Latino Population Research Articles

Investigating SARS-CoV-2 Incidence and Morbidity in Ponce, Puerto Rico: Protocol and Baseline Results From a Community Cohort Study.

A better understanding of SARS-CoV-2 infection risk among Hispanic and Latino populations and in low-resource settings in the United States is needed to inform control efforts and strategies to improve health equity. Puerto Rico has a high poverty rate and other population characteristics associated with increased vulnerability to COVID-19, and there are limited data to date to determine community incidence. This study describes the protocol and baseline seroprevalence of SARS-CoV-2 in a prospective community-based cohort study (COPA COVID-19 [COCOVID] study) to investigate SARS-CoV-2 infection incidence and morbidity in Ponce, Puerto Rico. In June 2020, we implemented the COCOVID study within the Communities Organized to Prevent Arboviruses project platform among residents of 15 communities in Ponce, Puerto Rico, aged 1 year or older. Weekly, participants answered questionnaires on acute symptoms and preventive behaviors and provided anterior nasal swab samples for SARS-CoV-2 polymerase chain reaction testing; additional anterior nasal swabs were collected for expedited polymerase chain reaction testing from participants that reported 1 or more COVID-19-like symptoms. At enrollment and every 6 months during follow-up, participants answered more comprehensive questionnaires and provided venous blood samples for multiantigen SARS-CoV-2 immunoglobulin G antibody testing (an indicator of seroprevalence). Weekly follow-up activities concluded in April 2022 and 6-month follow-up visits concluded in August 2022. Primary study outcome measures include SARS-CoV-2 infection incidence and seroprevalence, relative risk of SARS-CoV-2 infection by participant characteristics, SARS-CoV-2 household attack rate, and COVID-19 illness characteristics and outcomes. In this study, we describe the characteristics of COCOVID participants overall and by SARS-CoV-2 seroprevalence status at baseline. We enrolled a total of 1030 participants from 388 households. Relative to the general populations of Ponce and Puerto Rico, our cohort overrepresented middle-income households, employed and middle-aged adults, and older children (P<.001). Almost all participants (1021/1025, 99.61%) identified as Latino/a, 17.07% (175/1025) had annual household incomes less than US $10,000, and 45.66% (463/1014) reported 1 or more chronic medical conditions. Baseline SARS-CoV-2 seroprevalence was low (16/1030, 1.55%) overall and increased significantly with later study enrollment time (P=.003). The COCOVID study will provide a valuable opportunity to better estimate the burden of SARS-CoV-2 and associated risk factors in a primarily Hispanic or Latino population, assess the limitations of surveillance, and inform mitigation measures in Puerto Rico and other similar populations. RR1-10.2196/53837.

Comparison of US emergency departments by HIV priority jurisdiction designation: A case for geographically targeted screening in teaching hospitals.

The Ending the HIV Epidemic (EHE) Initiative targets a subset of United States (US) priority jurisdictions hardest hit by HIV. It remains unclear which emergency departments (EDs) are the most appropriate targets for EHE-related efforts. To explore this, we used the 2001-2019 National Emergency Department Inventories (NEDI)-USA as a framework to characterize all US EDs, focusing on those in priority jurisdictions and those affiliated with a teaching hospital. We then incorporate multivariable regression to explore the association between ED characteristics and location in an HIV priority jurisdiction. Further, to provide context on the communities these EDs serve, demographic and socioeconomic information and sexually transmitted infection case rate data were included. This reflected 2019 US Census Bureau data on age, race, ethnicity, and proportion uninsured and living in poverty along with 2001-2019 Centers for Disease Control and Prevention case rate data on chlamydia, gonorrhea, and syphilis. We found that EDs in priority jurisdictions (compared to EDs not in priority jurisdictions) more often served populations emphasized in HIV-related efforts (i.e., Black or African American or Hispanic or Latino populations), communities with higher proportions uninsured and living in poverty, and counties with higher rates of chlamydia, gonorrhea, and syphilis. Further, of the groups studied, EDs with teaching hospital affiliations had the highest visit volumes and had steady visit volume growth. In regression, ED annual visit volume was associated with an increased odds of an ED being located in a priority jurisdiction. Our results suggest that geographically targeted screening for HIV in a subset of US priority jurisdiction EDs with a teaching hospital affiliation could be an efficient means to reach vulnerable populations and reduce the burden of undiagnosed HIV in the US.

Why Culture and Context Matters: Examining Differences in Mental Health Stigma and Social Distance Between Latino Individuals in the United States and Mexico.

This study examines the influence of cultural context on social distance and perceptions of stigma towards mental health conditions among Latino populations in Houston, TX, USA and Mexico City, Mexico. We employed a community-based experimental vignette survey to assess perceptions towards individuals experiencing symptoms of alcohol misuse, depression, and psychosis. Participants (n = 513) from Houston and Mexico City were asked about their willingness to accept community members experiencing mental health symptoms in various social roles, their perceptions of stigma related to these symptoms, anticipated danger, possible positive outcomes, and the community member's ability to change. Findings demonstrate significant differences in stigma perceptions between Latino respondents in the US and in Mexico. Houston participants reported lower public stigma and perceived dangerousness of someone with mental health concerns compared to respondents in Mexico City. Furthermore, the cultural context may influence the association between various dimensions of stigma, with some inverse relationships occurring based on location of data collection. Findings illuminate the complex interplay between cultural context, mental health symptoms, and stigma, and underscores the need for culturally nuanced interventions to reduce mental health stigma and promote service utilization in Latino communities.

Historical racial redlining and contemporary patterns of income inequality negatively affect birds, their habitat, and people in Los Angeles, California

Abstract The Home Owners’ Loan Corporation (HOLC) was a U.S. government-sponsored program initiated in the 1930s to evaluate mortgage lending risk. The program resulted in hand-drawn “security risk” maps intended to grade sections of cities where investment should be focused (greenlined areas) or limited (redlined zones). The security maps have since been widely criticized as being inherently racist and have been associated with high levels of segregation and lower levels of green amenities in cities across the country. Our goal was to explore the potential legacy effects of the HOLC grading practice on birds, their habitat, and the people who may experience them throughout a metropolis where the security risk maps were widely applied, Greater Los Angeles, California (L.A.). We used ground-collected, remotely sensed, and census data and descriptive and predictive modeling approaches to address our goal. Patterns of bird habitat and avian communities strongly aligned with the luxury-effect phenomenon, where green amenities were more robust, and bird communities were more diverse and abundant in the wealthiest parts of L.A. Our analysis also revealed potential legacy effects from the HOLC grading practice. Associations between bird habitat features and avian communities in redlined and greenlined zones were generally stronger than in areas of L.A. that did not experience the HOLC grading, in part because redlined zones, which included some of the poorest locations of L.A., had the highest levels of dense urban conditions (e.g., impervious surface cover), whereas greenlined zones, which included some of the wealthiest areas of the city, had the highest levels of green amenities (e.g., tree canopy cover). The White population of L.A., which constitutes the highest percentage of a racial or ethnic group in greenlined areas, was aligned with a considerably greater abundance of birds affiliated with natural habitat features (e.g., trees and shrubs). Conversely, the Hispanic or Latino population, which is dominant in redlined zones, was positively related to a significantly greater abundance of synanthropic birds, which are species associated with dense urban conditions. Our results suggest that historical redlining and contemporary patterns of income inequality are associated with distinct avifaunal communities and their habitat, which potentially influence the human experience of these components of biodiversity throughout L.A. Redlined zones and low-income residential areas that were not graded by the HOLC can particularly benefit from deliberate urban greening and habitat enhancement projects, which would likely carry over to benefit birds and humans.

H - 07 Associations among Cardiovascular Factors, Mood, and Cognition in Older Latinos: Preliminary Results from the Boston Latino Aging Study.

Cardiovascular risk factors and depression are prevalent in Latino populations and have been associated with an increased risk of cognitive decline and dementia. Adults with depressive symptoms also have an increased risk of cardiovascular disease. Understanding the link between these factors and how they impact dementia risk among Latino cohorts is critical for the development of preventative interventions. We examined the associations among cardiovascular risk factors, depression, and cognitive status in older Latinos living in Massachusetts. A total of 42 participants enrolled in the Boston Latino Aging Study (BLAST; n = 28, mean age = 65.36, SD = 7.35) and the Harvard Aging Brain Study Latino cohort (LHABS) (n = 14, mean age = 71.43, SD = 6.89) were included in the analyses. Participants completed a screening evaluation that included the Telephone Interview Cognitive Screen (TICS), the Geriatric Depression Scale (GDS), blood sampling to assess cholesterol, fasting glucose, and triglyceride levels, and systolic/diastolic blood pressure measurements. Spearman correlations were used to determine associations among cardiovascular risk factors, depression (GDS), and cognitive status (TICS). We found that triglycerides (r = -0.424, p = 0.005) and glucose (r = -0.317, p = 0.041) were negatively correlated with TICS. Systolic blood pressure (r = 0.325, p = 0.036) and fasting glucose (r = 0.327, p = 0.034) were positively correlated with GDS scores. Preliminary results suggest a link between cardiovascular risk factors (e.g., elevated triglycerides and glucose) and worse cognitive status. Additionally, findings suggest cardiovascular risk factors may be related to depressive symptoms in older Latinos. Further work with larger samples of Latino participants is needed to confirm our findings and examine relevant associations with other risk factors.

H - 69 Making Diagnostic Decisions Using Linguistically Congruent Neuropsychological Assessment in a Monolingual Low Education Latino: a Single Case.

As life expectancy and Latino populations increase in the United States, it is important to provide linguistically congruent neuropsychological assessments to assist in the treatment and diagnosis of neurodegenerative processes. This case used a linguistically congruent evaluation and appropriate norms in a 72-year-old Latin male with low education, to inform treatment recommendations. A 72-year-old Latin male with five years of education was referred by his neurologist in the context of cognitive, behavioral, and functional decline over the past several years. He was educated outside of the United States, in a Spanish-speaking country, and speaks limited English. Therefore, testing was administered in Spanish. All test data were compared to other Spanish-speaking clinical patients with low education levels from his country of origin when available (11 articles). Overall given the evidence, he was diagnosed with Mild Neurocognitive Disorder due to Multiple Etiologies, with behavioral disturbance. His profile revealed weaknesses in verbal learning and memory, attention, and psychomotor processing speed. However, when compared to non-corrected norms, he performed significantly different (at least 1 SD) across several measures. Using a linguistically congruent evaluation, in addition to a compilation of age and education-corrected norms, we came to a diagnostic conclusion of a Mild Neurocognitive Disorder. If the normative data not been corrected for age and education, his impairments in visuospatial abilities and attention would have been inflated. As the Latino population continues to age, it becomes increasingly important to develop ways to assess this population appropriately.

Diagnostic yield of chromosomal microarray in the largest Latino clinical cohort.

Copy number variants (CNVs) remain a major etiological cause of neurodevelopmental delay and congenital malformations. Chromosomal microarray analysis (CMA) represents the gold standard for CNVs molecular characterization. We applied CMA throughout the patient's clinical diagnostic workup, as the patient's medical provider requested. We collected CMA results of 3380 patients enrolled for 5 years (2016-2021). We found 830 CNVs in 719 patients with potential clinical significance, that is, (i) pathogenic, (ii) likely pathogenic, and (iii) variants of uncertain significance (VUS), from which 10.6% (predominantly involving chromosomes 15 and 22) were most likely the final cause underpinning the patients' clinical phenotype. For those associated with neurodevelopmental phenotypes, the rate of pathogenic or likely pathogenic findings among the patients with CNVs was 60.75%. When considering epileptic phenotypes, it was 59%. Interestingly, our protocol identified two gains harbored in 17q21.31 and 9q34.3, internationally classified initially as VUS. However, because of their high frequency, we propose that these two VUS be reclassified as likely benign in this widely heterogeneous phenotypic population. These results support the diagnostic yield efficiency of CMA in characterizing CNVs to define the final molecular cause of genetic diseases in this cohort of Colombian patients, the most significant sample of patients from a Latino population, and define new benign polymorphic CNVs.

Pre-exposure Prophylaxis Use and Discontinuation in a Federally Qualified Health Center in a Mexico-US Border City.

Latino men who have sex with men (MSM) experience disproportionately high rates of HIV diagnoses in the United States. Pre-exposure prophylaxis (PrEP) use is critical to reduce this inequity, but PrEP awareness, access, and use are low among Latino MSM. This study aims to describe patterns of PrEP persistence and discontinuation among predominately Latino MSM accessing PrEP in a federally qualified health center (FQHC) in El Paso, Texas. This retrospective cohort comprised individuals who were eligible for PrEP at a FQHC in El Paso, Texas, between January 30, 2019, and August 15, 2021. We defined hierarchical categories of PrEP use and discontinuation, which was defined as more than 120days between PrEP visits. We used Kaplan-Meier survival plots to estimate median time to first PrEP discontinuation. There were 292 patients evaluated for PrEP; 91% were Latino. The majority of PrEP patients (70%, 205/292) experienced any PrEP discontinuation, and the median time to first PrEP discontinuation was 202days (95% CI: 179-266). The proportion of patients who remained on PrEP at 3months after initiation was 82% (95% CI: 76%, 87%) and at 6months after initiation was 55% (95% CI: 46%, 62%). While 3-month PrEP retention was high in this predominately Latino MSM patient population, PrEP discontinuation was common. Interventions that enhance longer-term persistence and support for restarting PrEP are needed to reduce the persistent ethnoracial disparities in HIV incidence.

S323 Effect of a Local Media Intervention on Interest in Colonoscopy and Colorectal Cancer in the Indianapolis Latino Population: A Google Trends Analysis

S323 Effect of a Local Media Intervention on Interest in Colonoscopy and Colorectal Cancer in the Indianapolis Latino Population: A Google Trends Analysis

Young, Black/African American, and Latino communities are left behind despite legislative efforts in California to reduce HIV/STI disparities.

Sexually transmitted infections (STI) have been on the rise in the United States with racial/ethnic minority groups, gay and bisexual men, and youth experiencing the highest STI and HIV infection rates. In 2022, California became the first state in the nation to pass legislation, Senate Bill 306 (SB 306), requiring health care plans to cover the costs of home test kits for STIs, including HIV. This study examines provisions within SB 306 and its potential to reduce STI and HIV disparities among key demographic groups and geographic regions within California. Ecological cross-sectional study involving 58 California counties. Descriptive statistics and choropleth maps compared HIV/STI prevalence rates, uninsured rates, demographic composition, and healthcare provider coverage across California counties. Three geographically weighted Poisson regression analyses were conducted to separately examine the association between proportion of uninsured and HIV, gonorrhea, and chlamydia prevalence rates. HIV/STI rates were significantly and positively associated with the proportion of uninsured residents in Central and Southern California counties. These counties had a higher proportion of demographic groups vulnerable to HIV/STI including a large Latino, Black/African American, and younger (age 15-24) population but had a lower rate of healthcare providers with prescription authority for home testing kits, which is a requirement under SB 306. Cutting-edge solutions are needed to stem the rising tide of new STI and HIV infections. While SB 306 is novel and innovative in intent, its coverage gaps will increase disparities and inequities among historically underserved populations.

The American Dream: Is Immigration Associated with Life Satisfaction for Latinos of Mexican Descent?

The Latino population is one of the largest immigrant groups in the United States, with the majority being of Mexican descent. Whether immigrating to the US is positive for the well-being of Mexican immigrants and future generations is an important question. We examined how nativity status and quality of life indicators relate to life satisfaction among foreign-born and US-born Mexican descent Latinos living in California. Participants (N = 893) were from the California Quality of Life Survey, a population-based mental health survey of the California population. Multiple regressions examining sociodemographic and indicators of life satisfaction found higher life satisfaction among the foreign-born compared to US-born: (US-born first generation: Wald F = 18.70, p < 0.001; US-born second generation and higher: Wald F = 12.09, p < 0.001), females (Wald F = 7.05, p < 0.01), and individuals reporting more social support (Wald F = 40.20, p < 0.001), absence of frequent distress (Wald F = 41.46, p < 0.001), and better physical health (Wald F = 15.28, p < 0.001). Life satisfaction was lower for US-born Mexicans than for Mexican immigrants. Research, interventions, and policies are needed for mental health equity that address this lack of well-being in US-born Mexican Latinos.

Report of 5146 Cases of Coronavirus Disease 2019-Related Mortality From Cook County, Illinois Causes of Death, Demographics, and Comorbidities.

A cross-sectional study used 5216 laboratory-confirmed coronavirus disease 2019 (severe acute respiratory syndrome coronavirus 2)-related mortality cases in Cook County of Illinois. The data set included each case's demographic data, manner of death, and comorbidities. The age ranged from 0 to 108 years, with a median of 73.5 years. There were few mortality cases in the age group younger than 30 years, and the incidence of fatal infection increased with age. We demonstrated an increased incidence of mortality in males compared with females (P < 0.01). The urban population had a higher incidence of fatal infection than the suburban population (P < 0.01). We found a significant increase (P < 0.01) in the incidence of fatal coronavirus disease 2019 (severe acute respiratory syndrome coronavirus 2) infection in African American males compared with background frequencies. Latino population demonstrated younger ages at death compared with the non-Latino population. Obesity and hypertension significantly predict fatal outcomes in the younger age group. In comparison, dementia and hypertensive and arteriosclerotic cardiovascular disease are significant predictive factors in the older age group. In a large data set, we demonstrated that the demographical distribution of the population and comorbidities is associated with the risk of fatal complications and death.

State-Level Anti-Immigrant Sentiment and Policies and Health Risks in US Latino Children.

Although systemic inequities, broadly defined, are associated with health disparities in adults, there is a dearth of research linking contextual measures of exclusionary policies or prejudicial attitudes to health impairments in children, particularly among Latino populations. In this study, we examined a composite measure of systemic inequities in relation to the cooccurrence of multiple health problems in Latino children in the United States. Participants included 17 855 Latino children aged 3 to 17 years from the National Survey of Children's Health (2016-2020). We measured state-level systemic inequities using a factor score that combined an index of exclusionary state policies toward immigrants and aggregated survey data on prejudicial attitudes toward immigrants and Latino individuals. Caregivers reported on 3categories of child health problems: common health difficulties in the past year, current chronic physical health conditions, and current mental health conditions. For each category, we constructed a variable reflecting 0, 1, or 2 or more conditions. In models adjusted for sociodemographic covariates, interpersonal discrimination, and state-level income inequality, systemic inequities were associated with 1.13 times the odds of a chronic physical health condition (95% confidence interval: 1.02-1.25) and 1.24 times the odds of 2 or more mental health conditions (95% confidence interval: 1.06-1.45). Latino children residing in states with higher levels of systemic inequity are more likely to experience mental health or chronic physical health conditions relative to those in states with lower levels of systemic inequity.

Psychometric Validity of the Areas of Work Life Scale (AWS) in Teachers and Healthcare Workers in México.

The areas of work life scale (AWS) has shown to be a suitable marker of perceived fit between employees' abilities and the psychosocial demands of the job, but validation studies are practically nonexistent in the Latino population. The purpose of this study was twofold: firstly, to examine the factor structure, reliability, and invariance between sex and occupation of the AWS scale, and secondly, to test the AWS-burnout relationship within the framework of the structural mediational model proposed by Leiter and Maslach (2005). N = 305 health workers and N = 324 teachers from different work settings answered the AWS and MBI-GS scales. In this study, 64.4% of the participants were females (N = 405), and the mean age was 34.7 (sd = 11.7, rank = 56). Robust methods for statistical analyses were used. The results showed that the original version had marginal fit indices due to a method effect (negative phrasing items), and when seven negative items were removed, a final best model was found (CFI = 0.997; RMSEA = 0.060; SRMRu = 0.047). Non-invariance between occupation and sex was found, and the internal consistency was from marginal to satisfactory (ω = 0.658 to 0.840). The mediational structural model tested confirmed the expected associations between AWS and burnout. In conclusion, the Mexican translation of the AWS in its 22-reduced version showed reliability and validity in Mexican work contexts, specifically in healthcare workers and teachers.

Evaluation of the Relationship Between Diabetic Macular Edema and Renal Function in a Latino Population.

Diabetic macular edema (DME) is one of the leading causes of vision impairment. The relationship between DME and estimated glomerular filtration rate (eGFR) has not been clearly evaluated in Hispanic or Latino populations. The objective of this study was to evaluate the eGFR in a Latino population with DME. A cross-sectional, observational, and descriptive study was carried out on the basis of a multicenter phaseIII clinical trial. A total of 82 subjects diagnosed with DME (36 women and 46 men) were included in the study. The mean age was 61.93 ± 6.71years. Mean values of the blood chemistry parameters glycated hemoglobin and eGFR were 7.20 ± 0.95% and 74.42 ± 26.82mL/min/1.73m2, respectively. The time elapsed since diagnosis of diabetes mellitus was 15.30 ± 7.35years, while the duration of DME was 1.41 ± 1.75years. Mean values for central macular thickness (CMT) and total macular volume (TMV) were 440.99 ± 132.22µm and 11.97 ± 2.11mm3, respectively. DME duration had a negative correlation with TMV (Rho- 0.26, p < 0.05) and a positive correlation with mean arterial pressure (Rho0.26, p < 0.05). CMT was correlated with TMV (Rho0.43, p < 0.0001) and visual acuity (Rho0.26, p < 0.05). No significant correlations were observed between eGFR and CMT, TMV, or any demographic variable (p > 0.05). Chronic kidney disease (CKD) was associated with hypertension (OR9.32, p = 0.035), elevated intraocular pressure (IOP) (OR0.03, p = 0.011), and advanced age (OR0.45, p = 0.011). CMT was significantly associated with TMV (β = 27.69, p < 0.0001). We did not find a correlation between eGFR and DME. Our findings suggest that the presence of hypertension is associated with a decrease in the GFR < 60mL/min/1.73m2, and CKD may be associated with advanced age and elevated IOP which may increase the risk for the development of glaucoma. NCT05217680 (clinicaltrials.gov).

Cause-specific mortality by county, race, and ethnicity in the USA, 2000–19: a systematic analysis of health disparities

Large disparities in mortality exist across racial-ethnic groups and by location in the USA, but the extent to which racial-ethnic disparities vary by location, or how these patterns vary by cause of death, is not well understood. We aimed to estimate age-standardised mortality by racial-ethnic group, county, and cause of death and describe the intersection between racial-ethnic and place-based disparities in mortality in the USA, comparing patterns across health conditions. We applied small-area estimation models to death certificate data from the US National Vital Statistics system and population data from the US National Center for Health Statistics to estimate mortality by age, sex, county, and racial-ethnic group annually from 2000 to 2019 for 19 broad causes of death. Race and ethnicity were categorised as non-Latino and non-Hispanic American Indian or Alaska Native (AIAN), non-Latino and non-Hispanic Asian or Pacific Islander (Asian), non-Latino and non-Hispanic Black (Black), Latino or Hispanic (Latino), and non-Latino and non-Hispanic White (White). We adjusted these mortality rates to correct for misreporting of race and ethnicity on death certificates and generated age-standardised results using direct standardisation to the 2010 US census population. From 2000 to 2019, across 3110 US counties, racial-ethnic disparities in age-standardised mortality were noted for all causes of death considered. Mortality was substantially higher in the AIAN population (all-cause mortality 1028·2 [95% uncertainty interval 922·2-1142·3] per 100 000 population in 2019) and Black population (953·5 [947·5-958·8] per 100 000) than in the White population (802·5 [800·3-804·7] per 100 000), but substantially lower in the Asian population (442·3 [429·3-455·0] per 100 000) and Latino population (595·6 [583·7-606·8] per 100 000), and this pattern was found for most causes of death. However, there were exceptions to this pattern, and the exact order among racial-ethnic groups, magnitude of the disparity in both absolute and relative terms, and change over time in this magnitude varied considerably by cause of death. Similarly, substantial geographical variation in mortality was observed for all causes of death, both overall and within each racial-ethnic group. Racial-ethnic disparities observed at the national level reflect widespread disparities at the county level, although the magnitude of these disparities varied widely among counties. Certain patterns of disparity were nearly universal among counties; for example, in 2019, mortality was higher among the AIAN population than the White population in at least 95% of counties for skin and subcutaneous diseases (455 [97·8%] of 465 counties with unmasked estimates) and HIV/AIDS and sexually transmitted infections (458 [98·5%] counties), and mortality was higher among the Black population than the White population in nearly all counties for skin and subcutaneous diseases (1436 [96·6%] of 1486 counties), diabetes and kidney diseases (1473 [99·1%]), maternal and neonatal disorders (1486 [100·0%] counties), and HIV/AIDS and sexually transmitted infections (1486 [100·0%] counties). Disparities in mortality among racial-ethnic groups are ubiquitous, occurring across locations in the USA and for a wide range of health conditions. There is an urgent need to address the shared structural factors driving these widespread disparities. National Institute on Minority Health and Health Disparities; National Heart, Lung, and Blood Institute; National Cancer Institute; National Institute on Aging; National Institute of Arthritis and Musculoskeletal and Skin Diseases; Office of Disease Prevention; and Office of Behavioral and Social Sciences Research, US National Institutes of Health.

Examining COVID-19 testing and vaccination behaviors by heritage and linguistic preferences among Hispanic, Latino, or Spanish RADx-UP participants

The Hispanic, Latino, or Spanish (hereafter, “Hispanic”) populations in the U.S. bear a disproportionate burden of COVID-19-related outcomes, including disease incidence and mortality. Developing culturally appropriate national public health services for Hispanic persons remains a challenge. This study examined the association of heritage and language preference with COVID-19 testing (tested vs. not tested) and vaccination (vaccinated vs. not vaccinated) outcomes among Hispanic participants from 18 Rapid Acceleration of Diagnostics-Underserved Populations (RADx-UP) projects (n = 3308; mean age = 44.1 years [SD = 14.9], 60% women; 83% spoke other than English at home). Generalized estimating equation models adjusted for age, gender, education level, income, insurance coverage, geographic region, comorbidities, and prior infection. Relative to Mexican heritage, individuals identifying as Puerto Rican or Dominican were more likely to test for COVID-19, and South American heritage was associated with higher testing and vaccination rates. Speaking Spanish or another language at home was associated with increased testing compared with speaking English at home for individuals who preferred not to report their heritage, and increased vaccination for those with Mexican, Cuban, or Central American heritage. This study highlights heterogeneity in testing and vaccination behaviors among Hispanic populations based on heritage and language preference, underscoring the diversity within the U.S. Hispanic community. In contrast to other studies on linguistic acculturation and health care utilization, our study found that a language other than English spoken at home was associated with greater vaccine uptake. That is, enculturation – the retention of Spanish language and presumably of Hispanic cultural norms – was linked with being vaccinated.

The burden of stomach cancer mortality by county, race, and ethnicity in the USA, 2000–2019: a systematic analysis of health disparities

There are persistent disparities in stomach cancer mortality among racial-ethnic groups in the USA, but the extent to which these patterns vary geographically is not well understood. This analysis estimated age-standardised mortality for five racial-ethnic groups, in 3110 USA counties over 20 years, to describe spatial-temporal variations in stomach cancer mortality and disparities between racial-ethnic groups. Redistribution methods for insufficient cause of death codes and validated small area estimation methods were applied to death registration data from the US National Vital Statistics System and population data from the US National Center for Health Statistics to estimate annual stomach cancer mortality rates. Estimates were stratified by county and racial-ethnic group (non-Latino and non-Hispanic [NL] American Indian or Alaska Native [AIAN], NL Asian or Pacific Islander [Asian], NL Black [Black], Latino or Hispanic [Latino], and NL White [White]) from 2000 to 2019. Estimates were corrected for misreporting of racial-ethnic group on death certificates using published misclassification ratios. We masked (ie, did not display) estimates for county and racial-ethnic group combinations with a mean annual population of less than 1000; thus, we report estimates for 3079 (of 3110) counties for the total population, and 474, 667, 1488, 1478, and 3051 counties for the AIAN, Asian, Black, Latino, and White populations, respectively. Between 2000 and 2019, national age-standardised stomach cancer mortality was lowest among the White population in every year. Nationally, stomach cancer mortality declined for all racial-ethnic groups across this time period, with the most rapid declines occurring among the Asian (percent decline 48.3% [45.1-51.1]) and Black populations (42.6% [40.2-44.6]). Mortality among the other racial-ethnic groups declined more moderately, decreasing by 36.7% (35.3-38.1), 35.1% (32.2-37.7), and 31.6% (23.9-38.0) among the White, Latino, and AIAN populations, respectively. Similar patterns were observed at the county level, although with wide geographic variation. In 2019, a majority of counties had higher mortality rates among minoritised racial-ethnic populations compared to the White population: 81.1% (377 of 465 counties with unmasked estimates for both racial-ethnic groups) among the AIAN population, 88.2% (1295 of 1469) among the Latino population, 99.4% (663 of 667) among the Asian population, and 99.9% (1484 of 1486) among the Black population. However, the size of these disparities ranged widely across counties, with the largest range from 0.3 to 17.1 among the AIAN population. Stomach cancer mortality has decreased substantially across populations and geographies in the USA. However, disparities in stomach cancer mortality among racial-ethnic groups are widespread and have persisted over the last two decades. Local-level data are crucial to understanding the scope of this unequal burden among minoritised groups in the USA. National Institute on Minority Health and Health Disparities; National Heart, Lung, and Blood Institute; National Cancer Institute; National Institute on Aging; National Institute of Arthritis and Musculoskeletal and Skin Diseases; Office of Disease Prevention; and Office of Behavioral and Social Sciences Research, National Institutes of Health (contract #75N94019C00016).

Cephalometric Characteristics in Chilean Latino Population with Normal Occlusion and Harmonic Profiles in Permanent Dentition. A Retrospective Study

Cephalometric Characteristics in Chilean Latino Population with Normal Occlusion and Harmonic Profiles in Permanent Dentition. A Retrospective Study

Effects of caregiver-child acculturation on child obesity among US Latino individuals.

The goal of this study was to assess the association of Latino caregiver-child nativity status (US- and foreign-born) with child obesity using a nationally representative sample. Using data from the National Health and Nutrition Examination Survey (NHANES 1999-2018), this study used generalized linear models to identify associations between caregiver-child nativity status (as a proxy for acculturation) and children's BMI. Compared with foreign-born caregiver-child dyads, US-born caregiver-child dyads had 2.35 times the risk of class 2 obesity (95% CI: 1.59-3.47) and 3.60 times the risk of class 3 obesity (95% CI: 1.86-6.96). Foreign-born caregiver and US-born child dyads had 2.01 times the risk of class 2 obesity (95% CI: 1.42-2.84) and 2.47 times the risk of class 3 obesity (95% CI: 1.38-4.44; p < 0.05 for class 2 and class 3). Compared with foreign-born Latino caregiver-child dyads, dyads with US-born caregivers and children and dyads with foreign-born caregivers and US-born children had significantly increased risk across the severe classes of obesity. Examining the influence and relationship of varying acculturation levels in an immigrant household will help guide more effective clinical and policy guidelines surrounding obesity and weight management in both pediatric and adult US Latino populations.