ABSTRACT
Research indicates that neighborhood context can have a significant effect on the health of older adults. The evidence suggests that there may be physical health benefits afforded to Mexican Americans living in ethnically homogenous neighborhoods, despite the relatively high economic risk in such neighborhoods, but few studies have considered the effect of neighborhood ethnic density on mental health outcomes in older adults. This study evaluated the association between neighborhoods with a high proportion of Mexican Americans and depressive symptoms in very old Mexican Americans. Hierarchical linear modeling was used to examine data from Wave 5 (2004/05) of the Hispanic Established Populations for the Epidemiologic Study of the Elderly. Subjects included 1,875 community-dwelling Mexican Americans aged 75 and older living in 386 neighborhoods in five states in the southwestern United States (Arizona, California, Colorado, New Mexico, Texas). Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale (α=0.88). Results showed that, in very old men, there was a significant negative association between percentage of Mexican Americans in the neighborhood and depressive symptoms (P=.01). In women, the direction of the association was the same, but the effect was not significant. These findings suggest that the proportion of Mexican Americans in the neighborhood matter more for very old Mexican American men than women. Further research may inform screening and treatment for depressive symptoms based on differences in neighborhood composition. Recommendations include culturally customized programs that offer older Mexican Americans greater mobility and access to programs and opportunities in culturally identifiable neighborhoods.
Subject(s)
Activities of Daily Living , Depression/ethnology , Mexican Americans , Residence Characteristics , Aged , Aged, 80 and over , Female , Humans , Male , Prevalence , Risk Factors , Sex Distribution , United States/epidemiologyABSTRACT
The purpose of this study is to determine if English language use is associated with smoking, diabetes, hypertension, limitations in Activities of Daily Living (ADL), and 12-year mortality in older Mexican Americans. Using data from a cohort of 3,050 Mexican Americans aged 65 years and older, we examined prevalence of 4 health indicators and survival over 12 years of follow-up by English language use. English language use is associated with increased odds of hypertension in men, independent of nativity and sociodemographic control variables. Among women, English language use is associated with lower odds of ADL limitations and increased odds of smoking. The associations for women were partially explained by occupational status and nativity. After adjusting for health conditions, sociodemographics, and nativity, English language use was associated with increased mortality among men. Interaction terms revealed that for both men and women, higher English language use was associated with mortality for respondents with the highest level of income only. English language use is a predictor of health and mortality in older Mexican Americans separate from country of birth.
Subject(s)
Acculturation , Health Status , Language , Mexican Americans , Mortality/ethnology , Activities of Daily Living , Aged , Cohort Studies , Diabetes Mellitus/ethnology , Female , Humans , Hypertension/ethnology , Male , Sex Factors , Smoking/ethnology , Socioeconomic FactorsABSTRACT
OBJECTIVES: We investigated ethnic differences in allostatic load in a population-based sample of adults living in Texas City, TX, and assessed the effects of nativity and acculturation status on allostatic load among people of Mexican origin. METHODS: We used logistic regression models to examine ethnic variations in allostatic load scores among non-Hispanic Whites, non-Hispanic Blacks, and people of Mexican origin. We also examined associations between measures of acculturation and allostatic load scores among people of Mexican origin only. RESULTS: Foreign-born Mexicans were the least likely group to score in the higher allostatic load categories. Among individuals of Mexican origin, US-born Mexican Americans had higher allostatic load scores than foreign-born Mexicans, and acculturation measures did not account for the difference. CONCLUSIONS: Our findings expand on recent research from the National Health and Nutrition Examination Survey with respect to ethnicity and allostatic load. Our results are consistent with the healthy immigrant hypothesis (i.e., newer immigrants are healthier) and the acculturation hypothesis, according to which the longer Mexican immigrants reside in the United States, the greater their likelihood of potentially losing culture-related health-protective effects.
Subject(s)
Acculturation , Allostasis/immunology , Black or African American , Mexican Americans , White People , Adaptation, Psychological/physiology , Adult , Aged , Aged, 80 and over , Allostasis/physiology , Biomarkers , Female , Health Behavior , Health Surveys , Humans , Logistic Models , Male , Middle Aged , Nutrition Surveys , TexasABSTRACT
In previous research on cognitive decline among older adults, investigators have not considered the potential impact of contextual variables, such as neighborhood-level conditions. In the present investigation, the authors examined the association between 2 neighborhood-context variables-socioeconomic status and percentage of Mexican-American residents-and individual-level cognitive function over a 5-year follow-up period (1993-1998). Data were obtained from the Hispanic Established Populations for Epidemiologic Studies of the Elderly, a longitudinal study of community-dwelling older Mexican Americans (n = 3,050) residing in the southwestern United States. Individual records were linked with 1990 US Census tract data, which provided information on neighborhood characteristics. Hierarchical linear growth-curve models and hierarchical logistic models were used to examine relations between individual- and neighborhood-level variables and the rate and incidence of cognitive decline. Results showed that baseline cognitive function and rates of cognitive decline varied significantly across US Census tracts. Respondents living in economically disadvantaged neighborhoods experienced significantly faster rates of cognitive decline than those in more advantaged neighborhoods. Odds of incident cognitive decline decreased as a function of neighborhood percentage of Mexican-American residents and increased with neighborhood economic disadvantage. The authors conclude that neighborhood context is associated with late-life cognitive function and that the effects are independent of individual-level risk factors.
Subject(s)
Cognition Disorders/epidemiology , Cognition Disorders/psychology , Mexican Americans/psychology , Mexican Americans/statistics & numerical data , Residence Characteristics/statistics & numerical data , Aged , Aged, 80 and over , Censuses , Cognition Disorders/ethnology , Female , Health Status , Humans , Interviews as Topic , Logistic Models , Longitudinal Studies , Male , Risk Factors , Socioeconomic Factors , Southwestern United States/epidemiologyABSTRACT
OBJECTIVES: Few studies have investigated smoking and cognitive decline (CD) among older Mexican Americans. In this study, the authors explore the relationship between smoking status and cognitive changes over time in a large sample of community-dwelling older adults of Mexican descent. DESIGN: Latent growth curve analyses were used to examine the decreasing growth in the number of correct responses on a test of cognitive functioning with increasing age (7 years with four data collection points). SETTING: In-home interviews were obtained from participants residing in the Southwest United States. PARTICIPANTS: Participants were community-dwelling older Mexican Americans. MEASUREMENTS: Cognitive functioning was assessed at each of the four data collection points with the Mini-Mental State Examination. Participants' self-reports of health functioning and smoking status were obtained at baseline. RESULTS: With the inclusion of health variables and other control variables, the effect of smoking status on cognitive functioning was significant such that the decrease in the number of correct responses over time was greater for smokers than for nonsmokers. CONCLUSIONS: Smoking increases risk for CD among community-dwelling older Mexican Americans. There are numerous health benefits in quitting smoking, even for older adults who have been smoking for many years. Further efforts to ensure that smoking cessation and prevention programs are targeted toward Hispanics are necessary.