Mexican-origin Adults Research Articles

Intergenerational Photovoice Projects

Intergenerational photovoice groups are promising for promoting health through the topic that is explored and through group dynamics that can foster healthy relationships and communication. To investigate the potential benefits of intergenerational photovoice projects, photovoice groups were conducted in urban Minnesota, United States, and in rural Morelos, Mexico, between 2009 and 2012 with Mexican-origin adults and their adolescent relatives. Seven photovoice groups of adult-adolescent dyads met for eight sessions and developed exhibits highlighting their views on health and migration and made policy recommendations, using messages conveyed through their words and photographs. Informal process evaluation and focus groups were used to elicit feedback about photovoice project participation. Photovoice project themes were descriptively analyzed. Focus group evaluation data were thematically summarized, and facilitator reflections were descriptively summarized to identify factors associated with intergenerational photovoice groups. Seventy-five participants were recruited. Photovoice themes represented effects of migration on health, family, and well-being. The following two evaluative themes were identified: (a) participant sentiments about the benefits of photovoice participation and (b) facilitator observations of intergenerational photovoice group benefits and challenges. Participants described opportunities to learn new things and barriers to healthy relationships that the project was eliminating by providing them with time to work together. Used in health promotion, photovoice is a valuable tool that contributes to understanding the complex underlying factors influencing behaviors and health.

Sitting time and health outcomes among Mexican origin adults: obesity as a mediator

BackgroundSitting time and sedentary behaviors have been associated with adverse health outcomes including obesity, diabetes and cardiovascular disease (CVD) within non- Hispanic White populations. Similar associations have not been described within Hispanic populations despite their high CVD risk profile. This study aimed to assess the association between sitting time and obesity, self-reported diagnosed diabetes, hypertension and high cholesterol among a large cohort (N=11,268) of Mexican origin adults and to assess whether obesity mediated these associations.MethodsUsing a cross-sectional design, data collected between 2004 and 2010 were analyzed in late 2010. Regression analyses evaluated associations between self-reported daily sitting hours and disease outcomes, controlling for demographics, employment status, family disease history, and light, moderate and strenuous physical activity.ResultsParticipants were mostly female (81.1%) Mexican origin adults. Sitting time was associated with increased odds of being obese, having diabetes and having hypertension, but not high cholesterol. Adjusted odds ratios of participants who reported sitting > 4 hours/day compared to those sitting 1-2 hours/day were for obesity OR=1.55 (95% CI 1.39, 1.73), p<.001, for diabetes OR=1.29 (95% CI, 1.09, 1.52), p=.003, for hypertension OR=1.17 (95% CI, 1.01, 1.37), p=.041. Associations controlled for physical activity and employment status. Effects on hypertension and diabetes were mediated by obesity.ConclusionsSitting time was significantly associated with detrimental health outcomes, independent of physical activity. Obesity mediated these relationships for diabetes and hypertension. Future research should assess whether interventions addressing sitting time are feasible and effective among Mexican origin populations.

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.

Psychometric Evaluation of the Demographic Index of Cultural Exposure (DICE) in Two Mexican-Origin Community Samples.

Reliability and validity evidence is provided for the Demographic Index of Cultural Exposure (DICE), consisting of six demographic proxy indicators of acculturation, within two community samples of Mexican-origin adults (N= 497 for each sample). Factor analytic procedures were used to examine the common variance shared between the six demographic indicators hypothesized to correlate with acculturation. The index was cross-validated across two samples by comparing fit indices. Finally, index criterion validity was assessed using correlations between index scores and five common behavioral/psychological domains of Latino cultural identity: language use (Spanish and English), cultural practices, folk health beliefs, and fatalism. Results indicated that the six demographic indicators loaded onto one latent factor and that this model had good fit across both samples. In addition, DICE scores correlated with four of the five behavioral/psychological measures. Future use of the DICE as an efficient way to approximate cultural exposure is discussed.

Correlates of Medication Nonadherence Among Latinos With Type 2 Diabetes

The purpose of this study is to assess factors related to diabetes medication nonadherence in a sample of predominantly Spanish-speaking Mexican-origin adults residing along the US-Mexico border. As part of a randomized controlled trial, 302 patients randomly sampled from a clinic roster completed a baseline interview. Medication nonadherence was assessed with the Morisky Medication Adherence Scale. Consistent with the framework proposed by Venturini et al, four factors were examined: patient-related attributes, drug regimen characteristics and complexity, health status, and patient-provider interaction characteristics. Sixty percent of the patients were classified as nonadherent. Men, those who engaged in diabetes control behaviors less frequently, and individuals with depression were more likely to be classified as nonadherent. Among those who were Spanish-dominant, education and self-rated health also were significantly and negatively related to medication adherence; patients with a high school education or greater and those who more positively rated their health were more likely to be classified as nonadherent compared to those with less than a high school education and those who rated their health as poor. Results reflect potentially higher medication nonadherence rates for Latinos with type 2 diabetes living in rural communities along the US-Mexico border. Additionally, this study supports the need to address strategies to support medication adherence, including addressing depression, for diabetes control. Strategies to promote adherence among Latino men are sorely needed, as are strategies to address forgetfulness and carelessness regarding diabetes medicine taking.

Social Influence and Motivation to Change Health Behaviors among Mexican-Origin Adults: Implications for Diet and Physical Activity

To evaluate whether influence from social network members is associated with motivation to change dietary and physical activity behaviors. Baseline assessment followed by mailing of family health history-based personalized messages (2 weeks) and follow-up assessment (3 months). Families from an ongoing population-based cohort in Houston, Texas. 475 adults from 161 Mexican-origin families. Out of 347 households contacted, 162 (47%) participated. Family health history, social networks, and motivation to change behaviors. Two-level logistic regression modeling. Having at least one network member who encourages one to eat more fruits and vegetables (p = .010) and to engage in regular physical activity (p = .046) was associated with motivation to change the relevant behavior. About 40% of the participants did not have encouragers for these behaviors. Identification of new encouragers within networks and targeting natural encouragers (e.g., children, spouses) may increase the efficacy of interventions to motivate behavioral changes among Mexican-origin adults.

Age-related differences in biomedical and folk beliefs as causes for diabetes and heart disease among Mexican origin adults.

An understanding of health beliefs is key to creating culturally appropriate health services for Hispanic populations in the US. In this study we explore age-based variations in causal beliefs for heart disease and diabetes among Mexican origin adults in Houston, TX. This cross-sectional study included 497 adults of Mexican origin. Participants were asked to indicate the importance of biomedically defined and folk illness-related risk factors as causes for heart disease and diabetes. Biomedical risk factors were ranked highest as causes of diabetes and heart disease among all participants. Folk illness-related factors were ranked below biomedical factors as causes of heart disease among all age groups. Susto was ranked above the median as a risk factor for diabetes among older participants. Age-related differences in causal beliefs may have implications for designing culturally appropriate health services, such as tailored diabetes interventions for older Mexican origin adults.

Walking for transportation among Latino adults in San Diego County: who meets physical activity guidelines?

U.S. Latinos engage in nonleisure-time walking (NLTW) more than other ethno-racial groups. Studies are needed to explore factors associated with NLTW to inform interventions for effective physical activity promotion. To examine the social-ecological correlates of NLTW among Mexican-origin Latinos. Individual, social, and environmental level factors and PA were assessed in a telephone survey completed by 672 Mexican-origin adults randomly sampled in San Diego County. Data were collected in 2006 and analyzed in 2009. Participants were mostly female (71%), with an average age of 39 years. Less than one-third met PA guidelines for NLTW (29%). Structural equation modeling showed that NLTW was positively associated with being female, but negatively associated with living in the U.S. ≥ 12 years, and being U.S.-born. In this sample NLTW differed by various indicators of acculturation and gender. These findings might help inform the development of interventions to promote NLTW and thus physical activity in Mexican-origin adults.

Paradise Shift: Immigration, Mobility and Inequality in Southern California

In a context of widening economic inequality and governmental persecution of undocumented immigrants, central theoretical and policy questions concern the social mobility (intra- and inter-generational) of new ethnic groups being formed as a result of mass migration from Latin America and Asia - especially the rapidly growing generation of children of immigrants now making their transitions to adulthood (finishing their education, entering full-time work, forming families of their own). In this paper findings are presented from merged samples of two research studies in Southern California (IIMMLA and CILS-III). The focus is on the educational mobility of foreign-parentage (1.5- and 2nd-generation) young adults of Mexican, Salvadoran, Guatemalan, Filipino, Chinese, Korean, Vietnamese, Cambodian and Laotian origin - representing distinct and segmented modes of incorporation. The analysis examines factors which facilitate or derail their mobility prospects, including the relative role of parental human capital and legal/citizenship status, family and neighborhood contexts growing up, early school achievement, acculturation, incarceration, and teenage and non-marital child-bearing, compared to patterns observed for native-parentage (3rd-generation and beyond) white, black, and Mexican-American peers. The relationship of acculturation and mobility, the resultant formation of new patterns of urban ethnic inequality and their implications for social science and public policy, are also addressed.

Willingness of Mexican-American Adults to Share Family Health History with Healthcare Providers

Collecting family health history (FHH) information to share with healthcare providers is an important aspect of health-risk assessment. To examine associations between the content of FHH-informed risk feedback and willingness to share the information with a healthcare provider. Data were collected between June 2008 and July 2009 from 475 Mexican-origin adults residing in 161 households. Participants completed surveys 3 months after receiving FHH-informed risk feedback. Households were randomly assigned to feedback conditions in which household members received one or more of the following: an FHH pedigree, personalized risk assessments (PRAs), and tailored behavioral recommendations. Logistic regression models were fitted using generalized estimating equations, with exchangeable covariances, to account for the clustering of responses within and the random assignment of feedback condition to household. Analyses were completed in May 2010. Participants who received personalized risk assessments were more willing to share their feedback with a provider than those who received a pedigree only (OR=2.25, p=0.02). The receipt of tailored behavioral recommendations did not significantly increase willingness to share feedback with a provider (OR=0.79, p=0.48). The provision of PRAs in FHH assessments appears to motivate participants to consider sharing their FHH with a healthcare provider.

Do Mexican immigrants “import” social gradients in health to the US?

Greater educational attainment is consistently associated with lower mortality and better health, a pattern known as the social gradient. However, recent research suggests that Mexican-origin adults in the US have weak or flat gradients, in contrast to steep gradients for non-Hispanic whites. In this study we evaluate one hypothesis for this finding: Is the relative weakness of education gradients in health behaviors observed among Mexican-origin adults in the US due to weak gradients in the sending population? We test this "imported gradients" hypothesis with data from two nationally-representative datasets: the US National Health Interview Survey (NHIS) and the Mexican National Health Survey (ENSA 2000). We compare education gradients in smoking and obesity for recently-arrived Mexican immigrants in the US to the corresponding gradients in high-migration regions of Mexico. Results partially support the imported gradients hypothesis and have implications for health education and promotion programs targeted to immigrant populations to reduce racial and ethnic disparities in health in the US.

Motivation for Health Screening: Evaluation of Social Influence Among Mexican-American Adults

Americans of Mexican origin are at high risk for developing cardiovascular disease. This study aimed to evaluate the associations between the presence of social network members who encourage screening and individuals' motivation to undergo three types of health screening: blood cholesterol, blood pressure, and blood glucose. The distinct roles of encouragers from different generations (older, same, and younger) were evaluated. Adults of Mexican origin (N=452) aged 20-75 years from 162 households in Houston TX were included in this cross-sectional study by completing surveys in 2008 regarding their intentions to screen, health behaviors, illness beliefs, social networks, and family health history in either English or Spanish. Data were analyzed in 2009. About one third of the participants reported having at least one same-generation network member who encouraged screening; smaller proportions reported having at least one older- (17% to 19%) and one younger-generation (11% to 12%) encourager. The presence of at least one older-generation encourager was associated with higher levels of intention to screen for all three screenings controlling for sociodemographic characteristics and illness beliefs. Having at least one same-generation encourager was associated with higher levels of intention to screen for blood cholesterol. Social influence may play an important role in motivating individuals to engage in screenings. Network-based intervention involving older individuals to provide encouragement to younger network members should be explored as a means to increase motivation to screen among this population.

Migraine headache in affectively ill latino adults of mexican american origin is associated with bipolarity.

The objective of this cross-sectional study was to determine the prevalence of migraine headache among depressed Latino adults of Mexican American origin meeting the criteria for bipolar disorder (BPD) or major depressive disorder (MDD) relative to patients in a psychiatric comparison group. In a mental health clinic for the indigent, consecutively and systematically evaluated acutely depressed Latino adults received structured diagnostic psychiatric interviews based on modules extracted from the Structured Clinical Interview for DSM-IV. All were asked as part of routine assessment whether they had headaches "in the last week." Patients with unilateral, pounding, pulsating headache were classified as having migraine headache. The prevalence of migraine headache among the patients with BPD and MDD was contrasted with that of patients in a psychiatric comparison group composed of patients with disorders other than schizophrenia or schizoaffective disorder. Logistic regression was used to test for associations and control for confounding effects. The data were collected between August 2001 and November 2004. Eighty-seven patients had BPD and 123 had MDD. Bipolar patients were 2.9 times more likely to have migraine headaches than patients with MDD (P < .0001). There was a trend for patients with MDD to have a higher prevalence of migraine than patients in the psychiatric comparison group. Bipolar patients had a high prevalence of migraine headache relative to patients with MDD. This study suggests that migraine is linked to bipolarity.

Colorectal Cancer Screening of Californian Adults of Mexican Origin as a Function of Acculturation

Californian Latinos have lower rates of colorectal cancer (CRC) screening compared to non-Latino whites, which may account in part for disparities in colorectal incidence trends. Participants, 603 Mexican-American men and 893 women aged 50 and older who had not been diagnosed with colon cancer, reported CRC screening behavior on the 2005 California Health Interview Survey. A 7-item acculturation index (English language use/proficiency, nativity, citizenship, and years living in the U.S.) was developed. A logistic regression model predicted CRC screening as a function of acculturation. Higher acculturated Mexican-Americans were 3-4 times more likely to have had both fecal occult blood test and endoscopic CRC screening. Lower acculturated Mexican men and women were twice as likely to not have any CRC screening. Colorectal screening is effective in preventing cancer; educational and outreach efforts and efforts to decrease language barriers among lower-acculturated Mexican-Americans should be intensified.

The Coming of the Second Generation: Immigration and Ethnic Mobility in Southern California

In a context of widening inequality and governmental persecution of undocumented immigrants, central questions concern the social mobility of new ethnic groups formed as a result of mass migration from Latin America and Asia—especially the growing number of children of immigrants now transitioning to adulthood. This article presents findings from merged samples of two research studies in Southern California, the Children of Immigrants Longitudinal Study (CILS-III) and Immigration and Intergenerational Mobility in Metropolitan Los Angeles (IIMMLA). The focus is on the educational mobility of foreign-parentage (1.5- and second-generation) young adults of Mexican, Salvadoran, Guatemalan, Filipino, Chinese, Korean, Vietnamese, Cambodian, and Laotian origin. The author examines factors that facilitate or derail mobility, including the role of parental human capital and legal/citizenship status, family and neighborhood contexts, early school achievement, acculturation, incarceration, and teenage and nonmarital childbearing, compared to patterns observed among native-parentage (third-generation and beyond) whites, blacks, and Mexican Americans. The article then considers the relationship between acculturation and mobility outcomes and the resulting new patterns of urban ethnic inequality.

Perceived Discrimination, Perceived Stress, and Mental and Physical Health Among Mexican-Origin Adults

This study provided a test of the minority status stress model by examining whether perceived discrimination would directly affect health outcomes even when perceived stress was taken into account among 215 Mexican-origin adults. Perceived discrimination predicted depression and poorer general health, and marginally predicted health symptoms, when perceived stress was taken into account. Perceived stress predicted depression and poorer general health while controlling for the effects of perceived discrimination. The influence of perceived discrimination on general health was greater for men than women, and the effect of perceived stress on depression was greater for women than men. Results provide evidence that discrimination is a source of chronic stress above and beyond perceived stress, and the accumulation of these two sources of stress is detrimental to mental and physical health. Findings suggest that mental health and health practitioners need to assess for the effects of discrimination as a stressor along with perceived stress.

Pain Complaints in Latino Adults of Mexican Origin With and Without Major Depressive Episode

The aim of this retrospective, cross-sectional study was to determine the prevalence of 5 pain complaints among Latino adults of Mexican origin meeting the criteria for major depressive episode (MDE). In a mental health clinic for the indigent, consecutively evaluated Latino adults of Mexican origin received structured diagnostic psychiatric interviews based on modules extracted from the Structured Clinical Interview for DSM-IV Axis I Disorders-Clinical Version. All were specifically asked whether they had experienced headache, backache, abdominal pain, myalgia, or arthralgia "in the last week." Patients meeting the criteria for MDE were compared to patients without MDE from the same clinic. Associations and statistical significance of the differences between groups were determined using logistic regression models. The data were collected between August 2003 and November 2004. Two hundred ten patients had an MDE, and 35 individuals without an MDE comprised the comparison group. Eighty-eight percent of the patients with MDE versus 53% of the controls had at least 1 pain complaint (p < .0001). Patients with MDE were 8.3 times more likely to have 1 or more pain complaints than the comparison patients (p < .0001). The significant relationship between depression and pain applied when we examined those with ≥ 2, ≥ 3, and ≥ 4 pain complaints. Twenty-eight percent of the MDE subjects had all 5 pain complaints compared to 3% of subjects without MDE (p = .013). The method of assessment of the presence of pain led to the detection of a remarkably high prevalence of pain complaints. The findings presented have important implications not only for the practice of those who are widely recognized as being primary care physicians but also for practitioners of all clinical disciplines.

Public schools, private foods: Mexicano memories of culture and conflict in American school cafeterias

In this article I present and explore the school cafeteria childhood memories of four Mexicano (Mexican-origin) adults as illustrations of the importance of the school cafeteria as a complex public eating space for ethnic minority students. For students from non-dominant groups, the school lunchroom is more than just a place to eat lunch, it is a place where assimilative food pressures and peer relationships collide, forcing children to negotiate a home-school cultural divide through food and eating choices. The stories and memories of the adults considered here reflect the various ways they as Mexicano children balanced the social and class dynamics of the school lunch program and the potentially disparate food norms and dietary lessons of the school institution, those of their school peers, and those they knew from their own homes and communities. In addition, their stories had nutritional implications as well—specifically how school food served as a daily “American food” contact point for them as children, and how the school lunch catalyzed changes in their childhood food habits and those of their families. Personal accounts like those presented here display the significance and complexity of the American school cafeteria as a problematic “public” eating space for Mexicano children and a need for nutritionists, educators, and food service professionals to consider this setting in discussions of multicultural schooling and dietary acculturation.

Access to Preventive Services for Adults of Mexican Origin

Immigrants arrive in the U.S. with better than average health, which declines over time. Clinical preventive services can prevent or delay some of that decline, but little research in this area focuses specifically on Mexican immigrants who are the largest contemporary immigrant group. This article finds that recent Mexican immigrants were the least likely to receive preventive care services, even after adjusting for sociodemographic differences in the population. Long-stay Mexican immigrants were more similar to U.S.-born Mexican Americans in preventive service use rates, who in turn had lower rates than U.S.-born non-Latino whites. Monolingual Spanish speaking Mexican immigrants were the least likely to have obtained preventive services. Having no usual source of care is the strongest predictor of the underuse. The persistent gap in preventive services across all subgroups of adults of Mexican origin suggests structural barriers to their preventive care.

Delayed Spatial Assimilation: Multigenerational Incorporation of the Mexican–Origin Population in Los Angeles

This article examines the nature and degree of spatial integration across generations among young adults of Mexican origin in metropolitan Los Angeles. Drawing on a new, unique data set that covers more than four generations of persons of Mexican origin, the research tests the extent to which residential settlement patterns follow two potential trajectories: one specified by a model of traditional spatial assimilation, which views economic and ethnic integration as increasing steadily across generations, or a new model of delayed spatial assimilation, which depicts residential mobility as stalling for a generation or more, in part because of intergenerational family obligations up through the second generation. While individual–level socioeconomic characteristics tend to rise uniformly in support of the classic assimilation model, neighborhood–level evidence shows that substantial spatial integration does not emerge until the third generation—a finding supporting the delayed assimilation model. Also, generational differences in the proportion Anglo of respondents’ neighborhoods outpace differences in median income. These results are consistent with the idea that delayed spatial assimilation involves an additional early phase of incorporation for those of Mexican origin.