Acculturative stress, anxiety, and depression among Mexican immigrant farmworkers in the midwest United States

No previous studies have examined the psychological functioning of immigrant farmworkers in the midwest United States. The purposes of the present study were threefold: (1) to assess the prevalence levels of anxiety and depression in a sample of Mexican immigrant farmworkers in the midwest United States; (2) to explore the relationships among acculturative stress, anxiety, and depression; and (3) to examine the variables that best predict anxiety and depression. The overall sample revealed elevated levels of anxiety and depression. Immigrant farmworkers with heightened levels of acculturative stress reported high levels of anxiety and depression. Family dysfunction, ineffective social support, low self-esteem, lack of choice in the decision to immigrate and live a migrant farmworker lifestyle, high education levels, and low levels of religiosity were significantly associated with high levels of anxiety and depression. The overall findings suggest that Mexican immigrant farmworkers who experience elevated levels of acculturative stress may be at risk for experiencing high levels of anxiety and depression. The findings highlight the importance of establishing prevention and treatment services for migrant farmworkers that aim to increase levels of emotional support, self-esteem, and coping skills.     

The clinical gaze in the practice of migrant health: Mexican migrants in the United States

This paper utilizes eighteen months of ethnographic and interview research undertaken in 2003 and 2004 as well as follow-up fieldwork from 2005 to 2007 to explore the sociocultural factors affecting the interactions and barriers between U.S. biomedical professionals and their unauthorized Mexican migrant patients. The participants include unauthorized indigenous Triqui migrants along a transnational circuit from the mountains of Oaxaca, Mexico, to central California, to northwest Washington State and the physicians and nurses staffing the clinics serving Triqui people in these locations. The data show that social and economic structures in health care and subtle cultural factors in biomedicine keep medical professionals from seeing the social determinants of suffering of their unauthorized migrant patients. These barriers lead clinicians inadvertently to blame their patients--specifically their biology or behavior--for their suffering. This paper challenges the focus of mainstream cultural competency training by showing that it is not the culture of the patient, but rather the structure and culture of biomedicine that form the primary barriers to effective multicultural health care.     

Factors associated with pesticide safety practices in farmworkers

BACKGROUND: Farmworkers and their families are exposed to pesticides through multiple pathways. Few studies have examined the frequency with which farmworkers engage in pesticide safety practices and the factors associated with their adoption. METHODS: Using a large sample of farmworkers (n = 554), we evaluated relationships between pesticide safety behaviors and farmworkers' beliefs, training history, handling of pesticides at work, perceived occupational exposure, and employers' provision of personal protective equipment. RESULTS: Performing behaviors at work was determined largely by whether personal protective equipment was provided. For home behaviors, female gender, living in a labor camp, being trained in the last 5 years, handling pesticides directly, and not perceiving organizational barriers to protecting oneself were associated with taking more precautions. CONCLUSIONS: These findings call for interventions that involve and engage multiple stakeholders to increase adoption of pesticide safety behaviors and reduce pesticide exposure in farmworkers.     

Time in the United States, social support and health behaviors during pregnancy among women of Mexican descent

Among women of Mexican descent, increased acculturation in the US has been associated with poorer health behaviors during pregnancy. This study examined a population of low-income women of Mexican descent in an agricultural community to determine: whether social support patterns were associated with age at arrival in the US; whether social support was associated with pregnancy behaviors; and whether increased social support could prevent some of the negative pregnancy behaviors that accompany acculturation. Participants were 568 pregnant women enrolled in prenatal care in the Salinas Valley, California. Participants were predominantly Spanish speaking, born in Mexico, and from farmworker families. Information on social networks, social support, age at arrival in the US, and pregnancy health behaviors was gathered during interviews conducted during pregnancy and immediately after delivery. Poorer health behaviors were observed among women who had come to the US at a younger age. Social support during pregnancy was lowest among women who had come to the US at an older age. High parity, low education, and low income were also associated with low social support. Higher social support was associated with better quality of diet, increased likelihood of using prenatal vitamins, and decreased likelihood of smoking during pregnancy. High social support also appeared to prevent the negative impact of life in the US on diet quality. Women with intermediate or low levels of social support who had spent their childhoods in the US had significantly poorer diet quality than women who had spent their childhoods in Mexico. However, among women with high social support, there was no difference in diet quality according to country of childhood. Thus, in the case of diet quality, increased social support appears to prevent some of the negative pregnancy behaviors that accompany time in the US among women of Mexican descent.     

HIV/AIDS knowledge among female migrant farm workers in the midwest

The rate of HIV infection in the migrant farm worker community is 10 times the national average. A survey was conducted of 106 female migrant farm workers in rural Northwest Ohio to assess HIV knowledge. The average participant's age was 28.7 years, 78 spoke Spanish, and 47 had an 8th- grade education. Fifty-six women received their information on HIV/AIDS from television. Eighty-seven women identified sexual contact as the major source of HIV transmission and 54 women identified the combination of sex, use of needles, and blood contact as the important routes. Sixty-nine women identified both homosexual and heterosexual intercourse as risk factors. Only 58 women identified perinatal infection as a route of HIV transmission and 59 women knew that treatment was available to prevent perinatal transmission. Although the majority of women had a good general knowledge of HIV transmission, further prevention education on perinatal transmission is needed among this population.     

The dynamic process of focus groups with migrant farmworkers: the Oregon experience

Focus groups with culturally diverse populations, and Latino farmworkers in particular, have been used as an effective research method. However, the specifics of planning and implementing focus groups with diverse populations have not been elaborated in the literature. Focus groups were used as part of The Reducing Pesticide Exposure in Minority Families Project to sucessfully elicit migrant farmworkers' views on pesticide exposure and preferences for educational method. Although attention was paid to cultural and lifestyle considerations in the planning and implementation of our focus groups, recruitment, environmental context, convener, focus group questions, and within-population differences were identified as areas that required ongoing assessment and operational change. Vigilance to the dynamics of the process resulted in more effective focus groups.     

The Effect of Time in the U.S. on the Duration of Breastfeeding in Women of Mexican Descent

Objectives: Although women of Mexican decent have high rates of breastfeeding, these rates may vary considerably by acculturation level. This study investigated whether increased years of residence in the U.S. is associated with poorer breastfeeding practices, including shorter duration of any and exclusive breastfeeding, in a population of low-income mothers of Mexican descent. Methods: Pregnant women (n = 490) were recruited from prenatal clinics serving a predominantly Mexican-origin population in an agricultural region of California. Women were interviewed during pregnancy, shortly postpartum, and when their child was 6 months, 1 year, 2 years, and 3.5 years of age. Results: Increased years of residence in the U.S. was associated with decreased likelihood of initiating breastfeeding and shorter duration of exclusive and any breastfeeding. Median duration of exclusive breastfeeding was 2 months for women living in the U.S. for 5 years or less, 1 month for women living in the U.S. for 6 to 10 years, and less than one week for women living in the U.S. for 11 years or more, or for their entire lives (lifetime residents). After controlling for maternal age, education, marital status and work status, lifetime residents of the U.S. were 2.4 times more likely to stop breastfeeding, and 1.5 times more likely to stop exclusive breastfeeding, than immigrants who had lived in the U.S. for 5 years or less. Conclusions: Efforts are needed to encourage and support Mexican-origin women to maintain their cultural tradition of breastfeeding as they become more acculturated in the U.S.     

Risk of smoking initiation among Mexican immigrants before and after immigration to the United States

Research has suggested that Latinos are less likely to initiate smoking than non-Latino whites. This advantage may be due in part to social and structural factors that deter smoking initiation among Latino immigrants, such as entry into the restrictive regulatory environment surrounding smoking in the U.S. and decreased exposure to family smoking influences, given that immigrants often leave parents and siblings behind in countries of origin. Although available data do not support a direct test of this hypothesis this study conducts an indirect test by comparing risk of initiation among Mexican immigrants before and after immigration to the U.S. If such factors influence initiation among Mexican immigrants, their risk should decline after immigration, relative to risk before immigration, since they are subject to these forces only after moving to the U.S.     

某电子制造企业外来劳务工工作倦怠现状及其与工作应激源的关系

目的 了解某电子制造企业外来劳务工群体工作倦怠现状,探讨工作应激源与工作倦怠的关系.方法 采用系统抽样方法抽取768名电子制造业生产线上外来劳务工,使用职业应激量表(OSI-R)中的职业任务问卷(ORQ)、工作倦怠量表(Job Burnout-General Survey,MBI-GS)进行问卷调查,应用多元回归分析方法研究工作应激源、工作倦怠二者的关系.结果 工作倦怠中的情绪衰竭(F=3.360,P=0.018)维度分值在各年龄组间有差异,情绪衰竭(F =6.169,P=0.013)和玩世不恭维度(F=4.340,P=0.038)分值在婚者低于不在婚者;工作应激源中的任务过重(=7.503,P=0.000)、任务不适(t=6.413,P=0.000)、任务冲突(t=2.179,P=0.030)、工作环境(t=4.610,P=0.000)因子对工作倦怠的情绪衰竭维度有影响,任务过重(t=4.747,P=0.000)、任务不适(t=7.221,P=0.000)、任务冲突(t=5.866,P =0.000)、责任感(t=-2.004,P=0.045)、工作环境(t=2.757,P=0.006)因子对玩世不恭维度有影响,任务不适(t=3.816,P=0.000)、任务模糊(t =4.106,P=0.000)、任务冲突(t=2.350,P=0.019)、责任感(t=-5.217,P=0.000)因子对成就感低落维度有影响.结论 年龄、婚姻状况与生产线上外来劳务工的工作倦怠有关,任务过重主要影响情绪衰竭,任务不适主要影响玩世不恭,责任感主要影响成就感低落.研究提示针对工作应激源的干预措施可以降低生产线上外来劳务工的工作倦怠.     

医学院校新生适应期焦虑水平评价及社会-心理因素分析

目的 了解医学院校新生的焦虑状况,分析其社会-心理因素,为及早发现潜在人群,及时实施干预提供依据.方法 采用焦虑自评量表（SAS）、应对方式量表、大学生担忧事件量表及相关社会人口学特征项组成的调查表,对2011级新生进行入学后适应期调查.结果 新生焦虑水平相对较高（18.2％）;因素分析发现,不同专业学生焦虑水平不同;专业兴趣度低者焦虑水平高,对经济情况的担忧情绪以及面对应激时采取自责应对,令其焦虑水平较高,而多参与活动及采用求助方式者焦虑水平较低.同时,中介作用分析发现,担忧事件这一应激源对焦虑情绪的影响部分,由应对方式加剧或缓解.结论 医学院校新生焦虑水平较一般人群高,且有自身的特殊性.加强入学教育,加深专业认知,积极应对,将有助于减缓焦虑情绪.     

Psychosocial Correlates of Dietary Supplement Use: Results from the National Survey of Midlife Development in the United States

Drawing on data gathered in the National Survey of Midlife Development in the United States, this study examined internal and external locus of control, self-esteem, neuroticism, perceived health status, uniqueness, and somatic amplification as correlates of dietary supplement use. With sex, race, and age measures also included in the study, bivariate analyses showed greater supplement use among women and older respondents as well as those scoring higher on internal locus of control, self-esteem, perceived health status, and somatic amplification. Regression analyses identified sex and internal locus of control as the strongest predictors. Interactions between age and external locus of control also emerged.     

Immigrants and the use of preventive care in the United States

Using data from the Medical Expenditure Panel Survey, we compare immigrants' use of preventive care with that of natives. We employ a multinomial switching regression framework that accounts for non-random selection into continuous private insurance, temporary private insurance, public insurance, and no insurance. Our results indicate that among the populations with continuous private coverage and without coverage (uninsured), immigrants, especially non-citizens, are less likely to use preventive care than natives. We find that the longer immigrants stay in the US the more their use of care approximates to that of natives. However, for most types of care, immigrants' use of care never fully converges to that of natives. Among the publicly insured population, immigrants' use of care is similar to natives, but non-citizen immigrants are significantly less likely to use preventive measures. We find that the ability to speak English does not have a significant effect on the use of preventive care among publicly insured persons.     

Follow-Up Two Years After Diagnosis of Diabetes in Patients With Psychosocial Problems Receiving an Intervention by a Medical Social Worker

We followed up the psychosocial situation two years after diabetes diagnosis in patients (n = 82) aged 18–65 years, with psychosocial problems (PSP; n = 27) or not (NPSP; n = 55). We used a social questionnaire, the Hospital Anxiety and Depression scale (HAD), the Sense of Coherence scale (SOC), and the General Coping Questionnaire (GCQ). The PSP group had a more difficult situation with more strained economy, lower social support, more anxiety and depression, and lower SOC on both occasions. Being in the PSP group predicted experiencing a strong negative influence of the disease at follow-up. Regarding coping strategies, “problem focusing” decreased in both PSP and NPSP over time. “Social trust” and “intrusion” decreased only in NPSP. Otherwise the coping pattern was unchanged, with PSP showing lower scores on “self-trust” and “minimization” and higher scores on “protest,” “isolation,” and “intrusion.” The most influenced areas at follow-up in the PSP group were work, relationship to partner and economy, and in the NPSP leisure-time activities, sexual life and work. Our findings underline the need to identify patients with psychosocial problems early.     

Paan and Gutka in the United States: an emerging threat

Smokeless tobacco and areca nut usage are integral cultural traditions in South Asia. Paan and gutka are two commonly used products which contain these ingredients. They are immensely popular in South Asia and with South Asian immigrants. Regular paan and gutka use is associated with several deleterious health consequences, most significantly oral cancer. Of particular concern is the markedly increased risk of oral cancer in South Asian immigrants when compared with the natives in new areas of settlement. The South Asian community in the United States is large and rapidly growing. Paan and gutka are legal in the United States, and readily available in ethnic enclaves. Smokeless tobacco prevention and cessation research and interventions have not yet addressed the unique sociocultural circumstances of this growing, at-risk community. The medical, dental, and public health communities need to join forces to combat this emerging threat.     

Orientations to motherhood and male partner support among women in Mexico and Mexican-origin women in the United States

Previous studies suggest that favorable pregnancy outcomes among Mexican immigrant women in the United States may be attributed to a protective sociocultural orientation, but few have explored the attitudes and values that shape Mexican women's perceptions of motherhood. This exploratory study examines orientation towards motherhood among Mexican and Mexican-origin women living in Mexico and the United States and their perceptions of their male partners' attitudes and roles. Focus groups were conducted with 60 pregnant low-income women in rural and urban communities in Mexico with high rates of migration to the US, among immigrant communities in rural and urban California and with US-born women of Mexican descent (Mexican Americans) in urban California. Notable differences were observed between women in Mexico and the US and between immigrant and Mexican American women in California as more women articulated life plans. Life plans seemed to reflect both processes of individuation and changing gender roles. While participants in Mexico largely abided by the conventional discourse on motherhood and domesticity, immigrants in California alternated between this ethos and the discourse of working mother, depending on financial resources. In contrast, Mexican American participants assumed multiple roles. These differing orientations may be linked to other factors, including fertility control, the amount and type of partner support, and stress during pregnancy.