El Paso County Research Articles

Exploring Factors Affecting Breastfeeding: Insights From Hispanic and Black Mothers and Healthcare Providers in El Paso, Texas

Objective:Breastfeeding has been shown to have many health benefits to both the infant and the mother. However, there are racial and ethnic disparities in breastfeeding rates across all U.S. states and territories. This study sought to understand the support needed to improve breastfeeding rates and address disparities in El Paso County, Texas using the socioecological model framework for analysis.Methods:We conducted focus groups involving 16 Hispanic and Black mothers. During these sessions, we asked them about the environmental and social factors that influenced their decisions to either start or stop breastfeeding. Additionally, we interviewed six health professionals to gain insights into the support activities they provide to breastfeeding women and identify potential gaps in care.Results:The study found several themes that align with prior research on breastfeeding support: (a) Breastfeeding is recognized as being healthy, but misconceptions exist about formula. (b) Some mothers find public breastfeeding or pumping inappropriate, but opinions vary. (c) Family members significantly influence the decision to breastfeed; their support varies. (d) Although aid from healthcare professionals (HCPs) in breastfeeding is appreciated and valued, it is not always available. (e) HCPs are not uniformly perceived as knowledgeable or helpful, occasionally providing conflicting information. (f) Prenatal classes featuring breastfeeding are appreciated, but the depth of information provided varies. (g) Women seek increased postdischarge support from hospitals. (h) The transition back to work introduces various challenges. (i) Community norms and attitudes toward breastfeeding can be unsupportive. (j) Demand exists for updated, accessible local breastfeeding resources. (k) The Special Supplemental Nutrition Program for Women, Infants, and Children is valued, but there is confusion about services and eligibility requirements. (l) Undocumented immigrants might hesitate to access public services due to concerns about their status.Conclusions:Breastfeeding support programs should take into account the cultural context, the influence of healthcare providers, and the availability of community support. Addressing these aspects can be key to promoting breastfeeding and reducing disparities in breastfeeding rates.

Food Insecurity Cost Estimates for El Paso, Texas

Food insecurity is a fairly pervasive problem throughout the United States that is especially burdensome for low-income regions. While the latter is generally recognized, there have been very few efforts to quantify the dollar costs of food insecurity, especially at the regional level. This study attempts to do so for El Paso County, Texas. This is achieved by first adjusting for inflation cost estimates in a prior national level study. Regional differences with respect to the nation are then utilized to calculate comparable costs for El Paso. Results indicate that the economic damage wrought by food insecurity in El Paso during 2023 exceeded $745 million. That represents nearly 2 percent of total personal income in the county for that year.

Immigrant Culture and Neighborhood Perceived Violent Crime and Violent Victimization: A Multi-Level Test of Enculturation to México, Acculturation to the US, and Support for the Code of the Street

Research on neighborhood immigration and crime rarely tests cultural explanations for the null or inverse associations typically found. We examine if support for the code of the street and measures of immigrant culture (acculturation and enculturation) mediate this relationship. We employ multilevel path modeling and survey data from neighborhoods in El Paso County, Texas, merged with census data. Supporting predictions, enculturation is inversely associated with support for the code of the street and enculturation mediates an indirect relationship between neighborhood immigration and neighborhood violent victimization. However, this relationship does not appear when perceived neighborhood violent crime is used as the dependent variable or the acculturation measure. While the code of the street is positively associated with both perceived neighborhood violent crime and violent victimization, it is not associated with neighborhood immigration and does not serve as a mediator. Implications for cultural explanations of the neighborhood immigration-crime association are discussed.

Immigration and Physical Discipline of Children: The Influence of Generational Status and Culture

ABSTRACTThis research examines whether physical punishment towards children in Méxican immigrant and native‐born Latinx families of Mexican heritage households varies across immigrant generational status and if physical punishment is associated with important measures of culture: familismo, traditional machismo, acculturation to the United States and enculturation to México. Data from a sample of households in El Paso County, Texas, are analysed using Firth logistic regression. Findings show that physical punishment is lowest in first‐generation immigrant households but, in sharp contrast, highest in 1.5‐generation immigrant households, suggesting the need for more precise measurement of immigration status as such differentiation can be masked with a more general approach to measuring immigrant generation. Findings also indicate that enculturation to México is protective towards physical punishment, while measures of acculturation, familismo and traditional machismo are not associated with this behaviour in multivariate models.

Skull of a new periptychid mammal from the lower Paleocene Denver Formation of Colorado (Corral Bluffs, El Paso County)

The Periptychidae, an extinct group of archaic ungulates (‘condylarths’), were the most speciose eutherian mammals in the earliest Paleocene of North America, epitomizing mammalian ascendency after the Cretaceous–Paleogene (K–Pg) mass extinction. Although periptychids are mostly known from fragmentary gnathic remains, the Corral Bluffs area within the Denver Basin, Colorado, has yielded numerous exceptionally well-preserved mammalian fossils, including periptychids, from the earliest Paleocene. Here we describe a partial cranium and articulated dentaries plus an additional unassociated dentary fragment of a small-bodied (~273–455 g) periptychid from ca. 610 thousand years after the K–Pg mass extinction (Puercan 2 North American Land Mammal ‘age’) at Corral Bluffs. Based on these new fossils we erect Militocodon lydae gen. et sp. nov. The dentition of M. lydae exhibits synapomorphies that diagnose the Conacodontinae, but it is plesiomorphic relative to Oxyacodon, resembling putatively basal periptychids like Mimatuta and Maiorana in several dental traits. As such, we interpret M. lydae as a basal conacodontine. Its skull anatomy does not reveal clear periptychid synapomorphies and instead resembles that of arctocyonids and other primitive eutherians. M. lydae falls along a dental morphocline from basal periptychids to derived conacodontines, which we hypothesize reflects a progressive, novel modification of the hypocone to enhance orthal shearing and crushing rather than grinding mastication. The discovery and thorough descriptions and comparisons of the partial M. lydae skull represent an important step toward unraveling the complex evolutionary history of periptychid mammals.

Social Concern Theory and Family Violence Among Latino Families.

This paper examines whether Agnew's Social Concern Theory can be applied to explain family violence perpetration among Latino families. Social concern theory maintains that people have biological inclinations to care for the welfare of others, desire close ties with certain individuals, follow certain moral intuitions, and conform to the behaviors of others. As such, this study tests whether an individual's social capital (care about the welfare of others), familismo (desire for close ties), code of the streets (moral intuitions), and obligation to obey the police (conformity to social norms) is associated with family violence among a Latino sample. Using data from the El Paso Neighborhood Survey Project, which surveyed a random sample of 1,059 adults living in El Paso County, Texas in 2014, findings indicate that three of out of four theoretical constructs in the final model were found to be significant. Higher levels of social capital and familismo were associated with lower odds of perpetrating family violence, while code of the streets increased family violence. Obligation to obey the police was non-significant. Agnew's theory modestly explained family violence among Latino families.

Notes from the Field: A Cluster of Multi-Strain Invasive Pneumococcal Disease Among Persons Experiencing Homelessness and Use of Pneumococcal Conjugate Vaccine - El Paso County, Colorado, 2022.

Notes from the Field: A Cluster of Multi-Strain Invasive Pneumococcal Disease Among Persons Experiencing Homelessness and Use of Pneumococcal Conjugate Vaccine - El Paso County, Colorado, 2022.

A Socio-Ecological Approach to A Community-Based Health Promotion Intervention on the U.S.-Mexico Border: Insights and Lessons Learned During the COVID-19 Pandemic

The Healthy Families Healthy Kids Initiative (HFHKI) is a community-based initiative developed based on the socio-ecological model to address preventive health care needs in El Paso County, Texas, one of the most economically and health-challenged border communities in the United States. HFHKI’s three main goals are to increase access to experiential learning and health education, service delivery, and sustainable systems/linkages of care. These were accomplished through seven critical activities. We present the rationale, background, setting, and conceptual framework for the initiative, followed by the methods used to develop and assess the success of the activities and results of our project outcomes. We end with a discussion of lessons learned and future directions. We also share insights gained from our community health promotion intervention during the COVID-19 pandemic, which will enrich current conversations among applied social scientists. Overall, our project served 2,347 participants of all age ranges during our first year of project implementation across all 7 activities. We recommend the use of the socio-ecological model in designing, implementing, and improving health interventions aimed at enhancing family and community health, with each intervention tailored to the needs of different segments of the community. While the need to contain the COVID-19 virus amid the pandemic has created challenges in health promotion efforts, the need to help affected communities regain control of their health cannot be stressed enough. Our project can serve as an implementation framework for community-based projects on the U.S.-Mexico border.

Immigrant status and the desire for a low profile from police

ABSTRACT Research into immigrant behaviors continues to expand as scholarship explores mechanisms surrounding the immigrant-crime paradox. An important and underexplored area in quantitative research surrounds low profile behaviors. The term “low profile” refers to a set of behaviors that immigrants and immigrant groups adopt to reduce or mitigate exposure to a variety of risky environments and institutional threats, particularly the police. This study explores the relationship between immigrant statuses and low profile behaviors in communities using data from El Paso County, Texas neighborhoods. El Paso offers unique insight into a binational border context that has historically welcomed immigrants and immigrant groups. The results suggest that being a first-generation immigrant predicts the belief that neighbors are likely to keep a low profile from the police; however, once culture and neighborhood-level factors are taken into consideration, this effect wanes. These findings emphasize the importance of low profile behaviors for future study.

An integrated ecological approach to countering targeted violence on the U.S.-Mexico border: Insights and lessons learned

Well-integrated and productive communities are an asset to the development and advancement of our nation, and they have an important role to play in planning, learning, and enforcing safety to enhance national and border security. REACH (Resilience, Education, Action, Commitment, and Humanity) is a community-based project housed at The University of Texas at El Paso that aims to prevent targeted violence and domestic terrorism in El Paso County. We integrated three frameworks (i.e., Whole Community Preparedness, Socio-Ecological Model, and Global Citizen Education) to involve local residents in efforts to combat and mitigate targeted violence. REACH had two goals: to (1) prevent targeted violence and domestic terrorism through education, outreach, and community capacity-building aimed at identifying and deterring radicalization (primary prevention) and (2) reduce the short-term and long-term impact and prevent re-occurrence of targeted violence and domestic terrorism (secondary and tertiary prevention). Overall, our project served 8,934 participants directly and reached many more through our media cavmpaigns and outreach efforts during our 2 years of project implementation (2021–2023). Our project design may serve as an implementation model for other community-based projects on the U.S.-Mexico border and can be replicated with other target populations in the U.S. Insights and lessons learned from this project are discussed.

Systems-Level Evaluation of Safe Routes to School Policies in El Paso, Texas: A Modeling Study on Health and Economic Outcomes.

Safe Routes to School (SRTS) policies are linked to physical health benefits for school-age children; however, few studies have assessed long-term impacts on cardiovascular disease (CVD). This study used systems science methods to predict long-term health and economic impact of SRTS among school-age children in El Paso County, Texas. We developed an agent-based model containing 2 modules: the pedestrian injury module and the CVD module. We simulated 10 000 school-age children under 2 scenarios-SRTS policies implemented and no SRTS policies implemented-and then calculated pedestrian injuries, pedestrian injury-related deaths, coronary heart disease (CHD) and stroke events, and health care costs. When SRTS policies were implemented, the model estimated 157 fewer CHD cases and 217 fewer stroke cases per 10 000 people and reduced CVD-related health care costs ($13 788 per person). The model also predicted 129 fewer pedestrian injuries and 1.3 injury-related deaths per 10 000 people and $2417 savings in injury-related health care costs. SRTS could save an estimated $16 205 per person in health care costs. This simulation shows SRTS in El Paso County could prevent pedestrian injuries among school-age children and protect cardiovascular health in the long term. Our findings provide evidence for practitioners and policy makers to advocate for SRTS policies at the local level.

Equitable bivalent booster allocation strategies against emerging SARS-CoV-2 variants in US cities with large Hispanic communities: The case of El Paso County, Texas.

COVID-19 is a disease that disproportionately impacts the Hispanic population, due to the prevalence of certain risk factors and the high number of essential workers in this community. In this work, we analyze the vaccination strategies that would minimize the COVID-19 health disparities in El Paso County, TX, in the context of the emergence of a new highly transmissible and immune-escaping SARS-CoV-2 variant. We stratify an age-structure stochastic SEIR model that tracks the evolution of immunity derived from infections and vaccination according to Hispanic vs non-Hispanic ethnicity and parameterize it to the demographic, health and immunization data of El Paso County, TX. After fitting the model, the results show that increasing vaccination with bivalent boosters by five-fold in anticipation of highly transmissible and immune escaping variants would decrease the cumulative hospital admissions and mortality from Mar 1, 2023, to Dec 31, 2023, by 62.72% and 61.41%, respectively. Further, our projections reveal that the disproportionate impact on the Hispanic community would be eliminated if approximately half of the doses that are given to the non-Hispanic group according to the equal distribution, would be re-allocated to the Hispanic population. Our findings can guide public health officials in US cities with large Hispanic communities and help them design vaccination strategies that minimize COVID-19 health disparities caused by emerging variants using specific vaccination strategies.

Mediation Analysis of Maternal Smoking, Gestational Age, and Birth Weight on the Texas-Mexico Border.

Published data on the indirect effect of maternal smoking on birth weight as mediated by gestational age in Hispanic populations are lacking. Our goal was to conduct such a mediation analysis using data from El Paso County, Texas. El Paso County is located on the US-Mexico border. A simple mediation analysis was conducted using year 2010 El Paso County birth certificate data. The SAS macro PROCESS 3.5.3 was used to estimate the direct and indirect effects of active maternal smoking (by trimester) on birth weight (in grams) in the setting of linear regression. The single mediator was gestational age in weeks. A direct or indirect effect was deemed to be present if the 95% confidence limits (CLs) excluded 0. Analyses were adjusted for multiple variables, including maternal prepregnancy body mass index. The indirect effect was reported along with a 95% bootstrap CL. A total of 16,654 singleton births were included in the cohort. The majority of the mothers were White Hispanic (87.2%). The mean (standard deviation) birth weight was 3198.6 g (517.2). A direct effect of maternal smoking during each trimester on birth weight was detected. An indirect effect of maternal smoking on birth weight was not detected in any of the trimesters. In adjusted analyses for the third trimester, the indirect effect for every 1-U increase in the mean number of cigarettes smoked per day was -4.18 (95% bootstrap CL -10.64 to 1.99). In our large, predominantly Hispanic cohort, it appears that gestational age is not a mediator of the effect of maternal smoking on birth weight. Future studies in our population should explore other possible mediators of this association.

The Impact of Community Health Information Exchange Usage on Time to Reutilization of Hospital Services.

Few studies have determined whether clinician usage of a community health information exchange (HIE) directly improves patient care transitions. We hypothesized that lookup in the HIE by primary care physicians of patients recently released from the hospital would increase the time until hospital reuse. We identified a retrospective cohort of 8,216 hospital inpatients aged over 18 years that were discharged from January 1, 2021 through November 30, 2021 using the Paso del Norte Health Information Exchange, in El Paso County, Texas. All patients had a primary care physician visit within 30 days after hospital discharge, and we identified patients that were looked up in the HIE close to that visit. Of the cohort, 2,627 were rehospitalized and 3,809 visited an emergency department (ED) during the follow-up window. The remaining 1,780 patients were controls. We conducted survival analysis, censoring at the second ED or inpatient visit or end of the study window (January 31, 2022). The model was adjusted by ethnicity, gender, insurance, and age. Lookup in the HIE was significantly associated with reducing the likelihood of visiting the ED by 53% and being rehospitalized by 61%. Lookup in the HIE was associated with an increased median time to use of the ED after inpatient discharge from 99 to 238 patient days. Ethnicity, insurance, gender, and age were also significant predictors of hospital reuse. Increased utilization of community HIEs by primary care physicians on behalf of their recently discharged patients may dramatically increase the time until inpatient or ED reuse.

Leveraging Community Context, Data, and Resources to Inform Suicide Prevention Strategies.

Colorado has consistently had one of the highest rates of suicide in the United States, and El Paso County has the highest number of suicide and firearm-related suicide deaths within the state. Community-based solutions like those of the Suicide Prevention Collaborative of El Paso County may be more effective in preventing suicide as they are specific to local issues, sensitive to local culture, and informed by local data, community members, and stakeholders.

Estimating historical exposure to perfluoroalkyl acids in Security, Fountain, and Widefield Colorado: use of water-infrastructure blending and toxicokinetic models.

Drinking water can be a major source of poly- and perfluoroalkyl substance (PFAS) exposure for humans. The lack of historic data on PFAS drinking-water concentrations and consumption patterns are a limiting factor for developing estimates of past exposure. Here, in contribution to a community-scale PFAS health effects study near fire training facilities that contaminated a local aquifer with PFASs, we present a novel water-infrastructure, mass-balance mixing model coupled to a non-steady state, single-compartment toxicokinetic model that used Monte Carlo simulations to estimate the start of PFAS exposure in drinking water for individuals within three PFAS-impacted communities in El Paso County, Colorado. Our modeling focused on perfluorohexane sulfonic acid (PFHxS) because median serum PFHxS concentrations in a sample of local residents (n = 213) were twelve times the median observed in the U.S. National Health and Nutrition Examination Survey (2015-2016). Modeling results for study participants were grouped according to their community of residence, revealing a median start of exposure for the town of Fountain of 1998 (25-75% interquartile range [IQR], 1992 to 2010), 2006 (IQR 1995 to 2012) for Security, and 2009 (IQR 1996-2012) for Widefield. Based on the towns' locations relative to an identified hydraulically upgradient PFAS source, the modeled exposure sequencing does not completely align with this conceptual flow model, implying the presence of an additional PFAS source for the groundwater between Widefield and Fountain.

Application of Regularized Logistic Regression and Artificial Neural Network Model for Ozone Classification across El Paso County, Texas, United States

Application of Regularized Logistic Regression and Artificial Neural Network Model for Ozone Classification across El Paso County, Texas, United States

Who discovers the firearm suicide decedent: an epidemiologic characterization of survivor-victims

BackgroundSuicide is the tenth leading cause of death in the United States, with over half of cases involving firearms. Despite research indicating negative effects of exposure to suicide, there is little research on who typically finds the body of the suicide decedent. Understanding who finds the body of the suicide decedent may be important to understand trauma and mental health effects.FindingsOf the 332 people who died by suicide in El Paso County, Colorado, 182 (55%) used firearms. Those who died by firearm suicide were more likely to be male (83.5% vs. 67.3%) have military affiliation (39.0% vs. 19.3%) and were less likely to have a known mental health diagnosis (47.3% vs. 64.7%) compared to those who died from other means. Most suicide decedents were found by a family member or friend (60.2%). The remaining decedents were found by a stranger/acquaintance (21.0%) or a first responder (22.4%) One-fifth of suicides involved forced witnessing (19%) and the majority were already deceased when the body was discovered (73.2%).ConclusionsWhile most suicide decedents are discovered by a family member or a friend, it is unknown what the bereavement and trauma-related outcomes are among people who discover a suicide decedent who has died by violent means, especially by firearms. Further studies exploring who discovers suicide decedents and targeted postvention strategies for supporting impacted family, friends, first responders, and strangers are needed.

Smoke-Free Policy Adoption in Horizon City and El Paso Community College: A Strategic Campaign Approach That Turns a "No" Into a "Yes".

Coalitions in Horizon City in El Paso County, Texas and the El Paso Community College (EPCC) had previously attempted to pass smoke-free policies in 2008 and 2016, respectively; however, both policies failed to pass at those times. The coalitions refocused their activities and were successful in passing policies in EPCC in 2020 and in Horizon City in 2021. We employed a participatory case study method to understand what factors changed between the first and second attempts at smoke-free policy adoption in Horizon City and EPCC. Using the Advocacy Coalition Framework as a basis for analysis, we identified the role of coalitions, their beliefs, use of power resources, role of policy brokers, and external events. We identify best practices and make recommendations for coalitions seeking to adopt smoke-free policies in other locations.

The Use of a SWOT Analysis to Evaluate a COVID-19 Mitigation Project in the Paso del Norte Region.

A SWOT (strengths, weaknesses, opportunities, and threats) analysis is a strategic planning and management technique used for project planning. It is sometimes called situational assessment or situational analysis. We applied this tool (with some adaptations) effectively in a health promotion/public health education intervention project in the Paso del Norte region. This region is composed of a predominantly Hispanic population and is marked by a dynamic flow of residents across the border. In this milieu, COVID-19 has disproportionately impacted communities of color and individuals who are economically and socially marginalized. The University of Texas at El Paso (UTEP) has partnered with the National COVID-19 Resilience Network (NCRN) to mitigate the impact of COVID-19 among farm and food production workers (i.e., farmworkers, dairy, and meat packing workers) in El Paso, Doña Ana, and Moore counties. Intervention strategies include: (1) providing culturally and linguistically appropriate COVID-19 information, (2) disseminating protective equipment, and (3) ensuring access to COVID-19 vaccines. After completing year 1 of the project, we conducted a multiple-level SWOT analysis to evaluate, gather insights, and develop actionable strategies that would allow better service delivery to our priority population. We provide this case study to illustrate how a SWOT analysis can be a useful tool for practitioners engaged in the practice of evaluating health promotion and disease prevention programs. Even when attention and energy is absorbed in the immediate course of action, a SWOT analysis can help to achieve positive and effective collaborations resulting in strong service levels.