Syndemic Suffering


Book Description

In a major contribution to the study of diabetes, this book is the first to analyze the disease through a syndemic framework, offering a model study of chronic disease disparity among the poor in high income countries.







The Effects of Cultural Orientation Change on Metabolic Health in a Sample of Mexican Immigrants to the United States


Book Description

Studies have identified metabolic health factors to be a major concern in Mexican-Americans, including Mexican immigrants to the United States (U.S.). Acculturation stress has been hypothesized to be a factor in the development of many health-related concerns in this population. Specifically, previous studies have shown that acculturation stress contributes to health concerns, including metabolic health concerns (e.g., diabetes, metabolic syndrome). The primary purpose of this study was to examine the relationship between cultural orientation, a measure of acculturation designed to provide more information than traditional acculturation measures, and metabolic health outcomes. Specific acculturation-related stressors (social support, job-related stress, and depression) were hypothesized mediators in this relationship among a convenience sample of 98 foreign-born Mexicans living in Utah County, Utah controlling for age, gender, socio-economic status (SES), and years in the U.S. Data were collected twice with a three year interval to examine change over time. Changes in these constructs were examined through the use of Growth Modeling with Bayesian estimation. The Acculturation Rating Scale for Mexican-Americans (ARSMA-II) was used to measure Anglo Cultural Orientation and Mexican Cultural Orientation. Standard blood analyses were used to measure metabolic health outcomes, which included glycosylated hemoglobin (HbA1c), insulin, and glucose. The Interpersonal Support Evaluation List (ISEL-12) was used to measure social support, the Job Content Questionnaire (JCQ) was used to measure job-related stress, and the Center for Epidemiological Studies-Depression Scale (CES-D) was used to measure depression. No change was identified in Anglo Cultural Orientation or Mexican Cultural Orientation over time in the majority of subjects. A positive relationship between Anglo Cultural Orientation and HbA1c was found, as was a negative relationship between Mexican Cultural Orientation and HbA1c. Mediation analyses showed a mediation effect of depression on the relationship between Anglo Cultural Orientation and glucose. Implications of findings, limitations, and directions for future research are discussed.




A Life-course Perspective on U.S. Migration Experience and Later-life Diabetes, Hypertension, and Depression for Middle-aged and Older Mexican Adults


Book Description

This dissertation explores the relationship between personal and spousal migration to the United States and later-life health for older Mexican adults living in Mexico in the context of other social determinants of health across the life-course determinants. I use the 2001 baseline wave of the Mexican Health and Aging Survey, a nationally representative sample of Mexican adults 50 years and older (born before 1951). I test the relationship between U.S. migration experience and later-life depression, diabetes, and hypertension for older Mexican men, and between spousal migration to the U.S. and later-life depression, diabetes, and hypertension for older Mexican women. I also examine the degree to which personal or spousal migration to the U.S. might mediate or moderate the relationship between early-life socio-economic status and health conditions, and later-life health outcomes. My results suggest that there is no significant main effect of U.S. migration experience on later-life health for older Mexican men, although return U.S. migrant men who report lower socio-economic standing later in life appear to have elevated risk of depression and diabetes. On the other hand, older Mexican women whose spouses migrated to the U.S. have significantly increased odds of later-life diabetes and hypertension if those women are no longer in a union by the time of the survey. The adverse effects of spousal migration to the U.S. are exacerbated by women's domestic labor outside the home and lack of decision-making power relative to their spouses, but buffered by their own migration experience. Finally, although greater socio-economic disadvantage in childhood predicts both U.S. migration (personal and spousal), and increased odds of later-life depression, diabetes, and hypertension, there is no evidence that US migration experience explains this life-course trajectory of socio-economic status and health. There is also limited evidence that a U.S. migration experience alters the relationship between childhood conditions and later-life health. Overall, for this group of older Mexican adults, the adverse effects of past U.S. migration experience are only observed for women whose spouses migrated to the U.S. and who are no longer in a union, which contributes to theories of the gendered geographies of power, or the ways in which migration may have different effects for men and women - in this case women who primarily stayed behind in Mexico. On the other hand, contrary to theories of migration stress, having a U.S. migration history does not appear to have a substantial effect on the health of return Mexican migrant men.




Mental Health


Book Description




Latino Health in the US


Book Description

Latinos and the health care system; life cycle and family health issues; patterns of chronic diseases; health in the work envirnoment; alcohol, drugs and mental health issues.







The Relationship Between Perceived Social Status, Stress, and Health in Mexican American Immigrants


Book Description

The current paper examines the relationship between social support, perceived social status and health in the context of the Hispanic Paradox. It was hypothesized that social support will predict perceived social status which, in turn, is an important factor in predicting physical health among Mexican immigrants. The current paper also hypothesized that stress mediates the relationship between perceived social status and health. Three hundred and twenty male and female Mexican immigrants (ages 18-79) completed questionnaires, wore ambulatory blood pressure monitors for 24 hours, and submitted blood samples. Results supported some, but not most hypotheses. Greater social support was related to higher perceived social status (p = 0.01) and stress mediated two indirect relationships between perceived social status and health outcomes. Specifically, as perceived social status increased calories consumed decreased (p = 0.01) and self-reported health improved (p = 0.02). Still, there were no direct relationships between perceived social status and health outcomes and only two stress mediated relationships. Implications of the results and future directions are addressed. The paper discusses the possibility that higher education and possible variations in degree of acculturation among study participants might have resulted in a unique relationship between perceived social status and health. The paper also addresses the role that a high LDS affiliation among participants might play in the relationship between perceived social status and health of Hispanic immigrants. Finally, the relationship between perceived social status and self-reported health as the study?s most consistent finding is discussed.