Intersecting Identities and Ideologies: Sociodemographic Predictors of 2024 Voting Among Mexican and Cuban Americans

The focus is on dietary diversity among United States (US) Hispanics, with attention given to differences by socioeconomic status (SES) and level of acculturation. The subjects of study were 18 to 74 years of age Mexican Americans (n = 3201), Cuban Americans (n = 831), and Puerto Ricans (n = 1224) included in the 1982–84 Hispanic Health and Nutrition Examination Survey (HHANES). Dietary diversity was assessed as ‘food group’ and ‘portion’ scores derived from single 24 hour recalls. Less than 10% of Hispanic men and 5% of women satisfy diversity recommendations (17 or more portions out of a possible 20) and patterns are as found in the general US population. Multivariate analysis suggest that among Mexican Americans and Puerto Ricans diversity is related to education and level of acculturation. Income is not related to diversity in any group. Generation of residency in the US is associated with less variety among Mexican Americans and Puerto Rican men. Socioeconomic status and acculturation are not significantly related to diversity among Cuban Americans. In conclusion, the diets of US Hispanics lack variety and this places these populations at long‐term health risk. While interventions need to consider the educational level and cultural differences among Hispanics, income levels are unrelated to diversity in all groups, and therefore, not an apparent limitation to change.

Are all immigrants in the United States willing and able to integrate successfully within a liberal democratic polity? This research question guides the three papers included in the present dissertation. To explore this question I designed and implemented a multi-city survey in the United States (the American Cities Survey) which contains representative immigrant, black, white, Latino and Asian samples drawn independently for each locality. Based on the findings of the American Cities Survey, which include multiple attitudinal, cultural background and political behavior measures at the individual level, along with socioeconomic and demographic measures in six distinct local institutional environments, I argue that all voting eligible immigrants and immigrant communities-regardless of their native origin and their ancestral religious affiliation-- are willing and able to integrate politically so long as political institutions and contexts (especially local ones) provide them with the same exposure to the political system and institutions, and opportunities to participate in politics as the ones provided to all other citizens. I thereby challenge both the academic and popular perceptions that certain immigrant groups have anti-democratic and anti-liberal attitudes due to their shared cultural characteristics (i.e. religious affiliation or political socialization in a non-democratic polity) that persist even after migrating to a liberal democratic polity and are passed on to the second generation. I discover that the notion that Latinos vote less than similarly situated blacks and whites has persisted overtime for two reasons: first, simply because a greater proportion of Latinos have settled in localities where institutions tend to inhibit political competition and depress turnout, biasing representative national samples; second, because the smallest geographical unit one can study with existing survey and Census (CPS) data does not allow for exploration of political behavior at the individual level beyond the state. This is problematic for studying groups like Latinos, because 50 percent of their population is concentrated in three states and less than ten cities. I find that the results found at the national level are not replicable at the local level and Latino political participation varies by city. In localities where institutions provide incentives for political party competition the probability of a citizen of Latino origin voting is equal to that of blacks and whites of similar age, income and education. In other words, the evidence presented here suggests that the correlation found at the national level between Latino immigrant group membership and apolitical attitudes and behavior is of a contingent, perhaps even spurious nature, artifice of geographical concentration of members of this group in local institutional environments that depress political activity. The theoretical framework and findings of this dissertation reveal that immigrant political attitudes and behavior towards the host country's political system is shaped mostly by individual experiences with this system, and not by prior or inherited cultural or religious beliefs from their (or their ancestor's) country of origin.

Latino Americans, also termed Hispanics, as individuals with ancestry in the US Southwest, Mexico, Puerto Rico, or Latin American countries, are widely diverse, even while their cinematic and televisual representations have often flattened differences in their construction of an imagined, universal Latin-ness, or Latinidad. This representational history has its roots in social history and particularly the historical oppression of Mexican Americans. Mexican Americans also historically have been the largest US Latino group. In 2011, they made up 64.6 percent of all Latino Americans, followed by Puerto Ricans (9.5 percent), Salvadorans (3.8 percent), Cuban Americans (3.5 percent), and smaller but increasing numbers of Latinos of Central and South American descent. Given their varied histories, Latino Americans differ widely with respect to such factors as class, immigrant generation, and media habits. Spanish-language usage is a commonality among many but not all Latino Americans. Younger Latino Americans are also increasingly acculturated, demonstrating hybrid media consumption of both English- and Spanish-language popular culture forms. Latino representation in US film and television is increasingly important to scholarship on American media, as the Latino population has grown exponentially in the last century and is expected to continue to increase. Latinos became the largest nonwhite group in the United States in 2000 and now make up more than 17 percent of the population and 20 percent of youth under the age of eighteen, according to the US Census Bureau. Scholarship on Latino representation in US film and English-language entertainment television, however, is still relatively new. Academic books on the topic began to be published in the early 1980s; pioneering scholars included Arthur Pettit (Image of the Mexican American in Fiction and Film, 1980), Frank Javier Garcia Berumen (The Chicano/Hispanic Image in American Film, 1995), Charles Ramírez Berg (whose work was later collected in Latino Images in Film: Stereotypes, Subversion and Resistance, 2002), Chon Noriega (editor of Chicanos and Film: Representation and Resistance, 1992), Rosa Linda Fregoso (The Bronze Screen: Chicana and Chicano Film Culture, 1993), and Clara Rodríguez (editor of Latin Looks: Images of Latinas and Latinos in the US Media, 1997). Some of the work of these scholars necessarily involved establishing the legitimacy of studying Latinos and film and television representation, as Angharad Valdivia (see Valdivia 2008, cited under Anthologies) and Ramírez Berg (see Berg 2002, cited under Introductory Works) have noted. The next generations of scholars have benefited from these inroads in Latino studies and media studies and the growth and acceptance of cultural studies traditions. Scholars in recent decades have explored Latino American media representation and stardom in US film and television from a variety of disciplinary and methodological approaches. This article reviews the most useful scholarship on Latinos and US film and television, with special attention to the salient themes and notable scholars in the field.

Parental involvement in education is a key focus of current policies and programs aimed at improving the academic outcomes of students at risk for academic underachievement. This study examines six forms of parental involvement in education to determine which forms of involvement have the strongest relationships with youths' academic outcomes. Using nationally representative data (N = 1,609) from the National Education Longitudinal Survey, this study focuses specifically on Mexican American families and youths, a population at high risk for academic underperformance. Findings show that the positive effects of parental involvement among Mexican American parents occur through involvement in the home, whereas parental involvement in school organizations is not associated with youths' achievement. Parents' investment of financial resources in their children's education was found to have a somewhat higher impact on achievement than forms of involvement that require parents' investment of time. Findings also suggest that the impact of these forms of parental involvement occurs prior to high school. KEY WORDS: academic achievement; Mexican American youths; parent involvement ********** Policy and program interventions aimed at improving children's academic outcomes often focus on increasing parental involvement. The federal No Child Left Behind Act of 2001 (RL. 107-110) highlights parental involvement as a key factor in improving academic outcomes, particularly for children attending schools that serve high proportions of low-income children (Title 1 schools). Indeed, parental involvement appears to be an important factor in improving children's academic outcomes, and a sizeable body of work generally points to the positive effects of parents' naturally occurring involvement (for a recent review, see Pomerantz, Moorman, & Litwack, 2007). However, less is known about the effects of parental involvement on academic outcomes among children of color, particularly Latino children (Jeynes, 2003). Effects of parental involvement in academics appear to differ among racial-ethnic groups (Desimone, 1999) and among different Latino nationality groups (Figueroa-Moseley, Ramey, Keltner, & Lanzi, 2006). In addition, different types of parental involvement have distinct relationships with academic outcomes (Domina, 2005; Jeynes, 2003; Pomerantz et al., 2007). Consequently, to understand the role of parental involvement and its potential utility for intervention in promoting academic achievement among children of color, and particularly Latino children, more studies that carefully examine the role of multiple forms of involvement with diverse samples are needed. Of critical importance are studies focused on Mexican American families, both those that have recently migrated and those that have resided in the United States for generations. Mexican Americans are by far the largest and fastest growing population of Latinos in the United States, accounting for 65% of U.S. Latinos and 9.7% of the entire U.S. population (U.S. Census Bureau, 2009). Among Latino groups, Mexican Americans are at gravest risk for living in poverty, in part because of lower rates of high school completion and college attendance within this group (U.S. Census Bureau, 2002). The likelihood of high school dropout is two to four times higher for Mexican American students than for Cuban and South American youths, even after controlling for factors such as socioeconomic status (Driscoll, 1999; Landale, Oropesa, & Llanes, 1998). Indicators of academic achievement, such as grades and performance on standardized tests, are, on average, lower among Mexican American children than among children from other immigrant and native-born groups (Ferguson, 2001; Kao & Thompson, 2003; Portes & Rumbaut, 2001). Thus, interventions to address the academic disparities faced by Mexican American children and youths are much needed. …

Available estimates of the health status and health care utilization of the US population often fail to distinguish the population by national origin thus overlooking important geographical socioeconomic and cultural differences that exist among these groups. According to the 1980 Census there were 14.6 million Hispanics in the US of whom 59.8% were of Mexican origin 13.8% were of Puerto Rican origin 5.5% were of Cuban origin and 20.9% were of origins. This report is the 1st national one to provide estimates on a variety of health indicators for the and non-Hispanic populations using data from the National Health Interview Survey (NHIS). Estimates are presented in this report for the US civilian noninstitutionalized population and for the total nonHispanic the white nonHispanic and the black nonHispanic segments of the population. Estimates are also presented forthe total population and the Mexican American the mainland Puerto Rican the Cuban American and other Hispanic populations thus allowing for cross-cultural comparisons. The primary focus of the report is however the data for the 4 groups. Data on the population are combined estimates for all people regardless of race. Mexican Americans had the lowest physician visit rate of any group studied 3.7 visits per person/year. In contrast Puerto Ricans along with Cuban Americans saw a physician the most frequently about 6 times a year on the average. Only 1 in 5 Puerto Ricans did not consult with a physician in the course of a year. About 1/3 of Mexican Americans 4 years of age and older visited a dentist within the year compared with almost 1/2 of all Hispanics Almost 1/2 of Puerto Ricans and Cuban Americans aged 4 and over saw a dentist at least once a year. Mexican Americans were among the least likely to be hospitalized (8.5%) whereas Puerto Ricans and Cuban Americans were the most likely to be hospitalized. Puerto Ricans had by far the highest incidence of acute vs. chronic conditions. As a group Mexican Americans had less restricted activity than did any group (measured by days lost from or confined to bed). Puerto Ricans had the greatest amount of restricted activity about 20% higher than for blacks the group with the next highest level of activity. Cuban Americans along with blacks had the greatest proportion of persons limited in their major activity and activities. For Cuban Americans this is mainly due to the large proportion of older people. Family income age and educational status are also correlated to health status and service utilization.

Background: American Indians/Alaska Natives (AIs/ANs) and United States (U.S.)-born Hispanic Americans (HAs) have higher kidney cancer mortality rates compared to non-Hispanic Whites (NHWs), but kidney cancer burden among these racial/ethnic minority groups are not well understood. The aim of our study was to evaluate the burden of renal cell carcinoma (RCC) among these groups at a State (Arizona) and national level with a focus on advanced stage (stage III/IV) diagnosis, indicative of delayed diagnosis, and overall poorer survival. Methods: A retrospective analysis of National Cancer Database (NCDB) and Arizona Cancer Registry (ACR) was conducted. RCC patients diagnosed between 2004 and 2015 in NCDB and between 2007 and 2016 in ACR with known race/ethnicity information were included. Multivariable logistic regression and Cox regression analysis were performed to ascertain the effect of race/ethnicity stage and overall survival. Results: There were a total of 405,073 cases in NCDB and 9,743 cases in ACR. In NCDB data, advanced stage was more common in AIs/ANs (31.5%) and HAs (28.6%) compared to NHWs (27.7%), but associations were not statistically significant. Among HAs, Mexican Americans were more likely to have advanced stage (34.1%) and had higher odds of advanced stage diagnosis compared to NHWs (OR 1.22, 95% CI: 1.11-1.35). In ACR, advanced stage diagnosis was common in Mexican Americans (47.2%), particularly U.S.-born Mexican Americans (49.1%). Advanced stage diagnosis was also more common in AIs/ANs compared to NHWs (31.5% vs. 26.4%). AIs/ANs and Mexican Americans had increased odds of advanced stage diagnosis compared to NHWs (OR 1.39, 95% CI: 1.08-1.79 and OR 2.08, 95% CI: 1.65-2.62 respectively). Risk of mortality was assessed adjusting for stage, surgical treatment, and socio-demographic factors. In NCDB, HAs had reduced mortality risk (HR 0.88, 95% CI: 0.85-0.91). Among HAs, HAs of South or Central American origin had the greatest reduced risk of mortality (HR 0.74, 95% CI: 0.59-0.92). In Arizona, AIs/ANs and HAs had significantly higher risk of mortality compared to NHWs (HR 1.55, 95% CI: 1.18-2.04 and HR 1.36, 95% CI: 1.14-1.64). The greatest risk of mortality was observed in U.S.-born Mexican Americans (HR 3.76, 95% CI: 2.97-4.76). Conclusion: Greater health disparities were observed in Arizona, at the State level than the national level. A Hispanic paradox was observed at the national level but not at the State level, Arizona. Impact: It is necessary to further investigate RCC health disparities at a State level, including regional variations in healthcare systems, rurality or distance to tertiary referral centers, and patient-related factors, such as access to care and co-morbidity, that contribute to racial health disparities. Citation Format: Ken Batai, Samer Asmar, Francine C. Gachupine, Juan Chipollini, Benjamin R. Lee. Renal cell carcinoma health disparities in American Indians Alaska Natives and Hispanic Americans: Comparison of National Cancer Database and Arizona Cancer Registry data [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 1179.

Chronic abdominal pain and depression. Epidemiologie findings in the United States. Hispanic health and nutrition examination survey

BACKGROUND Discrimination and xenophobia toward Hispanic and Latino communities increased during the COVID-19 pandemic, likely inflicting significant harm on the mental health of Hispanic and Latino individuals. Pandemic-related financial and social instability has disproportionately affected Hispanic and Latino communities, potentially compounding existing disparities and worsening mental health. OBJECTIVE This study aims to examine the association between discrimination and depressive symptoms during the COVID-19 pandemic among a national sample of Hispanic and Latino adults. METHODS Data from a 116-item web-based nationally distributed survey from May 2021 to January 2022 were analyzed. The sample (N=1181) was restricted to Hispanic or Latino (Mexican or Mexican American, Puerto Rican; Cuban or Cuban American, Central or South American, and Dominican or another Hispanic or Latino ethnicity) adults. Depression symptoms were assessed using the 2-item Patient Health Questionnaire. Discrimination was assessed using the 5-item Everyday Discrimination Scale. A multinomial logistic regression with a block entry model was used to assess the relationship between discrimination and the likelihood of depressive symptoms, as well as examine how controls and covariates affected the relationship of interest. RESULTS Mexican or Mexican American adults comprised the largest proportion of the sample (533/1181, 45.13%), followed by Central or South American (204/1181, 17.3%), Puerto Rican (189/1181, 16%), Dominican or another Hispanic or Latino ethnicity (172/1181, 14.6%), and Cuban or Cuban American (83/1181, 7.03%). Approximately 31.26% (367/1181) of the sample had depressive symptoms. Regarding discrimination, 54.56% (634/1181) reported experiencing some form of discrimination. Compared with those who did not experience discrimination, those who experienced discrimination had almost 230% higher odds of depressive symptoms (adjusted odds ratio [AOR] 3.31, 95% CI 2.42-4.54). Also, we observed that sociodemographic factors such as age and gender were significant. Compared with participants aged 56 years and older, participants aged 18-35 years and those aged 36-55 years had increased odds of having depressive symptoms (AOR 3.83, 95% CI 2.13-6.90 and AOR 3.10, 95% CI 1.74-5.51, respectively). Women had higher odds of having depressive symptoms (AOR 1.67, 95% CI 1.23-2.30) than men. Respondents with an annual income of less than US $25,000 (AOR 2.14, 95% CI 1.34-3.41) and US $25,000 to less than US $35,000 (AOR 1.89, 95% CI 1.17-3.06) had higher odds of depressive symptoms than those with an annual income of US $50,000 to less than US $75,000. CONCLUSIONS Our findings provide significant importance especially when considering the compounding, numerous socioeconomic challenges stemming from the pandemic that disproportionately impact the Hispanic and Latino communities. These challenges include rising xenophobia and tensions against immigrants, inadequate access to mental health resources for Hispanic and Latino individuals, and existing hesitations toward seeking mental health services among this population. Ultimately, these findings can serve as a foundation for promoting health equity.

Background: Compared to non-Hispanic Whites, Hispanic Americans have a significantly lower prevalence of peripheral arterial disease (PAD). Since Hispanic ethnicity in the United States is heterogeneous, the purpose of this study was to determine the differential odds for PAD by Hispanic/Latino subgroup. Methods: Subjects were 9,648 men and women over the age of 45 years enrolled in the Hispanic Community Health Study - Study of Latinos (HCHS-SOL) who were evaluated by extensive survey information, relevant physical measurements and fasting blood assays. The ankle brachial index (ABI) was computed as the higher of the posterior tibial and dorsalis pedis systolic blood pressures (SBP) for each leg divided by the higher brachial artery SBP. The index ABI was the lower of the two. An ABI ≤ 0.90 was criterion for the presence of PAD. Results: The mean age was 56 years and 62% were female. Thirty percent were Mexican American, while 27% were Cuban American, 19% Puerto Rican American, 9% Dominican American, 7% Central American, 5% South American and 3% Mixed or Other Hispanic ethnicities. Overall, the prevalence of an ABI ≤ 0.90 (PAD), 0.90 to 0.99 (borderline), 1.0 to 1.39 (normal) and ≥ 1.40 (high) was 5.7, 19.3, 72.5 and 2.6%, respectively. Cuban Americans had the highest prevalence of PAD (9.1%), followed by Puerto Rican (5.9%), Central American (5.3%), Mixed/Other (5.0%), Dominican (4.7%), South American (4.6%) and Mexican Americans (3.2%). The prevalence of an ABI ≥ 1.40 ranged from 3.1% (South Americans) to 0.6% (Mixed/Other). After multivariable adjustment, and compared to Mexican Americans, Cuban Americans had nearly a 3-fold higher odds for PAD (OR = 2.85). The odds of PAD for the other Hispanic/Latino groups ranged from 1.23 to 1.82. Although males had over a 3-fold higher odds of an ABI ≥ 1.40 (OR = 3.55), the odds did not differ significantly by Hispanic/Latino ethnicity. Conclusions: Compared to Mexican Americans, all other Hispanic/Latino ethnic groups have a significantly higher odds of having PAD, with the odds being nearly 3-fold higher among Cuban Americans.

Creatinine levels among Mexican Americans, Puerto Ricans, and Cuban Americans in the Hispanic Health and Nutrition Examination Survey

The Hispanic Health and Nutritional Examination Survey (HHANES) was utilized to examine diabetes-related risk factor variables between and among 3 Hispanic subgroups. The study design that was conducted was descriptive using the HHANES secondary data set. The sample included individuals between 20 and 74 years of age, self-identified as Mexican American, Puerto Rican, and/or Cuban American and had been told by a doctor that they had diabetes. The 5 diabetes-related risk factor variables were obesity measured by body mass index (BMI), hypertension by systolic blood pressure (SBP) and diastolic blood pressure (DBP), hyperlipidemia by cholesterol and triglyceride levels, renal insufficiency by blood urea nitrogen (BUN), and creatinine and fasting plasma glucose. This study demonstrates significant differences between specific subgroups through chi-square. SBP in Cuban Americans was significantly higher than that of Puerto Ricans (28.39 mmHg) and of Mexican Americans (25.94 mmHg). Cuban Americans also had significantly higher cholesterol values than Mexican Americans (88.49 mg/dL) and Puerto Ricans (84.49 mg/dL). The only significant difference for triglyceride was between Mexican Americans and Puerto Ricans (37.25 mg/dL). For BUN, there were significant differences when Cuban Americans (9.06 mg/dL) and Mexican Americans (2.20 mg/dL) were separately compared from Puerto Ricans, and Cuban Americans had significantly higher creatinine values than Puerto Ricans (0.38 mg/dL) and Mexican Americans (0.25 mg/dL). Through linear regression, significant differences for the association of each diabetes-related risk factor and the risk for diabetes complications were computed for each subgroup. For Mexican Americans and Puerto Ricans there were significant differences in overweight BMI (25.0-29.9 kg/m2) and obesity (> or =30.0 kg/m2); for Mexican Americans, Puerto Ricans and Cuban Americans in elevated SBP (130-139 mmHg) or elevated DBP (80-89 mmHg), for high SBP (> or =140 mmHg) or high DBP (> or =90 mmHg), and for high glucose (> or =126 mg/dL); and for Mexican Americans in elevated triglyceride (> or =150 mg/dL), elevated BUN (> or =21 mg/dL), and elevated creatinine (> or =1.5 mg/dL). The findings of this study will add to the diabetes and Hispanic literature highlighting the need to evaluate Hispanic subgroups in future health behavior and outcomes research.

The Hispanic Americans Baseline Alcohol Survey (HABLAS): Rates and predictors of DUI across Hispanic national groups

Background and Aims Ultra-processed foods (UPF) are formulations of ingredients that are mostly of exclusive industrial use and may contain additives like artificial colors, flavors, or stabilizers. The sale and consumption of these foods has been increasing despite their associations with increased risk for several non-communicable diseases including chronic kidney disease. Ultra-processed foods are widely accessible, more shelf-stable and convenient while tending to be more affordable and lower in nutritional quality. The aim of this study was to evaluate trends in kidney function and UPF intake and temporal effect of income among United States (US) adults. Method We used dietary intake data collected with 24-hour dietary recalls from 35160 US adults across 8 cycles of the National Health and Nutrition Examination Survey (NHANES) (from 2003-2004 to 2017-2018 cycles) to categorize intake using the Nova processed food classification system. Poisson regression models were used to assess the 15-year trends in populations at risk for kidney function decline (measured by estimated glomerular filtration rate [eGFR]) and higher percentage of calories from UPF (PC-UPF) consumed along with the temporal effect of income in select subpopulations and adjusted for age and gender and non-linear effects of income and age). Results Over the past 15 years eGFR, PC-UPF, and self-reported income continue to increase among US adults. However, the associations between eGFR, PC-UPF and income are quite complex, vary by subpopulation and non-linearly depend on age. Specifically, among Black adults adjusted for age (age2) and gender, eGFR was the lowest (85 mL/min/1.73 m2, 95% CI: 84.9, 85.0 mL/min/1.73 m2) among those with the lowest ($2,500) and highest ($125,000) income (p = 0.0000000579 for a quadratic term of income), respectively. Hispanic and Mexican Americans also have similar pattern eGFR with the lowest and highest income though the eGFR is consistently higher than White and Black Americans. Across cycles, White Americans with the lowest income ($2,500) have the highest PC-UPF (range: 57-62%, p <2e-16; mean: 59.4%, 95% CI: 59.3, 59.6%) while Black Americans with the lowest ($2,500) and highest income ($125,000) have the highest PC-UPF (range: 53-58%, p <2e-16; mean: 54.8%, 95% CI: 54.3, 55.4%). Income levels does not predict PC-UPF among Mexican Americans. Overall, the PC-UPF is steadily increasing in all population subgroups. Conclusion Among Non-White US adults, higher eGFR was associated with higher income until reaching a group-specific threshold when the relationship reversed. We observed a similar threshold pattern in the association between PC-UPF and income among Black and Hispanic Americans. These complex non-linear relationships between eGFR, PC-UPF and income are driven in part by age-related association and warrant further exploration.

Part 1 Issues and value questions: the issues - an overview, Antonio Furino and Fernando A. Guerra cooperative action for minority health policy, Henry G. Cisneros access to health care for Hispanics, Eli Ginzberg Latino health indicators and the underclass model - from paradox to new policy models, David E. Hayes-Bautista education, productivity and the national future, Ray Marshall. Part 2 Health risks for Hispanics: type II diabetes in Mexican Americans - a public health challenge, Michael P. Stern and Steven M. Haffner major infectious diseases causing excess morbidity in the Hispanic population, Ciro V. Sumaya the health status of US Hispanic children, Fernando S. Mendoza, et al health policy and the elderly Hispanic, David V. Espino and Marta Sotomayor traumatic injury in Hispanic Americans - a distinct entity, Eric Munoz, et al oral health of Hispanics - epidemiology and risk factors, John P. Brown. Part 3 Economic and social considerations: formulating health policy in a multicultural society, David E. Hayes-Bautista health insurance coverage and utilization of health services by Mexican Americans, Puerto Ricans and Cuban Americans, Fernando M. Trevino, et al the economic costs of an unhealthy Latino population, Adela de la Torre and Refugio I. Rochin health care on the US-Mexico border, David C. Warner. Epilogue: searching for solutions, Antonio Furino and Ciro V. Sumaya.

This paper describes the prevalence of total tooth loss, dental caries, and periodontal disease in 2,226 Puerto Ricans, 1,192 Cuban Americans, and 5,983 Mexican Americans, ages five to 74 years, who were examined during the 1982-84 Hispanic Health and Nutrition Examination Survey (HHANES). The prevalence of total tooth loss was 2.60, 6.10, and 2.80 percent among Mexican Americans, Cuban Americans, and Puerto Ricans, respectively. After adjusting for the confounding effects of age, sex, income, and education status, no statistically significant differences were found in the mean number of decayed teeth among the three groups of Hispanics. Puerto Rican children had an average of 2.09 filled teeth compared with an average of 1.39 and 1.43 filled teeth for Mexican Americans and Cuban Americans, respectively. In adults, Puerto Ricans and Cuban Americans had at least 40 percent higher mean number of filled teeth than Mexican Americans. Cuban American and Puerto Rican adults had about twice as many missing teeth as Mexican Americans. The pit-and-fissure tooth surfaces in children accounted for the majority of sites affected by caries. All Hispanics had a higher prevalence of gingivitis than American adults as estimated during the 1985-86 National Institute of Dental Research (NIDR) survey of American adults. Puerto Ricans had the highest level of periodontal disease and the highest Debris Index scores among the Hispanic groups.