Foreign-born Mexican Americans Research Articles

Propensity Scores in Health Disparities Research: The Example of Cognitive Aging and the Hispanic Paradox.

Individuals of Mexican ancestry in the United States experience substantial socioeconomic disadvantages compared with non-Hispanic white individuals; however, some studies show these groups have similar dementia risk. Evaluating whether migration selection factors (e.g., education) associated with risk of Alzheimer disease and related dementia (ADRD) explain this paradoxical finding presents statistical challenges. Intercorrelation of risk factors, common with social determinants, could make certain covariate patterns very likely or unlikely to occur for particular groups, which complicates their comparison. Propensity score (PS) methods could be leveraged here to diagnose nonoverlap and help balance exposure groups. We compare conventional and PS-based methods to examine differences in cognitive trajectories between foreign-born Mexican American, US-born Mexican American, and US-born non-Hispanic white individuals in the Health and Retirement Study (1994-2018). We examined cognition using a global measure. We estimated trajectories of cognitive decline from linear mixed models adjusted for migration selection factors also associated with ADRD risk conventionally or with inverse probability weighting. We also employed PS trimming and match weighting. In the full sample, where PS overlap was poor, unadjusted analyses showed both Mexican ancestry groups had worse baseline cognitive scores but similar or slower rates of decline compared with non-Hispanic white adults; adjusted findings were similar, regardless of method. Focusing analyses on populations where PS overlap was improved (PS trimming and match weighting) did not alter conclusions. Attempting to equalize groups on migration selection and ADRD risk factors did not explain paradoxical findings for Mexican ancestry groups in our study.

Metabolic Risk and Depression among Elderly Mexican Americans: The Roles of Nativity Status.

To evaluate the relationship between metabolic risk (MR) and depression in a sample of older Mexican Americans and examine whether the association differs by age at migration. Longitudinal study using data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly (HEPESE) (N=807, mean age = 84.3). The analytical sample was compiled from wave 6 (2007) to wave 7 (2010-2011) of HEPESE. Random-effect logistic regression examined the association between MR and depression and tested the model stratified by nativity status and age at migration. MR was associated with higher odds of depression for US-born Mexican Americans after controlling for potential confounders. Similarly, among Mexican Americans who migrated before age 20, MR was associated with higher odds of depression. The findings highlight the importance of age at migration when evaluating the health of foreign-born Mexican Americans from a life-course perspective. Particularly among Mexican Americans who migrated before age 20, those with MR were more vulnerable to depression than their counterparts without MR.

Cognitive Factors Associated with Frequency of Eating Out and Eating Takeout among Latinas

Higher frequency of eating outside the home can be an unhealthy behavior that may contribute to higher rates of obesity among Latinas, a disproportionately affected group. There is a growing need to understand potentially modifiable factors (eg, dispositional mindfulness, self-efficacy, nutrition knowledge) associated with higher frequency of eating outside the home in this population. This study assessed associations of cognitive factors (ie, dispositional mindfulness, self-efficacy of eating and purchasing healthy foods, nutrition knowledge) with frequency of eating out among Latinas. A secondary analysis was performed of data from a cross-sectional study of Latinas between February and May 2015. The study comprised a convenience sample of 218 Spanish- or English-literate Latinas, between the ages of 18 and 55 years, who lived in South or East Los Angeles and self-identified as the primary person responsible for grocery shopping in the household. Most participants identified as foreign-born Mexican Americans. Frequency of eating out was assessed as the outcome variable, and three cognitive variables (mindfulness disposition, self-efficacy, nutrition knowledge) served as independent variables. Multinomial models assessed the association between cognitive factors and frequency of eating out. Models were adjusted for age, English-speaking ability, income, having an obesity-related disease (ie, overweight or obesity, diabetes, high blood pressure, cardiovascular disease), household size, and education level. For every 1-unit increase in mindfulness disposition, the risk of a participant eating out every week compared with every month decreased by a factor of 0.42 (relative risk ratio [RRR] = 0.58, P < 0.01). For every 1-unit increase in self-efficacy, the risk of a participant eating out every week compared with every month decreased by a factor of 0.32 (RRR = 0.68, P < 0.05), and the risk of a participant eating out every 2 weeks compared with every month decreased by a factor of 0.44 (RRR = 0.56, P < 0.05). For every 1-unit increase in nutrition knowledge, the risk of a participant eating out every week compared with every month increased by a factor of 1.42 (RRR = 1.42, P < 0.01). Lower dispositional mindfulness was associated with higher frequency of eating out when comparing individuals who ate out at least every week with those who ate out once a month or less or every 2 weeks. Lower self-efficacy was associated with eating out more when comparing those who ate out once a month or less with those who ate out at least every week or every 2 weeks. Lower nutrition knowledge was associated with lower frequency of eating out for participants who ate out once a month or less compared with those who ate out at least every week.

METABOLIC SYNDROME AND LATE-LIFE DEPRESSION AMONG MEXICAN AMERICANS: THE ROLE OF NATIVITY

Metabolic syndrome (MS) has been reported to predict depression. However, studies evaluating if there are differences by nativity status among Mexican Americans are scarce. This study aims to examine the association between metabolic syndrome and depression among Mexican-American older adults. We also evaluated the role of nativity, sociodemographic and health risk factors. We use three waves (2006-2013) from the Hispanic Established Populations for the Epidemiologic Study of the Elderly (HEPESE; N=1,542, mean age =83.45 in 2006). MS was defined according to the National Cholesterol Education Programme (NCEP-ATP III) using abdominal obesity, use of antihypertensive medication, and insulin. Depression was ascertained by self-report of a CES-D score greater than 16. We applied random-effect logistic regression models which accounted for inter-individual correlation and adjusted for age, sex, education, smoking, alcohol use, physical performance, and self-esteem. We also tested for interaction between MS and nativity. Approximately 30% of foreign-born and 22% of US-born reported depression. The prevalence of MS was higher in the Foreign-born when compare to the US-born (5.89% vs. 5.35%). In the total sample, MS was associated with a higher risk of depression (OR=4.34, p=0.007). Foreign-born Mexican Americans were more likely to have depression (OR=1.70, p=0.002) when compared to US-born; however, foreign-born with MS reported lower depression (OR=0.26, p=0.052) after adjusting for potential confounders. Our finding adds to the concept of “metabolic depression,” and further highlights the importance of evaluating nativity to explain the differences in physical and psychological health among a sample of the Hispanic population at old age.

NATIVITY AND DISABILITY TRAJECTORIES AMONG TWO COHORTS

Nativity is an important characteristic in the context of disability in older adults, as it may influence attitudes and behaviors that can delay or accelerate the disability process. This study aims to assess trajectories of disability (defined as lower-body functional limitations, limitations in daily and instrumental activities of daily living, and gross mobility) in foreign-born and US-born Mexican Americans between 1993 and 2013. We used eight waves (1993 -2013) from the Hispanic Established Populations for the Epidemiologic Study of the Elderly (HEPESE; N=3050, mean age at baseline=73.6 (±6.8). Disability was assessed using self-reported limitations in activities of daily living (ADL /IADL). Nativity and age-at-migration were collected by self-report. We used linear and quadratic growth curve models to evaluate the trajectory of ADL/IADL disability over a period of 20 years and assessed variations by nativity status while adjusting for potential confounders. Approximately 19% of foreign-born and 17% of US-born reported having at least one ADL, while 51.5% natives and 58.7% of foreign-born had at least one IADL. Our results showed that after controlling for age at baseline, sex, marital status, self-reported health, chronic conditions, and education, foreign-born older adults were less likely to have ADL/IADL disability at baseline, but exhibited a faster rate of increase in disability over time (β =0.31 for ADL, β=0.07 for IADL). Our findings show that foreign-born older adults are accumulating disability at faster compared with their native peers, highlighting the importance of evaluating nativity differences in the health outcomes of Hispanic population at old age.

Social Determinants of Polypharmacy in First Generation Mexican Immigrants in the United States.

Socioeconomic status (SES) indicators are among the main social determinants of health and illness. Less, however, is known about the role of SES in the epidemiology of polypharmacy in immigrant Latino Americans living in the United States. This research studied the association between three SES indicators, education, income, and employment, and polypharmacy in older first generation Latino American immigrant adults. Data was obtained from the Sacramento Area Latino Study on Aging (SALSA, 1996-2008). A total of 632 older first generation Mexican-American immigrants to the U.S. entered this analysis. The independent variables were education, income, and employment. Polypharmacy was the outcome. Age, gender, physical health, smoking, and drinking were the covariates. Binary logistic regression was used to analyze the data. Employment was associated with lower odds of polypharmacy. The association between education and polypharmacy was above and beyond demographic factors, physical health, health behaviors, and health insurance. Neither education nor income were associated with polypharmacy. Other determinants of polypharmacy were poor self-rated health (SRH) and a higher number of chronic medical conditions (CMCs). Employment appears to be the major SES determinant of polypharmacy in older foreign-born Mexican Americans. Unemployed older Mexican American immigrants with multiple chronic diseases and those who have poor SRH have the highest need for an evaluation of polypharmacy. Given the age group of this population, most of them have health insurance, which provides an opportunity for reducing their polypharmacy.

The Relationship Between Educational Attainment and Health Care Access and Use Among Mexicans, Mexican Americans, and U.S.-Mexico Migrants.

The aim of the study was to assess the relationship between educational attainment and health care access and use among Mexican-origin populations. Data from the 2012 Mexican National Health and Nutrition Study, the 2013 Project Migrante Health Care Access and Utilization Survey, and the 2013-2014 California Health Interview Survey were used to examine educational gradients in health insurance, medical home, and hospitalization among Mexicans in Mexico, northbound, southbound, and deported migrants, and U.S.-and foreign-born Mexican Americans. College graduates had greater odds of being insured relative to those with less than a high school degree among Mexicans (AOR = 1.48, p < 0.001), northbound migrants (AOR = 3.69, p < 0.001), and the foreign-born (AOR = 2.01, p < 0.01), and of having a medical home among Mexicans (AOR = 1.95, p < 0.001) and the foreign-born (AOR = 2.14, p < 0.05). Eliminating differences by educational attainment in the U.S. will require policy changes like making immigrants eligible for public insurance. In Mexico, it will require targeted outreach to enroll underserved populations in existing public insurance programs.

Substance Use and Psychiatric Disorders Among Mexican Americans and Non-Hispanic Whites by Immigration Status.

To compare prevalence rates of alcohol, nicotine, and other drug use and major psychiatric disorders (major depressive disorder, persistent depression, bipolar I disorder, agoraphobia, social and specific phobias, and antisocial, schizotypal, and borderline personality disorders) between US-born and foreign-born Mexican Americans and non-Hispanic whites and between early entry versus later-entry foreign-born Mexican Americans and non-Hispanic whites. Data were derived from face-to-face interviews in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (N = 36,309). US-born Mexican Americans and US-born non-Hispanic whites were at greater risk (P < .05) of alcohol, nicotine, and any drug use and their associated disorders and other DSM-5 psychiatric disorders relative to their foreign-born counterparts. US-born non-Hispanic whites were more likely (P < .05) to use substances and develop many psychiatric disorders relative to US-born Mexican Americans. Foreign-born Mexican Americans < 18 years old at immigration were at greater risk of drug use, drug use disorders, and nicotine use disorder compared with foreign-born Mexican Americans ≥ 18 years old at immigration. Foreign-born non-Hispanic whites < 18 years old at immigration were more likely to use substances and to develop many psychiatric disorders relative to foreign-born non-Hispanic whites ≥ 18 years old at immigration. Taken together, the findings of this study support the healthy immigrant hypothesis and adverse role of acculturation for US-born and foreign-born Mexican Americans and non-Hispanic whites. Further research is warranted on immigration status and age at arrival into the United States and those processes underlying differential exposure to substances and development of psychiatric conditions. An understanding of these processes can be invaluable to clinicians in guiding culturally sensitive and informed prevention and intervention efforts.

ORAL HEALTH DISPARITIES AMONG OLDER ADULTS: RACE/ETHNICITY, LIFESTYLE, AND STRUCTURAL ACCESS TO CARE

Poor oral health is associated with lower quality of life in older adulthood. Although everyone experiences age-related declines in oral health, those with social and economic disadvantages experience more rapid decline and at younger ages. Yet gerontologists have given little systematic attention to documenting these disparities. Using data from the NHANES III (1988–1994) for White, Black, and Mexican-origin adults ages 50 to 70 (N= 2,320/ 1,243/1,171), we examine predictors of three indicators of oral health: no natural teeth; fair/poor self-rated oral health; irregular dentist visits. Multivariate logistic regression models indicate that White older adults have a higher likelihood of no natural teeth but Black and Mexican American older adults have greater rates of fair/poor oral health and irregular dentist visits. Those with less education and income have worse oral health. Those who ever smoked, or currently consume high levels of sugar drinks are more likely to have fair/poor oral health. Foreign-born Mexican Americans are least likely to have regular dentist visits. Black men who served in the military are significantly more likely to have regular dental visits and more natural teeth, but not White or Mexican Americans. Our findings demonstrate substantial social and economic influences on oral health among older adults and important disparities between race and ethnic groups in the United States. Premature decline in oral health is yet another consequence of a lifetime of low socioeconomic status and limited access to health care.

Does the Immigrant Advantage in Overweight/Obesity Persist over Time in Mexican American Youth? NHANES 1988-1994 to 2005-2014.

ObjectivesTo examine whether the relationship between nativity and overweight/obesity has changed over time among Mexican-American children and to investigate the implications of this pattern on overweight/obesity disparities relative to non-Hispanic Whites.MethodsUsing cross-sectional data from Mexican-Americans and non-Hispanic white children ages 4–17 years participating in the National Health and Nutrition Examination Surveys (1988–1994 (N=4,720) and 2005–2014 (N=7,275), we used log-binomial regression to calculate prevalence ratios (PR) of overweight/obesity by nativity status adjusting for sociodemographic covariates, survey period and a nativity by survey period interaction. In a separate covariate-adjusted model, we also tested a 3-level ethnicity-nativity by survey period interaction that included non-Hispanic Whites.ResultsIn 1988–1994, foreign-born Mexican-Americans had significantly lower prevalence of overweight/obesity compared to U.S.-born Mexican-Americans (PR=0.75, 95% CI: 0.61, 0.94). However, by 2005–2014, the nativity gap in overweight/obesity closed (PR=0.94; 95% CI: 0.84, 1.07). Moreover, while foreign-born Mexican-Americans had the lowest levels of overweight/obesity in 1988–1994, by 2005–2014, foreign-born and U.S.-born Mexican-Americans had comparable estimates, both significantly higher than that of non-Hispanic Whites.ConclusionsAlthough overweight/obesity disparities between Mexican-Americans and non-Hispanic Whites had previously been specific to U.S.-born Mexican-Americans, disparities in recent years have extended to foreign-born Mexican-Americans.

The Hispanic Paradox: Race/Ethnicity and Nativity, Immigrant Enclave Residence and Cognitive Impairment Among Older US Adults.

Hispanics, and particularly foreign-born Mexican Americans, have been shown to fare better across a range of health outcomes than might be expected given the generally higher levels of socioeconomic disadvantage in this population, a phenomena termed the "Hispanic Paradox". Previous research on social disparities in cognitive aging, however, has been unable to address both race/ethnicity and nativity (REN) in a nationally-representative sample of US adults leaving unanswered questions about potentially "paradoxical" advantages of Mexican ethnic-origins and the role of nativity, socioeconomic status (SES), and enclave residence. We employ biennial assessments of cognitive functioning to study prevalent and incident cognitive impairment (CI) within the three largest US REN groups: US-born non-Hispanic whites (US-NHW), US-born non-Hispanic blacks (US-NHB), US-born Mexican Americans (US-MA), and foreign-born Mexican Americans (FB-MA). Data come from a nationally-representative sample of community-dwelling older adults in the Health and Retirement Study linked with the 2000 Census and followed over 10years (N=8,433). Large disadvantages in prevalent and incident CI were observed for all REN minorities respective to US-born non-Hispanic whites. Individual and neighborhood SES accounted substantially for these disadvantages and revealed an immigrant advantage: FB-MA odds of prevalent CI were about half those of US-NHW and hazards of incident CI were about half those of US-MA. Residence in an immigrant enclave was protective of prevalent CI among FB-MA. The findings illuminate important directions for research into the sources of cognitive risk and resilience and provide guidance about CI screening within the increasingly diverse aging US population.

The Role of Physical Activity and Sedentary Behaviors in Explaining the Association Between Acculturation and Obesity Among Mexican-American Adults.

We investigated associations of acculturation with various types of activity (moderate-vigorous leisure-time physical activity [LTPA], moderate-vigorous work- and transportation-related physical activity, and sedentary activity), and whether these activities mediated the acculturation-obesity association among Mexican-Americans. Cross-sectional. National Health and Nutrition Examination Survey (NHANES) 2007-2010. Mexican-American NHANES participants aged ≥20 years (n = 1902). Demographic characteristics, physical activity, sedentary behavior, acculturation, and body mass index. Multinomial logistic regression was used to estimate associations of acculturation with categories of self-reported activity. Path analysis was used to test whether the activity measures mediated acculturation-obesity associations. In adjusted models, compared to U.S.-born Mexican-Americans, foreign-born Mexican-Americans living in the United States for less than 10 years were significantly less likely to be in the highest LTPA and sedentary activity categories, and more likely to be in the highest total and transportation activity categories. Foreign-born Mexican-Americans living in the United States for 10 years or more were significantly less likely to engage in high sedentary activity but more likely to engage in high transportation activity. Sedentary behavior was the strongest mediator of the acculturation-obesity association, accounting for 40.7% and 57.1% of the total effect of acculturation on obesity among foreign-born Mexican-Americans living in the United States for less than 10 years and for 10 years or more, respectively, compared to U.S.-born Mexican-Americans. Reducing sedentary behavior may lower the negative impact of acculturation on obesity.

Marriage, race/ethnicity, and psychological distress among foreign-born Chinese, Korean, Mexican, and Vietnamese Americans

ABSTRACTThe association between marriage and psychological distress has been well documented; however, whether race/ethnicity moderates this relationship remains vastly understudied. Our study investigated the effect of race/ethnicity on relationship between marriage and psychological distress among four groups of foreign-born Americans. Using the data from the 2009 California Health Interview Survey, we employed multivariate analyses to test the effect of interaction between marriage and race/ethnicity on psychological distress among foreign-born Mexicans (N=3,752), Chinese (N=812), Koreans (N=857) and Vietnamese (N=1,354). The analysis revealed that marriage significantly interacts with race/ethnicity in impacting psychological distress (F (7, 73) = 2.48, p < .01). Unmarried Mexicans (4.250, 95% CI = 3.566, 4.934) and unmarried Chinese (3.833, 95% CI = 2.738, 4.929) had a statistically greater average of psychological distress than married Mexicans (3.324, 95% CI = 3.124, 3.523) and married Chinese (2.591, 95% CI = 1.988, 3.184). Racial differences in terms of marital status and psychological distress existed only between married Chinese and Mexicans and between unmarried Mexicans and Vietnamese participants. Results highlight consideration for racial and ethnic differences in the association of marriage and psychological distress among these groups for culturally sensitive interventions.

The association between personality traits and body mass index varies with nativity among individuals of Mexican origin

Personality traits have been associated consistently with health-related outcomes, but less is known about how aspects of the sociocultural environment modify these associations. This study uses a sample of participants of Mexican origin (N = 1013) to test whether exposure to the United States, indexed by nativity (Mexicans living in Mexico, foreign-born Mexican Americans, and U.S.-born Mexican Americans), moderates the association between personality traits and body mass index (BMI). Higher Conscientiousness was associated with lower BMI, regardless of nativity. In contrast, the association between Neuroticism and BMI was moderated by exposure to the U.S.: Neuroticism was associated with higher BMI among U.S.-born Mexican Americans (partial r = .15) but not among Mexican participants (partial r = .00), an effect strongest and most robust for the impulsivity facet of Neuroticism. This finding suggests that with more exposure to the United States, those who are more emotionally impulsive are at greater risk for obesity. More broadly, these findings suggest that social and psychological vulnerabilities interact to contribute to health outcomes.

Differing Cognitive Trajectories of Mexican American Toddlers

Recent studies reveal early and wide gaps in cognitive and oral language skills—whether gauged in English or Spanish—among Latino children relative to White peers. Yet, other work reports robust child health and social development, even among children of Mexican American immigrants raised in poor households, the so-called immigrant advantage. To weigh the extent to which Mexican heritage or foreign-born status contributes to early growth, we first compare levels of cognitive and communicative skills among children of Mexican American and native-born White mothers at 9 and 24 months of age, drawing from a national sample of births in 2001. Just one fifth of Mexican American toddlers kept pace with the cognitive growth of White toddlers at or above their mean rate of growth through 24 months of age, matched on their 9-month cognitive status. We then assess how factors from developmental-risk or ecocultural theory help to explain which Mexican American toddlers kept pace with White peers. Growth was stronger among toddlers whose family did not live beneath the poverty line, and whose mothers reported higher school attainment, more frequent learning activities, and exhibited steadier praise during a videotaped interaction task, factors more weakly observed among foreign-born Mexican American mothers. We found little evidence that foreign-born mothers exercised stronger home practices that advanced toddlers’ early cognitive growth as posited by immigrant-advantage theory. The positive factors emphasized by developmental-risk theory helped to explain variation in the cognitive growth of children of native-born, but not foreign-born, Mexican mothers.

Abstract MP96: High Sedentary Activity Mediates the Association of Acculturation and Obesity in Mexican-American Adults: the National Health and Nutrition Examination Survey (NHANES) 2007-2010

Background: Higher levels of acculturation are associated with both higher leisure-time physical activity (LTPA), and higher obesity rates. However, few studies have examined associations of acculturation with other types of activity. Moreover, the extent to which these activities mediate relationships between acculturation and obesity is unknown. We examined associations of acculturation with four types of activity (moderate-vigorous LTPA, moderate-vigorous work- and transportation-related physical activity, and sedentary activity), and we tested whether these types of activity mediate the acculturation-obesity association among Mexican-American (MA) adults. Methods: We used cross-sectional data from 1,982 NHANES 2007-2010 MA participants aged 20+ years. Multinomial logistic regression (MLR) models were used to estimate associations of acculturation (based on nativity and length of residence in the US) with type of activity. Structural equation modeling was used to quantify the extent to which the four types of activity mediate the association of acculturation with obesity (BMI≥30 kg/m 2 ). Results: Foreign-born (FB) MAs had lower mean minutes per week of LTPA and sedentary activity but higher mean minutes of work and transportation activity, compared to US-born MAs. After adjusting for age, age 2 , gender, education and employment status in the MLR analyses, FB MAs living in the US &lt; 10 years were significantly less likely to perform recommended levels of LTPA (≥150 minutes/week) (Relative Risk Ratio (RRR): 0.67; 95% Confidence Interval (CI): 0.49, 0.92), but they were less likely to be sedentary (RRR: 0.15; 95% CI: 0.08, 0.26) and more likely to engage in high transportation- (RRR: 1.57; 95% CI: 1.12, 2.22) and work-related activities (RRR: 1.57; 95% CI: 1.02, 2.40) than US-born MAs. Adjusted MLR analyses also showed that FB MAs living in the US ≥ 10 years were more likely to perform high transportation activity (RRR: 1.37; 95% CI: 1.04, 1.81) and less likely to engage in high sedentary activity (RRR: 0.27; 95% CI: 0.22, 0.35) than US-born MAs. FB MAs living in the US &lt; 10 years and ≥ 10 years were both less likely to be obese compared to US-born MAs in sociodemographic-adjusted models. Sedentary activity was the strongest mediator of the acculturation-obesity association, accounting for 19.2% and 31.3% of the total effect of acculturation on obesity among FB MAs living in the US &lt;10 years and ≥10 years, respectively, compared to US-born MAs. The direct effect of acculturation on obesity (i.e., independent of all measured mediators and confounders) remained significant for both FB MAs living in the US &lt;10 years and those living in the US ≥10 years, compared with US-born MAs. Conclusions: These findings suggest higher sedentary activity may account for a substantial portion of the negative impact of acculturation on obesity. However, the mediation results suggest other factors also play a role.

Revisiting the Hispanic mortality advantage in the United States: The role of smoking

More than three decades of health disparities research in the United States has consistently found lower adult mortality risks among Hispanics than their non-Hispanic white counterparts, despite lower socioeconomic status among Hispanics. Explanations for the “Hispanic Paradox” include selective migration and cultural factors, though neither has received convincing support. This paper uses a large nationally representative survey of health and smoking behavior to examine whether smoking can explain life expectancy advantage of Hispanics over US-born non-Hispanics whites, with special attention to individuals of Mexican origin. It tests the selective migration hypothesis using data on smoking among Mexico-to-US migrants in Mexico and the United States. Both US-born and foreign-born Mexican-Americans exhibit a life expectancy advantage vis-à-vis whites. All other Hispanics only show a longevity advantage among the foreign-born, while those born in the United States are disadvantaged relative to whites. Smoking-attributable mortality explains the majority of the advantage for Mexican-Americans, with more than 60% of the gap deriving from lower rates of smoking among Mexican-Americans. There is no evidence of selective migration with respect to smoking; Mexicans who migrate to the US smoke at similar rates to Mexicans who remain in Mexico, with both groups smoking substantially less than non-Hispanic whites in the US. The results suggest that more research is needed to effectively explain the low burden of smoking among Mexican-Americans in the United States.

Demographic and socioeconomic correlates of adiposity assessed with dual-energy X-ray absorptiometry in US children and adolescents

Associations between demographic-socioeconomic characteristics and childhood obesity are complex in the United States. We examined associations between demographic-socioeconomic characteristics (age, sex, race-ethnicity, family income, household size, and birthplace) and adiposity measured by dual-energy X-ray absorptiometry in US children. Data were from 8-19-y-old US children enrolled in NHANES 2001-2004 (n = 5436). Adiposity was expressed as the fat mass index (FMI = fat mass/height(2); in kg/m(2)), percentage body fat (%BF), and prevalence of normal, overfat, and excess fat corresponding to %BF <25%, 25-29.9%, and ≥30% in boys and <30%, 30-34.9%, and ≥35% in girls, respectively. We used sex-specific linear and multinomial logistic regression models adjusted for demographic-socioeconomic factors. The prevalence of excess fat was higher in Mexican American (36%) than in white (28%; P ≤ 0.10) and black (21%; P < 0.05) boys; higher in Mexican American (44%) than in white (36%; P ≤ 0.10) and black (35%; P < 0.05) girls; and higher in US-born (38%) than in foreign-born (29%; P ≤ 0.10) Mexican American boys. In boys, %BF was higher in Mexican Americans and lower in blacks than in whites (P < 0.05). Adiposity was negatively associated with family income in white boys and girls and in Mexican American girls (P < 0.05). Racial-ethnic disparities in adiposity persisted (P < 0.001) after control for demographic-socioeconomic factors available in NHANES. The R(2) for sex-specific models of %BF or FMI regressed on age, race-ethnicity, family income, household size, and birthplace ranged from 2% to 11%. The association between demographic-socioeconomic factors and adiposity among US children varied substantially by age, sex, and race-ethnicity.

The Metabolic Syndrome, Biomarkers, and the Acculturation–Health Relationship Among Older Mexican Americans

To examine the acculturation-health relationship using metabolic syndrome biomarkers. Cross-sectional sample data. 1,789 Mexican Americans (60 years and older) from northern California. Biomarkers (waist circumference, blood pressure, fasting plasma glucose, triglycerides, and high-density lipids) were used to construct the metabolic syndrome indicator using American Heart Association criteria. MAIN PREDICTOR: Acculturation Rating Scale for Mexican Americans-II scores. Higher acculturation scores were associated with a significantly lower risk for the metabolic syndrome for foreign-born, but not U.S.-born, Mexican Americans. Immigrant health advantages over U.S.-born Mexican Americans are not evident in older adulthood. Higher acculturation was associated with lowered metabolic syndrome risk among older foreign-born Mexican Americans. This suggests that the prevailing acculturative stress hypothesis may not apply to the health of older adults and that any negative relationship between acculturation and health found in younger adults may yield to different developmental health influences in later adulthood.

Population Trends and Late-Life Disability in Hispanics From the Midwest

To describe the growth of the Hispanic population in the Midwest states of the United States, to present disability levels in older Mexican and non-Mexican-origin Midwest Hispanics by place of birth and poverty status, and compare disability levels among older Midwest Hispanics with those among Southwest Hispanics as well as non-Hispanics Whites and African Americans in each region. Population data come from decennial U.S. Census Bureau surveys. Disability data for adults ≥ 50 years old come from the 2008 American Community Survey. The Hispanic population in the Midwest has tripled since 1980 and now constitutes 6.6% of the entire Midwest population. Older Midwest Hispanics are somewhat younger, have a higher male-female ratio, and are more likely to be born outside the continental United States than Southwest Hispanics. In the Midwest, foreign-born Mexican American men report the lowest disability levels. Foreign-born Hispanic women of non-Mexican origin report the highest disability levels. Overall, older Hispanics have intermediate disability levels relative to non-Hispanic Whites and African Americans. Midwest Hispanics report less disability than Southwest Hispanics. There is substantial heterogeneity in late-life disability among Midwest Hispanics, which may be related to place of birth and of origin. Future research is needed to examine age at immigration and health selection as potential reasons for low disability levels among foreign-born Mexican American men.