Comparison of body mass indexes and cutoff points for estimating the prevalence of overweight in Hispanic women.

The anthropometric standards used for estimating the prevalence of overweight among Hispanic groups are generally developed in other populations. Our purpose was to identify appropriate anthropometric indicators and cutoff points for Hispanic women. Data from the Hispanic Health and Nutrition Examination Survey HHANES (1982-1984) included 1,784 Mexican American, 479 Cuban American, and 750 Puerto Rico women aged 25 to 74 years. The body mass indexes examined were weight/standing height1.5, weight/standing height2, weight/sitting height1.5, and weight/sitting height2. Appropriateness was based on correlation of the index with triceps and subscapular skinfold measurements and lack of association with standing or sitting height. The most appropriate indicator was weight/standing height2. To estimate overweight, the 85th percentiles for weight/standing height2 were obtained from the 20- to 29-year-olds in HHANES and the second National Health and Nutrition Examination Survey (NHANES II). For 10-year age intervals, the differences in proportions of women above those cutoff points were compared with a modified t test. The mean estimated prevalences of overweight were significantly higher with the NHANES II standard compared with the HHANES cutoff points (P < .05) for Mexican American women (43% vs 29%) and Puerto Rican women (40% vs 28%). They were slightly lower for the Cuban American women (36% vs 39%). Cutoff points are relative, not absolute, standards that must have biologic meaning. Before our results are used for assessing populations, the cutoff points should be tested for predictive validity with chronic disease rates.     

Macronutrient intakes among adult Hispanics: a comparison of Mexican Americans, Cuban Americans, and mainland Puerto Ricans.

OBJECTIVES. The purpose of this study was to compare energy and macronutrient intakes between adult Mexican Americans, Cuban Americans, mainland Puerto Ricans, and non-Hispanics. METHODS. Age-specific mean intakes were estimated based on 24-hour recalls from the Hispanic Health and Nutrition Examination Survey (HHANES) (1982 to 1984) and the Second National Health and Nutrition Examination Survey (NHANES II) (1976 to 1980) and were compared with the use of t tests. RESULTS. Mexican Americans had higher total fat, saturated fat, and monounsaturated fat intakes than did Puerto Ricans and older Cuban Americans. Cuban Americans and Puerto Ricans had similar intakes, except for younger Cuban Americans, who had higher total and saturated fat and lower carbohydrate intakes. Cholesterol intakes among Mexican American men and 60- to 74-year-old women were higher than those among other Hispanic groups. Carbohydrate and protein intakes were higher among Hispanic groups compared with those among non-Hispanics while total fat intakes were generally lower. CONCLUSIONS. Since macronutrient intakes differ between Hispanic groups, dietary research, recommendations, and interventions should be targeted to each group individually. Older Puerto Rican and Cuban American adults met population guidelines for reducing chronic disease risk for more macronutrients than any other group.     

Hypertension prevalence and the status of awareness, treatment, and control in the Hispanic Health and Nutrition Examination Survey (HHANES), 1982-84.

The prevalence rates of hypertension among adult (ages 18-74) Mexican Americans, Cuban Americans, and Puerto Ricans were estimated using data from the 1982-84 Hispanic Health and Nutrition Examination Survey (HHANES). Hypertension is defined as diastolic greater than or equal to 90 mm Hg, or systolic greater than or equal to 140 mm Hg, or currently taking antihypertensive medication. Among Mexican Americans in the Southwestern United States, 16.8 percent of the males and 14.1 percent of the females were found to be hypertensive. Among Cuban Americans in Dade County, Florida 22.8 percent of the males and 15.5 percent of the females were hypertensive. Among Puerto Ricans in the New York City area 15.6 percent of the males and 11.5 percent of the females were hypertensive. The age-adjusted rates are significantly lower than comparable rates for Whites and Blacks as measured in the second National Health and Nutrition Examination Survey (NHANES II), 1976-80. Control of hypertension in the HHANES populations fall short of the 1990 Objectives for the Nation established by the US Public Health Service 60 percent (34 percent controlled Mexican American hypertensives, 27.8 percent controlled Cuban American hypertensives, and 29 percent controlled Puerto Rican hypertensives.     

Risk factors for gallstone disease in the Hispanic populations of the United States

The 1982-1984 Hispanic Health and Nutrition Examination Survey used ultrasonography to investigate risk factors for gallstone disease (gallstones or cholecystectomy). Mexican American, Cuban American, and Puerto Rican men (n = 968) and women (n = 1,325) aged 20-74 years were selected from household samples in nine states. Among men, the risk of gallstone disease increased with age, education, and subscapular skinfold thickness. Among women, the risk of gallstone disease increased with age, body mass index, four skinfold measures, diabetes, impaired glucose tolerance, and oral contraceptive usage, but not with parity. Women currently using oral contraceptives were also found to be at increased risk of current gallstones. Menopause was a risk factor for gallstone disease and cholecystectomy. Alcohol consumption was negatively related to the risk of gallstone disease. In men, the cholesterol/high density lipoprotein cholesterol ratio was positively related to gallstone disease and, in women, this ratio was negatively related. This interaction between the effect of sex and the cholesterol/high density lipoprotein cholesterol ratio on gallstone disease was highly significant (p = 0.002). Mexican Americans were at increased risk of gallstone disease even when other risk factors were controlled in multiple logistic regression analysis.     

Low intakes of energy,folate, iron,and calcium of child-bearing Korean women

The focus is on dietary diversity among United States (US) Hispanics, with attention given to differences by socioeconomic status (SES) and level of acculturation. The subjects of study were 18 to 74 years of age Mexican Americans (n = 3201), Cuban Americans (n = 831), and Puerto Ricans (n = 1224) included in the 1982–84 Hispanic Health and Nutrition Examination Survey (HHANES). Dietary diversity was assessed as ‘food group’ and ‘portion’ scores derived from single 24 hour recalls. Less than 10% of Hispanic men and 5% of women satisfy diversity recommendations (17 or more portions out of a possible 20) and patterns are as found in the general US population. Multivariate analysis suggest that among Mexican Americans and Puerto Ricans diversity is related to education and level of acculturation. Income is not related to diversity in any group. Generation of residency in the US is associated with less variety among Mexican Americans and Puerto Rican men. Socioeconomic status and acculturation are not significantly related to diversity among Cuban Americans. In conclusion, the diets of US Hispanics lack variety and this places these populations at long‐term health risk. While interventions need to consider the educational level and cultural differences among Hispanics, income levels are unrelated to diversity in all groups, and therefore, not an apparent limitation to change.     

Long-term secular trends in initiation of cigarette smoking among Hispanics in the United States

Preventing the initiation of cigarette smoking plays a vital role in reducing rates of cigarette smoking. The authors investigated trends in cigarette smoking initiation among Mexican Americans, Cuban Americans, Puerto Rican Americans, compared with whites, by examining the cigarette smoking histories of adults from the 1982-83 Hispanic Health and Nutrition Examination Survey and the 1987 National Health Interview Survey. To evaluate these trends, they calculated the prevalence of cigarette smoking among 20-24-year-olds, an indicator of the rate of smoking initiation, in successive 5-year birth cohorts from 1908-12 to 1958-62 among Hispanics and from 1908-12 to 1963-67 among whites. Recently, rates of smoking initiation among Mexican American and Cuban American men have declined and converged with rates of initiation among white men. However, rates of initiation among Puerto Rican American men appeared to have remained unchanged since the 1950s. During the 1970s rates of smoking initiation among Cuban American and Puerto Rican American women surpassed those of white women. In the early 1980s, however, rates of initiation among these groups of Hispanic women have declined to levels comparable to or perhaps lower than the rates among white women. Although recently the rates among Mexican American women have been the lowest of all groups of women, they have not experienced appreciable declines. In general, rates of smoking initiation either declined or leveled off later for Hispanics than for whites. These results suggest that Hispanics tended to follow the smoking trends observed among whites and that special efforts are needed to prevent cigarette smoking among Hispanics.     

Access to health care among Hispanic or Latino women: United States, 2000-2002

OBJECTIVE: This report presents national estimates on access to health care for the following five subgroups of Hispanic or Latino women aged 18 years and over in the United States: Mexican, Puerto Rican, Cuban, Central or South American, and other Hispanic. For comparison, estimates are also presented for non-Hispanic white women and non-Hispanic black women. METHODS: Data for persons of all ages in the U.S. civilian noninstitutionalized population are collected each year in the National Health Interview Survey (NHIS), which is conducted by the Centers for Disease Control and Prevention's National Center for Health Statistics. Each year, data are collected for approximately 100,000 persons in 40,000 households. In the 2000-2002 surveys combined, data were collected for 54,763 women aged 18 years and over (9,082 Hispanic or Latino women), with an overall response rate of 73.4%. Estimates in this report are presented as annual estimates, averaged over the 3 survey years. Estimates were age adjusted to the 2000 U.S. standard population to permit comparison among the various race and ethnic subgroups. RESULTS: Among the 33.4 million Hispanic or Latino women in the United States, 31% lacked health insurance coverage at the time of interview, 20% had no usual place to go for medical care during the past year, and 22% experienced unmet health care needs during the past year due to cost. Of the five subgroups of Hispanic or Latino women, Mexican women (35%) and Central or South American women (36%) were more likely than Puerto Rican women (14%) and Cuban women (23%) to lack health insurance coverage. Mexican women (78%) and Central or South American women (78%) were less likely to have a usual place to go for health care compared with Puerto Rican women (90%), Cuban women (82%), and other Hispanic women (90%). The percentage of Hispanic or Latino women who had an unmet medical need due to cost was highest among Mexican women (24%) and lowest among Cuban women (14%). Lack of access to health care was most prevalent among Hispanic or Latino women who had poor or near poor poverty status, had less than a high school diploma, or were foreign born. CONCLUSION: Access to health care varied among subgroups of Hispanic or Latino women. Understanding these subgroup differences may help community-based programs improve access to care among Hispanic or Latino women.     

Epidemiology of self‐reported past heavy drinking in Hispanic adults

Objectives. Self‐reports of past heavy drinking correlate with the current drinking practices and with risk of mortality in non‐Hispanic males. The prevalence of past heavy drinking has not been reported in Hispanic populations.

Methods. Using data from the Hispanic Health and Nutrition Examination Survey (HHANES) we (1) report on the prevalence, duration and severity of past heavy drinking in three Hispanic groups, (2) compare the current alcohol consumption patterns among past heavy drinkers and those who do not report a history of past heavy drinking and (3) compare the risk factor profiles and health indicators in these two groups.

Results. The prevalence of past heavy drinking among Mexican American and Puerto Rican males ranged from 28–35% while the rates for Cuban American males ranged from 7–16%. The rates for Hispanic women were much lower (1–8%). The average years of past heavy drinking ranged from 2.3–14.9 years, while the alcohol consumption during the past heavy drinking period ranged from 24.4–44.0 drinks per week. Past heavy drinkers tended to consume more alcohol at present than did never heavy drinkers with the greatest differences found for Mexican American females. Comparisons of the risk factors and health indicators by drinking status revealed a higher prevalence of smoking among past heavy drinkers (50–60%) versus never heavy drinkers (34–43%). Past heavy drinking Mexican American females also reported significantly more chronic conditions and depressive symptoms than did never heavy drinkers.

Conclusions. Prevalence rates of past heavy drinking among Mexican American and Puerto Rican males are approximately three times higher than rates reported for non‐Hispanic male populations.     

Hispanic women's breast and cervical cancer knowledge, attitudes, and screening behaviors

PURPOSE: This study examined breast and cervical cancer knowledge, attitudes, and screening behaviors among different Hispanic populations in the United States. DESIGN: Data were collected from a random digit dial telephone survey of 8903 Hispanic adults from eight U.S. sites. Across sites, the average response rate was 83%. SETTING: Data were collected as part of the baseline assessment in a national Hispanic cancer control and prevention intervention study. SUBJECTS: Analysis was restricted to 2239 Hispanic women age 40 and older who were self-identified as either Central American (n = 174), Cuban (n = 279), Mexican American (n = 1550), or Puerto Rican (n = 236). MEASURES: A bilingual survey instrument was used to solicit information on age, education, income, health insurance coverage, language use, U.S.-born status, knowledge of screening guidelines, attitudes toward cancer, and screening participation. Differences in knowledge and attitudes across Hispanic groups were assessed by either chi-square tests or analysis of variance. Logistic regression models assessed the influence of knowledge and attitudes on screening participation. RESULTS: The level of knowledge of guidelines ranged from 58.3% (Mexican Americans) to 71.8% (Cubans) for mammography, and from 41.1% (Puerto Ricans) to 55.6% (Cubans) for Pap smear among the different Hispanic populations. Attitudes also varied, with Mexican Americans and Puerto Ricans having more negative or fatalistic views of cancer than Cuban or Central Americans. Knowledge was significantly related to age, education, income, language preference, and recent screening history. Overall, attitudes were not predictive of mammography and Pap smear behavior. CONCLUSIONS: Factors related to mammography and Pap smear screening vary among the different Hispanic populations. Limitations include the cross-sectional nature of the study, self-reported measures of screening, and the limited assessment of attitudes. The data and diversity of Hispanic groups reinforce the position that ethno-regional characteristics should be clarified and addressed in cancer screening promotion efforts. The practical relationships among knowledge, attitudes, and cancer screening are not altogether clear and require further research.     

Hearing loss and hearing aid use in Hispanic adults: results from the Hispanic Health and Nutrition Examination Survey.

Data from the Hispanic Health and Nutrition Examination Survey were employed to investigate the prevalence of hearing loss and hearing aid use in Mexican-American, Cuban-American, and Puerto Rican adults. Hearing loss was 6 to 14 times more prevalent in older (ages 54 to 74) vs younger (ages 20 through 34) subjects. Cuban Americans and Mexican Americans tended to have a similar prevalence of hearing loss, whereas Puerto Ricans had markedly lower rates. Mexican-American men had higher rates of hearing loss than Mexican-American women. The prevalence of hearing aid use among hearing-impaired individuals ranged from 2% to 11%. Implications for future research are discussed.     

Blood lead levels of 4-11-year-old Mexican American, Puerto Rican, and Cuban children

Data from the Hispanic Health and Nutrition Examination Survey were used to estimate arithmetic mean blood lead and percent with elevated blood lead [25 micrograms per deciliter (micrograms per dl) or greater] for 4-11-year-old Mexican American, Puerto Rican, and Cuban children. The sample size was 1,390 for Mexican American children, 397 for Puerto Rican children, and 114 for Cuban children. Puerto Rican children had the highest mean blood lead levels (11.5 micrograms per dl), followed by Mexican American children (10.4 micrograms per dl) and Cuban children (8.6 micrograms per dl, P less than .05). Puerto Rican children had the highest percent with elevated blood lead (2.7 percent); 1.6 percent of Mexican American children had elevated blood lead; less than 1 percent (0.9 percent) of the Cuban children had elevated blood lead (P less than .05). Mexican American girls had a lower mean blood lead level than did boys: 9.7 micrograms per dl versus 11.0 micrograms per dl (P less than .05). For both Puerto Rican and Mexican American children, younger age indicated a higher risk of having elevated blood lead levels. Mexican American children who lived in poverty had higher mean blood lead levels than did Mexican American children who did not live in poverty--11.6 micrograms per dl versus 9.6 micrograms per dl (P less than .05). Despite advances in primary prevention of lead toxicity in children during the past 10 years, many Hispanic children are at risk of lead toxicity. Approximately 19,000 Mexican American 4-11-year-old children living in the Southwest and approximately 8,000 Puerto Rican children living in the New York City area had elevated blood lead levels (greater than or equal to 25 micrograms per dl) during 1982-84.     

Sociodemographic correlates of visual acuity impairment in Hispanic children and adolescents

Sociodemographic correlates of visual impairment were examined in 6- to 19-year-old Hispanic children and adolescents using data from the Hispanic Health and Nutrition Examination Survey. Mexican American and Puerto Rican children whose parents had 0 to 6 years of education were more likely to remain visually impaired even when tested with their glasses or contact lenses, if any (i.e., with usual correction) than children whose parents reported 12 to 17 years of education. Mexican Americans residing below versus at or above the poverty line were more likely to remain visually impaired even with the usual correction. Mexican Americans enrolled in the Medicaid program or who were without health insurance were more likely to remain visually impaired than Mexican Americans with private health insurance. When tested without glasses or contact lenses, Cuban Americans and Mexican Americans born outside of the mainland United States had lower rates of visual impairment compared to those born in the United States; however, children in this latter group were more likely to remain visually impaired with usual correction than U.S.-born Mexican Americans. These findings suggest that Hispanic children from economically disadvantaged households and those born outside the United States may not be receiving optimal eye care that could improve visual function.     

Health outcomes among Hispanic subgroups: data from the National Health Interview Survey, 1992-95

BACKGROUND: Within the next 50 years, Hispanics will become the largest minority group in the United States. The largest Hispanic subgroups are those of Mexican, Cuban, and Puerto Rican descent. The Hispanic population is heterogeneous in terms of culture, history, socioeconomic status (SES) and health status. In this report, various health status measures are compared across Hispanic subgroups in the United States. METHODS: National Health Interview Survey (NHIS) data aggregated from 1992 through 1995 were analyzed. NHIS is one of the few national surveys that has a sufficiently large sample size to adequately compare the different subgroups. Data are presented for four Hispanic origin subgroups--Mexican, Cuban, Puerto Rican, and "other Hispanic" persons--for the Hispanic population as a whole and for the non-Hispanic white and non-Hispanic black populations. These groups are compared with respect to several health status outcomes, providing both age-adjusted and unadjusted estimates. RESULTS: The health indicators for Puerto Rican persons are significantly worse than for the other Hispanic origin subgroups. For example, about 21% of Puerto Rican persons reported having an activity limitation, compared with about 15% of Cuban and Mexican persons and 14% of "other Hispanic" persons. In contrast, the health indicators of Cuban persons are often better than those of the other subgroups. For example, Cuban persons reported an average of 3 days per year lost from school or work, compared with about 6 days for Mexican and Puerto Rican persons and 7 days for "other Hispanic" persons. Mexican persons fare better than Puerto Rican persons on measures such as restricted activity days, bed disability days and hospitalizations. CONCLUSION: These data demonstrate clear differences in health status as well as indicators of socioeconomic status across Hispanic subgroups in the United States. Data on Hispanic subgroups facilitate the planning of public health services for various underserved populations.     

A note on the measurement of hypertension in HHANES.

Using data from the HHANES, we found the rates of elevated blood pressure readings on clinical examination to be extremely low for a sample of Mexican American and Puerto Rican women. The prevalence rates were one-fourth to one-fifth the rates found for a comparable sample of White women from NHANESII. These findings are discrepant with the little that is known about hypertension prevalence among Hispanics and with estimates of hypertension prevalence for Mexican Americans and Puerto Ricans drawn from NHANESII. While our HHANES samples women had much lower rates of clinical high blood pressure than Whites, they reported hypertension histories in excess of Whites. Rates of medicine usage among Hispanics were insufficiently large for effective treatment to explain the disparity. The prevalence estimates increased, but the relative discrepancies remained when we altered our sample specifications and clinical high blood pressure measure. A possible explanation for these discrepancies is that few physicians performed the majority of blood pressure readings in our HHANES sample. This may have been statistically inefficient. The discrepancies noted suggest that HHANES may not be a reliable source of information on hypertension among Hispanic women.     

Contraceptive behavior among sexually active Hispanic adolescents

The purpose of this study was to examine those factors associated with the contraceptive behavior of a national representative sample of Hispanic female adolescents. The subjects included all (n = 85) unmarried, sexually active Hispanic women, aged 15 to 19, from the 1982 National Survey of Family Growth. Contraceptive behavior was measured on a normalized scale, ranging from oral contraceptives to no contraception. Mexican/American and Central/South American background females were more likely (p < 0.031) to use effective birth control than Puerto Rican, Cuban, and other Hispanic background subjects. Twenty additional social, behavioral, and demographic variables were found to be significantly associated (p < 0.05) with contraceptive behavior. Based on multiple regression analysis, seven of these variables were found to explain 62% (p < 0.0001) of the variation in the contraceptive behavior of this sample. Poorer contraceptive behavior was associated with noncompliance with the initial birth control method used (33.8%), lower coital frequency (8.3%), older postmenarchial age (5.7%), failure to use birth control at first coitus (4.6%), fewer years dating (4.0%), lower frequency of church attendance (3.3%), and never having experienced a pregnancy scare (2.0%). These findings suggest that the contraceptive behavior of Hispanic female adolescents is a dynamic process that can be understood in the context of previous sexual and contraceptive behavior.     

Immunization coverage among Hispanic ancestry, 2003 National Immunization Survey

BACKGROUND: The Hispanic population is increasing and heterogeneous (Hispanic refers to persons of Spanish, Hispanic, or Latino descent). The objective was to examine immunization rates among Hispanic ancestry for the 4:3:1:3:3 series (> or = 4 doses diphtheria, tetanus toxoids, and pertussis vaccine; > or = 3 doses poliovirus vaccine; > or = 1 doses measles-containing vaccine; > or = 3 doses Haemophilus influenzae type b vaccine; and > or = 3 doses hepatitis B vaccine). METHODS: The National Immunization Survey measures immunization coverage among 19- to 35-month-old U.S. children. Coverage was compared from combined 2001-2003 data among Hispanics and non-Hispanic whites using t-tests, and among Hispanic ancestry using a chi-square test. Hispanics were categorized as Mexican, Mexican American, Central American, South American, Puerto Rican, Cuban, Spanish Caribbean (primarily Dominican Republic), other, and multiple ancestry. RESULTS: Children of Hispanic ancestry increased from 21% in 1999 to 25% in 2003. These Hispanic children were less well immunized than non-Hispanic whites (77.0%, +/-2.1% [95% confidence interval] compared to 82.5%, +/-1.1% (95% CI) > in 2003). Immunization coverage did not vary significantly among Hispanics of varying ancestries (p=0.26); however, there was substantial geographic variability. In some areas, immunization coverage among Hispanics was significantly higher than non-Hispanic whites. CONCLUSIONS: Hispanic children were less well immunized than non-Hispanic whites; however, coverage varied notably by geographic area. Although a chi-square test found no significant differences in coverage among Hispanic ancestries, the range of coverage, 79.2%, +/-5.1% for Cuban Americans to 72.1%, +/-2.4% for Mexican descent, may suggest a need for improved and more localized monitoring among Hispanic communities.     

Gender, acculturation and alcohol use among Latina/o adolescents: a multi-ethnic comparison

This is the first study to examine the relationship between acculturation and alcohol use by gender and ethnicity using a nationally representative sample of Hispanic and non-Hispanic white adolescents. Specifically, we use data from the National Longitudinal Study of Adolescent Health (Add Health) to explore alcohol use and binge drinking for a sample that includes 6792 non-Hispanic whites, 910 Mexican Americans, 290 Cuban Americans, and 336 Puerto Ricans. Bivariate results reveal significant gender differences in alcohol use among first generation Mexican American, first generation Puerto Rican, and second generation Cuban American adolescents. In addition, these results indicate binge drinking differs significantly by gender among first generation Mexican American, first generation Cuban American, third plus generation Puerto Rican, and third plus generation non-Hispanic white adolescents. Multivariate logistic regression reveals that gender also moderates the effect of acculturation as well as ethnicity on alcohol use and abuse. Among both males and females, first generation immigrants are significantly less likely than third plus generation immigrants to use alcohol and binge drink while selective acculturation significantly reduces the odds of both behaviors. However, the effects of immigrant generation and selective acculturation on binge drinking are larger for females. Further, the trajectories that alcohol use and binge drinking follow with acculturation differ significantly by gender and ethnicity. These results reaffirm the need to further develop theoretical models and intervention strategies that are both gender-specific and culturally-specific, targeting high risk groups in particular in these efforts.     

Overall health and healthcare utilization among latino american women in the United States

Abstract Purpose: The purpose of this study was to examine the chronic conditions, behavioral-mental health and service utilization of Latino American women in the first epidemiologic survey in the United States. Methods: Using a national sample (n=1427) from the National Latino and Asian American Study, we assessed and compared the prevalence of overall health and service use in three major subgroups, Cuban, Mexican, and Puerto Rican, and in other Latino American women. Service use included general medical, mental health, and subspecialists. Results: In physical health, Puerto Rican American women reported the highest rate of asthma, whereas Mexican American women reported the highest rate of diabetes. Cuban American women reported the highest rate of hypertension and heart diseases. Body mass index (BMI) indicated that overweight (BMI 25-29.9?kg/m(2)) and obesity (BMI≥30?kg/m(2)) were prevalent in all three subgroups: two thirds of Mexicans and Puerto Ricans, respectively, and >50% of Cuban Americans. Of the sample, 11.6% rated their mental health status as fair or poor, and 10.8% reported at least one major depressive disorder (MDD) in the past 12 months. Puerto Rican American women had the highest rates on depression, substance abuse, and seeking mental health service, and Cuban American women saw specialists most frequently. Conclusions: Patterns of overall health issues varied among Latino American subgroup women, yet they have low rates of healthcare use. It is critical to further examine factors associated with the sex-specific health issues and with their health services underuse.     

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.     

Anthropometric evaluation of the body composition of black, white, and Puerto Rican newborns.

One hundred ninety-four white, black, and Puerto Rican infants 1 to 5 days old were measured in the ward nurseries of two Philadelphia city hospitals. In addition to birth weight and length, triceps and subscapular skinfolds and upper arm circumference were obtained. Upper arm muscle circumference was calculated. Females had greater skinfold thicknesses than males but significant differences were found only for the triceps. Whites and blacks did not differ in skinfold thickness, but the Puerto Rican infants had significantly smaller triceps skinfolds. Differences in nutritional status are attributed to environmental factors.