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1.
Respir Med ; 150: 113-119, 2019 04.
Artículo en Inglés | MEDLINE | ID: mdl-30961936

RESUMEN

Little is known about adult-onset asthma in different ethnic groups. The aim of this study was to examine ethnic differences in the prevalence of adult-onset asthma and factors associated with this phenotype. Cross-sectional data of 23,356 participants of the HELIUS study were used, including Dutch, South-Asian Surinamese, African Surinamese, Moroccan, Turkish and Ghanaian origin participants. Adult-onset asthma was defined as: self-reported asthma symptoms or start of asthma-medication at age ≥18 years combined with a smoking history <10 pack years. The prevalence of adult-onset asthma and its association with potential risk factors were assessed by logistic regression analyses. The adjusted prevalence of adult-onset asthma was higher in the Turkish, Moroccan and South-Asian Surinamese groups (4.9-6.0%) compared to the Dutch, Ghanaian and African Surinamese origin groups (2.4-2.6%). In addition to ethnicity, age, female sex, BMI, and doctors' diagnosis of nasal allergy/hay fever and chronic sinusitis/polyps were independently associated with adult-onset asthma. There are significant differences in the adjusted prevalence of adult-onset asthma among six ethnic groups.


Asunto(s)
Edad de Inicio , Asma/diagnóstico , Asma/etnología , Fumar/efectos adversos , Adulto , Grupo de Ascendencia Continental Asiática/etnología , Asma/epidemiología , Estudios Transversales , Grupos Étnicos , Femenino , Ghana/etnología , Humanos , Masculino , Persona de Mediana Edad , Marruecos/etnología , Países Bajos/epidemiología , Países Bajos/etnología , Prevalencia , Factores de Riesgo , Fumar/epidemiología , Suriname/etnología , Turquia/etnología
2.
Nutr J ; 18(1): 21, 2019 03 28.
Artículo en Inglés | MEDLINE | ID: mdl-30922320

RESUMEN

BACKGROUND: Healthier dietary patterns are generally more costly than less healthy patterns, but dietary costs may be more important for dietary quality in lower educated and ethnic minority groups. The aim of this study was to investigate the association between dietary costs and dietary quality and interactions with ethnicity and socioeconomic position (SEP). METHODS: We used cross-sectional data from 4717 Dutch, Surinamese, Turkish and Moroccan origin participants of the multi-ethnic HELIUS study (the Netherlands), who completed an ethnic-specific food frequency questionnaire (FFQ). The primary outcome measure was dietary quality according to adherence to the Dutch Healthy Diet index 2015 (DHD15-index, range 0-130). Individual dietary costs (the monetary value attached to consumed diets in Euros) were estimated by merging a food price variable with the FFQ nutrient composition database. Regression analyses were used to examine main and interaction effects. Analyses were adjusted for age, sex, smoking, energy intake, physical activity, ethnicity and educational level. RESULTS: Having higher dietary costs was associated with higher dietary quality. Analyses stratified by educational level showed that associations were stronger in higher educated (Btertile3 = 8.06, 95%CI = 5.63; 10.48) than in lower educated participants (Btertile3 = 5.09, 95%CI = 2.74; 7.44). Stratification by ethnic origin showed strongest associations in Turkish participants (Btertile2 = 9.31, 95%CI = 5.96; 12.65) and weakest associations in Moroccan participants (Btertile3 = 4.29, 95%CI = 0.58; 8.01). Regardless of their level of education, Turkish and Moroccan individuals consumed higher quality diets at the lowest cost than Dutch participants. CONCLUSIONS: The importance of dietary costs for dietary quality differs between socioeconomic and ethnic subgroups. Increasing individual food budgets or decreasing food prices may be effective for the promotion of healthy diets, but differential effects across socioeconomic and ethnic subgroups may be expected.


Asunto(s)
Costos y Análisis de Costo , Dieta Saludable/estadística & datos numéricos , Dieta/economía , Grupos Étnicos , Factores Socioeconómicos , Adulto , Estudios Transversales , Registros de Dieta , Femenino , Alimentos , Humanos , Masculino , Persona de Mediana Edad , Grupos Minoritarios , Marruecos/etnología , Países Bajos , Suriname/etnología , Encuestas y Cuestionarios , Turquia/etnología
3.
Nutr Metab Cardiovasc Dis ; 29(1): 15-22, 2019 01.
Artículo en Inglés | MEDLINE | ID: mdl-30467070

RESUMEN

BACKGROUND AND AIMS: Cardiovascular disease (CVD) risk factors may occur among a substantial proportion of normal weight individuals, particularly among some ethnic minorities. It is unknown how many of these individuals would be missed by commonly applied eligibility criteria for cardiovascular risk screening. Thus, we aim to determine cardiovascular risk and eligibility for cardiovascular risk screening among normal weight individuals of different ethnic backgrounds. METHODS AND RESULTS: Using the HELIUS study (Amsterdam, The Netherlands), we determined cardiovascular risk among 6910 normal weight individuals of Dutch, South-Asian Surinamese, African Surinamese, Ghanaian, Moroccan and Turkish background. High cardiovascular risk was approximated by high metabolic risk based on blood pressure, HDL, triglycerides and fasting glucose. Eligibility criteria for screening were derived from Dutch CVD prevention guidelines and include age ≥ 50 y, family history of CVD, or current smoking. Ethnic group comparisons were made using logistic regression. Age-adjusted proportions of high metabolic risk ranged from 12.6% to 38.4% (men) and from 2.7% to 11.5% (women). This prevalence was higher among most ethnic minorities than the Dutch, especially among women. For most ethnic groups, 79.9%-86.7% of individuals with high metabolic risk were eligible for cardiovascular risk screening. Exceptions were Ghanaian women (58.8%), Moroccan men (70.9%) and Moroccan women (45.0%), although age-adjusted proportions did not differ between groups. CONCLUSION: Even among normal weight individuals, high cardiovascular metabolic risk is more common among ethnic minorities than among the majority population. Regardless of ethnicity, most normal weight individuals with increased risk are eligible for cardiovascular risk screening.


Asunto(s)
Grupo de Ascendencia Continental Africana , Grupo de Ascendencia Continental Asiática , Peso Corporal/etnología , Enfermedades Cardiovasculares/etnología , Grupo de Ascendencia Continental Europea , Disparidades en el Estado de Salud , Tamizaje Masivo/métodos , Adulto , Factores de Edad , Biomarcadores/sangre , Presión Sanguínea , Enfermedades Cardiovasculares/sangre , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/fisiopatología , Femenino , Ghana/etnología , Humanos , Masculino , Persona de Mediana Edad , Marruecos/etnología , Países Bajos/epidemiología , Valor Predictivo de las Pruebas , Prevalencia , Medición de Riesgo , Factores de Riesgo , Factores Sexuales , Suriname/etnología , Turquia/etnología
4.
Drug Alcohol Depend ; 194: 197-204, 2019 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-30447512

RESUMEN

BACKGROUND: The prevalence of smoking varies across ethnic groups in developed countries, but little is known about ethnic variations in specific aspects of nicotine dependence (ND). We conducted item-response analyses in current smokers to compare ND factors across five ethnic groups. METHODS: Data were obtained from a population-based, multi-ethnic cohort study conducted in the Netherlands. The Fagerström Test for Nicotine Dependence (FTND) was assessed in 1147 Dutch, 991 South-Asian Surinamese, 1408 African Surinamese, 1396 Turkish, and 584 Moroccan smokers (N = 5526). We tested whether the factorial structure of the FTND was invariant across ethnic groups using a multi-group confirmatory factor analysis. FTND item and total scores and factor means were compared across groups. RESULTS: The two-factor model representing "morning smoking" and "smoking patterns" provided an adequate fit. The items "Cigarettes smoked daily" and "Time until first cigarette" showed differential item functioning (DIF) as a function of ethnicity. Three out of four ethnic minority groups scored significantly higher on both factors compared to the Dutch origin group (all p < 0.001) before and after taking DIF into account, while the African Surinamese scored higher only on "morning smoking" when DIF was accounted for. DISCUSSION: The factor structure of the FTND is not measurement invariant across ethnic groups in this population-based sample. Accounting for DIF affecting the nicotine dependence factor scores, although South-Asian Surinamese, Turkish, and Moroccan groups showed higher levels of dependence than the Dutch origin group, genetic as well as environmental factors may account for the observed differences.


Asunto(s)
Grupos Étnicos/psicología , Estilo de Vida Saludable , Fumadores/psicología , Tabaquismo/etnología , Tabaquismo/psicología , Población Urbana/tendencias , Adulto , Grupo de Ascendencia Continental Asiática/etnología , Grupo de Ascendencia Continental Asiática/psicología , Estudios de Cohortes , Femenino , Estilo de Vida Saludable/fisiología , Humanos , Masculino , Persona de Mediana Edad , Marruecos/etnología , Países Bajos/etnología , Estudios Prospectivos , Cese del Hábito de Fumar/etnología , Cese del Hábito de Fumar/psicología , Suriname/etnología , Tabaquismo/diagnóstico , Turquia/etnología
5.
BMC Infect Dis ; 18(1): 612, 2018 Dec 03.
Artículo en Inglés | MEDLINE | ID: mdl-30509189

RESUMEN

BACKGROUND: In the Netherlands, there are strong disparities in Chlamydia trachomatis (CT) prevalence between ethnic groups. The current study aims to identify whether socioeconomic status, sexual risk behavior and sexual healthcare seeking behavior may explain differences in CT seroprevalence between ethnic groups. METHODS: We used 2011-2014 baseline data of the HELIUS (HEalthy LIfe in an Urban Setting) study, a multi-ethnic population-based cohort study in Amsterdam, the Netherlands, including participants from Dutch, African Surinamese, South-Asian Surinamese, Ghanaian, Moroccan and Turkish origin. For this analysis, we selected sexually active, heterosexual participants aged 18-34 years old. CT seroprevalence was determined using a multiplex serology assay. The CT seroprevalence ratios between different ethnicities are calculated and adjusted for potential indicators of socioeconomic status, sexual risk behavior and sexual healthcare seeking behavior. RESULTS: The study population consisted of 2001 individuals (52.8% female) with a median age of 28 years (IQR 24-31). CT seropositivity differed by ethnicities and ranged from 71.6% (African Surinamese), and 67.9% (Ghanaian) to 31.1% (Turkish). The CT seroprevalence ratio of African Surinamese was 1.72 (95% CI 1.43-2.06) and 1.52 (95% CI 1.16-1.99) of Ghanaian as compared to the Dutch reference group, after adjustment for socioeconomic status, sexual risk behavior and sexual healthcare seeking behavior. CONCLUSIONS: Indicators of socioeconomic status, sexual risk behavior, and sexual health seeking behavior could not explain the higher CT seroprevalence among African Surinamese and Ghanaian residents of Amsterdam.


Asunto(s)
Infecciones por Chlamydia/epidemiología , Chlamydia trachomatis , Grupos Étnicos/estadística & datos numéricos , Conductas Relacionadas con la Salud , Asunción de Riesgos , Conducta Sexual , Población Urbana/estadística & datos numéricos , Adolescente , Adulto , Asia/etnología , Infecciones por Chlamydia/sangre , Infecciones por Chlamydia/etnología , Chlamydia trachomatis/inmunología , Chlamydia trachomatis/aislamiento & purificación , Estudios de Cohortes , Estudios Transversales , Femenino , Ghana/etnología , Conductas Relacionadas con la Salud/etnología , Heterosexualidad/estadística & datos numéricos , Humanos , Masculino , Marruecos/etnología , Países Bajos/epidemiología , Estudios Seroepidemiológicos , Conducta Sexual/etnología , Conducta Sexual/estadística & datos numéricos , Clase Social , Suriname/etnología , Turquia/etnología , Adulto Joven
6.
BMJ Open ; 8(8): e022241, 2018 08 08.
Artículo en Inglés | MEDLINE | ID: mdl-30093521

RESUMEN

OBJECTIVE: Few European studies examined frailty among older persons from diverse ethnic backgrounds. We aimed to examine the association of ethnic background with frailty. In addition, we explored the association of ethnic background with distinct components that are considered to be relevant for frailty. DESIGN AND SETTING: This was a cross-sectional study of pooled data of The Older Persons and Informal Caregivers Survey Minimum DataSet (TOPICS) in the Netherlands. PARTICIPANTS: Community-dwelling persons aged 55 years and older with a Dutch, Indonesian, Surinamese, Moroccan or Turkish ethnic background were included (n=23 371). MEASUREMENTS: Frailty was assessed with the validated TOPICS-Frailty Index that consisted of 45 items. The TOPICS-Frailty Index contained six components: morbidities, limitations in activities of daily living (ADL), limitations in instrumental ADL, health-related quality of life, psychosocial health and self-rated health. To examine the associations of ethnic background with frailty and with distinct frailty components, we estimated multilevel random-intercept models adjusted for confounders. RESULTS: TOPICS-Frailty Index scores varied from 0.19 (SD=0.12) among persons with a Dutch background to 0.29 (SD=0.15) in persons with a Turkish background. After adjustment for age, sex, living arrangement and education level, persons with a Turkish, Moroccan or Surinamese background were frailer compared with persons with a Dutch background (p<0.001). There were no significant differences in frailty between persons with an Indonesian compared with a Dutch background. The IADL component scores were higher among all groups with a non-Dutch background compared with persons with a Dutch background (p<0.05 or lower for all groups). CONCLUSIONS: Compared with older persons with a Dutch background, persons with a Surinamese, Moroccan or Turkish ethnic background were frailer. Targeted intervention strategies should be developed for the prevention and reduction of frailty among these older immigrants.


Asunto(s)
Grupos Étnicos/estadística & datos numéricos , Anciano Frágil/estadística & datos numéricos , Anciano , Estudios Transversales , Femenino , Humanos , Vida Independiente/estadística & datos numéricos , Indonesia/etnología , Masculino , Persona de Mediana Edad , Marruecos/etnología , Países Bajos/epidemiología , Factores de Riesgo , Suriname/etnología , Turquia/etnología
7.
Soc Sci Med ; 211: 87-94, 2018 08.
Artículo en Inglés | MEDLINE | ID: mdl-29913304

RESUMEN

PURPOSE: A higher own-group ethnic density in the area of residence is often associated with a lower risk for psychotic disorder. For common mental disorders the evidence is less convincing. This study explores whether these findings are mirrored in data on dispensing of antipsychotics and antidepressants. METHODS: Health insurance data on dispensed medication among all adults living in the four largest Dutch cities were linked to demographic data from Statistics Netherlands. Dispensing of antipsychotics and antidepressants in 2013 was analyzed in relation to the proportion of the own ethnic group in the neighborhood. RESULTS: Higher own-group ethnic density was associated with lower dispensing of antipsychotics among the Moroccan-Dutch (N = 115,455), after adjusting for age, gender, and SES of the neighborhood (ORadj for the highest vs. the lowest density quintile = 0.72 [0.66-0.79]). However, this association vanished after adjustment for household composition (ORadj = 0.93 [0.85-1.03]). Similar results were found for the Turkish-Dutch (N = 105,460) (ORadj = 0.86 [0.76-0.96] and 1.05 [0.94-1.18]). For those of Surinamese (N = 147,123) and Antillean origin (N = 41,430), in contrast, the association between ethnic density and lower risk remained after each adjustment (P < 0.001). For antidepressants, a negative association with own-group ethnic density was consistently found for those of Antillean origin (ORadj = 0.62 [0.52-0.74]) only. CONCLUSION: These data on dispensing of psychomedication confirm the ethnic density hypothesis for psychosis alongside earlier equivocal findings for other mental disorders. The negative association between own-group ethnic density and dispensing of antipsychotics among the Moroccan- and Turkish-Dutch may be explained, at least in part, by a favourable household composition (i.e., living in a family) in high-density neighborhoods.


Asunto(s)
Antidepresivos/administración & dosificación , Antipsicóticos/administración & dosificación , Emigrantes e Inmigrantes/estadística & datos numéricos , Grupos Étnicos/estadística & datos numéricos , Adolescente , Adulto , Anciano , Antidepresivos/uso terapéutico , Antipsicóticos/uso terapéutico , Femenino , Accesibilidad a los Servicios de Salud/normas , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Marruecos/etnología , Programas Nacionales de Salud/organización & administración , Programas Nacionales de Salud/estadística & datos numéricos , Países Bajos , Trastornos Psicóticos/tratamiento farmacológico , Suriname/etnología , Turquia/etnología
8.
Soc Psychiatry Psychiatr Epidemiol ; 53(9): 921-930, 2018 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-29796849

RESUMEN

PURPOSE: Depression and posttraumatic stress disorder (PTSD) may be linked to the metabolic syndrome (MetS). Consistency of this association across ethnic groups and the influence of comorbidity of depression/PTSD were examined. METHODS: Cross-sectional baseline data from the HELIUS study were used (4527 Dutch, 2999 South-Asian Surinamese, 4058 African Surinamese, 2251 Ghanaian, 3522 Turkish and 3825 Moroccan participants). The Patient Health Questionnaire-9 (PHQ-9) (score range 0-27) measured depressive symptoms. A 9-item questionnaire (score range 0-9) measured PTSD symptoms. The MetS was defined according to the International Diabetes Federation. The association of a depressed mood (PHQ-9 sum score ≥ 10) and severe PTSD symptoms (sum score ≥ 7) with the MetS was examined using logistic regression. Interaction with ethnicity and between a depressed mood and severe PTSD symptoms was tested. RESULTS: A depressed mood was associated with the MetS [OR (95% CI) = 1.37 (1.24-1.51)] in the total sample and consistent across ethnic groups (p values for interaction all > 0.05). Severe PTSD symptoms were significantly associated with the MetS in the Dutch [OR (95% CI) = 1.71 (1.07-2.73)]. The South-Asian Surinamese, Turks and Moroccans showed weaker associations than the Dutch (p values for interaction all < 0.05). A depressed mood and severe PTSD symptoms did not interact in the association with the MetS (p values for interaction > 0.05). CONCLUSIONS: A depressed mood was consistently associated with the MetS across ethnic groups, but the association between severe PTSD symptoms and the MetS maybe ethnicity dependent. The association with the MetS was not different in case of depressed mood/severe PTSD symptoms comorbidity.


Asunto(s)
Depresión/epidemiología , Síndrome Metabólico/epidemiología , Trastornos por Estrés Postraumático/epidemiología , Adolescente , Adulto , Anciano , Comorbilidad , Estudios Transversales , Depresión/etnología , Femenino , Ghana/etnología , Humanos , Masculino , Síndrome Metabólico/etnología , Persona de Mediana Edad , Marruecos/etnología , Países Bajos/etnología , Suriname/etnología , Turquia/etnología , Adulto Joven
9.
Dementia (London) ; 17(7): 840-857, 2018 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-27306963

RESUMEN

Background The prevalence of dementia is increasing among people with a Turkish, Moroccan and Surinamese-Creole background. Because informal care is very important in these communities, it is pertinent to see what explanations female family carers have for dementia and whether they can discuss dementia openly within the community and the family. Method Forty-one individual interviews and six focus group interviews ( n = 28) were held with female Turkish, Moroccan and Surinamese Creole family carers who are looking after a close relative with dementia, and who live in The Netherlands. Qualitative analysis has been carried out, supported by the software MaxQda. Results The dominant explanations of dementia given by the female family carers interviewed are in line with what Downs et al. describe as the explanatory models 'dementia as a normal ageing process' and 'dementia as a spiritual experience'. In addition, some female family carers gave explanations that were about an interplay between various factors. Turkish and Moroccan informal caregivers ascribe the causes of dementia relatively often to life events or personality traits, whereas Surinamese Creole caregivers frequently mention physical aspects, such as past dehydration. However, the explanatory model 'dementia as a neuropsychiatric condition', which is dominant in Western cultures, was rarely expressed by the informal caregivers. The female family carers generally talked openly about the dementia with their close family, whereas particularly in the Turkish and Moroccan communities open communication within the broader communities was often hampered, e.g. by feelings of shame. Conclusions Female family carers of Turkish, Moroccan or Surinamese Creole backgrounds often consider dementia as a natural consequence of ageing, as a spiritual experience, and/or as an interplay between various factors. They feel they can talk openly about dementia within their close family, while outside the close family this is often more difficult.


Asunto(s)
Cuidadores/psicología , Comunicación , Demencia/etnología , Emigrantes e Inmigrantes/psicología , Familia/etnología , Conocimientos, Actitudes y Práctica en Salud/etnología , Mujeres/psicología , Adulto , Anciano , Demencia/enfermería , Femenino , Humanos , Masculino , Persona de Mediana Edad , Marruecos/etnología , Países Bajos/etnología , Investigación Cualitativa , Suriname/etnología , Turquia/etnología
10.
Nutr Diabetes ; 7(12): 300, 2017 Dec 19.
Artículo en Inglés | MEDLINE | ID: mdl-29259157

RESUMEN

Accumulation of metabolites may mark or contribute to the development of type 2 diabetes mellitus (T2D), but there is a lack of data from ethnic groups at high risk. We examined sphingolipids, acylcarnitines and amino acids, and their association with T2D in a nested case-control study among 54 South Asian Surinamese, 54 African Surinamese and 44 Dutch in the Netherlands. Plasma metabolites were determined at baseline (2001-2003), and cumulative prevalence and incidence of T2D at follow-up (2011-2012). Weighted linear and logistic regression analyses were used to study associations. The mean level of most sphingolipids was lower, and amino-acid levels higher, in the Surinamese groups than among the Dutch. Surinamese individuals had higher mono- and polyunsaturated acylcarnitines and lower plasma levels of saturated acylcarnitine species than the Dutch. Several sphingolipids and amino acids were associated with T2D. Although only the shorter acylcarnitines seemed associated with prevalent T2D, we found an association of all acylcarnitines (except C0, C18 and C18:2) with incident T2D. Further analyses suggested a potentially different association of several metabolites across ethnic groups. Extension and confirmation of these findings may improve the understanding of ethnic differences and contribute to early detection of increased individual risk.


Asunto(s)
Grupo de Ascendencia Continental Africana , Aminoácidos/sangre , Grupo de Ascendencia Continental Asiática , Glucemia/metabolismo , Diabetes Mellitus Tipo 2/etnología , Grupo de Ascendencia Continental Europea , Esfingolípidos/sangre , Adulto , Estudios de Casos y Controles , Diabetes Mellitus Tipo 2/sangre , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Países Bajos/epidemiología , Prevalencia , Suriname/etnología
11.
Ned Tijdschr Geneeskd ; 161: D1362, 2017.
Artículo en Holandés | MEDLINE | ID: mdl-29192566

RESUMEN

OBJECTIVE: To examine changes in breastfeeding rates in 0 to 6 month old infants in Amsterdam, the Netherlands, over the period from 2009 to 2015, for the total population as well as for various ethnic groups. DESIGN: Cross-sectional study. METHOD: Breastfeeding rates were examined for the period from 2009 to 2015 in 165,420 registrations of 75,543 infants at the ages of 2 weeks, 3 months and 6 months for the entire Amsterdam population and for various ethnic groups. Differences were analysed using χ2 tests. RESULTS: The weighted percentage of total breastfeeding (exclusive breastfeeding as well as a combination of breast and formula feeding) increased in the entire Amsterdam study population over the period from 2009 to 2015 (2 weeks: 87.8% to 89.1%; 3 months: 61.6% to 63.6%; 6 months: 39.5% to 42.2%). Increases were mainly the result of increases in weighted percentages for exclusive breastfeeding. The highest exclusive breastfeeding rates were observed among the Turkish ethnic group, the lowest among the Antillean/Aruban and Surinamese groups. CONCLUSION: Percentages for total breastfeeding as well as exclusive breastfeeding in Amsterdam rose over the period from 2009 to 2015, but there is room for improvement. Breastfeeding promotion, whether or not in combination with formula feeding, may be of particular benefit to children of Surinam or Antillean/Aruban descent. Before ethnicity-specific interventions can be implemented, more insight is needed in the reasons for the low breastfeeding rates in specific groups.


Asunto(s)
Lactancia Materna/tendencias , Lactancia Materna/etnología , Lactancia Materna/estadística & datos numéricos , Comparación Transcultural , Estudios Transversales , Femenino , Humanos , Lactante , Recién Nacido , Conducta Materna/etnología , Conducta Materna/psicología , Países Bajos/epidemiología , Vigilancia de la Población , Prevalencia , Suriname/etnología , Turquia/etnología
12.
Scand J Psychol ; 58(6): 571-580, 2017 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-29105122

RESUMEN

Considering how much we know about the impact of the Sense of Coherence (SOC) on different health-related outcomes, we know surprisingly little about how a strong SOC actually develops. In this study we examine the mechanisms behind the formation of a strong SOC and study the role of migration, integration and general resistance resources (GRRs) in this process. We held 46 life-story interviews with women of Turkish, Moroccan and Surinamese descent. We divided the respondents in a relatively strong and weak SOC group in order to discern patterns of life experiences associated with SOC development. We find that, as Antonovsky predicted, experiencing consistency and load balance are associated with a strong SOC. In opposition to Antonovsky's claims, decision making power is not a necessary condition to develop meaningfulness. Moreover, the women's life narratives show that migration and integration are related to the mechanisms shaping SOC, yet, the impact is subjective and depends on the availability and use of GRRs. Our findings provide improvements to Antonovsky's salutogenic theory and provide suggestions for interventions aimed at strengthening SOC.


Asunto(s)
Aculturación , Emigrantes e Inmigrantes/psicología , Sentido de Coherencia , Adulto , Femenino , Humanos , Persona de Mediana Edad , Marruecos/etnología , Países Bajos/etnología , Suriname/etnología , Turquia/etnología
13.
Public Health Nutr ; 20(13): 2374-2382, 2017 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-28724468

RESUMEN

OBJECTIVE: To identify a high-sugar (HS) dietary pattern, a high-saturated-fat (HF) dietary pattern and a combined high-sugar and high-saturated-fat (HSHF) dietary pattern and to explore if these dietary patterns are associated with depressive symptoms. DESIGN: We used data from the HELIUS (Healthy Life in an Urban Setting) study and included 4969 individuals aged 18-70 years. Diet was assessed using four ethnic-specific FFQ. Dietary patterns were derived using reduced rank regression with mono- and disaccharides, saturated fat and total fat as response variables. The nine-item Patient Health Questionnaire (PHQ-9) was used to assess depressive symptoms by using continuous scores and depressed mood (identified using the cut-off point: PHQ-9 sum score ≥10). SETTING: The Netherlands. RESULTS: Three dietary patterns were identified; an HSHF dietary pattern (including chocolates, red meat, added sugars, high-fat dairy products, fried foods, creamy sauces), an HS dietary pattern (including sugar-sweetened beverages, added sugars, fruit (juices)) and an HF dietary pattern (including high-fat dairy products, butter). When comparing extreme quartiles, consumption of an HSHF dietary pattern was associated with more depressive symptoms (Q1 v. Q4: ß=0·18, 95 % CI 0·07, 0·30, P=0·001) and with higher odds of depressed mood (Q1 v. Q4: OR=2·36, 95 % CI 1·19, 4·66, P=0·014). No associations were found between consumption of the remaining dietary patterns and depressive symptoms. CONCLUSIONS: Higher consumption of an HSHF dietary pattern is associated with more depressive symptoms and with depressed mood. Our findings reinforce the idea that the focus should be on dietary patterns that are high in both sugar and saturated fat.


Asunto(s)
Depresión/etiología , Dieta de Carga de Carbohidratos/efectos adversos , Dieta Alta en Grasa/efectos adversos , Dieta Occidental/efectos adversos , Disparidades en el Estado de Salud , Salud Urbana , Adolescente , Adulto , Anciano , Estudios de Cohortes , Estudios Transversales , Depresión/etnología , Depresión/psicología , Dieta de Carga de Carbohidratos/etnología , Dieta de Carga de Carbohidratos/psicología , Dieta Alta en Grasa/etnología , Dieta Occidental/etnología , Dieta Occidental/psicología , Azúcares de la Dieta/efectos adversos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Marruecos/etnología , Países Bajos , Escalas de Valoración Psiquiátrica , Sistema de Registros , Análisis de Regresión , Autoinforme , Suriname/etnología , Turquia/etnología , Salud Urbana/etnología , Adulto Joven
14.
BMJ Open ; 7(6): e012221, 2017 07 02.
Artículo en Inglés | MEDLINE | ID: mdl-28674122

RESUMEN

OBJECTIVES: In South Asian populations, little is known about the effects of intensive interventions to reduce the risk of type 2 diabetes on health behaviour. We examined the effectiveness at 2 years of a culturally targeted lifestyle intervention on diet, physical activity and determinants of behaviour change among South Asians at risk for diabetes. DESIGN: Randomised controlled trial with de facto masking. SETTING: Primary care. PARTICIPANTS: A total of 536 18- to 60-year-old South Asians at risk for diabetes (ie, with impaired glucose tolerance, impaired fasting glucose or relatively high insulin resistance) were randomised to the intervention (n=283) or a control (n=253) group. Data of 314 participants (n=165 intervention, n=149 control) were analysed. INTERVENTIONS: The culturally targeted intervention consisted of individual counselling using motivational interviewing (six to eight sessions in the first 6 months plus three to four booster sessions), a family session, cooking classes and a supervised physical activity programme. The control group received generic lifestyle advice. OUTCOME MEASURES: We compared changes in physical activity, diet and social-cognitive underlying determinants between the two groups at 2-year follow-up with independent-sample t-tests, chi-square tests and Fisher's exact tests. RESULTS: At the 2-year follow-up, participants in the intervention group were more moderately to vigorously active than at baseline, but compared with changes in the control group, the difference was not significant (change min/week 142.9 vs 0.5, p=0.672). Also, no significant difference was found between the two groups in changes on any of the components of the diet or the social-cognitive determinants of diet and physical activity. CONCLUSIONS: The culturally targeted lifestyle intervention led to high drop-out and was not effective in promoting healthy behaviour among South Asians at risk for diabetes. Given the high a priori risk, we recommend to develop new strategies, preferably more acceptable, to promote healthy behaviour. TRIAL REGISTRATION: NTR1499; Results. www.trialregister.nl/trialreg/admin/rctview.asp?TC=1499.


Asunto(s)
Diabetes Mellitus Tipo 2/prevención & control , Dieta , Ejercicio Físico , Atención Primaria de Salud , Prevención Primaria/métodos , Adulto , Femenino , Estudios de Seguimiento , Conductas Relacionadas con la Salud , Conocimientos, Actitudes y Práctica en Salud , Promoción de la Salud/métodos , Estilo de Vida Saludable , Humanos , India/etnología , Masculino , Persona de Mediana Edad , Entrevista Motivacional , Países Bajos , Pacientes Desistentes del Tratamiento , Factores de Riesgo , Autoeficacia , Apoyo Social , Suriname/etnología
15.
Eur J Clin Nutr ; 71(8): 987-994, 2017 08.
Artículo en Inglés | MEDLINE | ID: mdl-28466848

RESUMEN

BACKGROUND/OBJECTIVES: To investigate the association of dietary patterns derived by reduced rank regression (RRR) with depressive symptoms in a multi-ethnic population. SUBJECTS/METHODS: Cross-sectional data from the HELIUS study were used. In total, 4967 men and women (18-70 years) of Dutch, South-Asian Surinamese, African Surinamese, Turkish and Moroccan origin living in the Netherlands were included. Diet was measured using ethnic-specific food frequency questionnaires. Depressive symptoms were measured with the nine-item patient health questionnaire. RESULTS: By performing RRR in the whole population and per ethnic group, comparable dietary patterns were identified and therefore the dietary pattern for the whole population was used for subsequent analyses. We identified a dietary pattern that was strongly related to eicosapentaenoic acid+docosahexaenoic acid, folate, magnesium and zinc (response variables) and which was characterized by milk products, cheese, whole grains, vegetables, legumes, nuts, potatoes and red meat. After adjustment for confounders, a statistically significant inverse association was observed in the whole population (B: -0.03, 95% CI: -0.06, -0.00, P=0.046) and among Moroccan (B: -0.09, 95% CI: -0.13, -0.04, P=0.027) and South-Asian Surinamese participants (B: -0.05, 95% CI: -0.09, -0.01, P=<0.001), whereas no statistically significant association was found in the remaining ethnic groups. No statistically significant associations were found between the dietary pattern and significant depressed mood in any of the ethnic groups. CONCLUSIONS: No consistent evidence was found that consumption of a dietary pattern, high in nutrients that are hypothesized to protect against depression, was associated with lower depressive symptoms across different ethnic groups.


Asunto(s)
Depresión/etiología , Depresión/prevención & control , Dieta Saludable , Dieta/efectos adversos , Disparidades en el Estado de Salud , Cooperación del Paciente , Salud Urbana , Adulto , Grupo de Ascendencia Continental Asiática , Estudios de Cohortes , Factores de Confusión Epidemiológicos , Costo de Enfermedad , Estudios Transversales , Depresión/epidemiología , Depresión/etnología , Dieta/etnología , Dieta Saludable/etnología , Femenino , Humanos , Masculino , Marruecos/etnología , Países Bajos/epidemiología , Cooperación del Paciente/etnología , Prevalencia , Sistema de Registros , Riesgo , Suriname/etnología , Turquia/etnología , Salud Urbana/etnología
16.
BMC Health Serv Res ; 17(1): 350, 2017 05 15.
Artículo en Inglés | MEDLINE | ID: mdl-28506230

RESUMEN

BACKGROUND: In the Netherlands, ethnic minority populations visit their general practitioner (GP) more often than the indigenous population. An explanation for this association is lacking. Recently, health literacy is suggested as a possible explaining mechanism. Internationally, associations between health literacy and health care use, and between ethnicity and health literacy have been studied separately, but, so far, have not been linked to each other. In the Netherlands, some expectations have been expressed with regard to supposed low health literacy of ethnic minority groups, however, no empirical study has been done so far. The objectives of this study are therefore to acquire insight into the level of health literacy of ethnic minorities in the Netherlands and to examine whether the relationship between ethnicity and health care use can be (partly) explained by health literacy. METHODS: A questionnaire was sent to a sample of 2.116 members of the Dutch Health Care Consumer Panel (response rate 46%, 89 respondents of non-western origin). Health literacy was measured with the Health Literacy Questionnaire (HLQ) which covers nine different domains. The health literacy levels of ethnic minority groups were compared to the indigenous population. A negative binomial regression model was used to estimate the association between ethnicity and GP visits. To examine whether health literacy is an explaining factor in this association, health literacy and interaction terms of health literacy and ethnicity were added into the model. RESULTS: Differences in levels of health literacy were only found between the Turkish population and the indigenous Dutch population. This study also found an association between ethnicity and GP visits. Ethnic minorities visit their GP 33% more often than the indigenous population. Three domains of the HLQ (the ability to navigate the health care system, the ability to find information and to read and understand health information) partly explained the association between ethnicity and GP visits. CONCLUSIONS: In general, there are no differences in health literacy between most of the ethnic minority groups in the Netherlands and the indigenous Dutch population. Only the Turkish population scored significantly lower on several health literacy domains. Some domains of health literacy do explain the association between ethnicity and higher frequency of GP visits. Further research is recommended to understand the pathways through which health literacy impacts health care use.


Asunto(s)
Grupos Étnicos/estadística & datos numéricos , Alfabetización en Salud , Atención Primaria de Salud/estadística & datos numéricos , Anciano , Femenino , Medicina General/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Grupos Minoritarios/estadística & datos numéricos , Marruecos/etnología , Países Bajos , Antillas Holandesas/etnología , Suriname/etnología , Encuestas y Cuestionarios , Turquia/etnología
17.
BMC Pregnancy Childbirth ; 17(1): 79, 2017 03 06.
Artículo en Inglés | MEDLINE | ID: mdl-28264660

RESUMEN

BACKGROUND: To examine the preferences for comprehensive services and facilities in a new proposed birth center which will be established in a large Dutch city, specifically among pregnant women from different ethnic backgrounds. METHODS: The analyses of this study were based on a survey among 200 pregnant women living in The Hague, the Netherlands in 2011. Multiple linear regression was applied to analyze if preferences differ by ethnic background, controlling for various other predictors. RESULTS: Pregnant women had relatively strong preferences for comprehensive services and facilities to be offered by the new proposed birth center compared to both other dimensions of birth center care: extensive practical information and comfortable accommodation. With regard to ethnic differences, non-Dutch women had higher preferences for comprehensive care compared to Dutch women. This difference between Dutch and non-Dutch women increased with their level of education. CONCLUSIONS: Especially for non-Dutch women, birth centers that are able to provide comprehensive services and facilities can potentially be a good setting in which to give birth compared to hospitals or at home. In particular, higher educated non-Dutch women had a preference for the personalized care that could be offered by this new birth center.


Asunto(s)
Centros de Asistencia al Embarazo y al Parto , Grupos Étnicos , Prioridad del Paciente , Adulto , Escolaridad , Femenino , Humanos , Modelos Lineales , Partería , Marruecos/etnología , Países Bajos , Embarazo , Atención Prenatal , Factores Socioeconómicos , Suriname/etnología , Encuestas y Cuestionarios , Turquia/etnología , Adulto Joven
18.
Global Health ; 13(1): 11, 2017 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-28249611

RESUMEN

BACKGROUND: Previous studies found that while internationally financed economic development projects reduced poverty when measured in terms of per capita GDP, they also caused indigenous people to become disassociated, impoverished and alienated minorities whose health status has declined to unacceptable lows when measured in terms of mercury poisoning and the burgeoning rate of suicide. In this study, we developed a needs assessment and a policy-oriented causal diagram to determine whether the impaired health of the people in this region was at least partially due to the role the country has played within the global economy. Specifically, could the health and well-being of indigenous people in Suriname be understood in terms of the foreign investment programs and economic development policies traceable to the Inter-American Development Bank's Suriname Land Management Project. METHODS: Interviews took place from 2004 through 2015 involving stakeholders with an interest in public health and economic development. A policy-oriented causal diagram was created to model a complex community health system and weave together a wide range of ideas and views captured during the interview process. RESULTS: Converting land and resources held by indigenous people into private ownership has created an active market for land, increased investment and productivity, and reduced poverty when measured in terms of per capita GDP. However, it has also caused indigenous people to become disassociated, impoverished and alienated minorities whose health status has declined to unacceptable lows. While the effects of economic development programs on the health of vulnerable indigenous communities are clear, the governance response is not. The governance response appeared to be determined less by the urgency of the public health issue or by the compelling logic of an appropriate response, and more by competing economic interests and the exercise of power. CONCLUSION: The health and well-being of the indigenous Wayana in Suriname's interior region is at least partially due to the role the country has played within the global economy. Specifically, the health and well-being of indigenous people in Suriname can be understood to be a result of foreign development bank-funded projects that drive the government of Suriname to trade land and natural resources on the global market to manage their country's balance of payments.


Asunto(s)
Desarrollo Económico/tendencias , Servicios de Salud del Indígena/estadística & datos numéricos , Salud Pública/tendencias , Factores Socioeconómicos , Servicios de Salud Comunitaria/métodos , Servicios de Salud Comunitaria/tendencias , Desarrollo Económico/historia , Historia del Siglo XXI , Humanos , Recursos Naturales/provisión & distribución , Política Pública/historia , Política Pública/tendencias , Investigación Cualitativa , Suriname/etnología , Poblaciones Vulnerables/etnología
19.
Public Health Nutr ; 20(11): 1983-1992, 2017 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-27122356

RESUMEN

OBJECTIVE: To test Koctürk's model of dietary change among South-Asian Surinamese in the Netherlands. The model categorizes foods into staple, complementary and accessory foods and postulates that dietary change after migration begins with accessory foods while foods associated with ethnic identity (staple foods) change at a slower rate. DESIGN: Cross-sectional data from the HELIUS study. Dietary intake was assessed with an FFQ. Acculturation was based on social contacts and sense of belonging and was translated into four strategies of acculturation: assimilation, integration, separation and marginalization. Other indicators of acculturation included residence duration, age at migration and migration generation status. SETTING: Amsterdam, the Netherlands. SUBJECTS: Participants of Dutch (n 1456) and South-Asian Surinamese origin (n 968). RESULTS: Across all acculturation strategies, South-Asian Surinamese participants reported significantly higher intakes of rice (staple food) and chicken (complementary food) and significantly lower intakes of red meat and vegetables (complementary foods) and cookies and sweets (accessory food) than Dutch participants. Men, second-generation and assimilated South-Asian Surinamese were inclined towards Dutch foods such as potato, pasta and red meat. Accessory foods like fruits showed variation across acculturation strategies. CONCLUSIONS: Consistent with the Koctürk model, the intake of staple foods was stable among South-Asian Surinamese irrespective of acculturation strategy while the intake of accessory foods like fruit varied. Contrary to expectations, South-Asian Surinamese showed consistently high intakes of complementary foods like chicken and fish irrespective of acculturation strategy. Public health practitioners should take into consideration the complex and dynamic nature of dietary acculturation.


Asunto(s)
Aculturación , Grupo de Ascendencia Continental Asiática , Dieta/etnología , Adolescente , Adulto , Anciano , Estudios Transversales , Emigración e Inmigración , Grupos Étnicos , Femenino , Frutas , Humanos , Masculino , Persona de Mediana Edad , Países Bajos , Evaluación Nutricional , Salud Pública , Carne Roja , Factores Socioeconómicos , Suriname/etnología , Encuestas y Cuestionarios , Verduras , Adulto Joven
20.
J Gerontol B Psychol Sci Soc Sci ; 72(1): 109-119, 2017 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-26248622

RESUMEN

OBJECTIVES: We validate a translated version of the De Jong Gierveld Loneliness Scale (DJGLS) for use among older migrants from Turkish and Moroccan descent and validate the original Dutch version of the same scale for Surinamese migrants in the Netherlands. METHOD: The data were derived from a population-based cross-sectional study among community-dwelling individuals aged 55 and older. In addition to translating the DJGLS for these ethnic groups, several statistical analyses were performed to assess the scale's reliability and validity. RESULTS: The DJGLS proved to be internally consistent and to have adequate convergent validity among all ethnic groups. Latent structure analysis confirmed the two latent factors (emotional and social subscales) in all groups, but also showed that fit was not optimal in most groups. Known groups validity was observed using functional limitations and subjective health as grouping variables. CONCLUSIONS: The results provide sufficient support for use of the translated version of the 11-item DJGLS among Turkish and Moroccan older migrants and use of the Dutch version for Surinamese older migrants as a reliable and valid measure of loneliness. Fit of latent structural models varied between good and poor. Further research is needed to investigate ethnic differences in levels and determinants of loneliness.


Asunto(s)
Envejecimiento/psicología , Comparación Transcultural , Emigrantes e Inmigrantes/psicología , Soledad/psicología , Psicometría/estadística & datos numéricos , Encuestas y Cuestionarios , Traducción , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Marruecos/etnología , Países Bajos , Suriname/etnología , Turquia/etnología
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