Hypertension Prevalence, Treatment, and Control 90 Days After Acute Stroke Among Mexican American and Non-Hispanic White Adults.

BACKGROUND: High blood pressure (BP) increases recurrent stroke risk. METHODS AND RESULTS: We assessed hypertension prevalence, treatment, control, medication adherence, and predictors of uncontrolled BP 90 days after ischemic or hemorrhagic stroke among 561 Mexican American and non-Hispanic White (NHW) survivors of stroke from the BASIC (Brain Attack Surveillance in Corpus Christi) cohort from 2011 to 2014. Uncontrolled BP was defined as average BP ≥140/90 mm Hg at 90 days poststroke. Hypertension was uncontrolled BP or antihypertensive medication prescribed or hypertension history. Treatment was antihypertensive use. Adherence was missing zero antihypertensive doses per week. We investigated predictors of uncontrolled BP using logistic regression adjusting for patient factors. Median (interquartile range) age was 68 (59-78) years, 64% were Mexican American, and 90% of strokes were ischemic. Overall, 94.3% of survivors of stroke had hypertension (95.6% Mexican American versus 92.0% non-Hispanic White; P=0.09). Of these, 87.9% were treated (87.3% Mexican American versus 89.1% non-Hispanic White; P=0.54). Among the total population, 38.3% (95% CI, 34.4%-42.4%) had uncontrolled BP. Among those with uncontrolled BP prescribed an antihypertensive, 84.5% reported treatment adherence (95% CI, 78.8%-89.3%). Uncontrolled BP 90 days poststroke was less likely in patients with stroke who had a primary care physician (adjusted odds ratio [aOR], 0.45 [95% CI, 0.24-0.83]; P=0.01), greater stroke severity (aOR per-1-point-higher National Institutes of Health Stroke Scale score, 0.96 [95% CI, 0.93-0.99]; P=0.02), or more depressive symptoms (aOR per-1-point-higher Personal Health Questionnaire Depression Scale-8 score, 0.95 [95% CI, 0.92-0.99] among those with a history of hypertension at baseline; P=0.009). CONCLUSIONS: Greater than one third of survivors of stroke have uncontrolled BP at 90 days poststroke in this population-based study. Interventions are needed to improve BP control after stroke.

Mexican-origin women's individual and collective strategies to access and share health-promoting resources in the context of exclusionary immigration and immigrant policies.

BACKGROUND: A growing literature has documented the social, economic, and health impacts of exclusionary immigration and immigrant policies in the early 21st century for Latiné communities in the US, pointing to immigration and immigrant policies as forms of structural racism that affect individual, family, and community health and well-being. Furthermore, the past decade has seen an increase in bi-partisan exclusionary immigration and immigrant policies. Immigration enforcement has been a major topic during the 2024 Presidential election cycle, portending an augmentation of exclusionary policies towards immigrants. Within this context, scholars have called for research that highlights the ways in which Latiné communities navigate exclusionary immigration and immigrant policies, and implications for health. This study examines ways in which Mexican-origin women in a midwestern northern border community navigate restrictive immigration and immigrant policies to access health-promoting resources and care for their well-being. METHODS: We conducted a grounded theory analysis drawing on interviews with 48 Mexican-origin women in Detroit, Michigan, who identified as being in the first, 1.5, or second immigrant generation. Interviews were conducted in English or Spanish, depending on participants' preferences, and were conducted at community-based organizations or other locations convenient to participants in 2013-2014. RESULTS: Women reported encountering an interconnected web of institutional processes that used racializing markers to infer legal status and eligibility to access health-promoting resources. Our findings highlight women's use of both individual and collective action to navigate exclusionary policies and processes, working to: (1) maintain access to health-promoting resources; (2) limit labeling and stigmatization; and (3) mitigate adverse impacts of immigrant policing on health and well-being. The strategies women engaged were shaped by both the immigration processes and structures they confronted, and the resources to which they had access to within their social network. CONCLUSIONS: Our findings suggest a complex interplay of immigration-related policies and processes, social networks, and health-relevant resources. They highlight the importance of inclusive policies to promote health for immigrant communities. These findings illuminate women's agency in the context of structural violence facing immigrant women and are particularly salient in the face of anti-immigrant rhetoric and exclusionary immigration and immigrant policies.

Changes in the Perceptions of the Neighborhood Environment and Physical Activity Patterns Among Mexican Americans on the Texas-Mexico Border.

INTRODUCTION: Little research on the association of neighborhood environment with physical activity in resource-poor communities has been done. This study assessed changes in perceptions of the neighborhood environment and the association between those perceptions and physical activity in Mexican Americans on the Texas-Mexico border in an area where there would be community efforts to enhance pedestrian and cycling infrastructure and programming. METHODS: We analyzed data from a population-based cohort of Mexican American individuals on the Texas-Mexico border. From 2008 to 2018, interviewer-administered questionnaires were used to collect perceptions of neighborhood environment and physical activity at baseline, 5- and 10-year follow-ups, and at other ancillary study visits, with an average of 3 data points per participant. We conducted multivariable longitudinal logistic regression analyses to assess if the changes in odds of positive perceptions of the neighborhood environment over the study years differed by physical activity patterns. RESULTS: The sample (n = 1036) was mostly female (71%), born in Mexico (70%), and had no health insurance (69%). We saw improvements in the perceptions of several neighborhood environment attributes from 2008 to 2018, though we saw different longitudinal trajectories in these perceptions based on an individual's longitudinal physical activity patterns. By 2014-2018, we saw significantly higher positive perceptions of the neighborhood environment for those who consistently met physical activity guidelines compared with those who did not (adjusted rate ratio = 1.12, P = .049). DISCUSSION: We found that perceptions of many neighborhood environment attributes improved between 2008 and 2018, and that overall positive perceptions were associated with consistently meeting physical activity guidelines over time.

Diabetes and Hospitalizations Among Mexican Americans Aged 75 Years and Older.

OBJECTIVE: To examine factors associated with hospitalization among Mexican Americans aged 75 years and older with diabetes (with and without complications) and without diabetes over 12 years of follow up. METHODS: Participants (N = 1454) were from the Hispanic Established Population for the Epidemiologic Study of the Elderly (2004/2005-2016) residing in Arizona, California, Colorado, New Mexico, and Texas. Measures included socio-demographics, medical conditions, falls, depressive symptoms, cognitive function, disability, physician visits, and hospitalizations. Participants were categorized as no diabetes (N = 1028), diabetes without complications (N = 180), and diabetes with complications (N = 246). RESULTS: Participants with diabetes and complications had greater odds ratio (1.56, 95% Confidence Interval = 1.23-1.98) over time of being admitted to the hospital in the prior year versus those without diabetes. Participants with diabetes had greater odds of hospitalization if they had heart failure, falls, amputation, and insulin treatment. CONCLUSIONS: In Mexican American older adults, diabetes and diabetes-related complications increased the risk of hospitalization.

Risk factors associated with loneliness among mexican-origin adults in southern Arizona.

This study examines factors associated with symptoms of loneliness among a sample (n = 213) of mostly Mexican-origin adults at risk of chronic diseases in Southern Arizona's Pima, Yuma, and Santa Cruz counties. It uses baseline data from a community-based participatory research partnership and multinominal logistic regression models. Controlling for chronic diseases and sociodemographic characteristics, perceived social support and hope exhibit negative main effects on loneliness when comparing individuals who experienced loneliness for 5-7 days in the preceding week with those who did not encounter such feelings during the same period (adjusted odds ratio, AOR = 0.49 and 0.47; 95% confidence interval, CI = 0.34-0.73 and 0.29-0.75, respectively). However, when considered together, perceived social support and hope display a positive and statistically significant combined effect on loneliness (AOR = 1.03; 95% CI = 1.01-1.06). Holding all covariates constant, individuals reporting loneliness for 5-7 days exhibit a relative risk ratio of 1.24 (95% CI = 1.06-1.46) for a one-unit increase in physical problem severity compared to those who do not experience loneliness. Moreover, being 65 years old or older (AOR = 0.16, 95% CI = 0.03-0.84), and having been born in Mexico and lived in the US for less than 30 years (AOR = 0.12, 95% CI = 0.02-0.74) are associated with negative main effects on loneliness when comparing individuals who experienced loneliness 1-2, and 5-7 days in the preceding week with those who did not feel loneliness during the same timeframe, respectively. Recognizing the crucial role of loneliness in shaping health outcomes for Mexican-origin adults, our findings underscore the significance of fostering supportive environments that not only enhance well-being but also cultivate robust community bonds within the US-Mexico border region.

Resiliency and Barriers to Successful Aging Among Middle-Aged Mexican Immigrants Residing in a Rural Agricultural Community.

OBJECTIVES: The Latino population is one of the largest, most diverse, and fastest-growing demographic groups in the United States. Although Latinos enjoy longer life spans and reduced mortality risk relative to non-Hispanic Whites, they have higher rates of chronic health conditions such as diabetes and dementia and live more of their older years with poor health and disability. Such inequities point to the need for this research focused on examining resiliency strategies and barriers to successful aging among various U.S. Latino subgroups. METHODS: This qualitative study used thematic content analysis to examine resiliency strategies and barriers to successful aging among Mexican immigrant women (n = 40) residing in an underserved agricultural community and entering mid-life (mean = 49 years old). RESULTS: With regards to barriers to successful aging, 3 themes emerged: (1) stressful lifestyle in the United States compared to the participants' home countries; (2) stress from expectations at home; and (3) stress due to work and the various components around work. The following 4 resiliency strategies emerged: (1) family as a motivation for moving forward in life and focusing on the success of children; (2) having a positive mindset; (3) praying to God for strength to overcome obstacles; and (4) self-care. DISCUSSION: Despite experiencing barriers to successful aging, participants practice various resiliency strategies to age successfully. Because many of the barriers identified are related to poverty-related stressors, systemic solutions addressing the social determinants of health are needed.

The maintenance of mexican traditional medicine practices among mexicans in southern Arizona.

Mexicans in the United States have been reported to maintain practices of Mexican traditional medicine at comparably higher rates than most other populations, including other Latino sub-groups. In this cross-sectional study, we examined the pre- and post-migration traditional medicine practices of first-generation immigrants from Mexico living in southern Arizona. Our objective was to assess how migration affected Mexican immigrants' ethnomedical practices and to better understand the mechanisms and motivating factors for the post-migration maintenance of practice. We designed a survey instrument based off prior qualitative data on traditional medicine practices and translated it into Spanish. The survey measured the rates and frequency of six domains of lay healing practices: herbal medicine, healing foods, self-medication with over-the-counter medicine, and three types of specialty healers (curandero/a, and sobador/a, or partero/a), and asked questions about knowledge sources, reasons for maintaining practice post-migration, and to what extent participants believed the remedies were effective. The research team fielded the telephone-based survey from April 2022 to February 2023 to 300 first-generation adult Mexican immigrants residing in southern Arizona. A series of proportions tests were conducted to examine differences in reliance on lay healing pre- and post-migration as well as to assess differences between women's and men's lay practices. The data indicate a general, but moderated decline in lay medical practices post-migration, with the usage of expert healers declining at much higher rates than the three self-care domains. Women tend to use herbal medicine and healing foods at higher rates than men post-migration. This cross-sectional quantitative study confirms prior research indicating that traditional medicine practices are heavily relied upon by Mexican origin people both pre- and post-migration. These findings suggest that public health messaging and medical providers should better address and harness Mexican immigrants' lay medical practices in order to optimize health in this population.

Study protocol: Examining sexual and reproductive health literacy in Mexican American young women using a positive deviance approach.

Health literacy is generally low in marginalized groups, leading to delays in accessing care, poor health outcomes, and health disparities. Yet, some individuals in these groups demonstrate higher health literacy and better health outcomes. These exceptional cases exemplify 'positive deviance' because they have found ways to be successful where others have not. Identifying the methods, practices, and resources that these individuals have used to gain health literacy and healthcare access may have generalized application to improve health literacy, access to care, and health outcomes. Using the Integrated Model of Health Literacy, the main objectives of this study are to (1) identify facilitators, barriers, and strategies to gain sexual and reproductive health literacy and healthcare access and (2) to explore each of the core domains of health literacy as they relate to successful access of sexual and reproductive healthcare services among individuals identified as positive deviants. For the purposes of this mixed methods community engaged study, positive deviants are defined as Mexican American young women aged 18-29 years old living in Rural Western New York who have accessed sexual and reproductive healthcare within the past year. A community advisory committee will be formed to provide community-engaged guidance and support for the recruitment of participants. Positive deviants will participate in a survey and semi-structured interview. Data collection and analysis will be simultaneous and iterative. Results will provide evidence of positive deviant methods, practices, and strategies to gain health literacy and access to sexual and reproductive healthcare. Findings may reveal characteristics and patterns in the relationship of health literacy and healthcare access that can inform interventions to improve health literacy and make healthcare more accessible for this demographic group and context.

Hypertension Prevalence and Related Risk Factors Among Mexican American Adults Are Increasing: National Health and Nutrition Examination Survey 1999 to 2018.

BACKGROUND: Acculturation affects hypertension prevalence among Hispanic people, but there have been no recent analyses specifically focused on Mexican American (MA) people. We sought to determine age-adjusted hypertension prevalence, abdominal obesity, and acculturation trends among MA adults and non-Hispanic White adults. METHODS AND RESULTS: Data from the NHANES (National Health and Nutrition Examination Survey) were analyzed in 2-year increments to observe trends in hypertension and risk factors (age, sex, body mass index, smoking status, abdominal obesity, waist-to-height ratio (WHtR), education, and income). Acculturation was based on three commonly used measures. The sample included 30 920 adults. Age-adjusted hypertension prevalence is higher in MA adults (52.7%) than White adults (48.3%). Hypertension risk factors-age, obesity prevalence, WHtR, acculturation-all significantly increased among MA adults, while smoking declined. Higher acculturation scores increased hypertension likelihood (odds ratio [OR], 1.44 [95% CI, 0.91-1.97]) for MA adults compared with those with lower acculturation scores. White adults with elevated WHtR >0.5 had a 40% higher risk of hypertension than those with WHtR <0.5, but among MA adults, elevated WHtR did not increase risk for hypertension. There was a significant increase in hypertension prevalence among MA adults from 2003 to 2018 at an average biennial rate of 2.23%. There was no change in hypertension prevalence among White adults from 1999 to 2018. CONCLUSIONS: Over 20 years of NHANES, more highly acculturated MA adults were at greater risk for hypertension, despite declines in smoking and controlling for age, sex, obesity status, education, and income. Finding ways to promote more traditional lifestyle and eating habits for MA adults could be a beneficial approach to reducing hypertension risk factors in this population.

Dual-Language Use and Cognitive Function Among Mexican Americans Aged 65 and Older.

Background: Better English proficiency and higher frequency of using English among non-native speakers are associated with lower dementia risk. Objective: We investigated if Mexican American older adults who use English and Spanish to a more similar degree demonstrate better cognitive function than those who use one language more than the other. Methods: We used data from waves one (1992/93) to eight (2012/13) of the Hispanic Established Population for the Epidemiological Study of the Elderly. At baseline, participants were asked what language they usually use across communicative contexts. We based dual language on participants' use of Spanish and English within and across contexts. We categorized participants as low (n = 1,145), medium (n = 717), and high (n = 702) dual-language users. Linear mixed models were used to estimate the association between dual-language use, baseline Mini-Mental State Examination (MMSE) scores, and change in MMSE. Results: Participants in the medium and high dual-language use categories scored 1.91 points and 3.03 points higher at wave one compared to the low dual-language use category. Adjusting for education reduced the association between dual-language use and baseline MMSE (medium B = 0.99 SE = 0.19 p < 0.01; high B = 1.41 SE = 0.21 p < 0.01). The association between dual-language use and decline in the MMSE was not statistically significant. Conclusions: Greater dual-language use was associated with higher MMSE scores but not change in MMSE scores among Mexican Americans aged 65 and older. Future work should characterize bilingualism with greater nuance and use more rigorous cognitive measures to identify the components of the bilingual experience that may benefit the cognitive functioning of older adult bilinguals.

Mixed-Methods Study of Disability Self-Management in Mexican Americans With Osteoarthritis.

BACKGROUND: Health disparities in osteoarthritis (OA) outcomes exist both in the occurrence and treatment of functional limitation and disability for Mexican Americans. Although the effect of self-management of chronic illness is well established, studies demonstrate little attention to self-management of function or disability, despite the strong potential effect on both and, consequently, on patients' lives. OBJECTIVE: The purpose of this study pilot was to develop and test key variable relationships for a measure of disability self-management among Mexican Americans. METHODS: In this sequential, two-phased, mixed-methods, biobehavioral pilot study of Mexican American women and men with OA, a culturally tailored measure of disability self-management was created, and initial relationships among key variables were explored. RESULTS: First, a qualitative study of 19 adults of Mexican American descent born in Texas (United States) or Mexico was conducted. The Mexican American Disability Self-Management Scale was created using a descriptive content analysis of interview data. The scale was tested and refined, resulting in 18 items and a descriptive frequency of therapeutic management efforts. Second, correlations between study variables were estimated: Disability and function were negatively correlated. Disability correlated positively with social support and activity effort. Disability correlated negatively with disability self-management, pain, and C-reactive protein. Function was positively correlated with age, pain, and depression. Liver enzymes (alanine transaminase) correlated positively with pain and anxiety. DISCUSSION: This mixed-methods study indicates directions for further testing and interventions for disability outcomes among Mexican Americans.

Men of Mexican ethnicity, alcohol use, and help-seeking: "I can quit on my own."

INTRODUCTION: Hispanics report higher rates of problematic alcohol use compared to non-Hispanic Whites while also reporting lower rates of alcohol treatment utilization compared to non-Hispanics. The study employs Anderson's Behavioral Model of Healthcare Utilization Model to guide the exploration of alcohol use, help-seeking and healthcare utilization. METHODS: The present qualitative study explored help-seeking and alcohol treatment utilization for Hispanic men of Mexican ethnicity. A total of 27 participants (Mage = 35.7, SD = 10.82) completed a semi-structured interview that explored the treatment experiences and underlying psychological mechanisms that shaped their help-seeking. RESULTS: Through a thematic content analysis, the following themes emerged: 1) perceiving need with subthemes of familismo, role as protector and provider, and positive face; 2) predisposing beliefs on help-seeking; and 3) treatment experiences and elements of patient satisfaction with subthemes of monetized treatment, respect, and perceiving professional stigma. CONCLUSIONS: The findings in this article may assist in improving strategies for increasing alcohol treatment utilization among men of Mexican ethnicity. By exploring beliefs, values, and experiences health researchers can develop culturally informed intervention strategies.

Racial/Ethnic Differences in Self-Reported Upper Limb Limitations Among U.S. Older Adults.

BACKGROUND: The development of disability related to activities of daily living (ADL) is of great concern in the aging population, particularly for Hispanic and Non-Hispanic (NH) Black older adults, where disability prevalence is greater compared to NH Whites. ADL-disability is typically measured across many functional tasks without differentiating upper- versus lower-limb limitations, hindering our understanding of disability burden. Despite the importance of the upper limbs for completing ADL and known age-related declines in function, racial/ethnic differences in upper limb function remain largely unknown. METHODS: We identified 4 292 NH White, NH Black, and Mexican American older adults (≥65) from the 2011-2018 waves of the National Health and Nutrition Examination Survey (NHANES). We classified participants as having a limitation based on their ability to complete 5 upper-limb tasks (preparing meals, eating, dressing, reaching overhead, and grasping small objects) and compared limitation rates across racial/ethnic groups. RESULTS: Compared to NH Whites, NH Black older adults had significantly greater odds of reporting difficulties preparing meals (odds ratio [OR]: 1.36, 95% confidence interval [95% CI]: 1.01, 1.86) and dressing (OR: 1.55, 95% CI: 1.19, 2.02), while Mexican Americans had greater difficulty preparing meals (OR: 1.70, 95% CI: 1.12, 2.58), dressing (OR: 1.63, 95% CI: 1.12, 2.36), and grasping small objects (OR: 1.48, 95% CI: 1.06, 2.07). CONCLUSIONS: Our results demonstrate differences in self-reported upper limb ADL-disability across racial/ethnic groups, particularly for Mexican American older adults. Such findings underscore the need for routine monitoring of upper limb function throughout adulthood to identify limitations and target therapeutic interventions before independence is compromised.

The Association of Neighborhood Socioeconomic Status with Executive Function and Processing Speed in Cognitively Normal Mexican American Elders from the Health and Aging Brains Study: Health Disparities Cohort.

INTRODUCTION: Neighborhood socioeconomic status (NSES) has been linked with overall health, and this study will evaluate whether NSES is cross-sectionally associated with cognition in non-Hispanic whites (NHWs) and Mexican Americans (MAs) from the Health and Aging Brain: Health Disparities Study (HABS-HD). METHODS: The HABS-HD is a longitudinal study conducted at the University of North Texas Health Science Center. The final sample analyzed (n = 1,312) were 50 years or older, with unimpaired cognition, and underwent an interview, neuropsychological examination, imaging, and blood draw. NSES was measured using the national area deprivation index (ADI) percentile ranking, which considered socioeconomic variables. Executive function and processing speed were assessed by the trail making tests (A and B) and the digit-symbol substitution test, respectively. Linear regression was used to assess the association of ADI and cognitive measures. RESULTS: MAs were younger, more likely to be female, less educated, had higher ADI scores, performed worse on trails B (all p < 0.05), and had lower prevalence of APOE4 + when compared to NHWs (p < 0.0001). A higher percentage of MAs lived in the most deprived neighborhoods than NHWs. For NHWs, ADI did not predict trails B or DSS scores, after adjusting for demographic variables and APOE4. For MAs, ADI predicted trails A, trails B, and DSS after adjusting for demographic covariates and APOE4 status. CONCLUSION: Our study revealed that living in an area of higher deprivation was associated with lower cognitive function in MAs but not in NHWs, which is important to consider in future interventions to slow cognitive decline.

Co-action and changes in alcohol use during a smoking cessation attempt.

AIMS: Three smoking cessation studies (CARE, Break Free, Por Nuestra Salud [PNS]) were used to measure changes in average alcohol consumption, binge drinking and alcohol-related problems during a smoking cessation attempt and to explore co-action with smoking abstinence. DESIGN: CARE and PNS were longitudinal cohort cessation studies; Break Free was a two-arm randomized clinical trial. SETTING: Texas, USA. PARTICIPANTS: Participants were current smokers who were recruited from the community and received smoking cessation interventions. All participants received nicotine replacement therapy and smoking cessation counseling. CARE included 424 smokers (1/3 White, 1/3 African American and 1/3 Latino); Break Free included 399 African American smokers; PNS included 199 Spanish-speaking Mexican-American smokers. MEASUREMENTS: Weekly alcohol consumption was collected multiple times pre and post-quit, and binge drinking and alcohol-related problems were collected at baseline and 26 weeks post-quit. Analyses included only those who indicated current alcohol use. FINDINGS: Average alcohol consumption decreased from baseline to 26 weeks post-quit in CARE (F = 17.09, P < 0.001), Break Free (F = 12.08, P < 0.001) and PNS (F = 10.21, P < 0.001). Binge drinking decreased from baseline to 26 weeks post-quit in CARE (F = 3.94, P = 0.04) and Break Free (F = 10.41, P < 0.001) but not PNS. Alcohol-related problems decreased from baseline to 26 weeks post-quit in CARE (Chi-sq = 6.41, P = 0.010) and Break Free (Chi sq = 14.44, P = 0.001), but not PNS. CONCLUSIONS: Among current drinkers, alcohol use/problems appear to decrease during a smoking cessation attempt and remain low through 26 weeks after the quit attempt. Little evidence was found for co-action, with smoking abstainers and relapsers showing similar change in alcohol use/problems.

Vision Impairment and Frailty Among Mexican American Older Adults: A Longitudinal Study.

We examined the relationship between vision impairment (VI) and new-onset frailty among non-frail Mexican American older adults (≥70 years) at baseline and determined the differential impact of VI on each frailty criteria. Data were from an 18-year prospective cohort from the Hispanic Established Population for the Epidemiologic Study of the Elderly (1998/1999, N = 1072 to 2016, N = 175). Frailty was defined as ≥3 criteria: unintentional weight loss of >10 pounds, weakness, exhaustion, low physical activity, and slowness. VI was defined as difficulty in recognizing a friend at arm's length's away, across the room, or across the street. We found that participants with VI (near or distant) and distant VI had greater odds of frailty (near or distant VI, OR = 1.89, 95% CI = 1.30-2.73 and distant VI, OR = 1.95, 95% CI = 1.34-2.86, respectively) after controlling for covariates over time. Early screening (optimal management) of VI may prevent or delay onset of frailty among older Mexican Americans.

Traditional Mexican dietary pattern and cancer risk among women of Mexican descent.

PURPOSE: To examine the association of a traditional Mexican diet score with risk of total, breast, and colorectal cancer among women of Mexican ethnic descent in the Women's Health Initiative (WHI). METHODS: Participants were WHI enrollees who self-identified as being of Mexican descent. Data from food frequency questionnaires self-administered at study baseline were used to calculate the MexD score, with higher scores indicating greater adherence to an a priori-defined traditional Mexican diet (high in dietary fiber, vegetables, and legumes). Incident cancers were self-reported by participants from 1993 to 2020 and adjudicated by trained physicians. We used multivariable-adjusted Cox proportional hazards models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS: Among 2,343 Mexican descent women (median baseline age: 59 years), a total of 270 cancers (88 breast, 37 colorectal) occurred during a mean follow-up of 14.4 years. The highest tertile of MexD score was associated with a lower risk of all-cancer incidence (HR: 0.67; 95% CI 0.49-0.91; p-trend: 0.01) and colorectal cancer (HR: 0.38; 95% CI 0.14-0.998; p-trend < 0.05), with each unit increase in the MexD score associated with a 6% lower risk of all-cancer incidence (HR: 0.94; 95% CI 0.88-0.99). There was no statistically significant association with risk of breast cancer. CONCLUSION: Consumption of a traditional Mexican diet was associated with a significantly lower risk of all-cancer incidence and colorectal cancer. Confirmation of these findings in future studies is important, given the prevalence of colorectal cancer and a growing U.S. population of women of Mexican descent.

The Effect of Financial Strain on the Health Outcomes of Older Mexican-Origin Adults: Findings From the Hispanic Established Population for the Epidemiological Study of the Elderly (H-EPESE).

Predictors of health across the life-course do not maintain the same significance in very late life and the role of financial strain in health outcomes of very old adults remain unclear. Data from adults aged 74 + in waves 5 and 7 of the Hispanic Established Population for the Epidemiological Study of the Elderly (n = 772) study was used to evaluate the role of financial strain on the health of older Mexican Americans who have the highest poverty rate of any racial or ethnic group in the United States. We evaluate the association between episodic (one wave) and persistent financial strain (two waves), with follow-up health outcomes (self-rated health, ADL (limitations in activities of daily living)/IADL (limitations in instrumental activities of daily living) disability, and depressive symptoms). Adults with persistent strain were twice as likely to experience depressive symptoms and three times more likely to experience IADL limitations than the unstrained. Our findings highlight the role of stress proliferation and allostatic load processes leading to deteriorated health over time.

Racial differences in prevalence and impact of electrocardiographic subclinical myocardial injury risk factors.

BACKGROUND: We explored whether the reported racial differences in subclinical myocardial injury (SCMI) are due to variations in the prevalence or differential impact of the SCMI risk factors. METHODS: This analysis included 3074 Whites, 1337 Blacks, and 1441 Mexican Americans from the Third National Health and Nutrition Examination Survey who were free of cardiovascular disease. SCMI was defined from standard electrocardiograms as a cardiac infarction/injury score ≥ 10 points. Multivariable logistic regression analysis was used to assess the association of SCMI with its risk factors stratified by race. Multiplicative interaction between each risk factor and race was also examined. RESULTS: Overall prevalence of SCMI was 20.3%, with Mexican Americans exhibiting a lower prevalence than Whites and Blacks (16.5%, 20.4%, and 20.7%, respectively). Whites had more prevalence of dyslipidemia and smoking. Mexican Americans had more diabetes, while Blacks had more hypertension, obesity, and left ventricular hypertrophy. Significant risk factors for SCMI were older age, lower income (<20 K), smoking, diabetes, and no regular exercise. The association of SCMI with age was more pronounced in Mexican Americans (p-value for interaction 0.03), whereas the associations of SCMI with smoking, no-regular exercise, and diabetes were stronger in Whites (p-value for interaction 0.04, 0.001, 0.007, respectively). CONCLUSIONS: Heterogeneity in the racial differences in the prevalence of SCMI risk factors exists, but they do not explain racial differences in SCMI. The stronger associations of smoking, diabetes, and no regular exercise with SCMI partially explain the higher prevalence of SCMI in Whites.

Liver disease, heart failure, and 13-year mortality among Mexican American older adults: Nativity differences.

PURPOSE: To examine nativity differences of co-occurring liver disease (LD) and heart failure (HF) on 13-year mortality among Mexican American older adults. METHODS: Prospective cohort study of 1601 Mexican Americans aged ≥ 75 years from the Hispanic Established Population for the Epidemiologic Study of the Elderly (2004/05-2016). Participants were grouped into four groups: no LD and no HF (n = 1138), LD only (n = 53), HF only (n = 382), and both LD and HF (n = 28). We used Cox proportional hazards regression model to estimate the hazard ratio (HR) and 95% confidence interval (CI) of death over time. RESULTS: The HR of death, as a function of HF only, was 1.32 (95% CI=1.07-1.62) among US-born and 1.36 (95% CI=1.04-1.78) among foreign-born participants, vs. those with no LD and no HF. Among foreign-born participants, the HR of death as a function of LD and HF was 3.39 (95% CI=1.65-6.93) vs. those without either. LD alone was not associated with mortality in either group. Among US-born, co-occurring LD and HF was not associated with mortality. CONCLUSIONS: Foreign-born participants with both LD and HF were at higher risk of mortality over 13 years of follow up.