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1.
PLoS One ; 16(9): e0256085, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34469440

RESUMO

Researchers and journalists have argued that work-related factors may be partly responsible for disproportionate COVID-19 infection and death rates among vulnerable groups. We evaluate these issues by describing racial and ethnic differences in the likelihood of work-related exposure to COVID-19. We extend previous studies by considering 12 racial and ethnic groups and five types of potential occupational exposure to the virus: exposure to infection, physical proximity to others, face-to-face discussions, interactions with external customers and the public, and working indoors. Most importantly, we stratify our results by occupational standing, defined as the proportion of workers within each occupation with at least some college education. This measure serves as a proxy for whether workplaces and workers employ COVID-19-related risk reduction strategies. We use the 2018 American Community Survey to identify recent workers by occupation, and link 409 occupations to information on work context from the Occupational Information Network to identify potential COVID-related risk factors. We then examine the racial/ethnic distribution of all frontline workers and frontline workers at highest potential risk of COVID-19, by occupational standing and by sex. The results indicate that, contrary to expectation, White frontline workers are often overrepresented in high-risk jobs while Black and Latino frontline workers are generally underrepresented in these jobs. However, disaggregation of the results by occupational standing shows that, in contrast to Whites and several Asian groups, Latino and Black frontline workers are overrepresented in lower standing occupations overall and in lower standing occupations associated with high risk, and thus may be less likely to have adequate COVID-19 protections. Our findings suggest that greater work exposures likely contribute to a higher prevalence of COVID-19 among Latino and Black adults and underscore the need for measures to reduce potential exposure for workers in low standing occupations and for the development of programs outside the workplace.


Assuntos
COVID-19/epidemiologia , Grupos de Populações Continentais , Exposição Ocupacional/efeitos adversos , Ocupações , SARS-CoV-2 , Adulto , Grupos Étnicos , Feminino , Humanos , Masculino , Fatores de Risco , Fatores Socioeconômicos , Estados Unidos/epidemiologia , Local de Trabalho
2.
Demography ; 58(2): 773-784, 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33834231

RESUMO

We revisit a novel causal model published in Demography by Hicks et al. (2018), designed to assess whether exposure to neighborhood disadvantage over time affects children's reading and math skills. Here, we provide corrected and new results. Reconsideration of the model in the original article raised concerns about bias due to exposure-induced confounding (i.e., past exposures directly affecting future exposures) and true state dependence (i.e., past exposures affecting confounders of future exposures). Through simulation, we show that our originally proposed propensity function approach displays modest bias due to exposure-induced confounding but no bias from true state dependence. We suggest a correction based on residualized values and show that this new approach corrects for the observed bias. We contrast this revised method with other causal modeling approaches using simulation. Finally, we reproduce the substantive models from Hicks et al. (2018) using the new residuals-based adjustment procedure. With the correction, our findings are essentially identical to those reported originally. We end with some conclusions regarding approaches to causal modeling.

3.
PLoS One ; 16(3): e0247804, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33730061

RESUMO

Latinos in the US live significantly longer than non-Latino whites, but spend more years disabled. Differentials in socioeconomic status account for part, but not all, of the difference in older age disability between Latinos and whites. We hypothesize that a factor often ignored in the literature-the fact that Latinos, on average, have more physically strenuous jobs than non-Latino whites-contributes to the higher Latino risk of functional limitations at older ages. We use longitudinal data from the 1998-2014 Health and Retirement Study (HRS) comprising 17,297 respondents. Compared to US-born whites, Latinos, especially Latino immigrants, report substantially higher levels of physical effort at work. Latino-black differences are much smaller than Latino-white differences. As hypothesized, physical work effort is strongly related to functional limitations. However, differentials in physical work effort for Latinos and whites in their fifties and early sixties are weakly related to Latino-white differentials in FL at later ages.


Assuntos
Desempenho Físico Funcional , Idoso , Grupos Étnicos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Raciais , Fatores Sexuais , Estados Unidos
4.
medRxiv ; 2020 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-33236022

RESUMO

Researchers and journalists have argued that work-related factors may be partly responsible for disproportionate COVID-19 infection and death rates among vulnerable groups. We evaluate these claims by examining racial and ethnic differences in the likelihood of work-related exposure to COVID-19. We extend previous studies by considering 12 racial and ethnic groups and five types of potential occupational exposure to the virus: exposure to infection, physical proximity to others, face-to-face discussions, interactions with external customers and the public, and working indoors. Most importantly, we stratify our results by occupational status, defined as the proportion of workers within each occupation with some college education. This measure serves as a proxy for whether workplaces and workers employ significant COVID-19-related risk reduction strategies. We use the 2018 American Community Survey to identify recent workers by occupation, and link 409 occupations to information on work context from the Occupational Information Network to identify potential COVID-related risk factors. We then examine the racial/ethnic distribution of all frontline workers and frontline workers at highest potential risk of COVID-19, by occupational status and by sex. The results indicate that, contrary to expectation, White frontline workers are often overrepresented in high-risk jobs while Black and Latino frontline workers are generally underrepresented in these jobs. However, disaggregation of the results by occupational status shows that, in contrast to Whites and several Asian groups, Latino and Black frontline workers are overrepresented in lower status occupations overall and in lower status occupations associated with high risk, and are thus less likely to have adequate COVID-19 protections. Our findings suggest that greater work exposures likely contribute to a higher prevalence of COVID-19 among Latino and Black adults and underscore the need for measures to reduce potential exposure for workers in low status occupations and for the development of programs outside the workplace.

5.
Demography ; 55(1): 1-31, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29192386

RESUMO

Prior research has suggested that children living in a disadvantaged neighborhood have lower achievement test scores, but these studies typically have not estimated causal effects that account for neighborhood choice. Recent studies used propensity score methods to account for the endogeneity of neighborhood exposures, comparing disadvantaged and nondisadvantaged neighborhoods. We develop an alternative propensity function approach in which cumulative neighborhood effects are modeled as a continuous treatment variable. This approach offers several advantages. We use our approach to examine the cumulative effects of neighborhood disadvantage on reading and math test scores in Los Angeles. Our substantive results indicate that recency of exposure to disadvantaged neighborhoods may be more important than average exposure for children's test scores. We conclude that studies of child development should consider both average cumulative neighborhood exposure and the timing of this exposure.


Assuntos
Sucesso Acadêmico , Áreas de Pobreza , Características de Residência/estatística & dados numéricos , Meio Social , Adolescente , Criança , Desenvolvimento Infantil , Pré-Escolar , Feminino , Humanos , Estudos Longitudinais , Los Angeles , Masculino , Matemática , Leitura , Fatores Sexuais , Isolamento Social , Fatores Socioeconômicos , Estresse Psicológico/epidemiologia , Fatores de Tempo , Violência/estatística & dados numéricos
6.
Ethn Health ; 23(1): 57-71, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-27774801

RESUMO

OBJECTIVE: The increased risk for poor physical and mental health outcomes for older parents in Mexico who have an adult child living in the United States may contribute to an increased risk for cognitive impairment in this population. The objective of this study was to examine if older adults in Mexico who have one or more adult children living in the United States are more or less likely to develop cognitive impairment over an 11-year period compared to older adults who do not have any adult children living in the United States. DESIGN: Data for this study came from Wave I (2001) and Wave III (2012) of the Mexican Health and Aging Study. The final sample included 2609 participants aged 60 and over who were not cognitively impaired in 2001 and had one or more adult children (age ≥15). Participants were matched using a propensity score that was estimated with a multivariable logistic regression model that included sociodemographic characteristics and migration history of the older parents. RESULTS: Having one or more adult children living in the United States is associated with lower socioeconomic status and higher number of depressive symptoms, but greater social engagement for older parents living in Mexico. No significant differences in the odds for developing cognitive impairment according to having one or more adult children living in the United States were detected. CONCLUSION: In summary, having one or more adult children living in the United States was associated with characteristics that may increase and decrease the risk for cognitive impairment. This may contribute to the non-significant relationship between migration status of adult children and likelihood for cognitive impairment for older parents living in Mexico.


Assuntos
Crianças Adultas , Disfunção Cognitiva/diagnóstico , Pais/psicologia , Idoso , Feminino , Humanos , Masculino , Americanos Mexicanos , México/epidemiologia , México/etnologia , Pessoa de Meia-Idade , Fatores de Risco , Estados Unidos
7.
Gend Place Cult ; 25(6): 799-820, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30930555

RESUMO

This article explores determinants of women's autonomy in Egypt around the beginning of the 'Arab Spring' in 2011. We show that women's autonomy over time is a product not only of their individual characteristics, but also of the household and community environment in which they live. Using the 2006 and 2012 Egyptian Labor Market Panel Survey (ELMPS) and multilevel models, results demonstrate that women's autonomy changes over time. There are large and consistent variations in women's autonomy by household region of residence and wealth. For example, women in the rural and urban Upper Egypt region are less autonomous than women in the Cairo region, and women in wealthier households are less autonomous compared to the poorest households. Programs aiming to increase women's autonomy focus exclusively or primarily on women's own characteristics. These results indicate that strategies to improve women's autonomy should be mindful of the multiple dimensions of autonomy and have a programmatic focus on changing household and social environments.

8.
J Urban Health ; 94(6): 764-775, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28875414

RESUMO

In the USA, undocumented Latino immigrants may have poorer health because of barriers to health care, stressors, and detrimental effects of immigration enforcement. Previous immigrant health research, however, suggests that recently arrived Latino immigrants have better health than US-born Latinos and their health deteriorates over time. Given the current environments that undocumented immigrants face, legal status is a structural factor that likely influences the patterns of immigrant health. Therefore, the aim of this study was to examine the extent to which physical and mental health differed by legal status and duration in the USA for the Latino population in Los Angeles County, California. We conducted analysis of Latino respondents (n = 1396) to the Los Angeles Family and Neighborhood Survey (L.A.FANS) Wave II. We examined self-reported health, depression measured by the Composite International Diagnostic Interview-Short Form, and blood pressure collected by trained interviewers. Respondents reported their legal status, time in the USA, and other sociodemographic characteristics. Regression models were used to test associations between each outcome and 1) legal status and 2) legal status by duration (≤ 15 and > 15 years) in the USA. Without taking duration into account, we found no significant differences in outcomes between undocumented, documented, or US-born Latinos. Taking duration into account, shorter duration undocumented immigrants had worse self-reported health than the US born. Undocumented immigrants, regardless of duration, had higher blood pressure than documented immigrants who had been in the USA for less time and the same level of blood pressure as the US born. In contrast, shorter duration documented immigrants had lower blood pressure compared to longer duration documented immigrants and US-born counterparts, and marginally lower blood pressure than shorter duration undocumented immigrants. The findings suggest that the "health advantage" generally presumed to exist among immigrants may not affect undocumented immigrants.


Assuntos
Emigrantes e Imigrantes/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Hispano-Americanos/estatística & dados numéricos , Adulto , Depressão/epidemiologia , Feminino , Nível de Saúde , Humanos , Hipertensão/epidemiologia , Los Angeles , Masculino , Pessoa de Meia-Idade , Características de Residência , Fatores de Risco , Autorrelato , Inquéritos e Questionários , Fatores de Tempo , Estados Unidos
9.
J Epidemiol Community Health ; 71(7): 648-654, 2017 07.
Artigo em Inglês | MEDLINE | ID: mdl-28270501

RESUMO

BACKGROUND: Childhood family income variation is an understudied aspect of households' economic context that may have distinct consequences for children. We identified trajectories of childhood family income over a 12-year period, and examined associations between these trajectories and later psychiatric disorders, among individuals born in Sweden between 1987 and 1991 (n=534 294). METHODS: We used annual income data between the ages of 3-14 years and identified 5 trajectories (2 high-income upward, 1 downward and 2 low-income upward trajectories). Psychiatric disorders in the follow-up period after age 15 were defined from International Classification of Disease (ICD)-codes in a nationwide patient register. Multiadjusted risks for all psychiatric disorders, as well as for specific psychiatric diagnoses, were calculated as HRs with 95% CIs. RESULTS: Of the 5 identified income trajectories, the constant low and the downward trajectories were particularly associated with later psychiatric disorder. Children with these trajectories had increased risks for psychiatric disorder, including mood, anxiety, psychotic disorders and attention deficit/hyperactivity disorder. The association remained, even after adjusting for important variables including parental psychiatric disorder. In contrast, the relationship was reversed for eating disorders, for which children in higher income trajectories had elevated risks. CONCLUSIONS: Findings show that children growing up in a household characterised by low or decreasing family income have an increased risk for psychiatric disorder. Continued work is needed to reduce socioeconomic inequalities in psychiatric disorders. Policies and interventions for psychiatric disorders should consider the socioeconomic background of the family as an important risk or protective factor.


Assuntos
Renda/estatística & dados numéricos , Transtornos Mentais/epidemiologia , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Sistema de Registros , Fatores de Risco , Fatores Socioeconômicos , Suécia/epidemiologia
10.
J Affect Disord ; 212: 56-63, 2017 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-28142084

RESUMO

OBJECTIVE: Childhood social adversity has been associated with an increased risk of depression and other psychiatric disorders in adolescence and early adulthood. However, the role of timing and accumulation of adversities has not yet been established in longitudinal studies. We examined the association between childhood adversities and adolescent depressive symptoms, and the impact of timing and accumulation of adversity. METHOD: Longitudinal data were obtained from the Child Development Supplement to the Panel Study of Income Dynamics (n=2223), a nationally representative survey of US families that incorporates data from parents and their children. Negative binomial regression analysis was used to estimate effects of childhood social adversity on adolescent depressive symptoms, presented as Incidence Rate Ratios with 95% confidence intervals. RESULTS: Children exposed to social adversity reported higher levels of adolescent depressive symptoms captured by two depression scales. Single-parent household and residential instability were particularly associated with depressive symptoms. A positive relationship was found between cumulative adversity and the risk of adolescent depression. The timing of exposure appeared to have little effect on the risk of adolescent depressive symptoms. LIMITATIONS: The structure of the data implies that alternative causal pathways cannot be fully discounted. The self- or parent-reported data is subject to recall bias. CONCLUSION: Our findings support the long-term negative impact of childhood adversity on adolescent depressive symptoms, regardless of when in childhood the adversity occurs. Policies and interventions to reduce adolescent depressive symptoms need to consider the social background of the family as an important risk or protective factor.


Assuntos
Depressão/etiologia , Acontecimentos que Mudam a Vida , Psicologia do Adolescente , Adolescente , Criança , Pré-Escolar , Características da Família , Feminino , Humanos , Estudos Longitudinais , Masculino , Pais , Análise de Regressão , Fatores de Risco , Autorrelato
11.
BMC Public Health ; 17(1): 81, 2017 01 14.
Artigo em Inglês | MEDLINE | ID: mdl-28088219

RESUMO

BACKGROUND: Participation in the Supplemental Nutrition Assistance Program (SNAP) has been linked to an increased risk of obesity, but not much is known about the mechanisms behind this association. The objective of this study was to determine if the neighborhood density of unhealthy food outlets modifies the association between obesity and participation in SNAP. METHODS: Data comes from the first wave of the Los Angeles Family and Neighborhood Survey; included are a subsample of adults (18+ years) who were SNAP participants or eligible non-participants (N = 1,176). We carried out multilevel analyses with obesity (BMI ≥ 30 Kg/m2), SNAP participation, and the neighborhood density of unhealthy food outlets as dependent, independent and modifying variables, respectively, controlling for age, gender, race/ethnicity, marital status, working status, mental health, and neighborhood poverty. RESULTS: SNAP participants had double the odds of obesity compared to eligible non-participants (OR = 2.02; 95%CI = 1.44-2.83). However, the neighborhood density of unhealthy food outlets did not modify this association. CONCLUSIONS: SNAP participation was associated with higher odds of obesity in our primarily Hispanic sample in Los Angeles County, with no effect modification found for the unhealthy portion of the food environment. More research is needed with additional food environment measures to confirm our null findings. Additional research is needed to elucidate the mechanisms linking SNAP participation and obesity as they remain unclear.


Assuntos
Assistência Alimentar/estatística & dados numéricos , Abastecimento de Alimentos/estatística & dados numéricos , Obesidade/epidemiologia , Características de Residência/estatística & dados numéricos , Adulto , Estudos Transversais , Dieta/estatística & dados numéricos , Feminino , Hispano-Americanos/estatística & dados numéricos , Humanos , Los Angeles/epidemiologia , Masculino , Pessoa de Meia-Idade , Análise Multinível , Pobreza/estatística & dados numéricos
12.
BMC Pregnancy Childbirth ; 15: 225, 2015 Sep 22.
Artigo em Inglês | MEDLINE | ID: mdl-26396077

RESUMO

BACKGROUND: Increasing skilled birth attendance at delivery is key to reducing maternal mortality, particularly among marginalized populations. Despite China's successful rollout of a national policy to promote facility deliveries, challenges remain among rural and ethnic minority populations. In response, a Tibetan Birth and Training Center (TBTC) was constructed in 2010 to provide high-quality obstetric care in a home-like environment to a predominantly Tibetan population in Tso-ngon (Qinghai) province in western China to improve maternal care in the region. This study examines if and how first users of the TBTC differ from women in the broader community, and how this information may inform subsequent maternal health care interventions in this area. METHODS: Trained, Tibetan interviewers administered a face-to-face, quantitative questionnaire to two groups of married, Tibetan women: women who had delivered at the TBTC between June 2011-June 2012 (n = 114) and a non-equivalent comparison group of women from the same communities who had delivered in the last two years, but not at the TBTC (n = 108). Chi-squared and ANOVA tests were conducted to detect differences between the samples. RESULTS: There were no significant differences between the samples in education or income; however, women from the TBTC sample were significantly younger (25.55 vs. 28.16 years; p < 0.001) and had fewer children (1.54 vs. 1.70; p = 0.05). Items measuring maternity health care-seeking and perceived importance of health facility amenities indicated minimal differences between the samples. However, as compared to the community sample, the TBTC sample had a greater proportion of women who reported having the final say regarding where to deliver (26% vs. 14%; p = 0.02) and having a friend or family member who delivered at home (50% vs. 28%; p < 0.001). CONCLUSIONS: Findings did not support the hypothesis that the TBTC attracts lower-income, less-educated women. Minimal differences in women's characteristics and perceptions regarding delivery care between the two samples suggest that the TBTC is serving a broad cross-section of women. Differences between the samples with respect to delivery care decision-making and desire for skilled birth care underscore areas that may be further explored and supported in subsequent efforts to promote facility delivery in this population, and similar populations, of women.


Assuntos
Centros de Assistência à Gravidez e ao Parto/estatística & dados numéricos , Parto Obstétrico/estatística & dados numéricos , Serviços de Saúde Materna/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , População Rural/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Tomada de Decisões , Parto Obstétrico/métodos , Parto Obstétrico/psicologia , Escolaridade , Feminino , Humanos , Gravidez , Classe Social , Cônjuges , Inquéritos e Questionários , Tibet , Adulto Jovem
13.
Demography ; 52(6): 1853-68, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26385111

RESUMO

We use data from three rounds of the Mexican Family Life Survey to examine whether migrants in the United States returning to Mexico in the period 2005-2012 have worse health than those remaining in the United States. Despite extensive interest by demographers in health-related selection, this has been a neglected area of study in the literature on U.S.-Mexico migration, and the few results to date have been contradictory and inconclusive. Using five self-reported health variables collected while migrants resided in the United States and subsequent migration history, we find direct evidence of higher probabilities of return migration for Mexican migrants in poor health as well as lower probabilities of return for migrants with improving health. These findings are robust to the inclusion of potential confounders reflecting the migrants' demographic characteristics, economic situation, family ties, and origin and destination characteristics. We anticipate that in the coming decade, health may become an even more salient issue in migrants' decisions about returning to Mexico, given the recent expansion in access to health insurance in Mexico.


Assuntos
Emigração e Imigração , Nível de Saúde , Americanos Mexicanos , Idoso , Feminino , Humanos , Modelos Logísticos , Masculino , México/etnologia , Pessoa de Meia-Idade , Inquéritos e Questionários , Estados Unidos
14.
Soc Sci Med ; 142: 109-17, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26301483

RESUMO

Research has shown that childhood stress increases the risk of poor mental health later in life. We examined the effect of childhood stressors on psychological distress and self-reported depression in young adulthood. Data were obtained from the Child Development Supplement (CDS) to the national Panel Study of Income Dynamics (PSID), a survey of US families that incorporates data from parents and their children. In 2005 and 2007, the Panel Study of Income Dynamics was supplemented with two waves of Transition into Adulthood (TA) data drawn from a national sample of young adults, 18-23 years old. This study included data from participants in the CDS and the TA (n = 2128), children aged 4-13 at baseline. Data on current psychological distress was used as an outcome variable in logistic regressions, calculated as odds ratios (OR) with 95% confidence intervals (CI). Latent Class Analyses were used to identify clusters based on the different childhood stressors. Associations were observed between cumulative exposure to childhood stressors and both psychological distress and self-reported depression. Individuals being exposed to three or more stressors had the highest risk (crude OR for psychological distress: 2.49 (95% CI: 1.16-5.33), crude OR for self-reported depression: 2.07 (95% CI: 1.15-3.71). However, a large part was explained by adolescent depressive symptoms. Findings support the long-term negative impact of cumulative exposure to childhood stress on psychological distress. The important role of adolescent depression in this association also needs to be taken into consideration in future studies.


Assuntos
Estresse Psicológico/complicações , Adolescente , Comportamento do Adolescente/psicologia , Adulto , Criança , Pré-Escolar , Depressão/etiologia , Feminino , Nível de Saúde , Humanos , Estudos Longitudinais , Masculino , Razão de Chances , Pais , Fatores Socioeconômicos , Inquéritos e Questionários , Estados Unidos , Adulto Jovem
15.
Int J Gynaecol Obstet ; 129(3): 244-7, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25790795

RESUMO

OBJECTIVE: To identify sociodemographic characteristics and factors involved in Tibetan women's decisions to deliver at the Tibetan Birth and Training Center (TBTC) in rural western China. METHODS: In the present mixed-methods study, a random sample of married women who delivered at the TBTC between June 2011 and June 2012 were surveyed. Additionally, four focus group discussions were conducted among married women living in the TBTC catchment area. Descriptive analyses were conducted, and dominant themes were identified. RESULTS: In focus group discussions, women (n=33) reported that improved roads and transportation meant that access to health facilities was easier than in the past. Although some of the 114 survey participants voiced negative perceptions of healthcare facilities and providers, 99 (86.8%) indicated that they chose to deliver at the TBTC because they preferred to have a doctor present. Most women (75 [65.8%]) said their mother/mother-in-law made the final decision about delivery location. Women valued logistic and cultural aspects of the TBTC, and 108 (94.7%) said that they would recommend the TBTC to a friend. CONCLUSION: Study participants preferred delivery care that combines safety and comfort. The findings highlight avenues for further promotion of facility delivery among populations with lower rates of skilled deliveries.


Assuntos
Centros de Assistência à Gravidez e ao Parto/normas , Parto Obstétrico/normas , Satisfação do Paciente , Serviços de Saúde Rural/normas , Adolescente , Adulto , Centros de Assistência à Gravidez e ao Parto/economia , Centros de Assistência à Gravidez e ao Parto/estatística & dados numéricos , Assistência à Saúde Culturalmente Competente , Tomada de Decisões , Parto Obstétrico/economia , Parto Obstétrico/estatística & dados numéricos , Relações Familiares , Feminino , Grupos Focais , Acesso aos Serviços de Saúde , Parto Domiciliar/economia , Humanos , Percepção , Relações Médico-Paciente , Serviços de Saúde Rural/economia , Serviços de Saúde Rural/estatística & dados numéricos , Inquéritos e Questionários , Tibet , Transportes , Adulto Jovem
16.
Demography ; 51(4): 1159-73, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24788391

RESUMO

Although many studies have attempted to examine the consequences of Mexico-U.S. migration for Mexican immigrants' health, few have had adequate data to generate the appropriate comparisons. In this article, we use data from two waves of the Mexican Family Life Survey (MxFLS) to compare the health of current migrants from Mexico with those of earlier migrants and nonmigrants. Because the longitudinal data permit us to examine short-term changes in health status subsequent to the baseline survey for current migrants and for Mexican residents, as well as to control for the potential health selectivity of migrants, the results provide a clearer picture of the consequences of immigration for Mexican migrant health than have previous studies. Our findings demonstrate that current migrants are more likely to experience recent changes in health status-both improvements and declines-than either earlier migrants or nonmigrants. The net effect, however, is a decline in health for current migrants: compared with never migrants, the health of current migrants is much more likely to have declined in the year or two since migration and not significantly more likely to have improved. Thus, it appears that the migration process itself and/or the experiences of the immediate post-migration period detrimentally affect Mexican immigrants' health.


Assuntos
Emigrantes e Imigrantes/estatística & dados numéricos , Nível de Saúde , Americanos Mexicanos/estatística & dados numéricos , Adulto , Fatores Etários , Feminino , Humanos , Masculino , México/etnologia , Pessoa de Meia-Idade , Autorrelato , Fatores Sexuais , Fatores Socioeconômicos , Estados Unidos/epidemiologia
17.
Demography ; 51(3): 727-52, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24719273

RESUMO

Research on neighborhood effects has focused largely on residential neighborhoods, but people are exposed to many other places in the course of their daily lives-at school, at work, when shopping, and so on. Thus, studies of residential neighborhoods consider only a subset of the social-spatial environment affecting individuals. In this article, we examine the characteristics of adults' "activity spaces"-spaces defined by locations that individuals visit regularly-in Los Angeles County, California. Using geographic information system (GIS) methods, we define activity spaces in two ways and estimate their socioeconomic characteristics. Our research has two goals. First, we determine whether residential neighborhoods represent the social conditions to which adults are exposed in the course of their regular activities. Second, we evaluate whether particular groups are exposed to a broader or narrower range of social contexts in the course of their daily activities. We find that activity spaces are substantially more heterogeneous in terms of key social characteristics, compared to residential neighborhoods. However, the characteristics of both home neighborhoods and activity spaces are closely associated with individual characteristics. Our results suggest that most people experience substantial segregation across the range of spaces in their daily lives, not just at home.


Assuntos
Demografia/métodos , Características de Residência/estatística & dados numéricos , Meio Social , Adulto , Feminino , Sistemas de Informação Geográfica , Humanos , Los Angeles , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos
18.
J Hunger Environ Nutr ; 9(4): 512-522, 2014 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-26413180

RESUMO

Focusing on adults from the Los Angeles Family and Neighborhood Survey, we investigated whether mental health was a mediator in the association between obesity (body mass index ≥ 30 kg/m2) and participation in the Supplemental Nutrition Assistance Program (SNAP). The analyses included 1776 SNAP participants and eligible nonparticipants. SNAP participants had higher odds of obesity (odds ratio [OR] =2.6; 95% confidence interval [CI], 1.52-4.36) and of reporting a mental health problem (OR = 3.8; 95% CI, 1.68-8.44) than eligible nonparticipants; however, mental health was not a mediator in the association between SNAP participation and obesity. We recommend changes in SNAP to promote healthier food habits among participants and reduce the stress associated with participation.

19.
Reprod Health Matters ; 22(44): 164-73, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25555773

RESUMO

Among the Millennium Development Goals, maternal mortality reduction has proven especially difficult to achieve. Unlike many countries, China is on track to meeting these goals on a national level, through a programme of institutionalizing deliveries. Nonetheless, in rural, disadvantaged, and ethnically diverse areas of western China, maternal mortality rates remain high. To reduce maternal mortality in western China, we developed and implemented a three-level approach as part of a collaboration between a regional university, a non-profit organization, and local health authorities. Through formative research, we identified seven barriers to hospital delivery in a rural Tibetan county of Qinghai Province: (1) difficulty in travel to hospitals; (2) hospitals lack accommodation for accompanying families; (3) the cost of hospital delivery; (4) language and cultural barriers; (5) little confidence in western medicine; (6) discrepancy in views of childbirth; and (7) few trained community birth attendants. We implemented a three-level intervention: (a) an innovative Tibetan birth centre, (b) a community midwife programme, and (c) peer education of women. The programme appears to be reaching a broad cross-section of rural women. Multilevel, locally-tailored approaches may be essential to reduce maternal mortality in rural areas of western China and other countries with substantial regional, socioeconomic, and ethnic diversity.


Assuntos
Necessidades e Demandas de Serviços de Saúde , Serviços de Saúde Materna/organização & administração , Complicações na Gravidez/prevenção & controle , Adolescente , Adulto , China/epidemiologia , Países em Desenvolvimento , Feminino , Inquéritos Epidemiológicos , Humanos , Relações Interinstitucionais , Serviços de Saúde Materna/métodos , Mortalidade Materna , Pessoa de Meia-Idade , Gravidez , Complicações na Gravidez/mortalidade , Tibet/epidemiologia , Adulto Jovem
20.
Soc Sci Med ; 90: 40-8, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23746607

RESUMO

In recent decades there has been an increasing interest in understanding the role of social and physical contexts in influencing health behaviors and outcomes. This is especially true for weight, which is considered to be highly dependent on environmental factors. The evidence linking neighborhood characteristics to weight in the United States, however, is mixed. Many studies in this area are hampered by cross sectional designs and a limited scope, insofar as they investigate only one dimension of neighborhood context. It is also unclear to what extent neighborhood characteristics account for racial/ethnic disparities in weight. Using longitudinal data from the Los Angeles Family and Neighborhood Survey (L.A. FANS), we compare patterns of weight change between Hispanics and other racial and ethnic groups in order to evaluate whether we observe a pattern of unhealthy assimilation in weight among Hispanic immigrants and to identify differences in the rate at which different groups gain weight over time. We also explore the extent to which patterns of weight change are related to a wider range of community characteristics. We find that weight increases across all groups between the two study waves of L.A. FANS and that the increases are significant except for Asians/Pacific Islanders. With respect to differences in the pace of weight change, second and higher generation Hispanic women and black men gain weight more rapidly than their first generation Hispanic counterparts. Although the evidence presented indicates that first generation Hispanics gain weight, we do not find evidence for convergence in weight since the U.S.-born gain weight at a more rapid rate. The inclusion of community-level variables does not alter the relationships between the race, ethnicity, and immigrant generation categories and weight change. Of the six types of community characteristics considered, only collective efficacy is consistently and significantly associated with weight change, although the protective effect of neighborhood collective efficacy is seen only among women.


Assuntos
Índice de Massa Corporal , Hispano-Americanos/estatística & dados numéricos , Sobrepeso/etnologia , Grupos Populacionais/estatística & dados numéricos , Aculturação , Adulto , Afro-Americanos/estatística & dados numéricos , Americanos Asiáticos/estatística & dados numéricos , Emigração e Imigração/estatística & dados numéricos , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Grupo com Ancestrais Oceânicos/estatística & dados numéricos , Características de Residência/estatística & dados numéricos , Fatores de Risco , Fatores Socioeconômicos , Estados Unidos/epidemiologia
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