Foreign-Born Hispanic Women's Health Patterns in Allostatic Load Converge to U.S.-Born Hispanic Women at a Slower Tempo Compared With Men

ObjectivesWe investigated the patterns of foreign-born Hispanic health convergence to U.S.-born Hispanics using an allostatic load index, a subjective biological risk health profile, and we explored whether the health convergence patterns differ by sex.MethodsThe analytic sample consisted of 3,347 Hispanics from the pooled 2005–2010 National Health and Nutrition Examination Survey. We used negative binomial regression models to investigate the association between duration in the United States and the allostatic load index, while controlling for potential covariates.ResultsForeign-born Hispanics who had lived in the United States for 0–9 years and 10–19 years had lower levels of allostatic load than U.S.-born Hispanics; however, those who had lived in the United States for 20 or more years had a level of allostatic load similar to their U.S.-born counterparts. The pattern of immigrant health convergence shows a clear sex difference. In the sex-stratified models, we found that foreign-born Hispanic men converged to the level of allostatic load of U.S.-born Hispanic men after having lived in the United States for approximately 10 years. The health convergence pattern qualitatively differed for foreign-born Hispanic women, who remained healthier than U.S.-born Hispanic women regardless of duration in the United States.ConclusionsForeign-born Hispanics are healthier than their U.S.-born counterparts, providing support for the healthy migrant hypothesis. This relatively better health of foreign-born Hispanics disappears with a longer duration in the United States, providing support for the health convergence hypothesis, but is most noticeable for men. Foreign-born Hispanic women converge to U.S.-born Hispanic women's health status at a slower tempo, compared with foreign-born Hispanic men.     

Disparities in breast cancer treatment among American Indian, Hispanic and non-Hispanic White Women Enrolled in Medicare

Because racial/ethnic disparities in breast cancer survival have persisted, we investigated differences in breast cancer treatment among American Indian, Hispanic, and non-Hispanic White (NHW) women. Surveillance, Epidemiology and End Results data linked to Medicare claims in New Mexico and Arizona (1987-1997) among enrollees aged 65 and older were used to identify treatment, treatment interval, and mortality risk associated with delays in care. We identified 2,031 women (67 American Indian, 333 Hispanic and 1,631 NHW women with time to treatment information. Treatment intervals from diagnosis to surgery (all stages, 18 versus 4 days, p.     

Perimenopausal health self-efficacy among Hispanic Caribbean and non-Hispanic white women

The perimenopausal experience varies among different ethnic and cultural groups. This research examined perimenopausal health self-efficacy of Latinas and non-Hispanic White women and variables that predicted health in 147 women ages 40 to 60 in the Northeast United States. Self-efficacy scores were similar for both groups. Latinas scored lower, however, in the Cognition/Decision Making subscale of the Perimenopausal Health Self-Efficacy Survey (PHS-ES). Perceived health was predicted by control over health and stress for both, and greater self-efficacy was associated with higher perceptions of health. Subtle differences existed between the two groups, which may reflect cultural beliefs and barriers to care during midlife.     

Views of Mammography Screening Among U.S. Black and Hispanic Immigrant Women and Their Providers

Views of ethnic immigrant women's experiences about mammography screening are important to determine barriers to cancer screening. We explored perceptions and barriers about mammography screening and breast health services among Haitian, Hispanic, Portuguese, and Somali women (n = 51) using semistructured interviews. Providers (n = 19) offered insight into health system barriers. Content analysis was conducted using qualitative data from the 2011 Komen Massachusetts needs assessment. Grounded theory was employed to explore themes and patterns in narratives. Six themes represented knowledge, health care, culture, spirituality, survivorship, and health systems improvement. Results may inform breast health policies that impact ethnic immigrant women in Massachusetts.     

Measuring health variables among Hispanic and non-Hispanic children with chronic conditions

This paper addresses two concerns related to differences in the health status of Hispanic and non-Hispanic children: methodological issues in the measurement of health status across population subgroups and the substantive differences in the health of these subgroups. Interview data from a study of chronically ill children in a northeastern inner city were collected using carefully translated measures of health and health-related behaviors. The psychometric properties of the scales were assessed across the subgroups to determine if common interpretation of the scales was possible. After determining that this was the case, group means in health and health-related variables were compared. Despite sociodemographic group differences in variables, there were remarkably few differences among the groups on traditional morbidity measures. However, significant differences were found on four of five scaled health-related measures (the impact of the child's illness on the family, the child's functional status, and the mental health of both mother and child). These findings did not all favor the same group, suggesting that certain areas of function may present more problems for some subgroups. These differences virtually all disappear when multivariate techniques are used to control for variation in important socioeconomic characteristics among the three subgroups. Statements that the health status of one subgroup is better than that of another are too simplistic if they do not indicate the particular aspect of health status being discussed and control for differences among the groups in maternal education, family structure, maternal welfare status, and similar background characteristics.     

First Trimester Prenatal Care Initiation Among Hispanic Women Along the U.S.-Mexico Border

Background First trimester prenatal care (FTPNC) is associated with improved birth outcomes. U.S.-Mexico border Hispanic women have lower FTPNC than non-border or non-Hispanic women. This study aimed to identify (1) what demographic, knowledge and care-seeking factors influence FTPNC among Hispanic women in border counties served by five Healthy Start sites, and (2) what FTPNC barriers may be unique to this target population. Healthy Starts work to eliminate disparities in perinatal health in areas with high poverty and poor birth outcomes. Methods 403 Hispanic women of reproductive age in border communities of California, Arizona, New Mexico and Texas were surveyed on knowledge and behaviors related to prenatal care (PNC) and basic demographic information. Chi square analyses and logistic regressions were used to identify important relationships. Results Chi square analyses revealed that primiparous women were significantly less likely to start FTPNC than multiparous women (χ² = 6.8372, p = 0.0089). Women with accurate knowledge about FTPNC were more likely to obtain FTPNC (χ² = 29.280, p < .001) and more likely to have seen a doctor within the past year (χ² = 5.550, p = .018). Logistic regression confirmed that multiparity was associated with FTPNC and also that living in Texas was negatively associated with FTPNC (R² = 0.066, F(9,340) = 2.662, p = .005). Among 27 women with non-FTPNC, barriers included late pregnancy recognition (n = 19) and no medical insurance (n = 5). Conclusions This study supports research that first time pregnancies have lower FTPNC, and demonstrated a strong association between delayed PNC and late pregnancy recognition. Strengthened investments in preconception planning could improve FTPNC in this population.

     

Severe injury among Hispanic and non-Hispanic white children in Washington state

OBJECTIVES: The authors' anecdotal experience at a regional Level I trauma center was that Hispanic children were overrepresented among burn patients, particularly among children with burns due to scalding from hot food. This study describes injury incidence and severity among Hispanic and non-Hispanic white infants, children, and adolescents with serious traumatic injuries in Washington State. METHODS: Data from the Washington State Trauma Registry for 1995-1997 were used to identify injured individuals aged < or = 19 years. Ratios of overall and mechanism-specific injury incidence rates for Hispanic children relative to non-Hispanic white children were calculated using denominator estimates derived from U.S. Census Bureau population data. Hispanic children and non-Hispanic white children were also compared on several measures of severity of injury. RESULTS: In 1995-1997, serious traumatic injuries were reported to the Registry for 231 Hispanic children aged < or = 19 years (rate: 54 per 100,000 person-years) and for 2,123 non-Hispanic white children (56 per 100,000 person-years), yielding an overall rate ratio (RR) of 1.0 (95% confidence interval [CI] 0.8, 1.1). Motor vehicle crashes and falls accounted for one-third to one-half of the injuries for each group. Infants, children, and adolescents identified as Hispanic had higher rates of injuries related to hot objects (i.e., burns) (RR=2.3; 95% CI 1.3, 4.1), guns (RR=2.2; 95% CI 1.5 to 3.3), and being cut or pierced (RR=3.5; 95% CI 2.2 to 5.5). The Hispanic group had a lower injury rate for motor vehicle accidents (RR=0.7; 95% CI 0.5, 0.9). Mortality rates were similar (RR=1.1; 95% CI 0.7, 1.7). The mean length of hospital stay was 5.5 days for the Hispanic group and 8.8 days for the non-Hispanic white group (difference=3.3 days; 95% CI -0.7, 7.4). CONCLUSIONS: The study found little difference between Hispanic and non-Hispanic white infants, children, and adolescents in the burden of traumatic pediatric injury. However, burns, guns, drowning, and being pierced/cut appeared to be particularly important mechanisms of injury for Hispanic children. More specific investigations targeted toward these injury types are needed to identify the underlying preventable risk factors involved.     

Variation in Self-Perceived Fecundity among Young Adult U.S. Women

BackgroundIndividuals’ perceptions of their fecundity, or biological ability to bear children, have important implications for health behaviors, including infertility help-seeking and contraceptive use. Little research has examined these perceptions among U.S. women.MethodsThis cross-sectional study examines perceptions of one's own fecundity among U.S. women aged 24 to 32 who participated in the 2009–2011 rounds of the National Longitudinal Survey of Youth (1997) cohort. Analyses were limited to 3,088 women who indicated that they or their partners never received a doctor's diagnosis regarding fertility difficulties.ResultsOf the women in the sample, 67% perceived their hypothetical chances of becoming pregnant as very likely; the remainder perceived their chances as somewhat likely (13%), not as likely (15%), or provided a “don't know” response (6%). Twenty-six percent of Black women and 19% of Latina women perceived themselves as not very likely to become pregnant, compared with only 12% among non-Black/non-Latina women (p < .001). Only 6% of women with a college degree perceived their chances of becoming pregnant as not very likely, compared with 36% among women without a high school degree (p < .001). Racial/ethnic and educational differences persisted in fully adjusted models. Other factors associated with fecundity self-perceptions include partnership status, parity, fertility expectations, sexual activity, prolonged exposure to unprotected intercourse for at least 6 and/or 12 months without becoming pregnant, and self-rated health.ConclusionsFindings indicate that self-perceived fecundity differs systematically by demographic and other characteristics. This phenomenon should be investigated further to understand how it may influence disparities in health behaviors and outcomes.     

Contraceptive knowledge and use among low-income Hispanic immigrant women and non-Hispanic women

BACKGROUND: With the rising influx of Hispanics to the United States, there is an ongoing need to promote health and wellness care to this non-English-speaking, minority population group. Programs, specifically developed to address the unique cultural mores of Hispanics, need to focus on increasing knowledge about health issues, particularly in the area of reproductive health. A study was conducted in Memphis, TN, to examine the differences between low-income Hispanic immigrants' and low-income non-Hispanics' (1) contraceptive use; (2) reproduction and contraception knowledge; as well as (3) the demographic and knowledge factors associated with their choice of contraceptive, in order to better formulate successful educational programs for area Hispanics. STUDY DESIGN: A cross-sectional survey of 226 women, recruited through a federal assistance program in Tennessee, was performed over a 5-month period in 2000 to 2001. Women, between the ages of 18 and 42, were individually interviewed to learn more about their reproduction knowledge and method of contraception. RESULTS: This study found that knowledge about reproduction and contraceptive use was significantly lower among Hispanics than non-Hispanics. Furthermore, contraceptive use was significantly lower among Hispanics than among non-Hispanics. Hispanics were less likely to use the oral contraceptive or have a tubal ligation, preferring injectable contraceptive. Non-Hispanics, who were more likely to use contraceptive methods, were less likely to use injectables, preferring the oral contraceptive. Among Hispanics, knowledge about contraceptives, number of children and marital status were associated with contraceptive use. Among non-Hispanics, only education was associated with contraceptive use. CONCLUSION: Interventions targeting Hispanic immigrants should be developed to increase their knowledge about contraceptive methods.     

Cigarette use among Hispanic and non-Hispanic white school children, Albuquerque, New Mexico.

We conducted a survey of cigarette usage among Hispanic and non-Hispanic White school children in Albuquerque, New Mexico. The distributions of current, experimental, and never smokers were similar in the two groups. Among smokers, the average weekly cigarette consumption was 19 for Hispanic White males, 14 for non-Hispanic White males, 16 for non-Hispanic White females, and nine for Hispanic White females. Educational programs are needed to maintain the low-risk status of Southwestern Hispanics for cigarette-related diseases.     

Participation in physical activity among normal- and overweight Hispanic and non-Hispanic white adolescents

BACKGROUND: The purpose of this study was to determine the relation between weight status and participation in physical activity (PA) among Hispanic and non-Hispanic white (NHW) adolescent boys and girls. METHODS: In this cross-sectional study, height and weight were measured and a modified 2001 Youth Risk Behavior Survey was administered to 1,302 Hispanic and NHW adolescents, aged 14-17 years, attending high school in Nueces County, Texas. Linear regression analysis was used to assess the relation between weight status (normal weight or "at risk for overweight and overweight" [AR&O]) and PA, including moderate PA, vigorous PA, strength training, participation in team sports, and TV viewing, according to gender and ethnicity. RESULTS: Thirty-eight percent of adolescents were AR&O, including 32% and 48% of Hispanic girls and boys, respectively, and 22% and 35% of NHW girls and boys, respectively. As expected, boys reported participating in more PAs than girls. Compared with NHW girls, both normal weight and AR&O Hispanic girls reported significantly fewer bouts of moderate activity, less involvement in team sports, and more time watching TV. Normal weight boys reported participating in significantly more vigorous activity than those who were AR&O. Hispanic boys reported more strength training than NHWs; however, they watched significantly more hours of TV than NHW boys. CONCLUSIONS: Hispanic and NHW high school students reported participation in different PAs; this information may be useful for planning health and physical education curriculum.     

Disability and Pap smear receipt among U.S. Women, 2000 and 2005

CONTEXT: Sexually experienced women are at risk of cervical cancer, one of the most common female reproductive cancers. Nearly 20% of U.S. women aged 18–64 have a disability, and disability is associated with health care access; however, the relationship between disability and Pap smear receipt remains underexplored. METHODS: Data on 20,907 women aged 21–64 from the 2000 and 2005 National Health Interview Surveys were used to investigate the relationship between disability and cervical cancer screening. Logistic regression analyses were conducted to assess the association between disability and both women's receipt of a Pap smear and their receipt of a doctor's recommendation for a Pap smear in the past year. RESULTS: Having a disability was negatively associated with Pap smear receipt (odds ratio, 0.6). Compared with women with no disabilities, those with mobility limitations and those with other types of limitations had reduced odds of having received a Pap smear (0.5–0.7). Disability was positively associated with having received a recommendation for a Pap smear (1.2); however, among women who had received a recommendation, those with disabilities had reduced odds of having received a Pap smear (0.5). Among women who had not received a Pap smear, 31% of those with disabilities and 13% of others cited cost or lack of insurance as the primary reason. CONCLUSIONS: The negative relationship between Pap smear receipt and multiple types of disability suggests barriers beyond the human‐made physical features of the environment. Efforts to reduce inequalities in reproductive health care access should consider the needs of women with disabilities.     

Invasive cervical cancer among Hispanic and non-Hispanic women--United States, 1992-1999

During 1973-1999, both the incidence of and death rates for cervical cancer decreased approximately 50% in the United States. For 2002, approximately 13,000 new cases of invasive cervical cancer are expected, and approximately 4,100 women will die of the disease. Although invasive cervical cancer can be prevented by regular screening, the prevalence of Papanicolaou (Pap) testing remains relatively low among minority populations such as Hispanic women. To characterize the incidence of invasive cervical cancer, CDC analyzed incidence data for Hispanic and non-Hispanic women during 1992-1999 in 11 geographic areas with population-based registries. This report summarizes the results of this analysis, which indicate that the incidence of invasive cervical cancer decreased for Hispanic and non-Hispanic women. However, among women aged > or = 30 years, cervical cancer incidence for Hispanic women was approximately twice that for non-Hispanic women. To lower the incidence of invasive cervical cancer, local health organizations should provide culturally appropriate public health interventions that encourage participation in readily accessible cervical cancer-screening programs.     

Patient-Perceived Pressure from Clinicians for Labor Induction and Cesarean Delivery: A Population-Based Survey of U.S. Women

ObjectiveTo determine whether patient-perceived pressure from clinicians for labor induction or cesarean delivery is significantly associated with having these procedures.ConclusionsPatient-perceived pressure from clinicians significantly predicts labor induction and cesarean delivery. Efforts to reduce provider–patient miscommunication and minimize potentially unnecessary procedures may be warranted.     

Depressive symptoms in the immediate postpartum period among Hispanic women in three U.S. cities

The aim of this was to examine rates and determinants of depressive symptomatology in the immediate postpartum period among Hispanic women in the United States. A total of 3952 Hispanic women who had delivered infants (parturients) were interviewed in postpartum wards in Miami, New York City and San Francisco. Symptoms of depression were regressed onto a series of social, psychological, and socioeconomic variables. Results showed that 42.6% of participants were probable cases of depression (CES-D > or = 16). Depression was negatively associated with perceived level of social support (adjusted OR = 0.59, 95% CI: 0.53-0.67) and health insurance coverage (adjusted OR = 0.68, 95% CI: 0.49-0.95), but not with the degree of acculturation or immigration status. It was found that depressive symptoms are common among Hispanic parturients. Pregnant Hispanic women should be carefully monitored for signs of depression and appropriate preventive measures are needed.     

Childbearing characteristics of U.S.- and foreign-born Hispanic mothers

This study compares maternal and infant health and sociodemographic characteristics of U.S.-born and foreign- or Puerto Rican-born Hispanic mothers and their babies, using data from the national vital statistics system and the 1980 National Natality Survey. While nearly half of all Hispanic mothers and Mexican and Puerto Rican mothers were born in the United States, less than 10 percent of Cuban and other Hispanic mothers were U.S. born. Compared with foreign- or Puerto Rican-born Hispanic mothers, U.S.-born mothers tended to be younger, to have had fewer high-order births, to be less likely to receive delayed or no prenatal care, to have higher educational attainment, and to be more likely to be unmarried. The incidence of low birth weight among infants born to Hispanic mothers, particularly Mexican and Cuban women, was relatively low. When the proportions of low birth weight were examined by nativity status, infants born to foreign- or Puerto Rican-born women were consistently less likely to be of low birth weight. In an effort to account for these findings, the mother's smoking status before and during pregnancy is examined. Compared with non-Hispanic mothers, Hispanic mothers were much less likely to have smoked before or during pregnancy. These data are examined to see if they account for the better outcome as measured by birth weight for Hispanic births, especially those to foreign- or Puerto Rican-born women.