US-born Hispanics Research Articles

Are immigrants migrating away from transit? Immigrant transit use trends in California

While patronage on most public transit systems around the world remains modestly to significantly depressed post-pandemic, transit ridership had mostly been declining across the US since 2014. Advocates, practitioners, and scholars have offered a range of explanations for pre-pandemic patronage decline. This analysis examines the demand-side of this phenomenon by focusing on high-propensity transit riders, and, in particular, immigrants in the most populous US state: California. Drawing on the California add-on to the 2009 and 2017 National Household Travel Surveys, we evaluate changes in transit use among Hispanic and Asian immigrants. We find that during the study period, transit trip frequency of Hispanic immigrants declined, converging toward the ridership patterns of US-born Hispanics. While this trend was largely the result of rising incomes, increased vehicle ownership, and lower residential densities among non-US-born Hispanics, all else equal, Hispanic immigrants continued to use transit more than their US-born counterparts. By contrast, transit trip making by Asian immigrants diverged from that of US-born Asians. Notably, this divergence was not the result of declining per-person trip making by Asian immigrants, which was relatively stable during the study period. Instead, the growing gap was due to increases in transit trip frequency by US-born Asians.

EFFECTS OF SOCIAL ENGAGEMENT ON WELL-BEING AND COGNITIVE FUNCTIONING IN OLDER HISPANICS

Abstract Research on engaged lifestyles demonstrates the importance of social engagement for aging well. The present study examined this thesis in the context of minority aging. With the theoretical lens that Hispanic cultures value social relationships, we tested whether social engagement was particularly important for maintaining well-being and cognitive functioning in Foreign-born (FB-H) and U.S.-born Hispanics (USB-H) relative to non-Hispanic Whites (NHW). Participants (N = 2677) was drawn from older adults in the Health and Retirement Study who completed the 2008, 2012, 2016, and 2020 module at least once. Two types of social engagement were assessed. Social interactions were based on the frequency of interactions with close partners (i.e., children, family members, and friends). Social activity participation was measured by the frequency of volunteering, doing charity, joining clubs, and attending meetings of non-religious organizations. Results of random intercept linear models controlling for covariates showed that, consistent with the literature, social interactions predicted better life satisfaction and that both aspects of social engagement predicted better immediate and delayed recall. Unexpected patterns emerged when interaction effects of race/nativity and social engagement were tested. While the general pattern held for NHWs, we found that greater social interactions predicted lower life satisfaction in USB-H. For FB-H, greater participation in social activities correlated with lower performance on immediate recall. Echoing a recent study that reveals mixed evidence for the well-documented paradox that Hispanic immigrants hold health advantages (Tarraf et al., 2020), we call for more research on lifestyle factors and aging trajectories in racially diverse populations.

Driving return on media investment with US Hispanics in the 21st century: The nativity-based view

Ever since the nativity-based view (NBV) was first introduced in 2015, business practitioners have been surprised to learn that there is a better way to target US Hispanics than by simply using Spanish-language media. This was a watershed moment for the US advertising and marketing industry — a paradigm shift that leading brands, advertising agencies and research companies did not see coming. Challenging the Hispanic marketing paradigm, the NBV proposes that nativity is more effective in driving media return on media investment than marketing to Hispanics in-language. To address recent concerns that the NBV, as a construct, lacks internal validity, this paper compares past NBV research spanning almost a decade versus 2023 data. This study continues to show that there are significant differences between US-born and foreign-born Hispanics on a number of dimensions, including demographics, language usage, media consumption and return on media investment. This new media model has strong implications for marketing to US Hispanics in the 21st century, providing brands and advertising agencies with a simple, and more effective model that has lived in the shadows of language-based marketing since the early 1990s. This paper suggests companies that follow the customer rather than the industry narrative are better positioned to win in an overwhelming US-born Hispanic marketplace.

Roles of Income and Acculturation in the Hispanic Paradox: Breastfeeding Among Hispanic Women.

Despite Hispanics' high prevalence of breastfeeding compared to other racial/ethnic groups, contributing factors remain unclear. This study examines the complex relationship among Hispanic nativity, acculturation, income, and breastfeeding. The Fragile Families Child Wellbeing Study baseline (1998-2000) and Year 1 data (1999-2001) were used, including 4,077 women (933 non-Hispanic white, 2,046 non-Hispanic Black, 352 US-born Mexicans [USM], 299 US-born other Hispanics [USH], 302 foreign-born Mexicans [FBM], and 145 foreign-born other Hispanics [FBH]). Logistic regression estimated odds ratios(OR) and 95% confidence intervals(CI) for associations between Hispanic nativity and breastfeeding initiation and 4-month and 6-month breastfeeding, accounting for acculturation (Spanish language use, cultural engagement, religiosity, and traditional gender role attitudes), demographics, income, and health factors. Models were run for the overall sample and stratified by low vs. high income (above median: $21,600). FBM(OR:2.35, 95%CI 1.33,4.15) and FBH(OR:2.28, 95%CI 1.23,4.24) had higher odds, while USM(OR:0.55, 95%CI 0.41,0.73) and USH(OR:0.50, 95%CI 0.37,0.67) had lower odds of breastfeeding initiation, compared to white women. USM had lower odds of 4-month(OR:0.53, 95%CI 0.36,0.80) and 6-month breastfeeding(OR:0.38, 95%CI 0.23,0.63), as did USH for 4-month(OR:0.64, 95%CI 0.42,0.99) and 6-month breastfeeding(OR:0.50, 95%CI 0.30,0.85). In stratified models, low-income (vs. high-income) FBH had higher odds of breastfeeding initiation(OR:3.73 95%CI 1.43,9.75) and 4-month(OR:3.01 95%CI 1.12,8.04) and 6-month breastfeeding(OR:3.08 95%CI 1.07,8.88), yet effects of acculturation across income strata are inconsistent. The Hispanic paradox operates differentially due to nativity, income, and acculturation. Breastfeeding intervention and promotion may require tailored approaches to Hispanic subgroups.

Abstract P518: Distinctive Blood Metabolomic Profiles Between US-Born and Foreign-Born Hispanics/Latinos: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Introduction: US-born Hispanics have a worse cardiometabolic profile compared to foreign-born Hispanics, but the underlying mechanisms are not fully understood. Hypothesis: We hypothesize that, compared to foreign-born Hispanics, US-born Hispanics have a distinctive blood metabolomic profile, which might be related to diet/lifestyle and gut microbiota and associated with health outcomes. Methods: Serum levels of 634 metabolites were profiled in US Hispanics in the Hispanic Community Health Study/Study of Latinos (N=3941 in discovery dataset; N=2368 in replication dataset). We used multiple linear regression to identify metabolites associated with US nativity. Machine-learning algorithms were used to identify potential determinants of metabolites based on genetics, sociodemographic factors, diet, lifestyle, clinical parameters, and gut microbiota. We examined prospective associations of baseline metabolites with risk of incident diseases during a 6-year follow-up using Poisson regression. Results: We identified 158 metabolites associated with US nativity in discovery dataset (FDR<0.05), 135 of which were validated in replication dataset (87 higher and 48 lower in US born vs foreign-born). A metabolomic score showed a high discriminatory ability for US-born vs foreign-born Hispanics (AUC = 0.84 and 0.82 in discovery and replication datasets, respectively) and a dose-response relationship with longer duration of US residence. Variations of these US-nativity related metabolites were explained more by nongenetic factors, especially diet and gut microbiota, compared to those unrelated to US nativity, while variations explained by genetics between these two groups of metabolites were similar. Specifically, the US-born related metabolomic profile was characterized by lower levels of many metabolites in amino acid and xenobiotic pathways (e.g., ergothioneine, phenylpropionate, indole propionate, β-cryptoxanthin, carotene diol). These metabolites were positively associated with plant-based food intake (e.g., whole grain, fruits, vegetables) and beneficial fiber-utilizing bacteria (e.g., Eubacterium, Roseburia, Oscillibacter). Cardiometabolic and kidney function traits showed stronger overall associations with US-nativity related metabolites compared to other clinical traits (e.g., liver function, lung function). Prospective analyses showed that metabolites higher in US-born Hispanics were generally associated with higher risk of server obesity, hypertension, diabetes, chronic kidney disease and asthma, while those higher in foreign-born Hispanics were generally associated with lower risk of these diseases. Conclusion: Compared to foreign-born Hispanics, US-born Hispanics showed an unfavorable blood metabolomic profile associated with multiple chronic diseases, which might be partially related to diet and gut microbiota acculturation.

Hispanic Americans in the Labor Market: Patterns over Time and across Generations

This article reviews evidence on the labor market performance of Hispanics in the United States, with a particular focus on the US-born segment of this population. After discussing critical issues that arise in the US data sources commonly used to study Hispanics, we document how Hispanics currently compare with other Americans in terms of education, earnings, and labor supply, and then we discuss long-term trends in these outcomes. Relative to non-Hispanic Whites, US-born Hispanics from most national origin groups possess sizeable deficits in earnings, which in large part reflect corresponding educational deficits. Over time, rates of high school completion by US-born Hispanics have almost converged to those of non-Hispanic Whites, but the large Hispanic deficits in college completion have instead widened. Finally, from the perspective of immigrant generations, Hispanics experience substantial improvements in education and earnings between first-generation immigrants and the second-generation consisting of the US-born children of immigrants. Continued progress beyond the second generation is obscured by measurement issues arising from high rates of Hispanic intermarriage and the fact that later-generation descendants of Hispanic immigrants often do not self-identify as Hispanic when they come from families with mixed ethnic origins.

The Fading of Protective Roots: A Multivariate Analysis of the Risk of Hypertension among Hispanics by Nativity.

To examine the effects of Hispanic nativity on the risk and severity of hypertension relative to US-born non-Hispanic whites. The analytic sample (n = 34,007) was comprised of cross-sectional data drawn from twenty years of the National Health and Nutrition Examination Survey, 1999-2018. Foreign-born Hispanics aged 65 years and older had a greater risk of severe hypertension compared to non-Hispanic Whites. When examined by length of residency in the US, elderly foreign-born Hispanics with less than 10 years of residency were at greater risk of hypertension and severe hypertension, while those with 20 or more years of residency had similar risks compared to non-Hispanic Whites. The "Hispanic Paradox" of better health despite lower socioeconomic status, was not observed in foreign-born or US-born Hispanics aged 65 years and older. Among elderly immigrants, those with fewer years of residency had the greatest hypertensive risk.

CHANGES IN FUNCTIONAL STATUS AMONG US ADULTS IN LATE MID-LIFE FROM THE HEALTH AND RETIREMENT STUDY 2004–2016

Abstract Reducing racial/ethnic disparities in health and functioning among older adults are salient key goals in the U.S. health policy. This study examined whether and how the functioning have progressed between White and minority populations in late midlife in recent years. We analyzed the Health and Retirement Study (HRS) among adults ages 45-64 years across two time periods (2004-2010 and 2010-2016). Using generalized linear regression, we modeled changes in activities of daily living (ADL) and changes in instrumental activities of daily living (IADL) as a function of race/ethnicity and sequentially adjusted for period specific risk factors including sociodemographic factors, health insurance, health behaviors and social networks. Oaxaca-Blinder Regression Decomposition (OBRD) techniques are used to assess the contributions of these factors to the observed trends in ADL/IADL. We find changes in ADL is significantly higher for Blacks (Odds Ratios of 1.23, CI 1.01-1.48) and US-born Hispanics (Odd Ratios of 1.54, CI 1.12-2.12) after adjusting for all the risk factors in the second period. About two-thirds of the disparity in functional status of adults is explained in our OBRD model and more than 70% of these explained differences among minorities is related to socio-demographic factors. This probably occurred due to the differences in income and net wealth which began to widen during the time of 2008 financial crisis. Although recently there is a decline in disability trends for older adults in U.S., our findings point to an increase in racial/ethnic disparities in functional status for adults in late midlife.

Racial/Ethnic Differences in Biological Aging and Their Life Course Socioeconomic Determinants: The 2016 Health and Retirement Study.

Objectives: This study examined differences in accelerated biological aging among non-Hispanic Blacks, Hispanics, and non-Hispanic Whites in the United States and assessed whether including life course socioeconomic conditions attenuated observed racial/ethnic differences. Methods: Data came from the Venous Blood Collection Subsample of the Health and Retirement Study. We used a comprehensive summary measure of biological age (BA-22). We determined whether key lifetime socioeconomic conditions contributed to racial/ethnic differences in biological aging. Results: Findings indicated that non-Hispanic Blacks and Hispanics have accelerated aging, and non-Hispanic Whites have decelerated aging. Racial/ethnic differences were strongly tied to educational attainment. We also observed a significant difference by birthplace for Hispanics. US-born Hispanics had accelerated biological aging, whereas foreign-born Hispanics did not. In age-stratified analyses, these racial/ethnic differences were found for adults aged 56-74, but not for adults aged 75+. Conclusions: These findings provide insight into biological differences underlying racial/ethnic disparities in health.

Race/Ethnicity and Birthplace as Risk Factors for Gastric Intestinal Metaplasia in a Multiethnic United States Population.

Several US subgroups have increased risk of gastric cancer and gastric intestinal metaplasia (GIM) and may benefit from targeted screening. We evaluated demographic and clinical risk factors for GIM and examined the interaction between race/ethnicity and birthplace on GIM risk. We identified patients who had undergone esophagogastroduodenoscopy with gastric biopsy from 3/2006-11/2016 using the pathology database at a safety net hospital in Houston, Texas. Cases had GIM on ≥1 gastric biopsy histopathology, whereas controls lacked GIM on any biopsy. We estimated odds ratios and 95% confidence intervals (CI) for associations with GIM risk using logistic regression and developed a risk prediction model of GIM risk. We additionally examined for associations using a composite variable combining race/ethnicity and birthplace. Among 267 cases with GIM and 1,842 controls, older age (vs <40 years: 40-60 years adjusted odds ratios (adjORs) 2.02; 95% CI 1.17-3.29; >60 years adjOR 4.58; 95% CI 2.61-8.03), Black race (vs non-Hispanic White: adjOR 2.17; 95% CI 1.31-3.62), Asian race (adjOR 2.83; 95% CI 1.27-6.29), and current smoking status (adjOR 2.04; 95% CI 1.39-3.00) were independently associated with increased GIM risk. Although non-US-born Hispanics had higher risk of GIM (vs non-Hispanic White: adjOR 2.10; 95% CI 1.28-3.45), we found no elevated risk for US-born Hispanics (adjOR 1.13; 95% CI 0.57-2.23). The risk prediction model had area under the receiver operating characteristic of 0.673 (95% CI 0.636-0.710) for discriminating GIM. We found that Hispanics born outside the United States were at increased risk of GIM, whereas Hispanics born in the United States were not, independent of Helicobacter pylori infection. Birthplace may be more informative than race/ethnicity when determining GIM risk among US populations.

Racial and ethnic inequities in occupational exposure across and between US cities

Research suggests that racial/ethnic disparities in COVID-19 in the US are largely driven by higher rates of exposure to SARS-CoV-2 among Hispanic/Latino and Black populations. Occupational exposures play a large role in structuring risk of exposure, and essential workers are at elevated risk of COVID-19 infection. At a national-level, workers categorized as “essential” and “high-risk” are disproportionately Hispanic/Latino, but we lack analysis examining local-level racial/ethnic disparities in potential occupational exposures. Using the 2015–2019 5-year American Community Survey, we estimated disparities between the proportion of US Born Hispanic/Latino, foreign-born Hispanic/Latino, and non-Hispanic white (NHW) essential or high-risk workers in 27 of the largest metropolitan areas in the country. We found that, on average, 66.3%, 69.9%, and 62.6% of US-born Hispanics, foreign-born Hispanics, and NHW, respectively, are essential workers, while 50.7%, 49.9%, 49.5% are high exposure risk workers, respectively. The median absolute difference in proportions of US born Hispanic/Latino and NHW essential workers was 4.2%, and between foreign-born Hispanic/Latino and NHW essential workers was 7.5%, but these disparities varied widely by city. High likelihood of occupational transmission may help explain disparities in COVID-19 infection and mortality for Hispanic/Latino populations, especially foreign-born, and may also help explain heterogeneity in the magnitude of these disparities, with relevance for other acute infectious respiratory illnesses spread in the workplace.

Human papillomavirus awareness among foreign- and US-born Hispanics, United States, 2017-2018.

Human papillomavirus (HPV) and HPV vaccine knowledge and awareness are known to be lower among Hispanics compared to non-Hispanic whites. However, Hispanics in the US are a non-homogenous population, with significant differences by nativity, particularly between the US-and foreign-born individuals. We examined HPV and HPV vaccine awareness among foreign-born Hispanics, US-born Hispanics, and US-born non-Hispanic whites. We analyzed data from the Health Information National Trends Survey (HINTS) 5, cycles 1 (2017) and 2 (2018), the most recent HINTS datasets including nativity information. We used descriptive statistics and multivariable regression to compare awareness of HPV and the HPV vaccine among ethnicity/nativity subgroups. Over 50% of foreign-born Hispanics had not heard of HPV, compared to 32% of US-born Hispanics (P<0.01) and 33% of non-Hispanic whites (p<0.01). Lack of HPV vaccine awareness among foreign-born Hispanics was not significantly different from US-born Hispanics (52% vs. 44%, p=0.12), but was significantly lower compared to non-Hispanic whites (52% vs. 32%, p<0.01). In multivariable analyses, non-Hispanic whites had over twice the odds of having heard of HPV than foreign-born Hispanics (p<0.05), while US-born Hispanics had 75% higher odds (p<0.05). Regarding HPV awareness, non-Hispanic whites had 95% higher odds of having heard of the HPV vaccine than foreign-born Hispanics (p<0.05), while differences between US and foreign-born Hispanics were not significant. There are significant nativity-related differences in HPV and HPV vaccine awareness and knowledge among US-born Hispanics. Over 50% of foreign-born Hispanic adults are unaware of HPV and the HPV vaccine.

Immigration History and Cognitive Function in Elderly US Hispanics

Background and Objectives. Few reports have examined the Hispanic Paradox with regard to cognitive function, most of which have led to inconclusive results. This study tested the null hypothesis that foreign-born and US-born Hispanics over age 60 have the same scores on cognitive function tests. Research Design and Methods. The National Health and Nutrition Examination Survey assessed cognitive functioning in 588 Hispanic participants aged 60 years and older in 2011 - 2014. The Digit Symbol Substitution test (DSST), CERAD Word Learning test and Animal Fluency Test (AFT) were administered. Results. Linear multiple regression analysis showed significantly lower test scores among foreign-born than US-born women for DSST and AFT and men for DSST independent of confounding variables. There was no significant difference in CERAD scores. Conclusion. Foreign-born Hispanic women aged 60 and over had lower scores than the US-born on two of three tests of cognitive function.

Racial, Ethnic, and Place-of-Birth Disparities in Body Types: Association to Glycated Hemoglobin in Older Adults

Obesity, a public health concern for older adults, contributes to abnormal glycated hemoglobin (HbA1c). We examine place of birth disparities in the prevalence rate of body types and their association to HbA1c using the National Health Nutrition and Examination Survey (NHANES) III. Body mass index /waist circumference (WC) cut off values were used to create six body types: normal weight with normal WC, overweight with normal WC, obese with normal WC, normal weight with high WC, overweight with high WC, and obese with high WC. Abnormal HbA1c was defined as HbA1c >5.7%. Weighted multivariable logistic regression adjusted for age, gender, education, and poverty-income-ratio was run. The sample population included 4,584 participants aged 50 years and older identifying as non-Hispanic whites (NHW), US-born Hispanics (USB-H), and foreign-born Hispanics (FB-H). The mean (SD) sample age was 63.9 (0.3). USB-H had the highest proportion of obese with high WC (35.6%,p<0.0001) compared to NHW (26.6%) and FB-H (22.2%). USB-H (aOR 1.97 95% CI 1.45,2.68) and FB-H (aOR 1.51 95% CI 1.10,2.06) had higher odds of abnormal HbA1c compared to NHW. Overweight with high WC (aOR 1.47 95% CI 1.11-1.93) and obese with high WC (aOR 2.11, 95% CI 1.60-2.79) had a high likelihood of abnormal HbA1c compared to normal weight with normal WC. Further adjustment for co-morbid conditions yielded a significantly improved fitting model (Maximum-rescaled R-square (MRRS) =0.1997,p<0.0001) compared to that further adjusted for health-related behaviors (MRRS=0.082,p<0.0001). The knowledge of these associations in an at-risk sub-population is insightful for clinical assessments and preventive interventions.

Otosclerosis in an Urban Population.

To investigate the evolving prevalence of otosclerosis in a large urban population. A retrospective review of patients in a large, urban, public health system was conducted from January 2010 to August 2019 to identify subjects with otosclerosis. Diagnostic testing included audiometry and computed tomography scans. Sex, age at diagnosis, treatment received, race, ethnicity, and country of birth were analyzed for each subject and compared with all eligible patients in the reference population. A total of 134 patients from a reference population of 672,839 were diagnosed with otosclerosis and analyzed. The otosclerosis patients were predominantly Hispanic (73%), of which the majority were foreign born (87%). The average age at onset was 46 years and 59% were women. The overall prevalence of otosclerosis was 20 of 100,000 patients. The crude prevalence of otosclerosis by ethnicity was 43 of 100,000 for Hispanics, 12.6 of 100,000 for Caucasians, and 3 of 100,000 for African Americans. Within the Hispanic population, the prevalence of otosclerosis was 60 of 100,000 for foreign-born individuals and 16 of 100,000 for those born in the USA (odds ratio [OR] = 3.69, [95% confidence interval [CI], 2.02-6.76], p < 0.0001). Prevalence was not significantly different among Caucasians and US-born Hispanics. Otosclerosis in the studied population was most common among Hispanic patients, though it was strongly influenced by country of birth. The "imported" otosclerosis cases are best explained by environmental influence rather than ethnic susceptibility. This discrepancy is likely due to variance in measles immunization rates among North and Central American countries before 1990.

Self-reported Hazardous Drinking, Hypertension, and Antihypertensive Treatment Among Hispanic Immigrants in the US National Health Interview Survey, 2016-2018.

Compared to the US-born population, Hispanic immigrants are reported to have lower age-adjusted prevalence of hypertension. However, country of origin, race/ethnicity, and risk behaviors associated with acculturation, including hazardous drinking, can affect the prevalence of hypertension. Additionally, health disparities across immigration/nativity status may be associated with suboptimal antihypertensive treatment and control of hypertension. In the present study, population-based data from the years 2016 to 2018 of the National Health Interview Survey (NHIS) were analyzed to assess the association of nativity status and hazardous drinking with hypertension among US-born and foreign-born Hispanic populations. Age-adjusted prevalence of past-year hypertension among foreign-born Hispanics was lower than US-born Hispanics. However, the proportion of Hispanic immigrants who had their blood pressure checked by a healthcare professional was also smaller than US-born Hispanics, suggesting that the prevalence of hypertension among Hispanic immigrants may be underreported. Hazardous drinking was associated with decreased odds of antihypertensive treatment among the Hispanic immigrants.

Abstract A030: Human papilloma virus awareness among non-Hispanics, U.S.-born Hispanics, and foreign-born Hispanics, United States, 2017-2018

Abstract Introduction: Hispanics are the largest and fastest growing minority in the U.S. Knowledge of Human Papilloma Virus (HPV), and the HPV vaccine is reportedly lower among Hispanics compared to non-Hispanic whites. However, the Hispanic population is not homogenous, and there may be significant differences among subpopulations (e.g., by country/region of origin). We examined HPV knowledge and awareness among non-Hispanics (NH), U.S. born Hispanics (USH), and Foreign-born Hispanics (FBH). Methods: We analyzed data from the Health Information National Trends Survey (HINTS) 5 cycle 1 (2017) and cycle 2 (2018). HINTS is a nationally representative cross-sectional sample of health media use and cancer-related knowledge among U.S. adults. Using SAS Version 9.4, we conducted Wald Chi-Square tests to attain descriptive statistics. We performed a multivariate logistic regression to assess the association between two parallel outcomes – (1) heard about HPV and (2) heard of the HPV vaccine, and the primary predictors – Hispanic ethnicity and nativity while controlling for sociodemographic factors. Results: The majority of FBH (92.57%) had been in the U.S. for more than 10 years. A higher proportion of both FBH (68.75%) and USH (67.17%) reported having an immediate family member between 9 and27 years old compared to NH (47.39%). A lower percentage of FBH (48.61%) had heard of HPV compared to USH (67.60%) and NH (64.73%). A lower percentage of FBH (47.74%) had heard of the HPV-vaccine compared to USH (55.71%) and NH (64.48%). In multivariable analyses, FBH had 44% (odds ratio [OR] = 0.56, confidence interval [CI] = 0.36 – 0.85) lower odds of having heard of HPV and USH had 42% (OR = 0.58, CI = 0.43 – 0.78) lower odds of having heard of HPV vaccine compared to NH after adjusting for sociodemographic factors. Additionally, being female, older in age, having some college education or higher, and household income of $35K-49,999 or &amp;gt;$75K were significantly associated with having heard of HPV and the HPV vaccine (p&amp;lt;0.0001). Conclusion: There are differences between FBH and USH in levels of HPV awareness. Within these subgroups, a disconnect exists regarding awareness of HPV and the HPV-vaccine. FBH were more aware of HPV but not as much about the HPV-vaccine while USH were less aware of HPV but more aware of the HPV-vaccine. Overall low level of awareness of HPV and the HPV vaccine is concerning given that a large proportion of USB and FHB have a vaccine-eligible family member 9-27 years old. Strategic HPV awareness campaigns are needed to target the different subgroups among Hispanics based on their nativity status. Citation Format: Betsy Escobar, Trisha Amboree, Maria Jibaja-Weiss, Jane Montealegre. Human papilloma virus awareness among non-Hispanics, U.S.-born Hispanics, and foreign-born Hispanics, United States, 2017-2018 [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr A030.

Abstract A029: Health information seeking among non-Hispanics, U.S.-born Hispanics, and foreign-born Hispanics, United States, 2017-2018

Abstract Introduction: Hispanics are the largest and fastest growing minority in the U.S. Compared to non-Hispanics (NH), they are likely to encounter barriers to achieve optimal health based on language, education, and literacy levels, access to care and lack of health insurance. Foreign-born Hispanics (FBH), in particular, are more likely than U.S-born Hispanics (USH) to experience these barriers. We examined health-seeking information behaviors among non-Hispanics (NH), U.S. born Hispanics (USH), and Foreign-born Hispanics (FBH). Methods: We analyzed data from the Health Information National Trends Survey (HINTS) 5 cycle 1 (2017) and cycle 2 (2018). HINTS is a nationally representative cross-sectional sample of health media use and cancer-related knowledge among U.S. adults. Using SAS Version 9.4, we conducted Wald Chi-Square tests to attain descriptive statistics. We performed a multivariate logistic regression to assess the association between the primary outcome – health-seeking information, and the primary predictors – Hispanic ethnicity and nativity while controlling for sociodemographic factors. Results: The majority of FBH (92.57%) had been in the U.S. for more than 10 years. A higher percentage of FBH (31.21%) had less than a high school education when compared to USH (7.76%) and NH (6.8%). Compared to NH (82.32%), a lower percentage of both FBH (62.95%) and USH (77.62%) sought health information (p&amp;lt;0.0001). However, a higher percentage of FBH (23.05%) sought health information from their doctor or health care provider compared to USH (13%) and NH (12.24%) a lower proportion of FBH (68.45%) used the internet to seek health information compared to USH (77.22%) and NH (77.23%). Similarly, a lower proportion of FBH (59.03%) reported using an electronic device to seek health information for themselves compared to USH (70.71%) and NH (73.59%). In multivariable analyses, FBH had 48% lower odds of seeking health information (odds ratio = 0.52, confidence interval = 0.33 – 0.84) compared to NH after adjusting for sociodemographic factors. Additionally, being female, having some college education or higher, and household income of $20K-$75K+ were significantly associated with seeking health information (p&amp;lt;0.0001). Conclusion: We found dramatic differences in the prevalence of health information seeking across groups, with an almost 15% lower prevalence among FBH when compared to USH, and approximately 5% lower prevalence among USH when compared to NH. Specifically, FBH were more likely to seek health information from their health care provider than by electronic devices or the internet compared to USH. Given that FBH are less likely to have a usual healthcare provider and access healthcare regularly, this may make them less likely to receive health information. Differences in health information seeking practices should be considered, and health information campaigns tailored to specific subgroups within the Hispanic population. Citation Format: Betsy Escobar, Trisha Amboree, Maria Jibaja-Weiss, Jane Montealegre. Health information seeking among non-Hispanics, U.S.-born Hispanics, and foreign-born Hispanics, United States, 2017-2018 [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr A029.

Prevalence and Patterns of Dental Care Utilization among US-Born and Non-US Born Hispanics in the Hispanic Community Health Study/Study of Latinos.

Access to routine dental services is important to maintaining good oral health. The aims of this study were to describe the dental care utilization patterns of a diverse group of Hispanic/Latino men and women and assess differences in dental care utilization by perceived need for dental care and proxy measures of acculturation. Data from 13,792 participants of the Hispanic Community Health Study were analyzed with SAS 9.4. Time since last dental visit was dichotomized into <1 and ≥1 y. Acculturation measures included the language and social subscales of the Short Acculturation Scale for Hispanics, the Multiethnic Study of Atherosclerosis nativity subscore, and immigrant generation. Survey logistic regression adjusted for demographic (age and sex) and health-related variables, estimated associations among perceived need for dental care, acculturation measures, and dental care utilization. About a quarter (23%) of the participants were born in the 50 US states, excluding territories, while 77% were non-US born. Overall, 74% perceived a need for dental care. Upon covariate adjustment, perceiving a need for dental care was associated with reduced odds of reporting a past-year dental visit (odds ratio, 0.32; 95% CI, 0.28 to 0.37), while there appeared to be no meaningful association between proxy measures of acculturation and past-year dental visit. Having health insurance was significantly associated with a past-year dental visit (odds ratio, 2.23; 95% CI, 1.99 to 2.49) for all groups combined and among the different Hispanic/Latino background groups. Acculturation affects general health and contributes to general health disparities; however, its role in dental care utilization remains questionable. Given that acculturation is a process that occurs over several years, longitudinal studies that evaluate oral health trajectories along the acculturation continuum are needed. The results of this study are valuable for dental public health program planning and implementation for minority groups, as it describes the varying patterns of dental care utilization among US-born and non-US born Hispanics/Latinos and identifies factors that may partly explain dental care utilization patterns, such as acculturation.

The Diverging Impacts of Segregation on Obesity Risk by Nativity and Neighborhood Poverty Among Hispanic Americans.

While racial residential segregation is frequently cited as a fundamental cause of racial health disparities, its health impacts for Hispanic Americans remain unclear. We argue that several shortcomings have limited our understanding of how segregation influences Hispanic health outcomes, most notably a failure to assess the possible diverging impacts of segregation by neighborhood poverty level and the conflation of segregation with ethnic enclaves. We use multiple years of restricted geocoded data from a nationally representative sample of the US population (2006-2013 National Health Interview Survey) to investigate the association between metropolitan-level Hispanic segregation and obesity by nativity and neighborhood poverty level. We find segregation to be protective against obesity for Hispanic immigrants who reside in low poverty neighborhoods. For Hispanic immigrants residing in higher neighborhood poverty, no association between segregation and obesity was found. Among US-born Hispanics, we observe an increased risk of obesity-but only for those in high poverty neighborhoods. No association was found for those in low and medium neighborhood poverty. Results provide evidence to indicate that the relationship between segregation and health for Hispanics is not uniform within a metropolitan area. In the case of obesity, the consequences of metropolitan Hispanic segregation can be either protective, null, or deleterious depending not only on local neighborhood context but also on nativity.