Religious Participation and Mortality Risk in Mexico.

OBJECTIVES: Although research suggests that religious involvement tends to favor longevity, most of this work has been conducted in the United States. This article explores the association between religious participation and all-cause mortality risk in Mexico. METHODS: We used data from the 2003-2015 Mexican Health and Aging Study (n = 14,743) and Cox proportional hazard regression models to assess the association between religious participation and all-cause mortality risk. RESULTS: Our key finding is that older Mexicans who participate once or more per week in religious activities tend to exhibit a 19% reduction in the risk of all-cause mortality than those who never participate. This estimate persisted with adjustments for health selection (chronic disease burden, activities of daily living, instrumental activities of daily living, cognitive functioning, and depressive symptoms), several potential mediators (social support, smoking, and drinking), and a range of sociodemographic characteristics. Although we observed considerable health selection due to physical health and cognitive functioning, we found no evidence of mediation. DISCUSSION: Our results confirm that religious participation is associated with lower all-cause mortality risk among older adults in Mexico. Our analyses contribute to previous research by replicating and extending the external validity of studies conducted in the United States, Israel, Denmark, Finland, and Taiwan.

Religious Attendance and the Social Support Trajectories of Older Mexican Americans.

In this paper, we directly assessed the extent to which the association between religious attendance and the social support trajectories of older Mexican Americans is due to selection (spurious) processes related to personality, health status, and health behavior. We employed seven waves of data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly (1993-2010) to examine the association between religious attendance and perceived social support trajectories (n = 2479). We used growth mixture modeling to estimate latent classes of social support trajectories and multivariate multinomial logistic regression models to predict membership in the social support trajectory classes. Growth mixture estimates revealed three classes of social support trajectories: high, moderate, and low. Multinomial logistic regression estimates showed that the odds of membership in the low support trajectory class (versus the high social support trajectory class) were lower for respondents who attended religious services yearly, monthly, weekly, and more than weekly than for respondents who never attend religious services. Religious attendance could not distinguish between membership in the moderate and high support trajectory classes. These results persisted with adjustments for age, gender, immigrant status, language proficiency, education, income, religious affiliation, marital status, living arrangements, contact with family/friends, secular group memberships, self-esteem, smoking, heavy drinking, depression, cognitive functioning, and physical mobility. We conclude that the association between religious attendance and the social support trajectories of older Mexican Americans is primarily driven by processes related to social integration, not selection.

Religious Participation and Biological Functioning in Mexico.

OBJECTIVE: Although several studies suggest that religious involvement tends to favor healthy biological functioning, most of this work has been conducted in the United States. This study explores the association between religious participation and biological functioning in Mexico. METHOD: The data are drawn from two waves of the Mexican Health and Aging Study (2003-2012) to assess continuous and categorical biomarker specifications. RESULTS: Across specifications, religious participation in 2003 is associated with lower levels of waist-to-hip ratio, total cholesterol, pulse rate, and overall allostatic load in 2012. Respondents who increased their participation over the study period also exhibit a concurrent reduction in pulse rate. Depending on the specification, participation is also associated with lower levels of diastolic blood pressure and C-reactive protein. Participation is generally unrelated to body mass index, glycosylated hemoglobin, and systolic blood pressure. DISCUSSION: Our results confirm that religious participation is associated with healthier biological functioning in Mexico.

Religious Attendance and the Mobility Trajectories of Older Mexican Americans: An Application of the Growth Mixture Model.

Although several studies have examined the association between religious involvement and physical functioning, there is no consistent empirical evidence concerning the true nature of the association. The Hispanic population is also surprisingly understudied in previous work. In this article, we employ seven waves of data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly to examine the association between religious attendance and performance-based mobility trajectories among older Mexican Americans. Growth mixture estimates reveal three latent classes of mobility trajectories: (1) high, (2) moderate, and (3) low. Multinomial logistic regression estimates show that the odds of being classified as having low mobility (versus high and moderate mobility) are lower for respondents who attend religious services than for respondents who never attend. Religious attendance does not distinguish between moderate and high mobility. Our regression results confirm that religious attendance is associated with favorable mobility trajectories among older Mexican Americans.

Perceived Social Support Trajectories and the All-Cause Mortality Risk of Older Mexican American Women and Men.

Although numerous studies of non-Hispanic Whites and Blacks show that social integration and social support tend to favor longevity, it is unclear whether this general pattern extends to the Mexican American population. Building on previous research, we employed seven waves of data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly to examine the association between perceived social support trajectories and the all-cause mortality risk of older Mexican Americans. Growth mixture estimates revealed three latent classes of support trajectories: high, moderate, and low. Cox regression estimates indicated that older Mexican American men in the low support trajectory tend to exhibit a higher mortality risk than their counterparts in the high support trajectory. Social support trajectories were unrelated to the mortality risk of older Mexican American women. A statistically significant interaction term confirmed that social support was more strongly associated with the mortality risk of men.

Perceived neighborhood safety and sleep quality: a global analysis of six countries.

OBJECTIVE: Building on previous North American and European studies of neighborhood context and sleep quality, we tested whether several self-reported sleep outcomes (sleep duration, insomnia symptoms, sleepiness, lethargy, and overall sleep quality) vary according to the level of perceived neighborhood safety in six countries: Mexico, Ghana, South Africa, India, China, and Russia. METHODS: Using data (n = 39,590) from Wave I of the World Health Organization's Longitudinal Study on Global Ageing and Adult Health (2007-2010), we estimated a series of multinomial and binary logistic regression equations to model each sleep outcome within each country. RESULTS: Taken together, our results show that respondents who feel safe from crime and violence in their neighborhoods tend to exhibit more favorable sleep outcomes than respondents who feel less safe. This general pattern is especially pronounced in China and Russia, moderately evident in Mexico, Ghana, and South Africa, and sporadic in India. Perceptions of neighborhood safety are strongly associated with insomnia symptoms and poor sleep quality (past 30 days), moderately associated with sleepiness, lethargy, and poor sleep quality (past 2 days), and inconsistently associated with sleep duration (past two days). CONCLUSIONS: We show that perceived neighborhood safety is associated with more favorable self-reported sleep outcomes in six understudied countries. Additional research is needed to replicate our findings using longitudinal data, more reliable neighborhood measures, and more direct measures of sleep quality in these and other regions of the world.

Longer lives, sicker lives? Increased longevity and extended disability among Mexican-origin elders.

OBJECTIVES: (a) To identify factors associated with different patterns of functional decline in a longitudinal sample of older Mexican-origin individuals, and (b) to determine the proportions of life after age 65 characterized by serious functional impairment. METHODOLOGY: We use the Hispanic Established Populations for Epidemiologic Studies of the Elderly to examine changes in objective Performance Oriented Mobility Assessments in a cohort of 3,050 Mexican-origin elders initially interviewed in 1993/1994 and recontacted 6 times over 17 years. This sample combined with an additional cohort of 902 individuals 75 and older added at wave 4 in 2004/2005 (combined sample = 3,952) is used in life table analyses to estimate the number of years after 65 characterized by serious functional impairment. RESULTS: Three distinct patterns of functional decline emerge: (a) high initial functioning followed by decline, but not to the level of disability (48%); (b) moderate initial functioning followed by decline to the level of disability (37.5%); and (c) initial disability followed by continued poor functioning (14.5%). Life table analyses reveal that subjects spent over half of the period after 65 with serious functional limitations. Significant gender and nativity differentials emerge. DISCUSSION: Protracted morbidity that accompanies increases in life expectancy has serious implications for the physical, social, and economic well-being of older individuals and their families, as well as for health and long-term care policy.

Subjective control and health among Mexican-origin elders in Mexico and the United States: structural considerations in comparative research.

OBJECTIVES: This study examines the joint impact of psychological and structural factors on Mexican and Mexican American elders' sense of personal control over important aspects of their lives and health in Mexico and the United States. METHODS: We employ the Mexican Health and Aging Study (MHAS) and the Hispanic Established Populations for Epidemiologic Studies of the Elderly (H-EPESE) to explore patterns of association among structural factors, personal characteristics, indicators of material and physical vulnerability, and expressed locus of control. RESULTS: The results suggest that an older individual's sense of personal control over important aspects of his or her life, including health, reflects real material and social resources in addition to individual predispositions. In Mexico, only the most privileged segment of the population has health insurance, and coverage increases one's sense of personal control. In the United States, on the other hand, Medicare guarantees basic coverage to the vast majority of Mexican Americans over 65, reducing its impact on one's sense of control. DISCUSSION: Psychological characteristics affect older individuals' sense of personal control over aspects of their health, but the effects are mediated by the economic and health services context in which they are expressed.

A comparison of the health of older Hispanics in the United States and Mexico: methodological challenges.

OBJECTIVE: This study compares various dimensions of physical and emotional health between older Mexican-origin individuals in the United States and in Mexico. METHOD: The samples are drawn from the Mexican Health and Aging Study (MHAS) and the Hispanic Established Epidemiologic Study of the Elderly (H-EPESE) and include 3,875 Mexican residents with no history of residence in the United States and 2,734 Mexican-origin individuals 65 and older who live in the southwestern United States. RESULTS: Both immigrant and native-born Mexican-origin elders in the United States report more chronic conditions than elderly Mexicans, but they report fewer symptoms of psychological distress. Longer residence in the United States is associated with higher body mass index scores. DISCUSSION: The discussion addresses the possibility that access to care influences reports of diagnosed conditions and touches on issues of comparability in cross-cultural research and the difficulty in clearly distinguishing cultural and system-level factors in the production and measurement of health.

Religious attendance and cognitive functioning among older Mexican Americans.

Research shows that social engagement reduces the probability of cognitive decline in late life. The purpose of this study was to test whether religious attendance, a major source of social engagement for many older individuals, is associated with slower rates of cognitive decline among older Mexican Americans. Using four waves of data collected from a sample of 3,050 older Mexican-origin individuals, we estimated a series of linear growth curve models to assess the effects of religious attendance on cognitive functioning trajectories. We used the Mini-Mental State Examination to measure cognitive functioning. Our central finding is that religious attendance is associated with slower rates of cognitive decline among older Mexican Americans. Specifically, respondents who attend church monthly, weekly, and more than weekly tend to exhibit slower rates of cognitive decline than those who do not attend church.

Religious attendance and mortality: an 8-year follow-up of older Mexican Americans.

OBJECTIVE: Studies in the area of religion and mortality are based primarily on data derived from samples of predominantly non-Hispanic Whites. Given the importance of religion in the lives of Hispanics living in the United States, particularly older Hispanics, we examine the effects of religious attendance on mortality risk among Mexican Americans aged 65 and older. METHODS: We employ data from the Hispanic Established Populations for Epidemiologic Studies of the Elderly to predict the risk of all-cause mortality over an 8-year follow-up period. RESULT: Overall, the results show that those who attend church once per week exhibit a 32% reduction in the risk of mortality as compared with those who never attend religious services. Moreover, the benefits of weekly attendance persist with controls for sociodemographic characteristics, cardiovascular health, activities of daily living, cognitive functioning, physical mobility and functioning, social support, health behaviors, mental health, and subjective health. DISCUSSION: Our findings suggest that weekly church attendance may reduce the risk of mortality among older Mexican Americans. Future research should focus on identifying other potential mediators of the relationship between religious involvement and mortality risk in the Mexican-origin population.