Mexican American Men Research Articles

Therapist Self-disclosure and Culturally Competent Care with Mexican–American Court Mandated Clients: A Phenomenological Study

Therapist self-disclosure (TSD) is a skill with numerous potential benefits and risks for the therapeutic alliance. While its effects have been established, little empirical research has examined the impact of TSD in cross-cultural treatment settings with court-mandated clients, a context with unique considerations. In an effort to help fill this gap, results of a phenomenological study examining the effects of TSD on Mexican–American men working with Anglo American therapists in a mandated treatment setting are presented. The results of this study indicate that TSD is a culturally competent intervention with several benefits for mandated clients, including strengthening the therapeutic alliance, normalizing client problems, lessening the therapist-client hierarchy, and modeling the acceptability of self-disclosure. Clinical and marriage and family therapy educational implications are also discussed.

Oxidative Stress, Testosterone, and Cognition among Caucasian and Mexican-American Men with and without Alzheimer's Disease

The use of testosterone among aging men has been increasing, but results from studies addressing the effectiveness of testosterone replacement therapy have been equivocal. Given our prior pre-clinical studies that reported a major influence of oxidative stress on testosterone's neuroprotective effects, we investigated whether the negative effects of testosterone on brain function were predicted by oxidative load. In order to test our hypothesis, we determined whether circulating total testosterone and luteinizing hormone correlated with cognition in a subset of the Texas Alzheimer's Research & Care Consortium (TARCC) cohort, consisting of Caucasian (n = 116) and Mexican-American (n = 117) men. We also assessed whether oxidative stress (as indexed by homocysteine levels) modified this relationship between sex hormones and cognition, and whether the levels of two antioxidants, superoxide dismutase-1 and glutathione S-transferase (GST), varied as a function of circulating testosterone. In a low oxidative stress environment, testosterone was positively associated with the level of the antioxidant, GST, while no deleterious effects on cognitive function were noted. In contrast, under conditions of high oxidative stress (homocysteine levels >12 μmol/L), testosterone and luteinizing hormone were associated with cognitive impairment, but only among Caucasians. The ethnic difference was attributed to significantly higher GST levels among Mexican-Americans. While testosterone may be beneficial under conditions of low oxidative stress, testosterone appears to have negative consequences under conditions of elevated oxidative stress, but only in Caucasians. Mexican-Americans, however, were protected from any deleterious effects of testosterone, potentially due to higher levels of endogenous antioxidant defenses such as GST.

Risk factors for cardiovascular disease among Mexican-American adults in the United States and Mexico: a comparative study

To compare cardiovascular disease (CVD) risk factors in a cohort of Mexican health workers with representative samples of US-born and Mexico-born Mexican-Americans living in the US. Data were obtained from the Mexican Health Worker Cohort Study (MHWCS) in Mexico and the National Health and Nutrition Examination Survey (NHANES) IV 1999-2006 in the US. Regression analyses were used to investigate CVD risk factors. In adjusted analyses, NHANES participants were more likely than MHWCS participants to have hypertension, high total cholesterol, diabetes, obesity, and abdominal obesity, and were less likely to have low HDL cholesterol and smoke. Less-educated men and women were more likely to have low HDL cholesterol, obesity, and abdominal obesity. In this binational study, men and women enrolled in the MHWCS appear to have fewer CVD risk factors than US-born and Mexico-born Mexican-American men and women living in the US.

CHRNA5 and CHRNA3 Variants and Level of Neuroticism in Young Adult Mexican American Men and Women

A lifetime history of alcohol dependence has been associated with elevations in neuroticism in Mexican American young adults. The identification of genetic markers associated with neuroticism and their influence on the development of alcohol use disorders (AUD) may contribute to our understanding of the relationship between personality traits and the increased risk of AUD in Mexican Americans. The purpose of this study was to investigate associations between neuroticism and 13 single nucleotide polymorphisms (SNPs) in the nicotinic acetylcholine (nAChR) α5-subunit (CHRNA5) and α3-subunit (CHRNA3) genes in young adult Mexican American men and women. Participants were 465 young adult Mexican American men and women who are literate in English and are residing legally in San Diego County. Each participant gave a blood sample and completed a structured diagnostic interview. Neuroticism was assessed using the Maudsley Personality Inventory. The minor alleles of four CHRNA5 polymorphisms (rs588765, rs601079, rs680244 and rs555018) and three CHRNA3 polymorphisms (rs578776, rs6495307 and rs3743078) showed associations with neuroticism. Several of these SNPs also displayed nominal associations with DSM-IV alcohol and nicotine dependence, but tests of mediation suggested that these relations could be partially explained by the presence of co-occurring neuroticism. These findings suggest that genetic variations in nicotinic receptor genes may influence the development of neuroticism, which in turn is involved in the development of AUDs and nicotine dependence in Mexican American young adults.

Binge drinking by gender and race/ethnicity among California adults, 2007/2009

Background: This study provides binge drinking population estimates for California adults by gender and detailed race/ethnicity categories. This information may be helpful for planning targeted initiatives to decrease binge drinking. Method: Data were from the 2007 and 2009 California Health Interview Surveys. The 98 662 respondents represent an annual estimated population of 27.2 million adults. Survey adjusted binary logistic regression was used to calculate gender-specific binge drinking population rates and multinomial logit regression to estimate binge drinking frequency. Results: Adjusting for socio-demographics, any binge drinking during the past year was reported by 31.0% (95% Confidence Interval = 30.5–31.4%) of men and 18.0% (17.7–18.3%) of women. Rates among White men and women were 30.5% and 19.6%, respectively. Binge drinking rates ranged from 11.9% among Chinese to 42.9% among Mexican men and from 4.8% among Vietnamese to 25.7% among “Other Latino” women. Five race/ethnicity categories of men and seven categories of women were significantly less likely to binge drink compared to Whites. Although Whites had the highest overall binge drinking rates, an estimated 12.5% of White men binge drank less than monthly, significantly exceeded by Mexican and Central American men, 19.9 and 19.6%, respectively. An estimated 9.6% of White women binge drank less than monthly, exceeded only by “Other Latino” women, 13.6%. Conclusion: These findings underscore the importance of detailed gender and race/ethnicity breakdowns when examining any binge drinking. Furthermore, there is variability across Asian and Latino subgroups in the frequency of binge drinking episodes, which is not evident in broad-group population studies.

Spatial accessibility of drug treatment facilities and the effects on locus of control, drug use, and service use among heroin-injecting Mexican American men

BackgroundThis study explores the spatial accessibility of outpatient drug treatment facilities and the potential relationship with drug use-related outcomes among Mexican American heroin users. MethodsSecondary data on 219 current and former heroin-injecting Mexican American men aged 45 and older were drawn from a research study in Houston, Texas. We used geographic information systems (GIS) to derive two spatial accessibility measures: distance from one's place of residence to the closest drug treatment facility (in minutes); and the number of facilities within a 10-minute driving distance from one's place of residence. Exploratory logistic regression analyses examined the association between the spatial accessibility of drug treatment facilities and several drug use-related outcomes: internal locus of control (LOC); perceived chances and worries of injecting in the next six months; treatment utilization; and location of last heroin purchase. ResultsParticipants with greater spatial access to treatment programs were more likely to report a higher chance of injecting in the near future. However, while current heroin users were more worried about injecting in the next six months, greater spatial access to treatment programs seemed to have a buffering effect. Finally, those who lived closer to a treatment programs were more likely to have last purchased heroin inside the neighborhood versus outside the neighborhood. Spatial accessibility was not associated with internal LOC or treatment utilization. ConclusionThe findings showed that the presence of outpatient treatment facilities—particularly services in Spanish—may influence perceived risk of future heroin use and purchasing behaviors among Mexican American men. Implications for future spatially-informed drug use research and the planning of culturally and linguistically responsive drug treatment programs are discussed.

Postnatal depression in Mexican American fathers: Demographic, cultural, and familial predictors

BackgroundAlthough maternal postpartum depression (PPD) is a well-documented phenomenon that has been the focus of a large body of literature, much less is known about the prevalence and predictors of depressive symptoms among fathers following the birth of a child. Particularly scarce is research with Mexican American men, an understudied population at high risk given limited socioeconomic resources and elevated rates of maternal PPD. MethodsThe current study used descriptive and path analyses to examine the prevalence and predictors of PPD in 92 Mexican American fathers (M age=31.3 years). ResultsAt both 15 and 21 postpartum week assessments, 9% of fathers met criteria for PPD. Path analyses suggested that unemployment status, fewer biological children, poor marital relationship quality, and lower orientation to Anglo culture predicted higher 15 week paternal PPD symptoms, which was associated with greater paternal depressive symptoms at 21 weeks. Predictive paths from symptoms of maternal to paternal PPD were not significant. LimitationsLack of generalizability to other ethnic groups, sampling of primarily resident fathers, and the absence of historical assessments of depression are limitations of the current study. ConclusionsFindings support the importance of PPD screenings among Mexican American fathers and suggest certain demographic, familial, and cultural factors may render men particularly vulnerable for maladjustment during the early infancy period.

Multidimensional Approaches to Examining Gender and Racial/Ethnic Stratification in Health

Abstract Extant research on health disparities has traditionally employed a unidimensional approach to stratification, focusing on gender and racial/ethnic inequality separately. Such studies implicitly assume that gender inequality is monolithic across racial/ethnic lines and that racial/ethnic stratification is similar for women and men. While informative, these traditional, unidimensional approaches artificially decouple gender and racial/ethnic inequality and, consequently, may obscure the gender-race/ethnicity-health relationship, thus limiting our understanding of the unique health experiences of women of color. This study extends prior research by using multidimensional approaches to examine whether gender and racial stratification combine in an additive or multiplicative fashion to shape functional health, consistent with double-jeopardy and intersectionality hypotheses, respectively. In addition, this study investigates the extent to which group differences in socioeconomic status (SES), health behaviors, and medical care explain gender-racial/ethnic disparities in health. We use data from the Health and Retirement Study, a nationally representative sample of older adults, to address these questions among a diverse sample of black, white, and Mexican American men and women. Results reveal that women of color have worse functional health than all other gender-racial/ethnic groups and that the joint impacts of gender and racial/ethnic oppression on functional health are additive among Mexican Americans and multiplicative among blacks. We find that multidimensional approaches-namely, double-jeopardy and intersectionality-as well as examination of various potential mediators of health disparities provide a better understanding of how health is shaped by multiple social locations.

Obesity in American Indian and Mexican American Men and Women: Associations with Blood Pressure and Cardiovascular Autonomic Control

Obesity is a serious public health problem, especially in some minority communities, and it has been associated with an increased risk of cardiovascular diseases. While obesity is a serious health concern in both American Indian and Mexican American populations, the relationship between obesity and cardiac autonomic control in these two populations is not well understood. The present study in a selected sample of American Indians and Mexican Americans assessed associations between obesity, blood pressure (BP), and cardiovascular autonomic control. Cardiovascular autonomic control, systolic and diastolic mean BP, and body mass index were obtained from one hundred thirty-two American Indian and Mexican American men and women who are literate in English and are residing legally in San Diego County. Men had a significant greater systolic and diastolic BP and were more likely to develop systolic prehypertension and hypertension than women. Obese participants showed greater mean heart rate (HR) and systolic and diastolic BP than nonobese participants. Obese men also exhibited greater cardiac sympathetic activity and lower cardiovagal control than obese women. These results suggest that obesity and gender differences in cardiovascular autonomic control may contribute to risk for cardiovascular disorders in this sample of American Indians and Mexican Americans.

Church-Based Social Support and a Sense of Belonging in a Congregation among Older Mexican–Americans

Research suggests that people with a strong sense of belonging in a congregation tend to rate their health in a more favorable way. However, relatively little is known about how a sense of belonging arises in a congregation. The purpose of the current study is to see if five different dimensions of church-based social support are associated with a sense of belonging in a congregation. In the process, an effort is made to contribute to the literature in two potentially important ways. First, the relationship between church-based support and belonging is evaluated with data from a nationwide survey of older Mexican–Americans. Second, tests are conducted to see if there are gender differences in the relationship between church-based support and belonging. The findings suggest that for the sample as a whole, receiving more of each type of church-based social support is associated with a stronger sense of belonging. Moreover, the results reveal that the relationship between all five types of church-based support and belonging is stronger for older Mexican–American men than for older Mexican–American women.

“El Lado Oscuro”: “The Dark Side” of Social Capital in Mexican American Heroin Using Men

This article describes social capital in a cohort of 227 Mexican American men who are long-term injection heroin users. Social capital scores for current and former users were similar, suggesting equal absolute values of capital, but associated with illicit activities in current users and with cessation efforts in former users. Stable drug-using relationships provided high negative capital, whereas conventional relationships provided positive capital. Thus, social capital functions dichotomously in positive and negative contextualized roles. This study provides an alternative understanding of the dynamic interactions between individuals, environment, and drug abuse and can inform prevention and treatment interventions for an important demographic group.

Assessing Gender Differences in the Relationship Between Negative Interaction With the Clergy and Health Among Older Mexican Americans

A rapidly growing literature indicates that supportive social relationships are associated with better physical and mental health. However, this research further reveals that interaction with others may also be conflicted and unpleasant. The purpose of the current study was to evaluate negative interaction that arises within a social context that is important to many older Mexican Americans (i.e., negative interaction with a member of the clergy). Findings from a nationwide survey of older Mexican Americans indicate that more frequent interpersonal conflict with a member of the clergy is associated with less favorable self-rated health as well as more acute and chronic health conditions. However, these effects were observed among older Mexican American women but not among older Mexican American men.

Contextual Influences on the Drinking of Male Latino Immigrant Day Laborers

This study explored self-reported alcohol use of Mexican and Central American men who had recently migrated to the United States to work. Ethnographic observation took place at a day laborer hiring site in 2006–2007 and qualitative interviewing involved 120 men with divergent drinking patterns. Short interviews were conducted informally on the street, and interviews lasting 1–2 hours addressed day laborers’ perspective about how life conditions shape where drinking takes place and how much alcohol gets consumed. Resulting situations, such as roommates bringing alcohol home for extended nights of drinking, and specific strategies used to avoid excess alcohol use are addressed.

Racial/ethnic differences in serum sex steroid hormone concentrations in US adolescent males

Contrary to the hypothesis that the racial/ethnic disparity in prostate cancer has a hormonal basis, we did not observe a difference in serum testosterone concentration between non-Hispanic black and white men in the Third National Health and Nutrition Examination Survey (NHANES III), although non-Hispanic black men had a higher estradiol level. Unexpectedly, Mexican-American men had the highest testosterone level. Next, we evaluated whether the same patterns are observed during adolescence, the time of prostate maturation. We measured serum testosterone, estradiol, and sex hormone-binding globulin (SHBG) by immunoassay in 134 males aged 12-19 in NHANES III. Mean concentrations were compared by race/ethnicity adjusting for age, Tanner stage, percent body fat, waist, physical activity, tobacco smoke, and the other hormones. After multivariable adjustment, in the 12-15-year-old males, testosterone concentration was lower in non-Hispanic blacks than whites (p = 0.043), SHBG concentration did not significantly differ between the two groups. Mexican-Americans had the highest testosterone (versus non-Hispanic black: p = 0.002) and lowest SHBG (versus non-Hispanic white: p = 0.010; versus non-Hispanic black: p = 0.047) concentrations. Estradiol concentration was lower in non-Hispanic blacks (p = 0.11) and Mexican-Americans (p = 0.033) compared with non-Hispanic whites. After multivariable adjustment, in the 16-19-year-old males, testosterone, estradiol, and SHBG concentrations did not differ between non-Hispanic blacks and whites. Mexican-Americans had the highest testosterone concentration (versus non-Hispanic white: p = 0.08), but did not differ from the other groups on estradiol and SHBG concentrations. In both age groups, these patterns were generally present, but less pronounced after adjusting for age and Tanner stage only. In adolescent males, non-Hispanic blacks did not have a higher testosterone concentration than non-Hispanic whites, and Mexican-Americans had the highest testosterone concentration, patterns similar to adult males.

Plasma choline metabolites associate with metabolic stress among young overweight men in a genotype-specific manner

OBJECTIVES:We aimed to test the hypotheses that (i) plasma choline metabolites differ between normal (body mass index (BMI)<25 kg m−2) and overweight (BMI ⩾25 kg m−2) men, and (ii) an elevated BMI alters associations between plasma choline metabolites and indicators of metabolic stress.DESIGN:This was a cross-sectional study. A one-time fasting blood sample was obtained for measurements of the choline metabolites and metabolic stress indicators (that is, serum alanine aminotransferase (ALT), glucose, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides and homocysteine), and for genotype determination.SUBJECTS:The analysis was conducted with 237 Mexican American men with a median age of 22 years.RESULTS:Compared with men with a normal BMI (n=98), those with an elevated BMI (n=139) had 6% lower (P=0.049) plasma betaine and an 11% lower (P=0.002) plasma betaine to choline ratio. Among men with an elevated BMI, plasma betaine and the plasma betaine to choline ratio positively associated (P⩽0.044) with a favorable serum cholesterol profile, and inversely associated (P=0.001) with serum ALT, a marker of liver dysfunction. The phosphatidylethanolamine N-methyltransferase (PEMT) 5465G→A (rs7946) genotype interacted (P⩽0.007) with the plasma betaine to choline ratio to modulate indicators of metabolic stress with stronger inverse associations observed among overweight men with the PEMT 5465GG genotype.CONCLUSIONS:Plasma choline metabolites predict metabolic stress among overweight men often in a genotype-specific manner. The diminished betaine among overweight men coupled with the inverse association between betaine and metabolic stress suggest that betaine supplementation may be effective in mitigating some of the metabolic insults arising from lipid overload.

Self‐Reported Sleep Characteristics and Mortality in Older Adults of Mexican Origin: Results from the Hispanic Established Population for the Epidemiologic Study of the Elderly

To determine how poor sleep affects the health of older ethnic minorities. Cross-sectional study involving a population-based survey. Hispanic Established Population for the Epidemiologic Study of the Elderly (H-EPESE) survey conducted in the southwestern United States. Two thousand two hundred fifty-six Mexican-American men and women aged 65 and older. The association between self-reported sleep problems and mortality over a 15-year period in a population based sample of older Mexican Americans was examined. Using five waves of data (1993-2008) from the H-EPESE, Cox proportional hazard models stratified according to sex were used to model the risk of death as a function of chronic sleep problems. Having any sleeping problems during the last month was associated with greater risk of mortality (hazard ratio=1.14, 95% confidence interval=1.00-1.29) in unadjusted models, although the association was attenuated after accounting for covariates. Similar factors explained the association between sleep and mortality in men and women: health behaviors, depressive symptoms, and health conditions. These factors are related to stress, and both may lead to poor sleep quality. Research is needed to better understand the factors moderating the relationship between sleep, mortality, and sex.

Routine physical activity and mortality in Mexican Americans aged 75 and older.

To examine the association between routine physical activity and risk of 3-year mortality in Mexican Americans aged 75 and older. Longitudinal study involving a population-based survey. Hispanic Established Population for the Epidemiologic Study of the Elderly (H-EPESE) survey conducted in the southwestern United States (TX, CO, AZ, NM, CA). Mexican-American men and women aged 75 and older (N = 948) participating in the H-EPESE. Responses to the Physical Activity Scale for the Elderly (PASE) were assessed in 2005-06. Mortality was determined according to report of relatives at 3-year follow-up and from the National Death Index. Covariates included sociodemographic characteristics, financial strain, smoking status, body mass index, activities of daily living, depressive symptoms, cognitive function, and comorbid conditions. The mean age of the sample was 82.2 ± 4.5. Cox proportional hazard regression estimated that the hazard ratios of death for persons in the low, moderate, and high quartiles of physical activity (PASE scale) ranged from 0.36 (95% confidence interval (CI) = 0.21-0.62) to 0.50 (95% CI = 0.31-0.82) compared to persons in the sedentary quartile after adjusting for covariates. Routine physical activity involving household and leisure activities was associated with lower 3-year risk of mortality in a sample of older Mexican Americans living in the community.

Choline metabolism biomarkers predict the risk of metabolic unfitness among young men

To test the hypothesis that plasma choline metabolism biomarkers, alone and together with genetic determinants of one carbon (1‐C) metabolism, predict metabolic unfitness associated with a lipid overload (i.e. obesity), a cross‐sectional analysis was conducted involving 249 Mexican American men with a median age of 22 y. Circulating concentrations of choline, betaine, folate, metabolic unfitness indicators (i.e. lipid panel and liver enzymes), and polymorphisms of 1‐C metabolizing genes (i.e. MTHFD1 G1958A) were assessed. Bivariate partial correlation tests and multivariate regression models were performed in data analysis. Plasma choline positively and plasma betaine negatively associated with body mass index (BMI) with lower plasma betaine observed in men whose BMI &gt; 25.8 kg/m2 (cohort median). In age‐ and BMI‐adjusted regression models, plasma betaine associated positively with serum HDL‐cholesterol. Further, plasma betaine associated negatively with serum alanine aminotransferase (ALT) among men with serum folate &lt; 14.5 ng/mL (cohort median) or among men with at least one copy of MTHFD1 1958A allele. In sum, these data demonstrate that choline metabolism markers predict the risk of metabolic unfitness and support the need to investigate the potential therapeutic benefits of choline/betaine on metabolic fitness.Grant Funding Source : NIH Grant #S06GM053933 and California Agriculture Research Initiative

Commentary on Caetano, Mills, and Vaeth (2012): The Role of Context on Alcohol Consumption Among Mexican Americans

In this commentary, we discuss a study by Caetano and colleagues (2012) that examines alcohol consumption and binge drinking behavior among U.S.-Mexico border and non-border Mexican Americans using data from the Hispanic Americans Baseline Alcohol Survey. We discuss how Caetano and colleagues (2012) addressed 3 gaps in our understanding of drinking behaviors among Hispanics: (1) effects of living near the U.S.-Mexico border, (2) gender differences in drinking behaviors, and (3) alcohol-related outcomes among young women. Findings suggest that Mexican American men and women living along the U.S.-Mexico border reported higher levels of drinking than their U.S. metropolitan counterparts (Caetano et al., 2012). This study represents an important contribution to the dearth of studies investigating disparities in alcohol-related consequences among Hispanic young adults living along the U.S.-Mexico border. Future research needs to examine why contextual factors of the U.S.-Mexico border generate differential effects in the Mexican American population.

Abstract P148: C-Reactive Protein (CRP) and the Prediction of Cardiovascular Death Among Mexican-Americans

Background: Addition of C-reactive protein (CRP) improves risk stratification provided by traditional Framingham risk factors (FRFs) in some populations, but findings vary by gender and by race/ethnicity. Whether CRP levels can improve risk prediction of cardiovascular mortality (CVD) among elderly Hispanics is unknown. Hypothesis: CRP will add incremental CVD risk prediction in addition to FRFs. Methods: We evaluated whether addition of baseline CRP to the Framingham risk score can improve CVD risk stratification for CVD death among 1,422 participants (536 males, 886 females) from the Sacramento Area Latino Study on Aging (SALSA). SALSA is a well-characterized, NIH funded cohort study of Mexican Americans aged &gt; 60 followed since 1998–1999. Death was ascertained by participant contacts, obituary reviews and cause of death from death certificates. We evaluated the association of CRP levels with CVD death using Cox proportional hazards models adjusting for FRFs stratified by gender. We calculated gender stratified net reclassification improvement (NRI) in models with and without CRP to predict 10-year CVD risks using the established FRFs categories (&lt;5%, 5–10%, 10–20%, &gt; 20%). Results: Mean baseline age was 70.7 and mean CRP level was 5.86 ng/ml. There were 167 CVD male deaths (mortality rate 39.2 per 1,000 person years) and174 among women (mortality rate 27.8 per 1,000 person years). Higher CRP levels were significantly associated with higher CVD mortality risk in men, HR of 1.29 (95% CI 1.11 – 1.50) but not women, HR 0.94 (95% CI 0.81 – 1.08) after adjustment for covariates. Addition of CRP was useful in reclassifying CVD death risk among men defined by FRF alone, and this was due to correct reclassification of those who did not experience CVD death from the highest risk group to a lower risk category. The majority of male participants (619/745=83%) were classified as having &gt;20%risk in the model without CRP. Mortality rate for men initially classified as having &gt; 20% risk was 37.9 per 1,000 person years. After addition of CRP, 6% were reclassified into an intermediate risk category (NRI 7.4%, p&lt; 0.001) and their mortality rate was 10.3 per 1,000 person years. Overall, NRI for men was 4.2% (p=0.05). In contrast, addition of CRP among women was associated with increased misclassification to a higher risk category (NRI= − 13.4%, p=0.0001). Conclusion: A risk prediction model that includes CRP improves cardiovascular risk classification among elderly Mexican-American men but not women as defined by traditional FRFs.