States. Interviews focused on participants' migration experiences, religious constructs, and stress responses. Results revealed that religious practices provided strength, well-being, and positive life outlook during the migration process. After migration, religious practices also assisted participants in creating a sense of community/family, as well as provided financial and social support during difficult times. Recommendations for future interdisciplinary research and for practitioners are discussed for individuals working with Latinx and immigrant populations.

Internal migration and the health of Indigenous Mexicans: A longitudinal study.

RATIONALE: Indigenous peoples have historically comprised a substantial part of migration streams around the world, yet our understanding of the effects of migration on indigenous health is limited. OBJECTIVE: To explore the migration-indigenous health relationship by assessing the impact of internal migration on the self-rated health trajectories of indigenous Mexicans. DATA AND METHOD: Using three waves of data (2002-2012) from the Mexican Family Life Survey, I estimated linear growth curves to examine differences in initial self-rated health and changes in self-rated health between indigenous and non-indigenous respondents (N = 12,533). Then, I investigated whether migrating domestically during the study period shaped indigenous health trajectories. RESULTS: At the baseline interview (before migration), indigenous migrants reported significantly better self-rated health than indigenous non-migrants and than all non-indigenous respondents. In spite of their better initial health, indigenous migrants' health deteriorated substantially after migration, such that by the time of the last interview they reported the worst health. The self-rated health of all other groups improved during the same period. CONCLUSION: Findings provide evidence of pre-migration health selection and post-migration health deterioration among Mexican indigenous migrants. These results suggest that internal migration is a risk factor that has an independent effect on indigenous health even after adjusting for personal, family, socioeconomic, and health care factors.

Stress across generations: A qualitative study of stress, coping, and caregiving among Mexican immigrant mothers.

OBJECTIVE: Hispanic immigrants represent the largest and fastest growing ethnic minority within the US, justifying increased attention to identify factors that influence declining immigrant health across generations. This study investigates the range of psychosocial stress exposures and coping mechanisms of Mexican immigrant mothers, and implications for the health of their US-born children. DESIGN: We conducted 10 focus groups with 1st generation Mexican-born immigrant mothers (n = 32 women) in Nashville, TN, in the summer of 2014. Focus groups elicited challenges and benefits of life as an immigrant mother. Data were analyzed using a modified grounded theory approach. RESULTS: We identified four themes that indicate how maternal stressors could impact children's health: (1) work-family tradeoff, (2) limited freedom/mobility, (3) reduction of social networks, and (4) transmission of anxiety and fears to children. Women in our study also engage in a range of coping mechanisms, including the creation of new social networks, seeking support in religion, and seeking help from community resources. CONCLUSION: These results highlight the importance of developing new questionnaires to elicit stress exposures for Mexican immigrant mothers. Findings also suggest the value of intervention strategies and social policies that would ultimately improve maternal and child health in this marginalized population.

Inclusive state immigrant policies and health insurance among Latino, Asian/Pacific Islander, Black, and White noncitizens in the United States.

Objectives: Policy-making related to immigrant populations is increasingly conducted at the state-level. State policy contexts may influence health insurance coverage by determining noncitizens' access to social and economic resources and shaping social environments. Using nationally representative data, we investigate the relationship between level of inclusion of state immigrant policies and health insurance coverage and its variation by citizenship and race/ethnicity. Methods: Data included a measure of level of inclusion of the state policy context from a scan of 10 policies enacted prior to 2014 and data for adults ages 18-64 from the 2014 American Community Survey. A fixed-effects logistic regression model tested the association between having health insurance and the interaction of level of inclusiveness, citizenship, and race/ethnicity, controlling for state- and individual-level characteristics. Results: Latino noncitizens experienced higher rates of being insured in states with higher levels of inclusion, while Asian/Pacific Islander noncitizens experienced lower levels. The level of inclusion was not associated with differences in insurance coverage among noncitizen Whites and Blacks. Conclusions: Contexts with more inclusive immigrant policies may have the most benefit for Latino noncitizens.

Something Old, Something New: When Gender Matters in the Relationship between Social Support and Health.

This paper investigates how social support differentially benefits self-rated health among men and women hospitalized with heart disease. Using cross-sectional data about patients admitted to a university hospital, we examine the extent to which gender moderates effects for the frequency of contact with family, friends, and neighbors on health and whether these effects differ between those with new versus established diagnoses. We find that gender differentiates the effect of nonmarital family contact on health but only when heart disease is newly diagnosed. When newly diagnosed, more frequent contact with family is associated with better self-rated health for women but not men. Men and women with preexisting diagnoses benefit equally from more frequent contact with family.

Effects of stress, health competence, and social support on depressive symptoms after cardiac hospitalization.

Little is known about the role of stress on the psychological well-being of patients after cardiac hospitalization or about factors that protect against or exacerbate the effects of stress. We use prospective data from 1542 patients to investigate the relationship between post-discharge stress and changes in depressive symptoms, and whether the level of prior depressive symptoms, health competence, and perceived social support moderate this relationship. Net of depressive symptoms in the 2 weeks prior to hospitalization, higher levels of post-discharge stress significantly increase depressive symptoms 30 days after discharge. The level of prior depressive symptoms moderates the effect of stress. On the other hand, perceived health competence and social support buffer the negative effects of post-discharge stress. Knowing which patients are particularly vulnerable to experiencing stress and a subsequent increase in depressive symptoms can help trigger interventions prior to discharge and possibly ameliorate the prevalence of depression.