Unraveling Familism and Depressive Symptoms among Dominican Women: A Multidimensional Analysis.

Familism is a multidimensional construct that includes familial support. However, limited research examines whether the sub-components of familism equally contribute to mental health and whether familism protects against depression beyond social support. To address these gaps, we test associations between the multidimensional components of familism (familial support, familial obligations, family as referents) and social support with depressive symptoms among immigrant Dominican women in New York City. We tested associations between the multidimensional components of familism, specifically, familial support, familial obligations, and family as referents (Sabogal et al., 1987), as well as social support, with depressive symptoms among 419 women. Multiple regression analysis indicated that whereas familial support predicted decreases in depressive symptoms (ß = - 0.15), family obligations, and family as referents did not. However, only social support predicted decreased depressive symptoms (ß= - 0.18) when accounting for covariates and familism subscales. Controlling for covariates, age predicted decreased depressive symptoms (ß = - 0.19), whereas self-rated poor health exhibited the inverse effect (ß = 0.17). These findings highlight the need for a nuanced understanding of familism, social support, and the association of cultural and demographic values on Latina mental health. These results illustrate the need for further analysis of social support and the multiple components of the familism construct.

The Repellent Capacity against Sitophilus zeamais (Coleoptera: Curculionidae) and In Vitro Inhibition of the Acetylcholinesterase Enzyme of 11 Essential Oils from Six Plants of the Caribbean Region of Colombia.

The repellent capacity against Sitophilus zeamais and the in vitro inhibition on AChE of 11 essential oils, isolated from six plants of the northern region of Colombia, were assessed using a modified tunnel-type device and the Ellman colorimetric method, respectively. The results were as follows: (i) the degree of repellency (DR) of the EOs against S. zeamais was 20-68% (2 h) and 28-74% (4 h); (ii) the IC50 values on AChE were 5-36 µg/mL; likewise, the %inh. on AChE (1 µg/cm3 per EO) did not show any effect in 91% of the EO tested; (iii) six EOs (Bursera graveolens-bark, B. graveolens-leaves, B. simaruba-bark, Peperomia pellucida-leaves, Piper holtonii (1b*)-leaves, and P. reticulatum-leaves) exhibited a DR (53-74%) ≥ C+ (chlorpyrifos-61%), while all EOs were less active (8-60-fold) on AChE compared to chlorpyrifos (IC50 of 0.59 µg/mL). Based on the ANOVA/linear regression and multivariate analysis of data, some differences/similarities could be established, as well as identifying the most active EOs (five: B. simaruba-bark, Pep. Pellucida-leaves, P. holtonii (1b*)-leaves, B. graveolens-bark, and B. graveolens-leaves). Finally, these EOs were constituted by spathulenol (24%)/ß-selinene (18%)/caryophyllene oxide (10%)-B. simaruba; carotol (44%)/dillapiole (21%)-Pep. pellucida; dillapiole (81% confirmed by 1H-/13C-NMR)-P. holtonii; mint furanone derivative (14%)/mint furanone (14%)-B. graveolens-bark; limonene (17%)/carvone (10%)-B. graveolens-leaves.

Vulnerability or Resiliency? A Two-Wave Panel Analysis of Social Network Factors Associated with Glycemic Levels among Mexican Immigrants in the Bronx, NYC, Before and During COVID-19.

Latinos have high rates of type 2 diabetes mellitus (T2DM) yet are characterized as having health-promoting social networks. The impacts of COVID-19 on personal networks were complex, especially in urban areas with high proportion of immigrants such as the Bronx in NYC. Our objective was to test the extent to which network characteristics increase vulnerability or resiliency for glycemic control based on data gathered from Mexican-origin Bronx dwellers. We used two-wave panel study analyzing self-reported personal social networks (n=30participants; 600network members) and HbA1c levels via dried blood spots in 2019, before the COVID-19 pandemic, and in 2021, a time after initial lockdowns and when the pandemic was still ravaging the community of study. Regression models adjusted for individual-level variables including sociodemographic and health indicators (i.e., physical health including COVID-19 and mental health). We found that an increase in the proportion of network members with diabetes predicted an increase in participant's HbA1c levels from 2019 to 2021 (ß=0.044, p < 0.05). Also, a greater proportion of network members consuming "an American diet" in 2019 predicted a decrease in participant's HbA1c levels (ß=-0.028, p < 0.01), while a greater proportion of network members that encouraged participants' health in 2019 predicted an increase in participant's HbA1c levels (ß=0.033, p < 0.05). Our study sheds light on specific social network characteristics relevant to individual diabetes outcomes, including potential longitudinal mechanistic effects that played out at the peak of the COVID-19 crisis.

South-to-South parental migration patterns and excess weight among children: Insights from a national cross-sectional study in Colombia.

BACKGROUND: Evidence from Latin America suggests that children embedded in South-to-North migrant networks (i.e. relatives who live abroad, typically in the United States) are at increased risk of excess weight. It is unclear if the same findings apply to children embedded in Latin American intraregional migration or South-to-South migration networks. OBJECTIVE: To compare excess weight among Colombian children embedded in South-to-South migration networks (n = 334) to children with non-migrant parents (n = 4272) using Colombia's 2015 National Survey of the Nutritional Situation. METHODS: Prevalence ratios (PRs) for excess weight (BMI z-score ≥1) by parent migration history were estimated using weighted multivariable logistic regression adjusting for demographics, child behaviours, community and household indicators, including household food insecurity. RESULTS: Most migrant parents returned to Colombia from Venezuela (84%) and reported higher household food insecurity rates than non-migrant parents (59% versus 32%). Models excluding household food insecurity showed that excess weight among children with migrant parents was 51% lower (PR = 0.49; 95% CI 0.25, 0.98) than among children with non-migrant parents. After adjustment for household food insecurity, no statistically significant differences were found. CONCLUSION: Colombian children with return migrant parents from Venezuela experienced less excess weight than children with non-migrant parents, but higher rates of food insecurity in migrant households might partially explain this difference. This study calls attention to two serious public health concerns for Colombian children-those who have excess weight and those who lack sufficient food, particularly among migrant returnees (a situation that may have worsened since the COVID-19 pandemic).

"No sufro, estoy bien/I am not suffering, so I am doing OK": A mixed method exploration of individual and network-level factors and Type 2 Diabetes Mellitus (T2DM) among Mexican American adults in New York City.

INTRODUCTION: The prevalence of type 2 Diabetes Mellitus (T2DM) is 2-3 times greater among Mexican Americans than non-Latino whites, and Mexican Americans are more likely to develop T2DM at younger ages and experience higher rates of complications. Social networks might play a crucial role in both T2DM etiology and management through social support, access to resources, social engagement, and health behavioral norms. OBJECTIVE: To quantitatively identify the social network features associated with glycated hemoglobin (HbA1c) in a community sample of Mexican immigrants residing in New York City, and to explore the extent to which these quantitative findings converge with qualitative narratives of their lived experiences. METHODS: This study used a convergent mixed methods design. To collect personal network data, we used EgoWeb, and obtained 1,400 personal network ties from 81 participants. HbA1c readings were collected using dried blood spots and categorized according to the laboratory criteria of the American Diabetes Association. Additional survey data were collected using Qualtrics software. To investigate the significance of the network-level factors after accounting for the socioeconomic and demographic individual-level factors that the literature indicates to be associated with T2DM, we used a multiple regression model on quantitative data sources. For the qualitative portion of the study, we selected a subset of individuals who participated in the quantitative portion, which represented 500 personal network ties from 25 participants. We conducted in-depth interviews guided by the visualization of these ties to explore who was helpful or difficult in managing their health and health behaviors. RESULTS: Individual-level indicators associated with lower HbA1c scores were body mass index (ß = -0.07, p<0.05), and healthy eating index scores (ß = -0.03, p<0.02). The network-level predictor associated with higher HbA1c levels was the percentage of diabetic alters in the network (ß = 0.08, p <0.001, with a 25% increase in the percentages associated 2.0 change in HbA1c levels. The qualitative data highlighted that most of the diabetes-related information diffused through the social networks of our participants was related to dietary practices, such as reducing sugar and red meat consumption, eating out less, and reducing portion sizes. Notably, even among those with elevated levels and diabetes-related health complications, HbA1c was not considered a part of the lay descriptions of good health since they were not "suffering." Participants regarded doctors as the ultimate authority in diabetes care, even if they had supportive members in their personal networks. CONCLUSION: Our study provides quantitative evidence for the significant role of diabetic network members in the etiology and management of T2DM among Mexican Americans. Our qualitative findings suggest important ley terms for T2DM management and the importance of physicians, which could be included in in future social networks studies seeking to diffuse diabetes-related health information for T2DM prevention and management efforts in this population.

Lessons Learned about Developing Faith and Public Health Partnerships to Address Health Disparities.

Partnerships between public health and faith-based organizations draw on the strengths of both sectors to achieve a shared interest in promoting health and reducing disparities. However, information about implementation of faith and public health partnerships-particularly those involving diverse racial-ethnic groups-is limited. This paper reports on findings from qualitative interviews conducted with 16 public health and congregational leaders around the country as part of the early phase of the development of a faith and public health partnership to address health disparities in Los Angeles, CA. We identified eight themes regarding the barriers and facilitators to building faith and public health partnerships and distilled these into 10 lessons for developing such approaches. These interviews identified that engaging religious organizations often requires building congregational capacity of the congregation to participate in health programs; and that trust is a critically important element of these relationships. Further, trust is closely related to how well each organization involved in the partnership understands their partners' belief structures, approaches to addressing health and well-being and capacities to contribute to the partnership. Tailoring congregational health programs to match the interests, needs and capacity of partners was identified as an important approach to ensuring that the partnership is successful. But, this is complicated by working across multiple faith traditions and the racial-ethnic backgrounds, thus requiring increased and diverse communication strategies on the part of the partnership leadership. These lessons provide important information for faith and public health leaders interested in developing partnered approaches to address health in diverse urban communities.

Household Food Security and Consumption of Sugar-Sweetened Beverages among New York City (NYC) Children: A Cross-Sectional Analysis of 2017 NYC Kids' Data.

Food insecurity is a stressor associated with adverse health outcomes, including the consumption of sugar-sweetened beverages (SSBs). Our study tests the hypothesis that other socioeconomic vulnerabilities may magnify this effect using cross-sectional data from the 2017 New York City (NYC) Kids Survey. Households providing an affirmative response to one or both food security screener questions developed by the US Department of Agriculture were coded as households with low food security. The number of sodas plus other SSBs consumed was standardized per day and categorized as 1 = none, 2 = less than one, and 3 = one or more. We tested the joint effect of low food security with chronic hardship, receipt of federal aid, and immigrant head of household on a sample of n = 2362 kids attending kindergarten and beyond using ordinal logistic regression and accounting for the complex survey design. Only having a US-born parent substantially magnified the effect of low household food security on SSB consumption (OR = 4.2, 95%CI: 2.9-6.3, p < 0.001) compared to the reference group of high household food security with an immigrant parent. The effect of low food security on SSB consumption among NYC children warrants intersectional approaches, especially to elucidate US-based SSB norms in low-food-security settings.

Insights from a cross-sectional binational study comparing obesity among nonimmigrant Colombians in their home country and Colombian immigrants in the U.S.

BACKGROUND: Latinos in the United States (U.S.) represent a heterogeneous minority population disproportionally impacted by obesity. Colombians in the U.S. are routinely combined with other South Americans in most obesity studies. Moreover, most studies among Latino immigrants in the U.S. solely focus on factors in the destination context, which largely ignores the prevalence of obesity and contextual factors in their country of origin, and warrant transnational investigations. METHODS: Using 2013-17 data from the New York City Community Health Survey (NYC CHS, U.S.) and the National Survey of the Nutritional Situation (ENSIN, Colombia), Colombians that immigrated to the U.S. and are living in NYC (n = 503) were compared to nonimmigrant Colombians living in their home country (n = 98,829). Prevalence ratios (PR) for obesity (BMI ≥ 30 kg/m2) by place of residence were estimated using multivariable logistic regression adjusting for socio-demographic characteristics and daily consumption of sugar-sweetened beverages. RESULTS: The prevalence of obesity was 49% greater for immigrant Colombians living in NYC when compared to nonimmigrant Colombians living in in their home country (PR = 1.49; 95% CI 1.08, 2.07). Colombian immigrant men in NYC were 72% more likely to have obesity compared to nonimmigrant men living in their home country (PR = 1.72; 95% CI 1.03, 2.87). No significant differences were found in the adjusted models among women. CONCLUSIONS: Colombian immigrants in NYC exhibit a higher prevalence of obesity compared to their nonimmigrant counterparts back home and sex strengthens this relationship. More obesity research is needed to understand the immigration experience of Colombians in the U.S. and the underlying mechanisms for sex difference. Public health action focused on women in Colombia and both Colombian men and women immigrants in the U.S. is warranted to avert the long-term consequences of obesity.

Examining the Independent Association Between Acculturative Stress and Psychological Distress Among Mexican Immigrants in New York City: An Exploratory Study.

Objective: This study examines the association between acculturative stress and psychological distress among Mexican immigrants living in New York City. It takes account factors such as language barriers, legal status, fear of deportation, and avoidance of social health and human services, and how these factors are implicated in the mental health status of the study population. Design: Study draws from a community-based sample of Mexican American adults from the Social Network of Mexican Americans study recruited from a church-based community center in the Bronx, New York. Eighty Mexican immigrants were included in this analysis. Descriptive statistics were used to display participants' characteristics. Pearson correlation and multiple regressions were run to determine the relationship between acculturative stress and psychological distress, and also with each of the items from the acculturative stress scale. Both scales have been validated among Spanish-speaking Latino immigrants. Results: A significant moderate positive relationship was found between acculturative stress and psychological distress. Within the acculturative stress scale, those items related to language discrimination, evasion of health services, and feeling guilty for leaving family/friends in home country had significant associations with increased psychological distress. Conclusion: The findings support the need for interventions that account for the major stressors associated with being a Mexican immigrant in the United States to prevent psychological distress, especially given the anti-immigration policies.

Nosotros mismos nos estamos matando/We are the ones killing ourselves: Unraveling individual and network characteristics associated with negative dietary acculturation among Mexican Americans in New York City.

BACKGROUND: Research on negative dietary acculturation among Mexican-Americans has mostly focused on individual-level processes and has largely ignored the role of social networks. METHODS: This mixed-method study used an egocentric network approach and derived 1620 personal ties of self-identified Mexican adults in New York. 24-hour dietary recalls were used to derive a total Healthy Eating Index (HEI) and subscores. The qualitative portion generated narratives around who helps or hinders their efforts to eat healthfully. RESULTS: At the individual level, age at which participants migrated to the U.S. was negatively associated with total HEI (ß = -0.39, p < .01). An annual income below $30,000 was positively associated with total HEI (ß = 0.25, p < .05) and with HEI fruit subscores (ß = 0.25, p < .05). Acculturative stress was negatively associated with HEI fruit (ß = -0.29, p < .05) and refined grain subscores (ß = -0.34, p < .01). At the network level, the proportion of network members who consumed traditional Latino diets was negatively associated with total HEI and HEI refined grains subscores (ß = -0.39, p < .001; and ß = -0.23, p < .05; respectively). In contrast, the proportion of alters who lived in another country was positively associated with HEI dairy subscores (ß = 0.25, p < .05). Juxtaposing qualitative participants' visual representation of their total HEI scores with their lay interpretations of healthy and unhealthy eating matched public health messages of reducing sugar, red meat intake, and processed foods. However, participants felt that this could only be achieved through restriction rather than balance. Qualitative narratives also elucidated how dietary acculturation and income could help shape dietary quality in unexpected ways. CONCLUSIONS: This study found evidence of negative dietary acculturation and showcases the complex ways in which both individual- and network-level processes help shape dietary choices for Mexican-Americans.

Root dentin translucency and age at death estimation in adults using single rooted teeth: Update of the Forensic International Dental Database.

Since the publication of Lamendin's age estimation technique, the root dentin translucency has received increasing attention as an important indicator of age. Recently, Parra and colleagues presented the Forensic International Dental Database (FIDB), a proposal to estimate age at death in adults based on Bayes theorem by applying the criteria of Lamendin's technique. The present study aims to update the procedure and to evaluate a new version of the method (named FIDBv2) using two control samples from Colombia and Greece. The performance of this new version was acceptable and suggests that the method is suitable for age at death estimation in adult individuals from different forensic contexts. The best approximations to chronological age were obtained for individuals between 30 and 60 years old, with errors less than 10 years. The age estimations calculated on control samples suggest the adequate performance of FIDBv2 on individuals from varied populations. It can be stated that the FIDBv2 constitutes a solid alternative to be used in contexts where no additional data are available. Here we reinforce the initial idea that this model for estimating age at death in adults may be generalizable to any forensic context in the world.

The copita question: Exploring alcohol consumption among Latina women.

We explored whether Dominican women underreport alcohol consumption according to questionnaire wording and examined factors associated with their alcohol use through structured interviews in Spanish. We measured consumption with the word "alcohol" and with the common colloquialisms "copita/trago/vinito." We used logistic regressions to examine associations between alcohol consumption, demographics, and alcohol-related norms. Of 419 female participants, 411 completed alcohol-related questions. Most (n=343, 83.5%) were current drinkers and 88 (21%) reported having never consumed alcohol but also that they occasionally drink a "copita/trago/vinito." This indicates alcohol use is potentially underreported among Dominican women. Alcohol-related research should incorporate culturally sensitive language to improve accuracy.

Impacto de la rehabilitación cardiaca de 8 vs 12 semanas sobre la calidad de vida de personas con angioplastia. Ensayo clínico aleatorizado / Impact of an 8 and 12-week Cardiac Rehabilitation Program on the Perception of Quality of Life in Patients with Coronary Angioplasty. A Randomized Controlled Trial

Introducción. La evaluación de la calidad de vida es un resultado de salud que comúnmente se asocia con la eficacia de los tratamientos derivados a los pacientes con enfermedad de las arterias coronarias. Específicamente, la literatura no es clara con respecto al papel de la rehabilitación cardíaca sobre la calidad de vida en población sometida a revascularización coronaria. Objetivo. Determinar si existen diferencias en la percepción de calidad de vida relacionada con la salud, después de asistir a un programa de rehabilitación cardiaca de 8 semanas comparado con uno de 12 semanas en personas post revascularización percutánea. Métodos. Ensayo clínico controlado aleatorizado, conformado por personas que asisten a rehabilitación cardíaca, divididas en dos grupos de estudio (8 y 12 semanas), quienes se evaluaron a través del Cuestionario SF-36.Resultados. La muestra estuvo conformada por 17 personas, con edad promedio de 63.1±6.9 años. Al comparar la evaluación pre y posttratamiento en cada grupo, se encontraron diferencias significativas en los dominios función física y rol físico en el grupo de 8 semanas; al realizar la comparación entre grupos hubo diferencias en el dominio emocional. Conclusión. Los resultados del estudio no evidenciaron diferencias en cuanto a la calidad de vida relacionada con la salud entre los grupos de estudio en el resultado global del cuestionario SF-36. Sin embargo, al comparar las dos intervenciones, el grupo de 8 semanas demostró mejores valores sobre el rol emocional

Introduction. The evaluation of quality of life is a health outcome that is commonly associated with the efficacy of treatments derived from patients with coronary artery disease. The literature is unclear regarding the role of cardiac rehabilitation on quality of life in the population undergoing coronary revascularization.Aim. To determine if there are differences in perception of health-related quality of life after attending an 8-week cardiac rehabilitation program compared to a 12-week program in people after coronary angioplasty. Methods. Randomized controlled clinical trial that included people with coronary angioplasty, who attended a cardiac rehabilitation program, divided in two groups (8 and 12 weeks), who were evaluated through the 8 domains of Short Form-36 Health Survey (SF-36). Results. The sample was made up of 17 people, with an average age of 63.1 ± 6.9 years. When comparing the evaluation before and after treatment in each group, sta-tistical differences were found in the physical-functioning and role-physical in 8 weeks group. Comparation between group show differences in role-emotional. Conclusion. The results of the present study did not show differences between the global score on health-related quality of life. However, when comparing the two in-terventions, the 8-week group showed better values on the role-emotional.

Latina Women in Academia: Challenges and Opportunities.

Latina women and other ethnic and racial groups continue to be underrepresented in science, technology, engineering, and mathematics (STEM) fields, including public health. This underrepresentation of people from diverse backgrounds and lived experiences in academic public health and other scientific disciplines is a form of epistemic oppression, exclusion that hinders contribution to knowledge production and advancement. Our analysis of 2021 data from the Association of Schools and Programs of Public Health indicates that Latinos/as represented only 6.0% of all instructional faculty and 6.1% of all tenured faculty at schools and programs of public health. We discuss the ways in which sociopolitical contexts, family-level dynamics and gendered norms, and institutional contexts hamper Latinas' full participation in academia. We propose solutions such as redefining metrics for success, leadership accountability, equity analyses, cluster hiring initiatives, and instituting structured mentoring and leadership programs. Bold actions are needed if we are to advance the scientific enterprise and address the diversity and equity problem in public health.

Latino Children's Obesity Risk Varies by Place of Birth: Findings from New York City Public School Youth, 2006-2017.

Introduction: Research showing that place of birth (POB) predicts excess weight gain and obesity risk among Latino adults has not prompted similar research in Latino children, although childhood is a critical period for preventing obesity. Objective: To identify differences in obesity risk among Latino children by POB. Methods: Longitudinal cohort observational study on public school children self-identified by parent/guardian as Latino in grades K-12 for school years 2006-07 through 2016-17 with measured weight and height (n = 570,172students; 3,103,642observations). POB reported by parent/guardian was categorized as continental United States [not New York City (NYC)] (n = 295,693), NYC (n = 166,361), South America (n = 19,452), Central America (n = 10,241), Dominican Republic (n = 57,0880), Puerto Rico (n = 9687), and Mexico (n = 9647). Age- and sex-specific BMI percentiles were estimated based on established growth charts. Data were analyzed in 2020. Results: Prevalence of obesity was highest among US (non-NYC)-born girls (21%) and boys (27%), followed by NYC-born girls (19%) and boys (25%). Among girls, South Americans (9%) had the lowest prevalence of all levels of obesity, while Puerto Ricans (19%) and Dominicans (15%) had the highest prevalence. Among boys, South Americans also had the lowest prevalence of all levels of obesity (15%), while Puerto Ricans (22%) and Mexicans (21%) had the highest. In adjusted models, obesity risk was highest in US (non-NYC)-born children, followed by children born in NYC (p < 0.001). Immigrant Latino children exhibited an advantage even after controlling for individual and neighborhood sociodemographic features, particularly Dominicans, South Americans, and Puerto Ricans. Conclusions: The heterogeneity of obesity risk among Latino children highlights the importance of POB.

Age-at-death estimation in adults using three forensic methodologies: A Lamendin's technique approach for Latin American context and the extension of a forensic international dental database.

In forensic science, the information that teeth provide to the age estimation process is very important. In adults, one of the most widely used indicators of skeletal age is the Root Dentin Translucency (RDT), mainly through the Lamendin technique, which is used in various Latin American contexts. Recently, Parra et al. (2020) have developed a Bayesian regression model using the Lamendin technique to establish standardized criteria for estimating age-at-death in adults in various forensic contexts. In this study, we evaluate the applicability of this proposal together with the proposal by Lamendin et al. (1992) and Prince and Ubelaker (2002) in Latin American contexts. A sample of single-rooted teeth belonging to 805 individuals from six Latin American countries was used. The results of the three proposals considered were analyzed taking into account factors such as age, sex, origin, and the tooth surface on which the variables were surveyed. Of the factors that would affect the estimates, it was found that the age of the individuals had the greatest influence. However, it was confirmed that the sex and surface of the teeth on which the measurements were taken did not influence the final result. On the other hand, as we expected, the application of the analyzed proposals would also be possible in other forensic contexts, as shown by the results obtained according to the origin. This research expands the FIDB with more information on Latino contexts.

Assessing the Health and Economic Impact of a Potential Menthol Cigarette Ban in New York City: a Modeling Study.

Menthol in cigarettes increases nicotine dependence and decreases the chances of successful smoking cessation. In New York City (NYC), nearly half of current smokers usually smoke menthol cigarettes. Female and non-Latino Black individuals were more likely to smoke menthol-flavored cigarettes compared to males and other races and ethnicities. Although the US Food and Drug Administration recently announced that it will ban menthol cigarettes, it is unclear how the policy would affect population health and health disparities in NYC. To inform potential policymaking, we used a microsimulation model of cardiovascular disease (CVD) to project the long-term health and economic impact of a potential menthol ban in NYC. Our model projected that there could be 57,232 (95% CI: 51,967-62,497) myocardial infarction (MI) cases and 52,195 (95% CI: 47,446-56,945) stroke cases per 1 million adult smokers in NYC over a 20-year period without the menthol ban policy. With the menthol ban policy, 2,862 MI cases and 1,983 stroke cases per 1 million adults could be averted over a 20-year period. The model also projected that an average of $1,836 in healthcare costs per person, or $1.62 billion among all adult smokers, could be saved over a 20-year period due to the implementation of a menthol ban policy. Results from subgroup analyses showed that women, particularly Black women, would have more reductions in adverse CVD outcomes from the potential implementation of the menthol ban policy compared to males and other racial and ethnic subgroups, which implies that the policy could reduce sex and racial and ethnic CVD disparities. Findings from our study provide policymakers with evidence to support policies that limit access to menthol cigarettes and potentially address racial and ethnic disparities in smoking-related disease burden.

Late HIV diagnosis among immigrants in Spain vs. native-born Spaniards, 2010-15.

BACKGROUND: In 2012, the central government of Spain enacted Royal Decree-Law (RDL) 16/2012 and Royal Decree (RD) 1192/2012, which abolished universal healthcare coverage, thus limiting access to care for undocumented immigrants. Free health care was also no longer granted to anyone who has never been employed. In this context, this study investigated the prevalence of late HIV diagnoses (LHDs) among immigrants living in Spain vs. native-born Spaniards. METHODS: Data (n = 5943) from the 2010 to 2015 Cohort of the Spanish AIDs Research Network were used, including HIV-positive and antiretroviral therapy (ART)-naïve patients throughout Spain. Multivariate logistic models were fitted to compare the prevalence of LHD among the groups, adjusting for covariates. RESULTS: The prevalence of LHD in the total sample was 39.5%. Compared with native-born Spaniards (n = 4445), immigrants (n = 1488) were more likely to have LHD (37.4% vs. 45.7%, respectively; P < 0.001). Multivariate analysis showed that the prevalence ratio of LHD among immigrants vs. native-born Spaniards was 1.15 [95% confidence interval (CI), 1.02-1.28], after adjusting for covariates. This disparity widened from 2010 to 2011 (APR = 1.14, 95% CI, 1.02-1.29) to 2012-15 (APR = 1.28, 95% CI, 1.17-1.39), although the change was not statistically significant. CONCLUSIONS: Immigrants in Spain had a higher risk of LHD compared with native-born counterparts. LHD is an important healthcare marker due to the positive benefits of early HIV diagnosis, including prevention, improvements in health outcomes and decreases in overall cost of treatment. More research is needed on the causes of the disparity and potential social and policy interventions to reduce the prevalence of LHD among immigrants.