Race-specific associations between psychological distress and obesity: the role of social cohesion.

OBJECTIVE: Nearly two-thirds of Black women in the US are obese. Studies have focused more on lifestyle and behavioral factors to explain racial disparities; less research has examined psychosocial factors such as psychological distress and social cohesion. While research suggests that social cohesion may confer benefits for health, no studies have assessed how social cohesion is related to both mental health and obesity, and potential racial differences. Our study examined associations between psychological distress, social cohesion, and obesity among Black and White adult women. DESIGN: Data are from the 2014-2018 National Health Interview Survey (n = 66,743). Participants self-reported psychological distress (Kessler K6 scale), obesity (body mass index≥30 kg/m2), and social cohesion. We fit logistic regression models of obesity with likelihood ratio tests for effect modification by social cohesion and by race. RESULTS: Psychological distress was associated with a 1.19 and 1.31 higher odds of obesity for Black (95% confidence interval: 1.05, 1.36) and White women (1.24, 1.39), respectively. Social cohesion was associated with a 0.75 lower odds of obesity among White (0.69, 0.81) but not Black women (odds ratio 0.94; 0.80, 1.10). Tests of interaction indicated no differences by social cohesion or race in the association between psychological distress and obesity. CONCLUSION: Findings highlight complex relationships between psychological distress, obesity, and social cohesion in Black and White women. Public health efforts should focus on understanding mechanisms relating social factors to health.

Household fear of deportation in Mexican-origin families: Relation to body mass index percentiles and salivary uric acid.

OBJECTIVE: Fear of deportation (FOD) is a prevalent concern among mixed-status families. Yet, our understanding of how FOD shapes human health and development is in its infancy. To begin to address this knowledge gap, we examined the relationship between household FOD, body mass index (BMI) percentiles and salivary uric acid (sUA), a biomarker related to oxidative stress/hypertension/metabolic syndrome, among 111 individuals living in Mexican-origin families. METHODS: Participants were 65 children (2 months-17 years, 49% female) and 46 adults (20-58 years, 71% female) living in 30 Mexican-origin families with at least one immigrant parent in Phoenix, AZ. We recruited families using cluster probability sampling of 30 randomly selected census tracts with a high proportion of Hispanic/Latino immigrants. The head of household completed a survey containing demographic, FOD, and psychosocial measures. All family members provided saliva (later assayed for sUA) and anthropometric measures. Relationships between household FOD, BMI percentile, and sUA levels were estimated using multilevel models. RESULTS: Higher levels of household FOD were associated with lower BMI percentiles and lower sUA levels between families, after controlling for social support and socioeconomic proxies. CONCLUSION: Key features of the social ecology in which mixed-status families are embedded are associated with individual differences in biological processes linked to increased risk for chronic disease.

Association between body mass index and salivary uric acid among Mexican-origin infants, youth and adults: Gender and developmental differences.

Uric acid (UA) is the end product of the metabolic breakdown of purine nucleotides. Recent studies have measured UA in saliva in relation to obesity and chronic disease risk. Given the increasing prevalence of metabolic syndrome among Latino youth, we examined gender and age differences in salivary uric acid (sUA) and weight in a sample of Mexican-origin children (n = 65, 2 months to 18 years, 49% female) and adults (n = 46, 19-58 years, 72% female). We measured weight, height, waist, and hip circumference and collected saliva samples (later assayed for sUA). Structural equation models estimated the relationship between age, developmental stage, and weight outcomes in relation to sUA levels between genders, while controlling for race. Results demonstrate that increased sUA levels were related to higher BMI percentiles in females of all ages (ß = 0.43, p < .001). There were significant differences in sUA levels between developmental stages for girls, with female toddlers having the highest sUA levels (ß = .28, p = .02). In an interaction between BMI z-score and gender between youth and adults, BMI has a larger effect on increasing sUA levels among younger girls (ß = 0.27, p < .03) and adult women (ß = 0.33, p = .02). Levels of sUA may be gender-specific in relation to BMI and developmental stage.

Comiendo Bien: The Production of Latinidad through the Performance of Healthy Eating among Latino Immigrant Families in San Francisco.

Utilizing a bricolage of interactionist cultural studies, ethnic foodways, and situational analysis this paper examines how Latino immigrants, representing six countries and multiple preimmigration class positions, come to perform Latinidad through the lay health practice of comiendo bien (eating well). Comiendo bien was examined through participant observation of 15 families living in San Francisco and 27 key informant interviews. Comiendo bien is a performance that exists through the convergence of multiple identity positions. Latina/o immigrants not only enact the Latinidad in the United States through artistic expression or political strategizing, but also by sharing an idealized practice of healthy eating.

The association between nutrition transition score and measures of obesity: results from a cross-sectional study among Latina/o immigrants in Baltimore.

BACKGROUND: Studies suggest that US Latinos have a higher prevalence of obesity than White Americans. However, obesity may differ by pre-immigration factors and Latinos' cultural representations of ideal body image. This paper explores whether country of origin's stage in the nutrition transition is related to Latino immigrants' BMI category and self-perception of weight. METHODS: Primary data originated from a cross-sectional questionnaire of Latina/o immigrants in Baltimore in 2011. A convenience sample of self-identified Latinos, ≥18 years old, living in Baltimore was recruited from a community-based organization. Data for each country represented in the sample were obtained from the WHO Demographic and Health Surveys and the UN Food and Agriculture Organization. Each country was scored for its stage in the nutrition transition using a six-point scoring system. Descriptive statistics were conducted to characterize the sample. Bivariate analyses were conducted to examine the relationship between the outcome variables and the predictors. Multivariate logistic regressions were conducted to examine whether a country's stage in the nutrition transition increased one's odds of having an obese BMI score (≥30 kg/cm2) and perceiving one's weight as overweight, while controlling for socio-demographic variables. RESULTS: The sample (n = 149) consisted of immigrants from 12 Latin American countries. Participants lived in the US for x=10.24 years. About 40% of the sample had BMI ≥30 kg/m2 (obese). The longer Latina immigrants' lived in the US, the less likely their country of origin's nutrition transition score would increase their odds of having a BMI ≥30 kg/m2 (OR = 0.97 p < 0.04). The higher the country of origin's nutrition transition score, the more likely BMI influenced Latino immigrants' perception of their weight as above normal (OR = 1.06, p < 0.04). The effect of the nutrition transition score had a stronger effect on females than males. CONCLUSION: These results suggest that country of origin's nutrition transition score and gender affect Latino immigrants' objective and subjective measures of weight. Future investigation should investigate the relationship between gender and the nutrition transition in Latin America and how the nutrition transition globalizes obesity and weight consciousness.

A remotely accessible plant-based culinary intervention for Latina/o/x adults at risk for diabetes: lessons learned.

Introduction: Little research has examined how community-engaged and -participatory dietary interventions adapted to remotely-accessible settings during the COVID-19 pandemic. Objectives: To identify lessons learned in design, implementation, and evaluation of a remotely-accessible, community-based, nurse-led approach of a culturally-tailored whole food plant-based culinary intervention for Latina/o/x adults to reduce type 2 diabetes risk, delivered during a pandemic. Methods: A mixed methods quasi-experimental design consisting of a pre-post evaluation comprised of questionnaires, culinary classes, biometrics, and focus groups. Lessons learned: Community partnerships are essential for successful recruitment/retention. To optimally deliver a remotely-accessible intervention, community leadership and study volunteers should be included in every decision (e.g., timeframes, goals). Recommendations include managing recruitment and supply chain disruption of intervention supplies. Conclusion: Future research should focus on increasing accessibility and engagement in minoritized and/or underserved communities, supply chain including quality assurance and delivery of services/goods, study design for sustainable, remotely-accessible interventions, and health promotion.

Reconsidering acculturation in dietary change research among Latino immigrants: challenging the preconditions of US migration.

BACKGROUND: Dietary changes among Latino immigrants are often attributed to acculturation. Acculturation-diet research typically assumes that migration to the US is necessary for negative dietary changes to occur in Latino immigrants' diets. OBJECTIVE: The goal of this article is to demonstrate that extant acculturation research is not adequate in capturing changes in Latino immigrants' diets. This is due to the role of globalization and transnational processes in modernizing their diets in Latin America. DESIGN: Utilizing an interactionist cultural studies approach, this exploratory situational analysis based on 27 in-depth interviews with Latino immigrants, nutrition reports, and transnational food companies' websites, examines how Latino immigrants were already engaging in negative dietary practices in their former country. RESULTS: Latino immigrants who resided in urban areas in their former countries and migrated to the US on or after 2000 were fully engaged in negative dietary practices prior to migration. Such practices included consuming food outside of the home and integrating processed food into their cooking. Their dietary practices were also informed by nutrition discourses. The modernization of food production and consumption and the transnational transmission of nutrition are transnational processes changing Latino immigrants' diets prior to migration. CONCLUSION: Researchers should approach the study of dietary change among Latino immigrants in the US through a transnational perspective in order to avoid overlooking potential confounders such as current food insecurity, new socioeconomic positions as undocumented, low-income persons, and increased hours worked outside of the home.

Racism-Related Experiences and Adiposity: Findings From the Black Women's Experiences Living With Lupus (BeWELL) Study.

INTRODUCTION: Studies suggest that higher rates of excess adiposity in Black women may in part be driven by experiences of racism. Racial microaggressions, which include unintentional and subtle slights and insults, and responses to racism such as racism-related vigilance, may contribute to adiposity in this population. This study examined these understudied racism-related facets as well as interpersonal racial discrimination in relation to adiposity in a cohort of Black women with systemic lupus erythematosus. METHODS: Data are from the Black Women's Experiences Living with Lupus (BeWELL) Study (2015-2017; n = 432). Linear regression was used to examine adiposity measures (body mass index [BMI], percent body fat, and waist-to-hip ratio), measured during a physical examination, in relation to self-reported measures of racial microaggressions, racism-related vigilance, and interpersonal racial discrimination. RESULTS: Compared with infrequent microaggressions, very frequent experiences of microaggressions were associated with 2.9 kg/m2 higher BMI (95% confidence [CI], 0.63-5.21) and 2.6% higher body fat (95% CI, 0.32-4.80) after adjusting for covariates. Racism-related vigilance, measured continuously, was positively associated with BMI (b = 0.84; 95% CI-0.08, 1.61) and percent body fat (b = 0.89; 95% CI, 0.14-1.64). Very frequent experiences of everyday discrimination were associated with a higher BMI (b = 2.70; 95% CI, 0.58-4.83) and waist-to-hip ratio (b = 0.32; 95% CI, 0.09-0.55) compared with less frequent everyday discrimination. CONCLUSIONS: Our results suggest that various dimensions of racism are associated with excess adiposity. Efforts to address obesity among Black women with systemic lupus erythematosus should consider these multiple aspects to decrease racial inequities in adiposity.

The Importance of Biobehavioral Research to Examine the Physiological Effects of Racial and Ethnic Discrimination in the Latinx Population.

A growing body of research is documenting how racial and ethnic populations embody social inequalities throughout the life course. Some scholars recommend the integration of biospecimens representing the hypothalamic-pituitary-adrenal axis, neurological and endocrinological processes, and inflammation to capture the embodiment of inequality. However, in comparison to other racial and ethnic groups, there has been little research examining how Hispanic/Latinx persons embody racial and ethnic discrimination, much less resulting from institutional and structural racism. We provide a rationale for expanding biobehavioral research examining the physiological consequences of racism among Latinx persons. We identify gaps and make recommendations for a future research agenda in which biobehavioral research can expand knowledge about chronic disease inequities among Latinx populations and inform behavioral and institutional interventions. We end by cautioning readers to approach the recommendations in this article as a call to expand the embodiment of racism research to include the diverse Latinx population as the United States addresses racial inequity.

Household fear of deportation in relation to chronic stressors and salivary proinflammatory cytokines in Mexican-origin families post-SB 1070.

Sociologists recognize that immigration enforcement policies are forms of institutionalized racism that can produce adverse health effects in both undocumented and documented Latinos and Mexican-origin persons in the United States. Despite this important advancement, little research examines the relationship between fear of immigration enforcement and biobehavioral health in mixed-status Mexican-origin families. This study applies an embodiment of racism approach to examine how household fear of deportation (FOD) is related to differences in salivary proinflammatory cytokines (IL-1 ß , IL-6, IL-8, and TNF α ) in healthy Mexican-origin families with at least one immigrant, living in Phoenix, AZ. Participants were 111 individuals (n=46 adults, 72% female; n=65 children, 49% female) from 30 low-income, mixed-status families. During a home visit, anthropometric measures and saliva were collected from each family member and a household survey was administered. Saliva was assayed for salivary IL-1 ß , IL-6, IL-8, and TNF α . Random effects multilevel structural equation models estimated the relationship between household FOD and a salivary proinflammatory cytokine latent variable between families, while controlling for other chronic stressors (economic/occupational, immigration, parental, and family conflict). Household FOD ( ß =0.68, p=0.04) and family conflict chronic stress ( ß =1.96, p=0.03) were strongly related to elevated levels of proinflammatory cytokines between families. These results were consistent in non-mixed and mixed-status families. Future research is needed to characterize what aspects of living with an undocumented family member shape the physical health outcomes of persons with authorized status or US-citizenship.

The Juxtaposition of Comiendo Bien and Nutrition: THE STATE OF HEALTHY EATING FOR LATINA IMMIGRANTS IN SAN FRANCISCO.

There warrants a discussion regarding how nutrition discourses transform lay health practices. Here, I discuss how the adaptation of nutrition discourses among Latina immigrants in San Francisco produces a negotiation between a discourse of nourishment and a discourse of satisfaction in their practice of comiendo bien (eating well). The discourse of satisfaction refers to eating as a way to fulfill symbolic, material or embodied desires, while a discourse of nourishment focuses on supplying the body with nutrients. Negotiating between these discourses transforms comiendo bien if: (1) Latino immigrant families have the resources to adhere to nutritional recommendations; and (2) the adherence to the nutritional recommendation transgresses a negative emotional or physical experience. Appropriating nutrition discourses produces food restrictions that disengage the body from culture and relegate eating to an alienated task. Although a nutritional approach to comiendo bien produces conflict between satisfaction and nourishment, "healthy eating" remains a juxtaposition between satisfaction and nourishment.

Going Beyond the Injury: Regulatory Conditions Contributing to Latina/o Immigrants' Occupational Psychosocial Stressors.

BACKGROUND: Utilizing a psychosocial stress approach, we report psychosocial stressors that Latina/o immigrant day laborers in Baltimore report as workplace hazards and the contextual factors that shape these stressors. METHODS: Through a community-academic partnership, we conducted focus groups (n = 18) and key informant interviews (n = 9) using instruments developed between academics and the community partner to inquire Latina/o immigrants' jobs, hazard awareness, occupational illnesses and injuries, and reporting behaviors. We conducted a transcript-based thematic analysis. RESULTS: The psychosocial stressors that Latina/o day laborers report as dangers at work are anxiety beating the deadline and fear from wage theft, sudden termination and immigration enforcement. DISCUSSION: More attention needs to be given to Latina/o immigrant day laborers' occupational psychosocial risks. Policies should be made to lower barriers for Latina/o immigrants to report grievances to state agencies.

Older people and social connectedness: how place and activities keep people engaged.

To understand how older adults perceive and navigate their neighborhoods, we examined the implications of activity in their neighborhoods for their health. We interviewed 38 adults (ages 62-85) who lived in San Francisco or Oakland, California. Seven key themes emerged: (1) people express a wide range of expectations for neighborliness, from "we do not bother each other" to "we have keys to each other's houses", (2) social distance between "other" people impede a sense of connection, (3) ethnic differences in living arrangements affect activities and activity locations, (4) people try to stay busy, (5) people able to leave their homes do many activities outside their immediate residential neighborhoods, (6) access to a car is a necessity for most, and (7) it is unusual to plan for the future when mobility might become limited. Multiple locations influence older adults' health, including residential neighborhoods. Older adults value mobility, active lives, and social connections.