Latino People Research Articles

Community Health Workers as Mental Health Paraprofessionals: Protocol for a Mixed-Methods Pilot Feasibility Study.

Community health workers (CHWs) are effective in delivering behavioral activation (BA), especially in low-resource settings. In an area with a lack of Spanish-speaking mental health counselors, such as southwest Montana, CHWs can provide needed care. The goal of this pilot study protocol is to test the feasibility, acceptability, and preliminary efficacy of a model of care that engages CHWs as providers of BA. We will train 2 CHWs in BA methodology. We will enroll 20 participants who screen positive for depression in a 12-week telephone intervention for BA. Preliminary efficacy will be tested in pre- and postscores of the Beck Depression Inventory and semistructured interviews. Feasibility and acceptability will be measured through participant retention and treatment adherence. The Therapeutic Alliance with Clinician Scale will be used to measure the strength of the therapeutic relationship. Descriptive statistics will measure alliances and repeated measures ANOVA will measure trends and changes in depression scores. Enrollment began in October 2023. A total of 12 participants completed at least 10 BA sessions and all study measures by the time the study concluded in May 2024. In August 2024, data analysis occurred with an anticipated manuscript to be submitted for publication in October 2024. Results from this study will inform future studies into the implementation of an evidence-based mental health intervention in a limited resource setting for Latino people with limited English proficiency. DERR1-10.2196/57343.

The Need for Culturally Tailored CKD Education in Older Latino Patients and Their Families

Older Latino adults (65+) comprise the fastest growing minoritized group among the older population in the US and experience a disproportionate burden of kidney failure as well as disparities in kidney care compared to non-Hispanic White individuals. Despite significant need and barriers uniquely faced by this population, few educational resources or decision aids are available to meet the language and cultural needs of Latino patients. Decision aids are designed to improve knowledge and empower individuals to engage in shared decision-making and have been shown to improve decisional quality and goal-concordant care among older patients with CKD. In this commentary, we examine the barriers faced by older Latino people with CKD who must make dialysis initiation decisions. We conclude that there is a need for culturally concordant decision aids tailored for older Latino patients with CKD to overcome barriers in access to care and improve patient-centered care for older Latino CKD patients.

Residential segregation and summertime air temperature across 13 northeastern U.S. states: potential implications for energy burden

High ambient summertime temperatures are an increasing health concern with climate change. This is a particular concern for minoritized households in the United States, for which differential energy burden may compromise adaptive capacity to high temperatures. Our research question was: Do minoritized groups experience hotter summers than the area average, and do non-Hispanic white people experience cooler summers? Using a fine-scaled spatiotemporal air temperature model and U.S. census data, we examined local (within-county) differences in warm season cooling degree days (CDDs) by ethnoracial group as a proxy for local energy demand for space cooling across states of the northeast and mid-Atlantic U.S. in 2003–2019. Using state-specific regression models adjusted for year and county, we found that Black and Latino people consistently experienced more CDDs, non-Hispanic white people experienced fewer CDDs, and Asian populations showed mixed results. We also explored a concentration-based measure of residential segregation for each ethnoracial group as one possible pathway towards temperature disparities. We included the segregation measure as a smooth term in a regression model adjusted for county and year. The results were nonlinear, but higher concentrations of white people were associated with lower annual CDDs and higher concentrations of Latino people were associated with higher annual CDDs than the county average. Concentrations for Black and Asian people were nonmonotonic, sometimes with bowed associations. These findings suggest that present-day residential segregation, as modeled by spatially smoothed ethnoracial subgroup concentrations, may contribute to summertime air temperature disparities and influence adaptive capacity. We hope these findings can support place-based interventions, including targeting of energy insecurity relief programs.

Latino-Hispanic Unsheltered Homelessness Before and After COVID-19.

Objectives. To identify sociodemographic shifts among unsheltered Latino people experiencing homelessness (PEH) between 2020-2022. Methods. We examined differences in characteristics reported in demographic surveys for Latino PEH older than 25 years from 2020 (n = 1215) and 2022 (n = 1395) in Los Angeles County, California, using weighted bivariate χ2 tests. Results. From 2020 to 2022, there was a 25% increase in the number of unsheltered Latino individuals. The share of Latino PEH who were unemployed increased (57% to 67%). The increase in homelessness occurred largely among individuals living in vehicles (14% to 33%), rather than in tents or on sidewalks. Latino PEH were significantly less likely to report mental illness (24% vs 18%) and had higher rates of first entry into homelessness in the past 2 years than non-Latino respondents. Conclusions. Our results are consistent with the effects of increasing socioeconomic vulnerability, likely related to COVID-19, in driving the increase in Latino PEH. Policy Implications. The rise in homelessness among economically vulnerable yet healthy Latinos suggests a need to bolster social safety nets and increase homelessness prevention programs. (Am J Public Health. 2024;114(S6):S510-S514. https://doi.org/10.2105/AJPH.2024.307717) [Formula: see text].

Telenovela (Spanish Soap Opera) Interventions on Latino Health: A Scoping Review.

Introduction: The use of telenovelas shows promise as a mode of education that could enhance Latino people's ability to prevent or manage different health conditions. This scoping review examined the available evidence about telenovela interventions on Latino health. Methods: A scoping review was conducted by searching five peer-reviewed databases for articles published on any date in English or Spanish. The methods of this review were guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews recommendations. Results: A total of 431 articles were identified, and 22 articles published between 1999 and 2022 were included in the final scoping review. Nineteen telenovela interventions were described in the literature. Most studies included telenovela interventions without other elements (n = 15; 68%), and 91% were conducted in the U.S. (n = 20). Studies were qualitative (n = 8; 36%), quantitative (n = 8; 36%), and mixed methods (n = 6; 27%), and most telenovela interventions were developed and/or tested in Spanish (n = 10; 53%). The most common topics for the telenovela interventions were substance use/risky sexual health behaviors, cardiovascular disease, and mental health. Conclusions: This scoping review may serve to continue empirical and theoretical work on telenovela-style entertainment interventions on Latino health and future implementation in real-life settings.

Neurocognition and its predictors in a linguistically and culturally diverse cohort of people with HIV

Objective: HIV/AIDS disproportionately affects Black and Latino people in the United States, yet there is a lack of research on predictors of neurocognitive outcomes in these groups. We examined neurocognitive performance and its key predictors across White, Black, and Latino people with HIV (PWH). Method: Participants included 586 PWH of White, Black, and Latino (English- and Spanish-speaking) background. Neurocognition was assessed via demographically-adjusted Fluid Cognition Composite T-scores from the NIH-Toolbox cognition battery, and individual tests comprising this composite. Predictors examined included sociodemographic and HIV disease characteristics, and medical, psychiatric and substance comorbidities. Results: Compared to White PWH, English-speaking Latino PWH had lower T-scores on the Fluid Cognition Composite, as well as Flanker Inhibition and Picture Sequence Memory tests. While there were no other significant group differences on Fluid Cognition, both Latino PWH language groups performed worse than Black PWH on Flanker Inhibition, and Black PWH performed worse than White PWH on List Sorting. Separate multivariable linear regression models by ethnic/racial/language group showed that significant correlates of worse Fluid Cognition included depressive symptoms among White PWH; hepatitis C co-infection among Black PWH; hypertension among English-speaking Latino PWH; and higher estimated duration of HIV disease and depressive symptoms in Spanish-speaking Latino PWH. Conclusions: Findings suggest worse neurocognition among English-speaking Latino PWH compared to Whites. Predictors of neurocognitive function among PWH differ across ethnic/racial and language groups. Consideration of these HIV disease characteristics and comorbidities may be valuable in developing targeted culturally-relevant interventions aimed at ameliorating neurocognitive dysfunction among diverse PWH.

COVID-19 pandemic–related emotional, social, and medical concerns of Latino patients with cancer: perspectives of mental health providers

Abstract Introduction: Latino people with cancer might face additional health, emotional, and socioeconomic burdens of the COVID-19 pandemic. Methods: This study included data from two waves of (independent) assessments with providers of mental health services to Latino/Hispanic people with cancer from the United States, Spain, and Latin America (first wave: May–July 2020; second wave: March–July 2021) who completed a cross-sectional online survey with open-ended and closed-ended questions, including concerns of people with cancer with/without COVID-19. Results: The response rates were 15% for Wave 1 (N = 88) and 14% for Wave 2 (N = 115). For Wave 1, 74 surveys were completed by clinicians and included in the analyses; for Wave 2, 115 surveys were included. Providers (first [77%] and second [84%] waves) reported that most patients had concerns about stress/symptoms of anxiety, followed by concerns about COVID-19 exposure (first [74%] and second [82%] waves) and family members' exposure (second wave 75%), hospital visits or appointments (82%, 79%, respectively), treatment/testing delays (69%, 72%, respectively), general health (58%, 71%, respectively), and income/salary loss or reduction (60%, 50%, respectively). According to providers, concerns of patients diagnosed with COVID-19 included fear of death and dying, spreading the disease, getting worse, and lack of appropriate medical care. Conclusion: Our findings reveal the need to address health, emotional, and socioeconomic burdens of the COVID-19 pandemic throughout Latin America, Spain, and the United States for Latino people with cancer. Interventions targeting the health care access, emotional, and socioeconomic needs of Latino people with cancer are warranted.

Racial and Ethnic Differences in the Risk of Dementia under Hypothetical Blood‐Pressure‐Lowering Interventions: The Multi‐Ethnic Study of Atherosclerosis

AbstractBackgroundBlack and Latino people have a higher risk of Alzheimer’s disease and related dementias (ADRD) as well as ADRD comorbidities, including hypertension. Since hypertension is perhaps the most important modifiable vascular risk factor for the development of ADRD, we aimed to study whether sustained hypothetical interventions to reduce systolic blood pressure (SBP) would differentially change ADRD risk across racial/ethnic groups.MethodWe used 19 years of follow‐up data from the Multi‐Ethnic Study of Atherosclerosis. The study population included 6806 individuals between 44 and 84 years old, free of clinically recognized CVD and dementia diagnosis at baseline. We defined two sustained interventions on SBP based on continually maintaining SBP below (1) 120 mmHg and (2) 140 mmHg. We considered incident dementia diagnoses as outcome. We applied the parametric g‐formula to adjust for baseline and time‐varying confounding. Baseline covariates included sex, age, education level, income, health insurance, and clinical variables (e.g. diabetes). Time‐varying covariates included SBP, total cholesterol, low‐density lipoprotein, body mass index, health behaviors (e.g. alcohol use), myocardial infarction, stroke, and coronary heart disease diagnosis.ResultMean age was 62.1 (SD = 10.2), 52.9% were female, 38.5% (2617) self‐identified as White, 27.8% (1890) as Black, 21.9% (1495) as Latino and 11.8% (804) as Chinese American. The observed 19‐year risk for dementia was 8.6%. Compared to no specified intervention, maintaining SBP below 120 mmHg was associated with an overall dementia risk reduction of about 5% in the full study population (risk ratio (RR): 0.95, 95%CI: 0.88, 1.02). The estimated RRs for this same comparison were: 0.95(95%CI: 0.87, 1.03) for White participants, 0.93 for Black participants (95%CI: 0.81,1.06), 0.92 for Latino participants (95%CI:0.81, 1.09), and 1.15 for Chinese American participants (95%CI: 0.74,1.63) (Table 1). Of note, the proportion of participants who would have had to have been intervened differed by race/ethnicity, where 92% Black participants, 82% of White and Chinese American, and 86% of Latino participants would have had to have been intervened to maintain SBP below 120 mmHg.ConclusionOur results highlight a heterogenous effect that should be considered for implementation of blood pressure control strategies.

HIV-Related Stigma and Multidimensional Frailty Among Older Latinos With HIV.

Introduction: Frailty is a geriatric syndrome of increased vulnerability to stressors marked by a higher risk for poor health outcomes. HIV-related stigma is a stressor for Latino people with HIV (PWH) and an important barrier to HIV care. This study examines the association between HIV-related stigma and multidimensional frailty among older Latino PWH. Methods: A cross-sectional design with 120 Latino PWH aged 50 and older was used. Self-reported questionnaires were administered to assess multidimensional frailty (Tilburg Frailty Indicator) and HIV-related stigma (HIV stigma scale). Results: Participants were 59.1 ± 7.0 years old, primarily White-Hispanic (85.00%, n = 102), single (48.33%, n = 58), and male (73.30%, n = 88). Nearly half of the participants were frail (45.85%, n = 55). Compared to non-frail, frail individuals had significantly higher scores in the total HIV-related stigma (M = 98.5 ± 24.7 vs. M = 85.3 ± 25.6, p = .020) and all subscales. The odds of multidimensional frailty were 1.021 times higher for people with higher HIV-related stigma scores (p = .007). This association remained significant after adjustment for income and comorbidities (p = .049). Conclusions: HIV-related stigma among older Latino PWH was significantly associated with their odds of being frail. Efforts to prevent multidimensional frailty should consider addressing HIV-related stigma through age-appropriate and culturally tailored resources for this group.

Naturalizing unnatural death in Los Angeles County jails.

In this paper we use quantitative and qualitative methods to examine how death investigations in Los Angeles County jails disproportionately naturalize death among Black and Latino incarcerated people. Our study is based on an assessment of 58 autopsies, coroner investigator narratives, and toxicology reports produced between 2009 and 2018. We found that the Medical Examiner frequently arrived at natural or undetermined death determinations that minimized the culpability of carceral staff for loss of life that occurred within county jail. In our dataset, Black people were disproportionately classified as natural. Undetermined deaths were almost exclusively Latino. More than 75% of the cases in our study were deaths that occurred before standing trial. Our findings reveal how biomedical knowledge about incarcerated Black and Latino people is used to erase the life-diminishing effects of punishment, neglect, and maltreatment that are central to the project of mass incarceration.

Identifying Learning Disability Screens for Spanish-Speaking Adults

The successful screening for possible learning disabilities (LD) is a crucial first step in the process of identifying signs of LD, gaining assistance and/or accommodations, and obtaining a more complete LD assessment. Although Latino people are the largest ethnic minority in the United States, and more specifically in California, there remains a clear need for a valid LD screening measure that is appropriate for adult Spanish speakers, particularly low-income individuals. This study evaluated the validity of three brief measures to screen for LD among low-income Spanish-speaking adults: Empire State Screen, Welfare-to-Work [WTW] 18, and MATILDA-R. The study also provides an initial estimate of LD risk in the low-income Spanish-speaking population. To estimate the predictive utility of each screening measure, 1,040 Spanish-speaking adults were administered each of the three screens and then assessed for indications of LD using multiple scoring methods (Bateria Discrepancy Diagnosis [BDD], pattern of strengths and weaknesses [PSW], and DSM-5). The translated WTW 18 Screen and the MATILDA-R appeared most promising. A culturally-sensitive, validated LD screen will help ensure that social workers and other helping professionals have access to appropriate and legally required interventions for this marginalized population.

A Tale of Two Audiences: Formative Research and Campaign Development for Two Different Latino Audiences, to Improve COVID-19 Prevention Behavior.

The COVID-19 pandemic disproportionately affected the Latino population in the United States, further exacerbating the existing racial and ethnic health disparities that this group faces. While government health entities rushed to develop COVID-19 prevention educational materials in Spanish, these failed to recognize the unique motivators and barriers that move different Latino audience segments to act. We conducted five online focus groups with two different Latino audience segments, general Latino people, and Latino migrant workers, to assess their experience navigating the pandemic, their engagement in preventive behavior, and their consumption of health news. While the general Latino audience had higher levels of social capital and established preventive healthcare, they were more skeptical about getting the COVID-19 vaccine. Migrant workers needed to be vaccinated to retain their jobs, and saw the vaccine as the only way to keep their families healthy. We used the focus group results to develop two different creative concepts that aligned with each audience's unique experience. Our study highlights the importance of developing hyper-focused messages, responsive to the experience of distinct audience segments, for maximum impact.

Is the Montreal Cognitive Assessment (MOCA) test better suited to cognitive impairment detection among Latino people than the Mini-Mental State Examination (MMSE)

In a sample of 60 patients over the age of sixty and Spanish as mother-tongue, the Montreal Cognitive Assessment (MOCA) and the Mini-Mental State Examination (MMSE) tests were carried out to determine if they can be used equally in patients with cerebrovascular disease of small vessel and clinically perceptible affectations of cognitive impairment and Dementia; and obtain similarly valid results. The population with Dementia and cognitive impairment is increasing. Multiple tools and techniques have been perfected to study this health condition to measure mental problems and Dementia. To obtain the sample, we used the simple random method. A protocol of 30 questions focused on evaluating complex cognitive functions was used to apply the MOCA test. In the MMSE test, an 11-question protocol was used to evaluate essential cognitive functions. The results showed that the MOCA test correctly identified an actual positive rate of 89.6% and a true negative rate of 66.7%. The MMSE test had a false positive rate of 4.4%, having a higher probability of falsely identifying an individual with cognitive impairment. The tests help determine the degree of cognitive deterioration, but with different sensitivities according to their level of studies, which should be preferred over the MOCA. Keywords: Mental health; MMSE; MOCA; cognitive impairment; elderly

Disparities in the Pretrial Process: Race, Ethnicity, and Citizenship

Prior work establishes that Black and Latino people face harsher treatment during the pretrial phase of the justice system. Yet, the mechanisms underlying pretrial racial and ethnic disparities remain unclear. Using multiple administrative data sources from a large jurisdiction in the southeast, we examined the influence of race, ethnicity, and citizenship on judicial decisions and defendant outcomes among people booked for a felony (n = 29,735). Of particular interest was the extent to which previously observed racial and ethnic disparities may be attributable to citizenship. Our results indicate that (1) Black and Latino people receive more punitive judicial decisions and experience worse pretrial outcomes than Whites, net of citizenship status; (2) noncitizens receive more lenient judicial decisions and experience better pretrial outcomes than citizens; and (3) citizenship status interacts with ethnicity, such that among noncitizens, Latinos suffer the worst outcomes of all groups. Implications for research and theorizing are discussed.

COVID-19 amplified racial disparities in the US criminal legal system

The criminal legal system in the USA drives an incarceration rate that is the highest on the planet, with disparities by class and race among its signature features1–3. During the first year of the coronavirus disease 2019 (COVID-19) pandemic, the number of incarcerated people in the USA decreased by at least 17%—the largest, fastest reduction in prison population in American history4. Here we ask how this reduction influenced the racial composition of US prisons and consider possible mechanisms for these dynamics. Using an original dataset curated from public sources on prison demographics across all 50 states and the District of Columbia, we show that incarcerated white people benefited disproportionately from the decrease in the US prison population and that the fraction of incarcerated Black and Latino people sharply increased. This pattern of increased racial disparity exists across prison systems in nearly every state and reverses a decade-long trend before 2020 and the onset of COVID-19, when the proportion of incarcerated white people was increasing amid declining numbers of incarcerated Black people5. Although a variety of factors underlie these trends, we find that racial inequities in average sentence length are a major contributor. Ultimately, this study reveals how disruptions caused by COVID-19 exacerbated racial inequalities in the criminal legal system, and highlights key forces that sustain mass incarceration. To advance opportunities for data-driven social science, we publicly released the data associated with this study at Zenodo6.

Underrepresented groups make small gains

From 2011 to 2021, women and Hispanic or Latino scientists achieved the largest increases in employment among underrepresented groups in the science, technology, engineering, and mathematics (STEM) workforce. Still, their share of the workforce remains low compared with their proportion of the US population, the newest National Science Foundation report on diversity in STEM shows. “Today’s report serves as a critical benchmark for measuring and evaluating the nation’s progress in this area,” NSF director Sethuraman Panchanathan said at a press conference. The fields of engineering and physical sciences, including chemistry, continue to have especially low percentages of women and underrepresented people of color (see pie chart) compared with social science fields. In 2021, the chemistry workforce, for example, included about 4.4% Black or African American people and 7.0% Hispanic or Latino people, data tables accompanying the report show. Women make up 35.1% of all chemists. Just 3% of people in

Self-stigma of mental illness among Latino people on the U.S.-México border.

Self-stigma of mental illness among Latino people on the U.S.-México border.

The Injustice Facing Latino Immigrants in Achieving The American Dream in Cristina Heriquez’s Novel The Book of Unknown

United States of America is known as a country that promises its people or immigrants who come to America to become successful by providing ‘American Dream’ as the country’s national ethos. These people are given equal chances to bring out their dreams and aspirations. However, American Dream is not always the dream for everyone as experienced by the characters in Christina Henriques’ novel The Book of Unknown Americans. Issue of injustice shadows immigrants who are in search of this dream. Facing problems of injustice such as racism, different treatment of immigrants, and sexual harassment are inevitable for these Latino people when they first come to the United States. This study is aimed at discussing the failures and injustices that Latino immigrants’ characters of the novel must face when they attempt of achieving the American Dream. The method used in this study is qualitative method. The data of this research are in the forms of language and its discourse. Stuart Hall’s Theory of Representation is used to analyze the research data. The results of this study show that not all-American dreams can be fulfilled easily, in particular for Latino immigrant characters in the novel. What have been faced by these characters are significant experiences to learn for anyone who wants to pursue their dream in United States of America.

Does affirming Black and Latino people asAmericanweaken racial solidarity? A surprising “no” from two pre-registered experiments

Drawing on social identity theory, we predicted that affirming Black and Latino individuals as American would undermine solidarity between people of color (PoC), who are broadly stereotyped by society as un-American. We tested this prediction in two pre-registered experiments with Black and Latino adults ( N = 1,880), where participants read about another minoritized group’s contribution to U.S. culture (i.e., Latino people: reggaetón and hip hop; Black people: jazz and hip hop). Reading about Latinos’ musical contributions to U.S. culture insignificantly reduced Black solidarity with PoC, although an increase in Black solidarity with PoC unexpectedly boosted support for pro-Latino policies. In turn, reading about Black contributions to U.S. culture surprisingly increased Latino solidarity with PoC, which then substantially heightened pro-Black policy support. This unanticipated mediation effect is statistically robust and substantively meaningful. We explain how these contradictory results help advance research on the conditions that catalyze solidarity between PoC.

Medicaid can and should play an active role in advancing health equity.

Medicaid can and should play an active role in advancing health equity.