United States-born Research Articles

Prevalence and resistance of Helicobacter pylori in a predominantly Hispanic population.

Helicobacter pylori (H. pylori) is the most common chronic bacterial infection in humans. The risk of acquiring H. pylori is related to socioeconomic status and living conditions early in life. Treatment regimens must consider local antibiotic resistance patterns. Adventist Health White Memorial Hospital serves a predominantly indigent population in east Los Angeles with a large number of immigrants from South and Central America. Data regarding the prevalence and resistance of H. pylori in this population is scant. To evaluate the prevalence and resistance of H. pylori and correlate with country of origin. All gastric biopsies were obtained by a single gastroenterologist at the hospital in a consecutive manner from patients with gastritis from 2017 to 2022 and sent to various labs for evaluation. Two hundred and sixty-six patients are born in the United States, 450, 171, 70, and 30 patients are immigrants from Mexico, Central and South America (CSA), Asia, and other countries respectively. Overall, 14.65% were found to be infected with H. pylori. Rates of infection in United States-born citizens, immigrants from Mexico, CSA, and Asia are 9.02%, 18.67%, 13.45%, and 11.43% respectively, with Mexican immigrants having a relative risk of 2.3889 [95% confidence interval (CI): 1.4789-3.8588, P = 0.0004] compared to those born in United States. No correlation seen between infection and length of time immigrants were in United States. Relative risk of infection in patients with no proton pump inhibitor use within the past 30 days found to be 1.9276 (95%CI: 1.3562-2.7398, P = 0.0003). Rates of resistance for clarithromycin and levofloxacin are 21.43% and 31.11%. H. pylori infection appears to be associated with low socioeconomic status and poor living conditions early in life. Clarithromycin and levofloxacin based treatment regimens should be avoided as first line therapy in this region, particularly in patients of Latin American origin.

Association of hepatitis delta virus infection and hepatocellular carcinoma, hepatic decompensation, all-cause and liver-related death in a national cohort.

Hepatitis Delta Virus (HDV) infection is the most severe form of chronic hepatitis. However, studies on outcomes and causes of death in a United States-born population, with primarily horizontal transmission of HDV, are lacking. The aim of this study was to conduct a national study of patients with hepatitis D to understand the natural history and outcomes compared to patients with hepatitis B virus (HBV). infection. In a national cohort of 4,817 HBV infected veterans tested for HDV (99.6% US-born, 3.3% HDV positive) over a 23-year period, we used multivariable models to identify the factors associated with a composite outcome of hepatocellular carcinoma (HCC), decompensation, and liver-related mortality (LRM), as well as all-cause mortality of patients with HDV compared to HBV mono-infection. HDV coinfection (vs. HBV monoinfection) was associated with a significantly higher incidence of composite liver-related outcomes at both 5 (23.84 vs. 7.98, p<0.001), and 10 years (19.14 vs. 10.18, p<0.001) respectively. The most common cause of death was liver-related (33.8% for HDV vs. 24.7% for HBV), followed by non-hepatic malignancies, (15.6 vs. 14.8%),cardiac (11.7 vs. 15.2%), and lung disease (5.2 vs. 3.7%). In multivariable models, HDV was associated with an increased risk of composite liver outcomes (aHR 2.57, 95% CI 1.87-3.52, p<0.001), and all-cause mortality (aHR 1.52, 95% CI 1.20-1.93, p<0.001). In a predominantly U.S born cohort of Veterans, HDV co-infection was associated with an increased risk of liver-related outcomes and all-cause mortality. Our findings support widespread testing for early identification of HDV.

Risk of Adverse Perinatal Outcomes Among African-born Black Women in California, 2011-2020.

African-born women have a lower risk of preterm birth and small for gestational age (SGA) birth compared with United States-born Black women, however variation by country of origin is overlooked. Additionally, the extent that nativity disparities in adverse perinatal outcomes to Black women are explained by individual-level factors remains unclear. We conducted a population-based study of nonanomalous singleton live births to United States- and African-born Black women in California from 2011 to 2020 (n = 194,320). We used age-adjusted Poisson regression models to estimate the risk of preterm birth and SGA and reported risk ratios (RR) and 95% confidence intervals (CI). Decomposition using Monte Carlo integration of the g-formula computed the percentage of disparities in adverse outcomes between United States- and African-born women explained by individual-level factors. Eritrean women (RR = 0.4; 95% CI = 0.3, 0.5) had the largest differences in risk of preterm birth and Cameroonian women (RR = 0.5; 95% CI = 0.3, 0.6) in SGA birth, compared with United States-born Black women. Ghanaian women had smaller differences in risk of preterm birth (RR = 0.8; 95% CI = 0.7, 1.0) and SGA (RR = 0.9; 95% CI = 0.8, 1.1) compared with United States-born women. Overall, we estimate that absolute differences in socio-demographic and clinical factors contributed to 32% of nativity-based disparities in the risk of preterm birth and 26% of disparities in SGA. We observed heterogeneity in risk of adverse perinatal outcomes for African- compared with United States-born Black women, suggesting that nativity disparities in adverse perinatal outcomes were not fully explained by differences in individual-level factors.

What's Behind the Dramatic Pre-2020 Declines in Hispanic/Latina Adolescent Childbearing? Decomposing Change by Age, Origin, and Nativity

PurposeTo assess whether the large declines in adolescent childbearing among Hispanic adolescents over the period 2000-2019 have been driven by co-occurring changes in the composition of the Hispanic population and, if so, whether they have done so differentially by Hispanic subgroup. MethodsWe use birth counts from the United States vital statistics system and population denominators from the United States decennial census long form 5-percent Public Use Microdata and the American Community Survey to conduct a decomposition analysis apportioning observed declines in Hispanic adolescent childbearing to: (1) compositional shifts in nativity, age, and region-of-origin and (2) subgroup changes in childbearing rates. ResultsThe Hispanic adolescent fertility rate fell by over 71% from 2000 to 2019, with Mexican-Origin, United States-born, and younger adolescents exhibiting the steepest declines (79%, 70%, and 80% declines, respectively). Results from the decomposition analysis show that almost 90% of the decline is due to within-group rate change, with some variability by subgroup and by decade. Only 10% of the decline was due to compositional changes, with shifts in nativity driving much of the effect. DiscussionDeclines in Hispanic adolescent childbearing over the last decades have occurred in spite of substantial shifts in the composition of the Hispanic population, not because of them. These findings set the stage for a more detailed examination of the drivers of change in sexual activity, contraceptive use, and abortion, all of which are proximate determinants of adolescent pregnancy and childbearing. Additionally, a focus on more distal factors is needed, including the role that changing political, societal, and economic conditions in the United States have for early fertility patterns.

Molecular Epidemiologic and Geo-Spatial Characterization of Staphylococcus aureus Cultured from Skin and Soft Tissue Infections from United States-Born and Immigrant Patients Living in New York City.

(1) Background: With increasing international travel and mass population displacement due to war, famine, climate change, and immigration, pathogens, such as Staphylococcus aureus (S. aureus), can also spread across borders. Methicillin-resistant S. aureus (MRSA) most commonly causes skin and soft tissue infections (SSTIs), as well as more invasive infections. One clonal strain, S. aureus USA300, originating in the United States, has spread worldwide. We hypothesized that S. aureus USA300 would still be the leading clonal strain among US-born compared to non-US-born residents, even though risk factors for SSTIs may be similar in these two populations (2) Methods: In this study, 421 participants presenting with SSTIs were enrolled from six community health centers (CHCs) in New York City. The prevalence, risk factors, and molecular characteristics for MRSA and specifically clonal strain USA300 were examined in relation to the patients' self-identified country of birth. (3) Results: Patients born in the US were more likely to have S. aureus SSTIs identified as MRSA USA300. While being male and sharing hygiene products with others were also significant risks for MRSA SSTI, we found exposure to animals, such as owning a pet or working at an animal facility, was specifically associated with risk for SSTIs caused by MRSA USA300. Latin American USA300 variant (LV USA300) was most common in participants born in Latin America. Spatial analysis showed that MRSA USA300 SSTI cases were more clustered together compared to other clonal types either from MRSA or methicillin-sensitive S. aureus (MSSA) SSTI cases. (4) Conclusions: Immigrants with S. aureus infections have unique risk factors and S. aureus molecular characteristics that may differ from US-born patients. Hence, it is important to identify birthplace in MRSA surveillance and monitoring. Spatial analysis may also capture additional information for surveillance that other methods do not.

Macrosomia is associated with overweight in childhood: a follow-back of a cohort established in the early years of the obesity epidemic

Objective: Interventions currently recommended to control and prevent obesity have not been successful. Recent research has shifted toward the transgenerational cycle of obesity. We assessed the association between fetal macrosomia and early childhood body weight. Methods: We conducted a follow-back study to link birth certificate data to the Third National Health and Nutrition Examination Survey (1988–1994) of 2621 United States-born singletons aged 2–6 years. Birth weight and gestational age data were collected from birth certificates. Fetal macrosomia was defined as ≥90th percentile of gestational age-race-sex-parity specific body weight distribution in 1989 vital statistics. Results: With 12.7% (standard error = 0.85%) of participants born macrosomic, the prevalence of obesity and overweight (BMI percentiles ≥85th in the CDC growth chart) among children was 17.8% (1.17%). When the body weight was measured against age-sex-specific height (BMI percentiles), macrosomia was significantly associated with overweight and obesity (odds ratio [OR] = 1.64, 95% confidence interval = 1.07–2.50) adjusted for family income, maternal age and marital status, race, maternal smoking during pregnancy, and breastfeeding. The association became insignificant after adjusting for postnatal lifestyle and parental body mass index (OR = 1.38 [0.84-2.26]]. When body weight was measured against age, children who were too heavy for their age were more likely to be born macrosomically (OR = 2.64 [1.66-4.22]) than their peers with healthy age-specific body weight. Conclusion: Fetal macrosomia was significantly associated with a doubled risk of heavy body weight in children aged 2–6 years.

Lactose-reduced infant formula with corn syrup solids and obesity risk among participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), a federal nutrition assistance program supporting low-income families, serves half of United States-born infants, most of whom are issued infant formula by age 2 mo. Obesity prevalence is high among children of low-income households, particularly formula-fed children. This study was conducted to determine whether glucose-based lactose-reduced infant formula made with corn syrup solids (CSSF) is associated with increased obesity risk compared with non-CSSFs that are lactose based. WIC administrative data on infant formula issuance and child weights and lengths were collected prospectively in Southern California between 2012 and 2020. Included children stopped breastfeeding by 3 mo, were issued cow's milk-based formula through 12 mo, and were enrolled through the final year of WIC eligibility at age 4 y ( n=15,246). CSSF issuance was assessed continuously (range 0-13 mo) and dichotomously (any, none). Poisson and linear risk regression with robust SE estimates generated risk ratios (RRs), risk differences, and CIs for child obesity [BMI for age (in kg/m 2) ≥95th percentile]. Any CSSF was issued to 23% of children, and 25% were obese at age 4 y. Children with any CSSF issuance had 10% higher obesity risk (RR: 1.10; 95% CI: 1.02, 1.20) than children with no CSSF issuance at age 2 y. Associations remained significant through age 4 y (RR: 1.07; 95% CI: 1.01,1.14), independent of maternal weight status, total formula issued and breastfeeding duration, and were not modified by child race or sex. Obesity risk increased with additional mo of CSSF exposure, reaching 16% higher risk (RR: 1.16; 95% CI: 1.05, 1.28) at age 2 y for children with 12 mo of CSSF. CSSF issuance is associated with increased obesity risk in the first 5 y life in a dose dependent manner, independently of maternal weight status, breastfeeding duration, and total formula issuance.

Children's Health Insurance Coverage and Parental Immigration Status: 2015-2019.

Rhetoric and policies aimed at restricting immigration to the United States, such as those proposed during the Trump administration, may lead to reduced enrollment in Medicaid for children of immigrants, even those who were legally eligible. This study assessed how children's health insurance coverage changed before versus during the Trump administration by parental immigration status. Using American Community Survey data, we compared changes in rates of uninsurance and Medicaid enrollment for children in the United States before (2015 to 2016) versus during (2017 to 2019) the Trump administration. Children were categorized by parental immigration status: citizen children with US-born parents, citizen children with naturalized parents, children from mixed-status families, or noncitizen children. The study population included 2 963 787 children between 2015 and 2019, representing approximately 64 million children annually. Throughout our study period, uninsurance rates for children from mixed-status families and noncitizen children were higher than citizen children with United States-born parents. Beginning in 2017, there were significant increases in uninsurance among children from mixed-status families (0.48 percentage points [PP], 95% confidence interval [CI]: 0.06 to 0.91) that increased to 1.48 PP (95% CI: 0.98 to 1.99) by 2019 when compared with concurrent trends among citizen children with US-born parents. Changes were accompanied by significant decreases in Medicaid enrollment by 2019 (-0.89 PP, 95% CI: -1.62 to -0.16). There were substantial disparities in uninsurance rates by parental immigration status. Compared with citizen children with US-born parents, uninsurance rates among children from mixed-status families significantly increased between 2017 and 2019, with the magnitude of disparity widening over time.

Hispanic Ethnicity Differences in Birth Characteristics, Maternal Birthplace, and Risk of Early-Onset Hodgkin Lymphoma: A Population-Based Case-Control Study.

Hispanic ethnicity differences in the risk of early-onset Hodgkin lymphoma diagnosed at &lt;40 years are understudied. We conducted a population-based case-control study to evaluate associations between birth characteristics and early-onset Hodgkin lymphoma with a focus on potential ethnic differences. This study included 1,651 non-Hispanic White and 1,168 Hispanic cases with Hodgkin lymphoma endorsing a range of races diagnosed at the age of 0 to 37 years during 1988-2015 and 140,950 controls without cancer matched on race/ethnicity and year of birth from the California Linkage Study of Early-Onset Cancers. OR and 95% confidence intervals (CI) were estimated from multivariable logistic regression models. Having a foreign-born mother versus a United States-born mother (i.e., the reference group) was associated with an increased risk of early-onset Hodgkin lymphoma among non-Hispanic Whites (OR = 1.52; 95% CI, 1.31-1.76; P &lt; 0.01) and a decreased risk among Hispanics (OR = 0.78; 95% CI, 0.69-0.88; P &lt; 0.01). Among both race groups, risk of early-onset Hodgkin lymphoma increased with birthweight and maternal age (all Ptrends &lt; 0.01). Among non-Hispanic Whites, each 5-year increase in maternal age (OR = 1.11; 95% CI, 1.04-1.18; Ptrend &lt; 0.01) and paternal age (OR = 1.07; 95% CI, 1.02-1.13; Ptrend &lt; 0.01) was associated with increased risk of early-onset Hodgkin lymphoma. Compared with female Hispanics, male Hispanics had an increased risk of early-onset Hodgkin lymphoma (OR = 1.26; 95% CI, 1.12-1.42; P &lt; 0.01). Maternal birthplace may play a role in risk of early-onset Hodgkin lymphoma that differs by ethnicity. The ethnic differences observed between certain birth characteristics, maternal birthplace, and early-onset Hodgkin lymphoma raise questions about the underlying biological, generational, lifestyle, residential, and genetic contributions to the disease.

Applying stress and coping models to ethnic/racial identity, discrimination, and adjustment among diverse adolescents.

Adopting the constructs of exposure, reactivity, and recovery, from stress and coping frameworks, this study investigated three models of discrimination, adjustment, and ethnic/racial identity among 76 African American, 145 Asian American, and 129 Latinx adolescents who were majority United States-born. The sample includes adolescents sampled from public schools in a large urban area in the northeastern United States, 62% female and with an average age of 14.3 years. Multilevel analyses support an exposure effect (Model 1) where a higher level of ethnic/racial identity (ERI) commitment was associated with a 28% reduction in experiencing discrimination stress. The negative effects of discrimination were attenuated by ERI commitment and centrality/private regard, while effects were exacerbated by ERI exploration (Model 2). Two approaches investigated next-day and longer-term recovery from discrimination (Model 3). With the exception of positive mood and anxiety, the data support recovery from discrimination stress. Discrimination is discussed in the development and maintenance of health disparities. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Cardiovascular Health and Healthcare Use of United States-Born and African-Born Blacks: A Review

Introduction Cardiovascular disease (CVD) is the leading cause of death globally, with Blacks in the United States (U.S.) is proportionately affected. Healthcare access and utilization have been reported as risk factors for poorer cardiovascular health among several U.S. populations. Aims and Objectives The purpose of this systematic literature review was to examine the results of existing studies reporting on cardiovascular health and healthcare utilization by African-born compared to U. S. -born Blacks. Methods A systematic literature review was conducted using keywords and medical subject headings (MESHs) in the PUBMED, Web of Science and CINAHL electronic databases. Exclusion and inclusion criteria determined articles to be reviewed for eligibility and methodological soundness. A pooled analysis was performed on all studies. Results Only seven studies met inclusion criteria. Four compared U. S. -born with African-born Blacks residing in the United States, while three compared U. S. -born Blacks with Blacks residing elsewhere. None of the studies examined the associations between healthcare utilization and cardiovascular health for these populations. Conclusion The results of this review indicate a need to examine the impact of healthcare utilization for increasing awareness, prevention and treatment of CVD in Blacks who reside in the United States regardless of their nativity.

Impact of Personal Social Network Types on Breastfeeding Practices in United States-Born Black and White Women.

Background: An individual's personal social network influences behavior; one is more likely to adopt behaviors consistent with norms within the network to avoid social stigma. Personal social network types, which are associated with individual behaviors, have been identified for new mothers: exclusive (kin centric) and expansive (not kin centric). Objective: To analyze the impact of personal social network type on breastfeeding practices in U.S.-born Black and White mothers. Methods: Mothers of infants <6 months old completed surveys about their personal social networks and feeding practices. Multinomial logit models examined how social network types moderated effects of sociodemographic factors on feeding practices. Results: Of 402 mothers, 67% self-identified as Black and 33% as White. Forty-six percent were exclusively breastfeeding; 26% were mixed breast and formula feeding. The likelihood of exclusively breastfeeding was positively associated with percentage of network members who had breastfed; this association was stronger for mothers with exclusive networks than those with expansive networks (β = 2.74, p < 0.001 versus β = 1.78, p = 0.03). Black race was positively correlated with exclusive breastfeeding or mixed feeding for mothers with exclusive networks (β = 1.50, p = 0.046; β = 1.86, p = 0.02, respectively). Lower educational level was negatively correlated with exclusive breastfeeding; this correlation was stronger for mothers with exclusive networks (β = -1.91, p = 0.002 versus β = -1.70, p = 0.04). Lower educational level was also negatively correlated with mixed feeding for mothers with exclusive networks (β = -1.61, p = 0.02). Conclusions: Mothers' personal social network type likely moderates the relationship between sociodemographic variables and feeding practices. While the influence of having network members with breastfeeding experience is important, the magnitude of influence is stronger in exclusive networks.

Discrimination and hair cortisol concentration among asian, latinx and white young adults

Discrimination is a form of chronic stress and hair cortisol concentration is an emerging biomarker of chronic stress. In a sample of 83 first-year college students (age x⋅⋅−=17.65, SD=48, 69% female, 84% United States-born, 24% Asian, 21% Latinx, and 55% White), the current study investigates associations between hair cortisol concentration with discrimination stress assessed across two timeframes: past year and past two weeks. Significant associations were observed for past year discrimination and hair cortisol concentration levels, but not for discrimination over the past two weeks. The current study contributes to a growing body of evidence linking discrimination stress exposure to neuroendocrine functioning.

The complex relationships among race/ethnicity, social determinants, and opioid utilization.

To examine individual- and community-level factors associated with racial/ethnic differences in individuals' opioid prescription use. Outpatient opioid prescription utilization and demographic, socioeconomic, and health characteristics from a nationally representative sample of the US noninstitutionalized civilian population obtained from 2013-2016 Medical Expenditure Panel Survey (MEPS) data and combined with 2012-2016 American Community Survey data and 2015 Health Area Resources File data. We use the Oaxaca-Blinder decomposition method to disaggregate racial/ethnic differences in prescription opioid utilization into differences explained by underlying predisposing, enabling and need characteristics, and unexplained differences. We use restricted-use geographic identifiers to supplement the MEPS data with information on community characteristics and local health care resources. The average annual rate of any outpatient opioid prescription use was higher for non-Hispanic whites (15.8%; standard errors [SE]: 0.3) than for non-Hispanic blacks and Hispanics by 1.4 percentage points (SE: 0.5) and 6.2 percentage points (SE: 0.4), respectively. The smaller difference between non-Hispanic blacks and whites is not explained by the differences in the risk factors, while almost all the difference between Hispanics and non-Hispanic whites can be explained by the differences in the means of the risk factors. The differences in the prevalence of pain, the rate of being United States-born, and the racial/ethnic composition of the community explain 2.4 (SE: 0.2), 1.4 (SE: 0.3), and 1.9 (SE: 0.4) percentage-point differences, respectively. Pain prevalence explains the difference regardless of opioid potency, while foreign-born status and community racial/ethnic composition explain the difference in higher-potency opioid utilization only. This study underscores the importance of accounting for both individual and community characteristics when investigating patterns in opioid use. Our results could assist policy makers in tailoring strategies to promote safer and more effective pain management based on individual and community characteristics.

966. Pregnancy Outcomes and Engagement in HIV Care for Pregnant Women Living with HIV in Rhode Island 2012-2019

BackgroundPrevention of mother to child transmission (PMTCT) of Human Immunodeficiency Virus (HIV) requires a comprehensive approach and understanding the cultural backgrounds of pregnant women living with HIV (PWLH). In Rhode Island (RI), 70% of women newly diagnosed with HIV are foreign-born (FB) despite only representing 14% of RI’s population. Understanding the similarities and differences of pregnancy characteristics and engagement in postpartum HIV care between United States born (USB) and FB women is needed to ensure PWLH remain engaged in care and that appropriate resources are provided to all women with HIV in our state to maintain successful PMTCT of HIV.MethodsA retrospective review of pregnant women living with HIV and their HIV-exposed infants evaluated in our hospital system were analyzed from 2012-2019. Clinical data were derived from medical records. Association between country of origin and sociodemographic, clinical, or lab variables were evaluated using chi-square test.ResultsA total of 72 pregnancies in 64 PWLH were included. Median # of pregnancies were 9 per year, median age at delivery 33 years, 54% of PWLH Black or African American, 33% Hispanic; 67.1% FB, most (56%) from Sub-Saharan Africa. Sixty-one % (n=42) with detectable (> 20 copies/mL) viral load (VL) during pregnancy, 23% (n=15) at delivery, only 1 VL > 200 at delivery. Pregnancy complications seen in 51%; 60% delivered vaginally; most (74%) at term. Engagement in postpartum HIV care declined from 71% at 6 months to 37% at 24 months. There was also decline in engagement in HIV care for the HIV exposed infants- 89% presented to the initial visit their children, from 89% attending the initial visit to 69% attending their last. DCYF involvement was more likely to occur in USB women compared to FB (P < 0.05). Other comparisons between FB & USB women including adherence to care were insignificant.ConclusionUSB PWLH are at higher risk of DCYF involvement compared to FB women. Investigation into this disparity is warranted, given the cultural and language differences between groups. Additional research to determine barriers to long-term postpartum follow up for women and their infants is urgently needed.Disclosures All Authors: No reported disclosures

Future Directions: Analyzing Health Disparities Related to Maternal Hypertensive Disorders.

Hypertensive disorders of pregnancy complicate up to 10% of pregnancies worldwide, constituting one of the most significant causes of maternal morbidity and mortality. Hypertensive disorders, specifically gestational hypertension, chronic hypertension, and preeclampsia, throughout pregnancy are contributors to the top causes of maternal mortality in the United States. Diagnosis of hypertensive disorders throughout pregnancy is challenging, with many disorders often remaining unrecognized or poorly managed during and after pregnancy. Moreover, the research has identified a strong link between the prevalence of maternal hypertensive disorders and racial and ethnic disparities. Factors that influence the prevalence of maternal hypertensive disorders among racially and ethnically diverse women include maternal age, level of education, United States-born status, nonmetropolitan residence, prepregnancy obesity, excess weight gain during pregnancy, and gestational diabetes. Examination of the factors that increase the risk for maternal hypertensive disorders along with the current interventions utilized to manage hypertensive disorders will assist in the identification of gaps in prevention and treatment strategies and implications for future practice. Specific focus will be placed on disparities among racially and ethnically diverse women that increase the risk for maternal hypertensive disorders. This review will serve to promote the development of interventions and strategies that better address and prevent hypertensive disorders throughout a pregnant woman's continuum of care.

Hope in the Shadows: Testing the Immigrant Optimism Hypothesis Among College Aspirational Latino Students.

Scholars have proposed that immigrant optimism explains why some immigrant students outperform their United States-born peers academically. Yet, immigrant optimism has not been directly measured. This study aims to test the immigrant optimism hypothesis by operationalizing it using the Children's Hope Scale. Using structural equation modeling, the author examined the associations between hope, immigrant generation, citizenship status, and academic outcomes among a sample of 2,369 Latino 14- to 17-year-old students. Though no difference by immigrant generation was found, undocumented students were more hopeful than their documented peers. This finding suggests that the documentation status has an indirect relative effect on academic outcomes via hope. This article reexamines the immigrant optimism as a resource that could be fostered among Latino youth, regardless of immigrant status.

Foreigner objectification, English proficiency, and adjustment among youth and mothers from Latinx American backgrounds.

Understanding the experience of foreigner objectification is relevant given the possibility of ethnocentrism, xenophobia, and mistrust of immigrants in the United States. The present study examines main and interactive effects of objectification and English proficiency on developmental outcomes among immigrant mothers and children. Our study includes 173 youth from Latinx backgrounds (52% female, Mage = 12.86 years, SD = .68; 87% United States-born) and their mothers (Mage = 38.26 SD = 5.65; all foreign-born) from emerging immigrant contexts. Bivariate and regression analyses suggest that lower English proficiency was associated with more objectification for youth; whereas higher English proficiency was associated with more objectification for mothers. For youth only, English proficiency was positively correlated with American identity. For both parents and youth, foreigner objectification was linked with negative psychological outcomes (e.g., mothers' depressive symptoms, youths' low self-esteem). Being subjected to assumptions that challenge individuals' social status can be psychologically harmful. Nuanced developmental variation, and implications regarding the dual role of objectification and English proficiency are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Differences in breast cancer outcomes amongst Black United States-born and Caribbean-born immigrants.

1088 Background: The Black population in the US constitutes of 4 million immigrants, with 50% from the Caribbean. It has been shown that breast cancer is responsible for 14%-30% of cancer deaths in the Caribbean; this is up to two times higher than the USA. Methods: Retrospective cohort of 1369 self-identified Black women with breast cancer. Data was obtained from Jackson Memorial Health Systems and University of Miami Health System Tumor Registry. Individual-level data from 1132 cases was used to estimate hazard rations (HRs) of women born in the Caribbean (CB) or in the USA (USB) using Cox proportional hazards regression analysis for overall survival. Median follow-up was 115 months (interquartile range, 91.9-138.1 months) per participant. Results: Data from 622 (54.9%) USB women and 507 (45%) CB women diagnosed with breast cancer between 2006-2017. 90% (n = 1232) of the cohort is of non-Hispanic ethnicity. Caribbean immigrants from Haiti (18.3%), Jamaica (6.5%), Bahamas (3.1%), Cuba and Dominica Republic (2.8% each), Trinidad and Tobago (1%) and other nationalities from the Organization of Eastern Caribbean States were included, mean age 55.7 [95% CI, 54.7-56.8]; USB mean age 57.6 [95% CI, 56.4-58.7] (P = 0.02). Compared to USB, CB had lower BMI at diagnosis 29.6 [95% CI, 28.9-30.3] versus 30.9 [95% CI, 30.1-31.7, P = 0.015]. Compared to CB patients, USB patients had more ER- [31.4% vs 39.1 %, P = 0.018] and triple negative breast cancers [19.6% vs 27.9%, P = 0.003]. Compared to USB patients, CB presented at more advanced stage, III and IV [44.2% vs 35.2%], p = 0.016. In spite of higher advanced stage at diagnoses, CB patients had a better breast cancer overall survival [HR = 0.75; 95%CI, 0.59-0.96; P = 0.024]. Black Hispanic patients had a better overall survival [HR = 0.51; 95%CI, 0.28-0.93; p = 0.028] compared to non-Hispanic Blacks. Compared to Hispanic Caribbean, non-Hispanic Caribbean had a worse overall survival [HR = 1.98; 95%CI, 1.00-3.94; P = 0.048]. The distribution of patients treated at the private cancer center and the safety net hospital were the same, differences in outcomes observed are due to intrinsic differences. Conclusions: This is the largest analysis to date of self-identified Black breast cancer patients in the context of nativity, race, ethnic identity and overall survival with clinico-pathologic characteristics. CB immigrants diagnosed with breast cancer have a better overall survival than US born Black patients. This finding suggests that within the African diaspora in the USA, additional factors beyond race contribute to the outcomes.

Distinct classes of alcohol use and related problems among Asian American young adults.

There is little understanding and minimal research identifying distinct subgroups of drinkers among ethnic minority populations, particularly Asian Americans, although growing evidence suggests that high-risk groups of Asian American drinkers exist. Sociocultural factors, including ethnic background and nativity status can be theoretically important factors that might be associated with these distinct groups. Additionally, well-established correlates of alcohol use, such as drinking to cope, Greek membership, and alcohol expectancies might also be associated with these distinct groups. The purpose of the study was to: (a) identify distinct classes of drinkers among 657 Asian American college students, and (b) examine the factors associated with the latent classes of drinkers. Four classes were identified, and the 2 high-risk groups included: (a) High Risk Binge Drinking class (10%): engaging in binge drinking (4 drinks in a 2 h sitting for women and 5 drinks for men) around 14.92 times in the past 3 months, reporting getting intoxicated 10.26 times over the past 3 months and 11 alcohol-related problems; (b) Monthly Binge Drinking class (27%): engaging in binge drinking 3.5 times in the past 3 months, reporting getting intoxicated 2.49 times over the past 3 months, and 7.8 alcohol-related problems. United States-born individuals were more likely to be in the High Risk Binge Drinking class; higher drinking to cope motives and being involved in a sorority or fraternity differentiated the higher drinking classes from the low-risk classes. Korean and South Asian Americans were less likely to be in the Monthly Binge Drinking class. This study illustrates that high risk drinking subgroups exist among Asian American young adults attending college, and identifies relevant correlates to drinking. (PsycINFO Database Record (c) 2019 APA, all rights reserved).