Latino Neighborhoods Research Articles

ADUs in Los Angeles: Where are they located and by how much do they raise property value?

AbstractUsing data from Los Angeles, this article explores the locational determinants as well as the assessed‐value effects of the presence of accessory dwelling units (ADUs). The results show that ADUs are less likely to be found on large parcels containing newer houses and at dense locations near the CBD, the LAX airport, and beaches. ADU presence is more likely close to commercial districts, light‐rail stations, and educational establishments but less likely in higher income areas and Black neighborhoods, although parcels in Latino neighborhoods are more likely to contain ADUs. The assessed‐value regressions show that ADU presence raises a parcel's assessed value and selling price by 7%–9%, while also accurately capturing the unusual rules for property assessments under California's Proposition 13.

What a mix! Volatile organic compounds and worker exposure in small business beauty salons in Tucson, Arizona.

Small business beauty salons have volatile organic compounds (VOCs) in their workplace air. VOCs are present as ingredients in beauty or hair products. They may also form because of chemical reactions, where thermal-styling elements accelerate the volatilization of these compounds. Uncertainties remain about the relationship between air pollutant concentrations and the variety of beauty salon activities in a work shift. Investigating these associations can help determine high-risk services, associated products, and at-risk workers. In this exploratory study, female community health workers recruited beauty salons from target zip codes in predominately Latino neighborhoods, including primarily Spanish-speaking small businesses. We collected salon chemical inventories, business characteristics, and participant activity logs to understand how chemicals and activities influence the total and specific VOC concentrations. We sampled personal total VOCs and specific VOCs from the same shop during the participant work shift. We also measured personal total VOCs for four work shifts per shop. A linear mixed effects model of log VOCs on the fixed effect of activity and the random effects of salon and shift within the salon showed that the variance between salons explains over half (55%) of the total variance and is 4.1 times bigger than for shifts within salons. Summa canisters detected 31 specific VOCs, and hazard scores ranged between 0 and 4.3. 2-Propanol (isopropyl alcohol) was the only VOC detected in all shifts of all salons. In this study, differences in VOC measurements were primarily between salons. These differences may result from differences in ventilation, services rendered, and product lines applied.

Impact of Receiving Hospital on Out-of-Hospital Cardiac Arrest Outcome: Racial and Ethnic Disparities in Texas.

Background Factors associated with out-of-hospital cardiac arrest (OHCA) outcome disparities remain poorly understood. We evaluated the role of receiving hospital on OHCA outcome disparities. Methods and Results We studied people with OHCA who survivedto hospital admission from TX-CARES (Texas Cardiac Arrest Registry to Enhance Survival), 2014 to 2021. Using census data, we stratified OHCAs into majority (>50%) strata: non-Hispanic White race and ethnicity, non-Hispanic Black race and ethnicity, and Hispanic or Latino ethnicity. We stratified hospitals into performance quartiles based on the primary outcome, survival with good neurologic outcome. We evaluated the association between race and ethnicity and care at higher-performance hospitals. We compared 3 models evaluating the association between race and ethnicity and outcome: (1) ignoring hospital, (2) adjusting for hospital as a random intercept, and (3) adjusting for hospital performance quartile. We adjusted models for possible confounders. We included 10 434 OHCAs. Hospital performance quartile outcome rates ranged from 11.3% (fourth) to 37.1% (first). Compared with OHCAs in neighborhoods of majority White race, those in neighborhoods of majority Black race (odds ratio [OR], 0.1 [95% CI, 0.1-0.1]) and Hispanic or Latino ethnicity (OR, 0.2 [95% CI, 0.2-0.2]) were less likely to be cared for at higher-performing hospitals. Compared with White neighborhoods (30.1%) and ignoring hospital, outcomes were worse in Black neighborhoods (15.4%; adjusted OR [aOR], 0.5 [95% CI, 0.4-0.5]) and Hispanic or Latino neighborhoods (19.2%; aOR, 0.6 [95% CI, 0.5-0.7]). Adjusting for hospital as a random intercept, outcomes improved for Black neighborhoods (aOR, 0.9 [95% CI, 0.7-1.05]) and Hispanic or Latino neighborhoods (aOR, 0.9 [95% CI, 0.8-0.99]). Adjusting for hospital performance quartile, outcomes improved for Black neighborhoods (aOR, 0.8 [95% CI, 0.7-1.01]) and Hispanic or Latino neighborhoods (aOR, 0.9 [95% CI, 0.8-0.996]). Conclusions In Black and Hispanic or Latino communities, OHCAs were less likely to be cared for at higher-performing hospitals, and adjusting for receiving hospital improved OHCA outcome disparities.

Between trust and resentment: Examining competing views toward the police in Latino neighborhoods

ABSTRACT In this paper, I examine citizen-police interactions in Latino communities near the US-Mexico border. Drawing on evidence from sixty-one in-depth interviews with residents, activists, and nonprofit workers living in San Diego, I explore Latinos’ perceptions of the police. Interview data, in conjunction with observational evidence from work with community-based organizations, revealed heterogeneity in the views of Latinos toward the police. Some Latino residents were skeptical of the police and resented policing practices, including sobriety checkpoints, vehicle seizures, and investigatory stops that targeted people concerning documentation status or prior system involvement, while other Latino residents trusted the police and their efforts to reduce crime. Yet still, some Latino residents expressed critical and positive views about the police. Interview data also highlight the financial, psychological, and social strain of local police practices on Latinos who have uncertain status or live in mixed-status households. These findings underscore the centrality of the criminal legal system in the lives of many Latinos and draw attention to heterogeneity in their experiences with, and views about, the police.

"This is not nostalgia": Contesting the Politics of Sentimentality in Boston's 2004 Parish Closure Protests

In 2004, the Catholic Archdiocese of Boston announced the closure or merger of nearly a quarter of its parishes in a massive reconfiguration process. Some Catholics responded with protests, staging prolonged church occupations and Vatican appeals to save their parishes. Though these protests garnered significant public sympathy and media attention, most were unsuccessful in preventing closure. Yet one grassroots campaign succeeded where many well-resourced resistance efforts did not. At St. Mary of the Angels—a small, eclectic, basement-level church in Egleston Square, a Black and Latino neighborhood in Roxbury—parishioners and community leaders launched a solidarity campaign to persuade the archdiocese that closing St. Mary's would decimate longstanding efforts to combat neighborhood violence. Whereas other anti-closure protests stressed parishioners' personal and familial attachments to their churches, St. Mary's campaign strategically eschewed the politics of sentimentality, emphasizing instead the congregation's crucial role in the local urban ecology. Drawing on interviews and archdiocesan and community archives, this study of the efforts to save St. Mary's demonstrates the overlooked significance of ecumenical, interfaith, and secular relationships in sustaining urban parishes. At the same time, it underscores the roles of race, class, and immigration in shaping public attention to church closures.

WITHDRAWN-Administrative Duplicate Publication: Mural Painting to Collect Sensitizing Data and Encourage Research Participation Among U.S. Latinos.

To describe a mural-based intervention that can be implemented in partnership with community members in Latino neighborhoods in order to improve awareness of barriers to recruitment/retention of U.S. Latinos in clinical research, while augmenting researchers' access to sensitizing concepts critical for rigorous study design. Background. Latinos in the United States suffer disproportionately from several chronic illnesses but are under-represented as researchers and participants in the National Institutes of Health-funded research. This lack of representation inhibits a nuanced awareness of the health needs of U.S. Latinos and hampers efforts to address a persistent lack of health equity among U.S. Latinos and other communities of color. Art-based interventions implemented in Latino communities are increasingly being recognized for their ability to bridge this gap and positively affect the quality and quantity of research partnerships between clinical researchers and U.S. Latinos. This article describes a mural-based intervention piloted in two predominantly Latino neighborhoods between 2016 and 2020. The design of this method was guided by community-partnered participatory research practices and involved an Assessment-Diagnosis-Planning-Implementation-Evaluation approach. Mural painting addressed many of the participation challenges often associated with under-representation of Latinos in academic research and allowed for sensitizing interviews with key community members surrounding topics of interest to the research team. Research methods that acknowledge traditional art forms, such as mural painting, create a space for building trust and spark interest in future research participation, while augmenting researchers' access to sensitizing concepts that may improve the cultural competence of future studies, projects, and interventions.

Coalition of Faith Leaders, Community Organizations, and Governmental Organizations to Implement a COVID-19 Campaign in a Latino Neighborhood, Baltimore, Maryland, 2020-2021.

The disproportionate impact of COVID-19 on low-income Latinos with limited access to health care services prompted the expansion of community-based COVID-19 services. From June 25, 2020, to May 20, 2021, we established a coalition of faith leaders, community organizations, and governmental organizations to implement a Spanish-language hotline and social media campaign that linked people to a COVID-19 testing site at a local church in a high-density Latino neighborhood in Baltimore, Maryland. This retrospective analysis compared the characteristics of Latinos accessing testing in community versus health care facility-based settings. (Am J Public Health. 2022;112(S9):S913-S917. https://doi.org/10.2105/AJPH.2022.307074).

Abstract PO-175: Neighborhood segregation typology and breast cancer risk: The Multiethnic Cohort Study

Abstract Background: Chronic stress as a result of residing in neighborhoods with higher levels of racial/ethnic segregation may increase a woman's risk of breast cancer. There is strong evidence of increased breast cancer risk due to social stress from animal models. Furthermore, epidemiologic studies have suggested links between racial/ethnic segregation and poor breast cancer outcomes. While a limited number of studies have demonstrated increased breast cancer risk and worse prognostic factors for African American women residing in neighborhoods with high racial/ethnic segregation compared to White women, no studies have examined this potential association in other racial/ethnic groups. Methods: Using data from the Multiethnic Cohort (MEC) (1993-2014), we examined the association between a neighborhood segregation typology of racial/ethnic compositions and incidence of primary, invasive breast cancer in a population-based sample of 101,811 African American, Japanese American, Latina, Native Hawaiian, and White women primarily residing in Los Angeles County, California and Hawaii. Segregation typology was based on the distribution of racial/ethnic groups across census tracts and linked to participants' geocoded baseline residential addresses. Hazard ratios (HRs) and 95% confidence intervals (CIs) for breast cancer risk were estimated using multivariable Cox proportional hazards regression adjusted for age, family history of breast cancer, reproductive and lifestyle risk factors for breast cancer, and stratified by state and self-reported race/ethnicity. For each state and racial/ethnic group, the reference typology was specific to co-ethnic residents. Results: A median follow-up of 20 years yielded 6,398 breast cancer cases. In California, African American women living in predominantly White neighborhoods had reduced risk of breast cancer (HR=0.68, 95%CI=0.46-0.99) compared to African American women living in predominantly Black neighborhoods. Among Latina women, compared to residents in predominately Latino neighborhoods, those in mixed White and Asian American/Pacific Islander (AAPI) (HR=1.54, 95%CI=1.05-2.25) and multiethnic White neighborhoods (HR=1.34, 95%CI=1.07-1.69) had increased risk of breast cancer. In Hawaii, Native Hawaiian women in predominantly AAPI neighborhoods had increased breast cancer risk (HR=1.20, 95%CI=1.04-1.38) compared to Native Hawaiian women in mixed White and AAPI neighborhoods. For Japanese American women in Hawaii, those living in mixed Native Hawaiian (HR=1.28, 95% CI=1.05-1.55) and multiethnic (HR=1.61, 95% CI=1.36-1.90) neighborhoods had higher breast cancer risk than those living in predominately Asian neighborhoods. Conclusion: This large-scale prospective study in a multiethnic population found differential associations between neighborhood racial/ethnic segregation and breast cancer risk by state of residence and self-reported race/ethnicity. Future research should aim to identify pathways through which segregation measures influence breast cancer risk in specific racial/ethnic populations. Citation Format: Meera Sangaramoorthy, Joseph Gibbons, Juan Yang, Katherine Lin, Yuqing Li, Jenna A Khan-Gates, Pushkar Inamdar, Christopher A. Haiman, Loïc Le Marchand, Lynne R Wilkens, Scarlett L. Gomez, Salma Shariff-Marco, Iona Cheng. Neighborhood segregation typology and breast cancer risk: The Multiethnic Cohort Study [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-175.

Biking where Black: Connecting transportation planning and infrastructure to disproportionate policing

This study asks whether deficiencies in transportation are associated with disproportionate policing in Chicago using the case of cycling. I examine how the number of bicycle citations issued per street segment are influenced by the availability of bicycle facilities and street characteristics, controlling for crash incidence, police presence, and neighborhood characteristics. Tickets were issued 8 times more often per capita in majority Black tracts and 3 times more often in majority Latino tracts compared to majority white tracts. More tickets were issued on major streets, but up to 85% fewer were issued when those streets had bike facilities, which were less prevalent in Black and Latino neighborhoods. Tickets were not associated with bicycle injury-crashes and inversely associated with vehicle injury-crashes. Infrastructure inequities compound the effects of racially-biased policing in the context of transportation safety strategies. Remedies include the removal of traffic enforcement from safe systems strategies and equitable investment in cycling.

Mural Painting to Collect Sensitizing Data and Encourage Research Participation Among U.S. Latinos.

To describe a mural-based intervention that can be implemented in partnership with community members in Latino neighborhoods in order to improve awareness of barriers to recruitment/retention of U.S. Latinos in clinical research, while augmenting researchers' access to sensitizing concepts critical for rigorous study design. Latinos in the United States suffer disproportionately from several chronic illnesses but are underrepresented as researchers and participants in National Institutes of Health-funded research. This lack of representation inhibits a nuanced awareness of the health needs of U.S. Latinos and hampers efforts to address a persistent lack of health equity among U.S. Latinos and other communities of color. Art-based interventions implemented in Latino communities are increasingly being recognized for their ability to bridge this gap and positively affect the quality and quantity of research partnerships between clinical researchers and U.S. Latinos. This article describes a mural-based intervention piloted in two predominantly Latino neighborhoods between 2016 and 2020. The design of this method was guided by community partnered participatory research practices and involved an Assessment-Diagnosis-Planning-Implementation-Evaluation approach. Mural painting addressed many of the participation challenges often associated with underrepresentation of Latinos in academic research and allowed for sensitizing interviews with key community members surrounding topics of interest to the research team. Research methods that acknowledge traditional art forms, such as mural painting, create a space for building trust and spark interest in future research participation, while augmenting researchers' access to sensitizing concepts that may improve the cultural competence of future studies, projects, and interventions.

Access to pharmacies and pharmacy services in New York City, Los Angeles, Chicago, and Houston, 2015-2020

BackgroundDespite the importance of pharmacies in ensuring medications and health care needs are met, there is limited up-to-date information regarding access to pharmacies or their services in the United States. ObjectivesTo evaluate trends and disparities in access to pharmacies in 4 largest cities in the United States, New York City, Los Angeles, Houston, and Chicago, by neighborhood racial and ethnic composition from 2015 to 2020. MethodsData from the National Council for Prescription Drug Programs (2015-2020) and the American Community Survey (2015-2019) were used. We examined neighborhoods (i.e., census tracts) and evaluated disparities in "pharmacy deserts" (low-income neighborhoods (1) whose average distance to the nearest pharmacy was at least 1 mile or (2) whose average distance to the nearest pharmacy was at least 0.5 mile and at least 100 households had no vehicle access). We also evaluated the differences in pharmacy closures and the availability of pharmacy services. ResultsFrom 2015 to 2020, the percent of neighborhoods with pharmacy deserts declined in New York City (from 1.6% to 0.9% of neighborhoods, P < 0.01), remained stable in Los Angeles (13.7% to 13.4%, P = 0.58) and Houston (27.0% to 28.5%, P = 0.18), and increased in Chicago (15.0% to 19.9%, P < 0.01). Pharmacy deserts were persistently more common in Black and Latino neighborhoods in all 4 cities. As of 2020, pharmacies in Black and Latino neighborhoods were also more likely to close and less likely to offer immunization, 24-hour, and drive-through services than pharmacies in other neighborhoods. ConclusionTo reduce disparities in access to medications and health care services, including those in response to the coronavirus disease 2019 pandemic (e.g., testing and vaccinations), policies that improve pharmacy access and expand the provision of pharmacy services in minority neighborhoods are critical.

Neighborhood racial/ethnic segregation and cognitive decline in older adults

Social determinants of health, including neighborhood factors, play a key role in the health of diverse older adults. However, few longitudinal studies have examined the role of neighborhood racial/ethnic segregation on cognitive decline in diverse samples. We examined older non-Hispanic White (NHW), Black, and Latino participants evaluated at an Alzheimer's Disease Research Center. Neighborhood racial/ethnic segregation was measured using the Getis-Ord Gi* statistic, a spatial measure of clustering that was created for Latino and Black clustering separately. Cognitive outcomes included episodic memory, semantic memory, and executive function. We used mixed effects multivariable regression models to evaluate associations between segregation and cognitive function and decline. We had 452 individuals: 46% NHW, 26% Black, and 21% Latino in 309 census tracts with an average of 5.2 years of follow-up data (range 0.6–15.0). In analyses that adjusted for a variety of covariates (including neighborhood SES), individuals in neighborhoods with a higher clustering of Latino residents (higher Gi* statistic) had slower declines over time on semantic memory and those in neighborhoods with a higher clustering of Black residents had slower declines over time on episodic memory. In race/ethnicity-stratified adjusted analyses: for Black participants, the association between clustering and cognition was present for episodic memory and executive function, showing lower baseline scores in highly clustered Black and Latino neighborhoods, respectively. There was no association with cognitive change. Among Latino participants, highly clustered Latino neighborhoods were associated with lower baseline scores in semantic memory, but slower declines in episodic memory; Latinos living in neighborhoods with a greater clustering of Black residents also had slower declines in episodic memory. Among NHWs, residing in neighborhoods with a higher clustering of Latino residents was associated with slower declines over time on semantic memory. Segregated neighborhoods may be differentially associated with cognitive outcomes depending on individual race/ethnicity.

Latino-to-Latino: Promotores' Beliefs on Engaging Latino Participants in Autism Research.

In Latino(a) communities, promotores de salud (i.e., community health workers; promotores) are becoming critical participants in prevention, health promotion, and the delivery of health care. Although involving culturally diverse participants in research is a national priority, recruitment and retention of research participants from these groups is challenging. Therefore, there is an increased need to identify strategies for successful recruitment of participants from underrepresented minority backgrounds. Our overall study purpose was to gain promotores' perspectives on recruiting Latino(a) immigrant community members for an intervention study on autism spectrum disorders (ASD). The goal of this paper is to explore insider promotores' views on the barriers and facilitators to research participation in the Latino(a) community and learn strategies for recruiting Latino(a) participants in a nontraditional destination city. We conducted qualitative focus groups with an established group of promotores known as Latinos Unidos por la Salud (LU-Salud), who were members of a community-academic research team. Fifteen LU-Salud promotores participated in the focus groups. Focus group interviews were analyzed by using Leininger's data analysis enabler. These results will inform our partnerships with promotores and Latino(a) neighborhood agencies to increase recruitment for community-based research on promoting awareness of ASD among Latino(a) families. Promotores were credible community members able to gain community trust and committed to improving the health and well-being of their Latino(a) community, including involving them in research. Latino(a) research involvement meant facilitating community members' engagement to overcome barriers of distrust around legal and health care systems. Challenges included legal uncertainties, language and literacy barriers, health knowledge, and economic hardship. Promotores also voiced the diversity of cultural practices (subcultures) within the Latino(a) culture that influenced: (1) research engagement, (2) guidance from promotores, (3) immersion in the Latino(a) community, and (4) health and well-being. Experienced promotores, who are living in a nontraditional migration area, believe the primary facilitator to increasing research involvement is Latino(a)-to-Latino(a) recruitment. These findings will aid in building partnerships to recruit participants for future studies that promote early recognition of ASD in the Latino(a) community.

Sermons to Address Obesity in Partnership With African American and Latino Churches

Sermons to Address Obesity in Partnership With African American and Latino Churches

Association of physical activity levels and brain white matter in older Latino adults

ABSTRACT Objective Investigate the associations between self-reported physical activity (PA) engagement and white matter (WM) health (i.e. volume, integrity, and hyperintensities) in older Latinos. Design Cross-sectional study with community-dwelling older adults from predominantly Latino neighborhoods. Participants: Thirty-four cognitively healthy older Latinos from two different cohorts. Measurements: Participants self-reported demographic information, PA engagement [Community Healthy Activities Model Program for Seniors (CHAMPS) Physical Activity Questionnaire for Older Adults] and magnetic resonance imaging (MRI). We used high-resolution three-dimensional T1- and T2-FLAIR weighted images and diffusion tensor imaging acquired via 3 T MRI. We performed a series of hierarchical linear regression models with the addition of relevant covariates to examine the associations between self-reported PA levels and WM volume, integrity, and hyperintensities (separately). We adjusted p-values with the use of the Benjamini-Hochberg's false discovery rate procedure. Results Higher reported levels of leisure-time moderate-to-vigorous PA were significantly associated with higher WM volume of the posterior cingulate (β = 0.220, SE = 0.125, 95% CI 0.009-0.431, p = 0.047) and isthmus cingulate (β = 0.212, SE = 0.110, 95% CI 0.001-0.443, p = 0.044) after controlling for intracranial volume. Higher levels of total PA were significantly associated with higher overall WM volume of these same regions (posterior cingulate: β = 0.220, SE = 0.125, CI 0.024-0.421, p = 0.046; isthmus cingulate: β = 0.220, SE = 0.125, 95% CI 0.003-0.393; p = 0.040). Significant p-values did not withstand Benjamini-Hochberg’s adjustment. PA was not significantly associated with WM integrity or WM hyperintensities. Conclusion Higher levels of PA, particularly higher leisure-time moderate-to-vigorous PA, might be associated with greater WM volume in select white matter regions key to brain network integration for physical and cognitive functioning in older Latinos. More research is needed to further confirm these associations.

Statin nonadherence in Latino and noncitizen neighborhoods in New York City, Los Angeles, and Chicago, 2012-2016

BackgroundLatino adults, especially immigrants without citizenship (i.e., noncitizens), experience considerable barriers to health care, including medications. Inequitable access to medications, especially statins, may exacerbate disparities in cardiovascular disease. Despite this, little is known about medication nonadherence in Latino neighborhoods, especially those with large noncitizen populations. ObjectivesTo estimate nonadherence to statins in Latino neighborhoods and evaluate differences on the basis of their noncitizen population. MethodsWe conducted a retrospective cohort study among 48,161 adults who lived in predominately Latino neighborhoods in New York City, Los Angeles, and Chicago and who initiated statin therapy from January 2012 to December 2015 using IQVIA LifeLink. Statin nonadherence was defined as a proportion of days covered amounting to less than 80% over 12 months. We focused on differences between neighborhoods with high noncitizen concentrations (areas where noncitizens are at least 35% of the adult population) and other Latino neighborhoods. We examined associations using logistic regressions adjusted for individual (e.g., payment method) and neighborhood characteristics (e.g., poverty). ResultsIndividuals living in neighborhoods with high noncitizen concentrations were more nonadherent to statins than those in Latino neighborhoods with fewer noncitizens (75.0% vs. 70.0%, adjusted odds ratio [aOR] 1.18, [95% CI 1.06–1.33]). These disparities were worse in New York City (77.7% vs. 69.1%, aOR 1.37, [95% CI 1.23–1.53]) and Chicago (76.1% vs. 68.8%, aOR 1.38, [95% CI 1.14–1.67]) than in Los Angeles (73.8% vs. 71.3%, aOR 1.10, [95% CI 1.01–1.20]). ConclusionNeighborhoods with large noncitizen populations have much higher rates of statin nonadherence than Latino neighborhoods with fewer noncitizens. These disparities were least pronounced in Los Angeles, where the county provides health care to all uninsured residents, including noncitizens without documentation to reside in the United States. Efforts to improve medication access in Latino neighborhoods should be multifocal and start by implementing state and local health care options for low-income residents, regardless of citizenship status.

Targeted Marijuana Law Enforcement in Los Angeles, 1914-1950

Marijuana was illegal to possess or sell in California for 103 years. The state first banned it in 1913, grouping it with opiates and cocaine on a list of prohibited vice drugs adopted six years earlier, meaning that it was subject to the same penalties as these other, far more dangerous, drugs until 1961. Initially framed as a “Mexican” drug, marijuana prohibition enforcement began on the periphery of Los Angeles in older Latino neighborhoods as well as in agricultural outposts where immigrants lived, worked, and gardened. Later this policing turned toward the city center, targeting the segregated section of Central Avenue with its jazz musicians and its multiracial nightlife, as well as actors and musicians in nearby Hollywood. By 1950, Los Angeles-area police were arresting more people for the possession or sale of marijuana than for heroin, other opiates, and cocaine combined. Mexican, Mexican American, and Black citizens were the targets of this enforcement in sharp disproportion to their presence there.

Where We Live Matters: Residential Influences on Health and Well-Being

Growing evidence indicates that residential contexts are implicated in the health and well-being of older adults. Operationalization of these contexts varies and includes psychosocial, physical and socioeconomic neighborhoods, and more proximal contexts (e.g., home environment). We aim to bring together a diverse set of papers focused on the living environment to understand how contextual factors are associated with individual outcomes. Muñoz and colleagues applied a lifespan perspective by evaluating associations between current and childhood neighborhood perceptions on cognitive health. Their results indicated that the association between perceived neighborhoods and cognition in adulthood was moderated by childhood neighborhoods. García and Ailshire contextualized the types of neighborhoods in which older Latinos live and how these influenced diabetes risk. They identified neighborhood clusters characterized by racial/ethnic and socioeconomic compositions and found that predominantly Latino neighborhoods with low SES were more likely to have diabetes compared to other neighborhood clusters. This symposium will also focus on the more proximal environment. Lee and Ailshire examined the neighborhood and home environment and found that the home’s proximity to green space and level of clutter within the home was associated with increased fall risks in older adults. Fingerman and colleagues coded older adults’ living spaces and found that personality type was associated with room conditions. Altogether, the presentations highlight the relevance of context measured across multiple levels of analyses and dimensions of well-being outcomes in aging individuals. Dr. Markus Schafer will provide a discussion of these findings and address the challenges and opportunities for future research.

¿Dónde Viven Los Latinos? The Types of Neighborhoods Older Latinos Live in and Their Implications for Diabetes

The spatial distribution of Latinos in U.S. neighborhoods is highly patterned due to a complex set of social, cultural, and economic forces, which leads to the differential distribution of and exposure of resources and opportunities across space. However, less is known about the types of neighborhoods older Latinos live in and how it impacts their health. Using census tracts from the year 2000, we employed a latent class analysis to explore how social and socioeconomic characteristics cluster together to create distinct neighborhood typologies. These typologies were then combined with data from the 2006-2016 Health and Retirement Study (n=3,047). We found that Latinos were more likely to live in predominantly Latino neighborhoods with low socioeconomic status (SES) (40%), multiracial neighborhoods with moderate SES (27%), and predominantly white neighborhoods with moderate SES (15%). Latinos living in predominantly Latino neighborhoods with low SES were more likely to have diabetes than other neighborhood typologies.

Abstract 136: Disparities in Out of Hospital Cardiac Arrest Care and Outcomes in Texas

Background: Minorities and impoverished persons experience disparities in access to healthcare. Large inequalities in out-of-hospital cardiac arrest (OHCA) care have been described. We sought to characterize racial and socioeconomic disparities in OHCA care and outcomes in Texas. Hypothesis: There are census tract level disparities in OHCA care and outcomes in Texas. Methods: We analyzed Texas-Cardiac Arrest Registry to Enhance Survival (CARES) data from 13 EMS agencies providing care in 15 counties to roughly 30% of the state population. We included all adult (&gt;=18 year) OHCA from 1/1/14 through 12/31/18 with complete data. Using census tract data, we stratified census tracts into racial/ethnic categories: &gt;50% non-Hispanic/Latino white, &gt;50% black, and &gt;50% Hispanic/Latino. We also stratified census tracts into neighborhoods above and below the median for socioeconomic characteristics: household income, employment rate, and high school graduation. We defined outcomes as bystander CPR rates, public bystander AED use, and survival to hospital discharge. Using mixed models, we analyzed the associations between outcomes and neighborhood (1) racial/ethnic categories and (2) socioeconomic categories. Results: We included data on 18,487 OHCAs from 1,727 census tracts. Relative to white neighborhoods, black neighborhoods had a significantly lower rate of bystander AED use (OR 0.3, CI 0.1-0.9), and Latino neighborhoods had a lower rate of bystander CPR (OR 0.7, CI 0.6-0.8), bystander AED use (OR 0.4, CI 0.3-0.6) and survival to hospital discharge (OR 0.9, CI 0.8-0.98). Lower income was associated with a lower rate of bystander CPR (OR 0.8, CI 0.7-0.8), bystander AED use (OR 0.5, 0.4-0.8), and survival to hospital discharge (OR 0.6, CI 0.5-0.9). Lower high school graduation was associated with a lower rate of bystander CPR (OR 0.8, CI 0.7-0.9) and bystander AED use (OR 0.6, CI 0.4-0.9). High unemployment was associated with lower rates of bystander CPR (OR 0.9, CI 0.8-0.94) and bystander AED use (OR 0.7, CI 0.5-0.99). Conclusion: Minority and poor neighborhoods in Texas experience large and unacceptable disparities in OHCA bystander response and outcomes. These data present an important opportunity for targeted resuscitation training and quality improvement.