RESUMO
This study examines the complex interplay of genetic and environmental interactions that shape chronic illness risk. Evidence is mounting for the role of genetic expression and the immune response in the pathogenesis of chronic disease. In the Rio Grande Valley of south Texas, where 90% of the population is Mexican American, chronic illnesses (including obesity, diabetes, nonalcoholic liver disease, and depression) are reaching epidemic proportions. This study leverages an ongoing family study of the genetic determinants of risk for obesity, diabetes, hypertension, hyperlipidemia, and depression in a Mexican American population. Data collected included blood pressure, BMI, hepatic transaminases, HbA1c, depression (BDI-II), acculturation/marginalization (ARSMA-II), and liver health as assessed by elastography. Heritability and genotype-by-environment (G×E) interactions were analyzed, focusing on the marginalization/separation measure of the ARSMA-II. Significant heritabilities were found for traits such as HbA1c (h2 = 0.52), marginalization (h2 = 0.30), AST (h2 = 0.25), ALT (h2 = 0.41), and BMI (h2 = 0.55). Genotype-by-environment interactions were significant for HbA1c, AST/ALT ratio, BDI-II, and CAP, indicating that genetic factors interact with marginalization to influence these traits. This study found that acculturation stress exacerbates the genetic response to chronic illness. These findings underscore the importance of considering G×E interactions in understanding disease susceptibility and may inform targeted interventions for at-risk populations. Further research is warranted to elucidate the underlying molecular pathways and replicate these findings in diverse populations.
Assuntos
Aculturação , Interação Gene-Ambiente , Americanos Mexicanos , Hepatopatia Gordurosa não Alcoólica , Humanos , Hepatopatia Gordurosa não Alcoólica/genética , Hepatopatia Gordurosa não Alcoólica/patologia , Hepatopatia Gordurosa não Alcoólica/etnologia , Masculino , Feminino , Americanos Mexicanos/genética , Adulto , Pessoa de Meia-Idade , Doença Crônica , Genótipo , Estresse Psicológico/genética , Predisposição Genética para Doença , Obesidade/genética , Texas/epidemiologiaRESUMO
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.
Assuntos
Anti-Hipertensivos , Hipertensão , Americanos Mexicanos , População Branca , Humanos , Americanos Mexicanos/estatística & dados numéricos , Feminino , Masculino , Idoso , Pessoa de Meia-Idade , Anti-Hipertensivos/uso terapêutico , Hipertensão/tratamento farmacológico , Hipertensão/etnologia , Hipertensão/epidemiologia , Hipertensão/fisiopatologia , População Branca/estatística & dados numéricos , Prevalência , Adesão à Medicação , Fatores de Tempo , Pressão Sanguínea/efeitos dos fármacos , Fatores de Risco , AVC Isquêmico/etnologia , AVC Isquêmico/epidemiologia , AVC Isquêmico/terapia , AVC Isquêmico/diagnóstico , Acidente Vascular Cerebral Hemorrágico/epidemiologia , Acidente Vascular Cerebral Hemorrágico/etnologia , Texas/epidemiologia , Acidente Vascular Cerebral/etnologia , Acidente Vascular Cerebral/epidemiologia , Resultado do TratamentoRESUMO
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.
Assuntos
Emigrantes e Imigrantes , Emigração e Imigração , Humanos , Feminino , Adulto , Emigrantes e Imigrantes/psicologia , Emigrantes e Imigrantes/estatística & dados numéricos , Pessoa de Meia-Idade , Emigração e Imigração/legislação & jurisprudência , Americanos Mexicanos/psicologia , Americanos Mexicanos/estatística & dados numéricos , Michigan , Acessibilidade aos Serviços de Saúde , Política Pública , Racismo , Teoria Fundamentada , Pesquisa Qualitativa , Promoção da Saúde/métodos , Adulto JovemRESUMO
Thirty-seven interviews of Mexican American women who crossed the border into the United States during the era of the Mexican Revolution of 1910 were analyzed using constructivist grounded theory methods. The intent is to expand the occupational therapy profession's occupational consciousness and cultivate cultural humility. Four themes emerged from the data: suffering, work, yearning for an education, and compassion for others. The findings suggest that environmental barriers such as hierarchy (patriarchy and discrimination) and physical barriers (limited access to built environments, lack of nonexploitative work opportunities, and hostile educational institutions) prevented occupational participation. Small acts of resistance through everyday living (finding joy, playing, self-sufficiency, and community organizing) were identified as facilitators of occupational participation. The research findings challenge proposed assumptions found within the occupational therapy literature: (1) humans and occupations exist as separate from their environments, and (2) work, productivity, and leisure contribute positively to health. The Transformative Model of Occupational Therapy is introduced as a decolonized framework that inextricably links individual health to community and global health. The model centers play, social participation, work, and education as occupations that contribute to the common good. These occupations are kept in equilibrium within the Four Pillars of Culture (self-determination, compassion, sustainability, and language) or the cultural values identified and derived from the stories.
Assuntos
Teoria Fundamentada , Americanos Mexicanos , Terapia Ocupacional , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Empatia , Americanos Mexicanos/psicologia , Terapia Ocupacional/métodos , Pesquisa Qualitativa , Participação Social , Estados UnidosRESUMO
Both parasympathetic nervous system regulation and receipt of social support from close relationships contribute to prosocial development, although few studies have examined their combined influences in adolescence and particularly within racially and ethnically minoritized populations. In this longitudinal study of 229 U.S. Mexican-origin adolescents (48% female-identifying), youths reported on receipt of social support from family and friends from 10 to 16 years, had their baseline respiratory sinus arrhythmia (RSA) measured at 17 years, reported their prosocial behavior and completed the Mind in the Eyes test to assess cognitive empathy at 17 and 19 years, and reported their prosocial civic behavior (i.e., community activity) at 19 years. Family social support predicted prosocial behavior at 17 years, and friend social support predicted prosocial civic behavior at 19 years. Compared to youths with lower or higher baseline RSA, youths with moderate RSA reported more prosocial civic behavior, had greater cognitive empathy, and tended to report more general prosocial behavior at 19 years. The quadratic association between baseline RSA and cognitive empathy was stronger for youths with greater family social support. These findings are the first to extend the evidence that moderate baseline parasympathetic nervous system activity supports prosocial development into late adolescence and with the U.S. Mexican-origin community, and these findings address calls for more integrative biopsychosocial studies of prosociality. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Assuntos
Empatia , Família , Amigos , Americanos Mexicanos , Sistema Nervoso Parassimpático , Arritmia Sinusal Respiratória , Comportamento Social , Apoio Social , Humanos , Adolescente , Feminino , Masculino , Sistema Nervoso Parassimpático/fisiologia , Estudos Longitudinais , Empatia/fisiologia , Arritmia Sinusal Respiratória/fisiologia , Adulto Jovem , Criança , Estados Unidos , Comportamento do Adolescente/fisiologia , Comportamento do Adolescente/etnologia , Desenvolvimento do Adolescente/fisiologiaRESUMO
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.
Assuntos
Exercício Físico , Americanos Mexicanos , Percepção , Características de Residência , Humanos , Feminino , Masculino , Texas , Americanos Mexicanos/psicologia , Americanos Mexicanos/estatística & dados numéricos , Adulto , Pessoa de Meia-Idade , Características da Vizinhança , Inquéritos e Questionários , México/etnologia , Estudos Longitudinais , Caminhada , Planejamento AmbientalRESUMO
BACKGROUND: Stroke survivors believe neighborhood resources such as community centers are beneficial; however, little is known about the influence of these resources on stroke outcomes. We evaluated whether residing in neighborhoods with greater resource density is associated with favorable post-stroke outcomes. METHODS AND RESULTS: We included Mexican American and non-Hispanic White stroke survivors from the Brain Attack Surveillance in Corpus Christi project (2009-2019). The exposure was density of neighborhood resources (eg, community centers, restaurants, stores) within a residential census tract at stroke onset. Outcomes included time to death and recurrence, and at 3 months following stroke: disability (activities of daily living/instrumental activities of daily living), cognition (Modified Mini-Mental State Exam), depression (Patient Health Questionnaire-8), and quality of life (abbreviated Stroke-Specific Quality of Life scale). We fit multivariable Cox regression and mixed linear models. We considered interactions with stroke severity, ethnicity, and sex. Among 1786 stroke survivors, median age was 64 years (interquartile range, 56-73), 55% men, and 62% Mexican American. Resource density was not associated with death, recurrence, or depression. Greater resource density (75th versus 25th percentile) was associated with more favorable cognition (Modified Mini-Mental State Exam mean difference=0.838, 95% CI=0.092, 1.584) and among moderate-severe stroke survivors, with more favorable functioning (activities of daily living/instrumental activities of daily living=-0.156 [95% CI, -0.284 to 0.027]) and quality of life (abbreviated Stroke-Specific Quality of Life scale=0.194 [95% CI, 0.029-0.359]). CONCLUSIONS: We observed associations between greater resource density and cognition overall and with functioning and quality of life among moderate-severe stroke survivors. Further research is needed to confirm these findings and determine if neighborhood resources may be a tool for recovery.
Assuntos
Atividades Cotidianas , Qualidade de Vida , Acidente Vascular Cerebral , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cognição , Depressão/epidemiologia , Depressão/psicologia , Americanos Mexicanos , Características da Vizinhança , Recidiva , Acidente Vascular Cerebral/psicologia , Sobreviventes/psicologia , Texas/epidemiologia , Fatores de Tempo , BrancosRESUMO
BACKGROUND: Informal home care is prevalent among Mexican American stroke survivors, but data on the impact on caregivers are not available. The aim was to assess ethnic differences in informal stroke caregiving and caregiver outcomes at 90 days poststroke. METHODS: Informal caregivers were recruited from the population-based Brain Attack Surveillance in Corpus Christi Project (2019-2023), conducted in a bi-ethnic community in Texas. Caregivers of community-dwelling stroke survivors who were not cognitively impaired and not employed by a formal caregiving agency were interviewed. Interviews included sociodemographics, dyad characteristics, Modified Caregiver Strain Index (range 0-26, higher more positive), Positive Aspects of Caregiving scale (range, 5-45, higher more), Patient Health Questionnaire-8 (range, 0-30, higher worse), and PROMIS (Patient-Reported Outcomes Measurement Information System)-10 physical (range, 16.2-67.7, higher better) and mental health (range, 21.2-67.6, higher better) summary scores. Stroke survivor data was from interviews and medical records. Propensity score methods were used to balance caregiver and patient factors among Mexican American and Non-Hispanic White caregivers by fitting a model with ethnicity of caregiver as the outcome and predictors being caregiver sociodemographics, patient-caregiver dyad characteristics, and patient sociodemographics and functional disability. Propensity scores were included as a covariate in regression models, considering the association between ethnicity and outcomes. RESULTS: Mexican American caregivers were younger, more likely female, and more likely a child of the stroke survivor than Non-Hispanic White caregivers. Mexican American caregiver ethnicity was associated with less caregiver strain (ß, -1.87 [95% CI, -3.51 to -0.22]) and depressive symptoms (ß, -2.02 [95% CI, -3.41 to -0.64]) and more favorable mental health (ß, 4.90 [95% CI, 2.49-7.31]) and positive aspects of caregiving (ß, 3.29 [95% CI, 1.35-5.23]) but not associated with physical health. CONCLUSIONS: Understanding the mechanisms behind more favorable caregiver outcomes in Mexican American people may aid in the design of culturally sensitive interventions to improve both caregiver and stroke survivor outcomes, potentially across all race and ethnic groups.
Assuntos
Cuidadores , Americanos Mexicanos , Acidente Vascular Cerebral , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cuidadores/psicologia , Americanos Mexicanos/psicologia , Acidente Vascular Cerebral/etnologia , Acidente Vascular Cerebral/enfermagem , Acidente Vascular Cerebral/psicologia , Texas/epidemiologia , BrancosRESUMO
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.
Assuntos
Diabetes Mellitus , Hospitalização , Americanos Mexicanos , Humanos , Idoso , Feminino , Masculino , Americanos Mexicanos/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Idoso de 80 Anos ou mais , Diabetes Mellitus/epidemiologia , Complicações do Diabetes/epidemiologia , Fatores de Risco , Acidentes por Quedas/estatística & dados numéricosRESUMO
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 (nâ =â 40) residing in an underserved agricultural community and entering mid-life (meanâ =â 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.
Assuntos
Emigrantes e Imigrantes , Americanos Mexicanos , Pesquisa Qualitativa , Resiliência Psicológica , População Rural , Humanos , Feminino , Pessoa de Meia-Idade , População Rural/estatística & dados numéricos , Emigrantes e Imigrantes/psicologia , Emigrantes e Imigrantes/estatística & dados numéricos , Americanos Mexicanos/psicologia , Americanos Mexicanos/estatística & dados numéricos , Envelhecimento/psicologia , Envelhecimento/etnologia , Estados Unidos/epidemiologia , Estados Unidos/etnologia , Envelhecimento Saudável/psicologia , Envelhecimento Saudável/etnologia , México/etnologia , Agricultura , Motivação , Estresse Psicológico/etnologia , Estresse Psicológico/psicologia , AdultoRESUMO
Although neighborhood contexts serve as upstream determinants of health, it remains unclear how these contexts "get under the skin" of Mexican-origin youth, who are disproportionately concentrated in highly disadvantaged yet co-ethnic neighborhoods. The current study examines the associations between household and neighborhood socioeconomic status (SES), neighborhood racial-ethnic and immigrant composition, and hair cortisol concentration (HCC)-a physiological index of chronic stress response-among Mexican-origin adolescents from low-income immigrant families in the United States. A total of 297 (54.20% female; mage = 17.61, SD = 0.93) Mexican-origin adolescents had their hair cortisol collected, and their residential addresses were geocoded and merged with the American Community Survey. Neighborhoods with higher Hispanic-origin and foreign-born residents were associated with higher neighborhood disadvantage, whereas neighborhoods with higher non-Hispanic White and domestic-born residents were associated with higher neighborhood affluence. Mexican-origin adolescents living in neighborhoods with a higher proportion of Hispanic-origin residents showed lower levels of HCC, consistent with the role of the ethnic enclave. In contrast, adolescents living in more affluent neighborhoods showed higher levels of HCC, possibly reflecting a physiological toll. No association was found between household SES and HCC. Our findings underscore the importance of taking sociocultural contexts and person-environment fit into consideration when understanding how neighborhoods influence adolescents' stress physiology.
Assuntos
Emigrantes e Imigrantes , Cabelo , Hidrocortisona , Americanos Mexicanos , Pobreza , Humanos , Adolescente , Feminino , Masculino , Hidrocortisona/metabolismo , Cabelo/química , Estados Unidos/etnologia , Pobreza/etnologia , Características de Residência , Características da Vizinhança , Classe Social , Estresse Psicológico/metabolismo , Estresse Psicológico/etnologiaRESUMO
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.
Assuntos
Solidão , Americanos Mexicanos , Humanos , Solidão/psicologia , Arizona , Feminino , Masculino , Adulto , Fatores de Risco , Pessoa de Meia-Idade , Americanos Mexicanos/psicologia , Americanos Mexicanos/estatística & dados numéricos , Apoio Social , Idoso , Adulto Jovem , Doença Crônica/psicologia , Pesquisa Participativa Baseada na Comunidade , Modelos LogísticosRESUMO
This article explores the experiences of Mexican American mothers who, confronted with the troubled emotions and behaviors of their adolescent children, felt compelled to seek help from mental health clinicians. Their experience is situated in the context of both psychiatrization, or the tendency to treat social problems as mental illness, and the landscape of contemporary mothering in the U.S., where maternal determinism, mother-blame, and the demand for intensive parenting hold sway. In this context, the moral crisis of mental health care-seeking for their children forces mothers to reconcile multiple competing stakes as they navigate the overlapping, and sometimes conflicting, moral-cultural worlds constituted by family and community, as well as mental health care providers. At the same time, it allows them an opportunity to creatively "reenvision" their ways of being mothers and persons. Their stories and struggles shed new light on contemporary conversations about psychiatrization, everyday morality, and mothering.
Assuntos
Americanos Mexicanos , Princípios Morais , Mães , Humanos , Mães/psicologia , Feminino , Adolescente , Americanos Mexicanos/psicologia , Adulto , Relações Mãe-Filho/etnologia , Serviços de Saúde Mental , Transtornos Mentais/terapia , Transtornos Mentais/etnologia , Estados Unidos , Poder Familiar/etnologia , Poder Familiar/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologiaRESUMO
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.
Assuntos
Aculturação , Hipertensão , Americanos Mexicanos , Inquéritos Nutricionais , Humanos , Americanos Mexicanos/estatística & dados numéricos , Hipertensão/epidemiologia , Hipertensão/etnologia , Masculino , Feminino , Prevalência , Adulto , Fatores de Risco , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Obesidade Abdominal/epidemiologia , Obesidade Abdominal/etnologia , Adulto Jovem , Idoso , Estudos Transversais , Medição de Risco , População Branca/estatística & dados numéricosRESUMO
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 (nâ=â1,145), medium (nâ=â717), and high (nâ=â702) 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 Bâ=â0.99 SEâ=â0.19 pâ<â0.01; high Bâ=â1.41 SEâ=â0.21 pâ<â0.01). 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.
Assuntos
Cognição , Americanos Mexicanos , Humanos , Americanos Mexicanos/psicologia , Americanos Mexicanos/estatística & dados numéricos , Masculino , Idoso , Feminino , Cognição/fisiologia , Idoso de 80 Anos ou mais , Testes de Estado Mental e Demência , Idioma , MultilinguismoRESUMO
OBJECTIVES: We test whether the level of acculturation is associated with reproductive autonomy among Mexican-origin Latinas in Oregon. STUDY DESIGN: This was a cross-sectional study that used validated reproductive autonomy and language-based acculturation scales and sociodemographic information. We compared maximum reproductive autonomy score, overall and for each subscale (decision-making, freedom from coercion, and communication), by acculturation group. We developed a multivariable logistic regression model adjusted for age, education, and regular income source. RESULTS: Our sample included 434 respondents: 70.7% low, 26.7% bicultural, and 2.5% in the high acculturation group. A higher unadjusted proportion of women in the bicultural/high acculturation group than the low acculturation group had maximum reproductive autonomy scores (13.4% compared with 3.9%; p < 0.001). In adjusted analyses, women in the high/bicultural acculturation group had significantly higher odds of reporting a maximum reproductive autonomy score (adjusted odds ratio = 2.55, 95% CI: 1.08-5.98). CONCLUSIONS: Language-based acculturation was positively associated with reproductive autonomy among a community-dwelling sample of Mexican-origin Latinas in Oregon.
Assuntos
Aculturação , Idioma , Americanos Mexicanos , Autonomia Pessoal , Humanos , Feminino , Oregon , Adulto , Estudos Transversais , Adulto Jovem , Adolescente , Tomada de Decisões , Modelos Logísticos , Hispânico ou Latino , CoerçãoRESUMO
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.
Assuntos
Letramento em Saúde , Acessibilidade aos Serviços de Saúde , Americanos Mexicanos , Saúde Reprodutiva , Saúde Sexual , Adolescente , Adulto , Feminino , Humanos , Adulto Jovem , Americanos Mexicanos/estatística & dados numéricos , New York , Serviços de Saúde Reprodutiva , Comportamento Sexual , População RuralRESUMO
We conducted focus groups with staff from 5 community-based organizations (21 participants; 86% female, 52% Hispanic/Latino/a/x and 24% Mexican/Mexican American) between August and October 2021. Results highlighted community partner perceptions of practices congruent (e.g., communication that built trust and dismantled power dynamics, a shared mission) and incongruent (e.g., intervention-community misalignment, research driven decision-making) with equitable implementation in the development, implementation, and evaluation of a promotores de salud intervention to increase COVID-19 testing and preventive behaviors among Latinx communities in Oregon. (Am J Public Health. 2024;114(S5):S377-S383. https://doi.org/10.2105/AJPH.2024.307686).
Assuntos
COVID-19 , Hispânico ou Latino , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , COVID-19/prevenção & controle , Grupos Focais , Promoção da Saúde/métodos , Oregon , Pesquisa Qualitativa , SARS-CoV-2 , Confiança , Americanos MexicanosRESUMO
PURPOSE: This study sought to understand family functioning surrounding weight in Mexican American women with obesity. METHODS: Semi-structured in-depth interviews were conducted with mothers and adult daughters (N = 116). RESULTS: Thematic analysis identified five themes. 1) The communication process drives perception of supportive messages. Messages perceived as non-supportive consist of directives as interventions, confirmation of faults, and critical compliments whereas supportive consist of compliments, encouragement, empathetic listening, and disclosure. 2) Acculturation differences interfere with intergenerational alliance. Differences involve dissonance in communication, behavioural expectations, and weight-related practices. 3) Maladaptive conflict responses contribute to relational strain. These responses include avoidance, withdrawal, and defensiveness. 4) Role transformations alter the generational hierarchical relationship. Daughters serve as role models, caregivers, or collaborators. 5) Low communal coping heightens psychological distress. It does so by challenging family roles, increasing social isolation, and compromising social support. CONCLUSION: Obesity interventions for Mexican American women may benefit from targeting relational skills to improve family functioning.
Assuntos
Adaptação Psicológica , Americanos Mexicanos , Mães , Obesidade , Apoio Social , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Adulto Jovem , Aculturação , Comunicação , Relações Familiares/psicologia , Relação entre Gerações , Americanos Mexicanos/psicologia , Mães/psicologia , Obesidade/psicologia , Obesidade/etnologia , Pesquisa QualitativaRESUMO
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.