A Latino advantage in oral health-related quality of life is modified by nativity status

Explanations for the social gradient in health status are informed by the rare exceptions. This cross-sectional observational study examined one such exception, the “Latino paradox” by investigating the presence of a Latino advantage in oral health-related quality of life and the effect of nativity status on this relationship. A nationally representative sample of adults (n = 4208) completed the National Health and Nutrition Examination Survey (NHANES) 2003–2004. The impact of oral disorders on oral health-related quality of life was evaluated using the NHANES Oral Health Impact Profile. Exposures of interest were race, ethnicity and nativity status. Covariates included sociodemographic characteristics, smoking status, self-rated health, access to dental care and number of teeth. Unconditional logistic regression models estimated odds of impaired oral health-related quality of life for racial/ethnic and nativity groups compared to the Non-Latino white population. Overall, prevalence of impaired oral health-related quality of life was 15.1%. A protective effect of Latino ethnicity was modified by nativity status, such that Latino immigrants experienced substantially better outcomes than non-Latino whites. However, the effect was limited to first-generation Latinos. U.S. born Latinos did not share the oral health-related quality of life advantage of their foreign-born counterparts. This advantage was not attributable to the healthy migrant phenomenon since immigrants of non-Latino origin did not differ from Non-Latino whites. The excess risk among Non-Hispanic Blacks was rendered non-significant after adjustment for socioeconomic position. A protective effect conferred by Latino nativity is unexpected given relatively disadvantaged socioeconomic position of this group, their language barrier and restrictions to needed dental care. As the Latino advantage in oral health-related quality of life is not explained by healthy immigrant selection, cultural explanations seem more likely than explanations based on characteristics of individuals.     

Compliance with Smoke-Free Policies in Korean Bars and Restaurants in California: a Descriptive Analysis

Background: Compliance with California’s smoke-free restaurant and bar policies may be more a functionof social contingencies and less a function of legal contingencies. The aims of this study were: 1) to reportindications of compliance with smoke-free legislation in Korean bars and restaurants in California; 2) to examinethe demographic, smoking status, and acculturation factors of who smoked indoors; and 3) to report social cuesin opposition to smoking among a sample of Koreans in California. Materials and Methods: Data were collectedby telephone surveys administered by bilingual interviewers between 2007-2009, and included California adultsof Korean descent who visited a Korean bar or restaurant in a typical month (N=2,173, 55% female). Results:1% of restaurant-going participants smoked inside while 7% observed someone else smoke inside a Koreanrestaurant. Some 23% of bar-going participants smoked inside and 65% observed someone else smoke insidea Korean bar. Presence of ashtrays was related to indoor smoking in bars and restaurants. Among participantswho observed smoking, a higher percentage observed someone ask a smoker to stop (17.6%) or gesture to asmoker (27.0%) inside Korean restaurants (N=169) than inside Korean bars (n=141, 17.0% observed verbal cueand 22.7% observed gesture). Participants who smoked inside were significantly younger and more acculturatedthan participants who did not. Less acculturated participants were significantly more to likely to be told to stopsmoking. Conclusions: Ten years after implementation of ordinances, smoking appears to be common in Koreanbars in California.     

中医文化传播的现代语境（四）：跨文化传播与全球化

语境既包括了外部客观环境,同时也包括了传播受众内在认知环境。当下中医跨文化传播面临着中国中医药的全球化、东西方文化冲突、高低语境文化差异的问题,须对中医跨文化传播策略进行合理调整,把握语境,加强文化适应,提高文化认同。     

Performance of Hispanics and Non-Hispanic Whites on the NIH Toolbox Cognition Battery: the roles of ethnicity and language backgrounds

Objective: This study examined the influence of Hispanic ethnicity and language/cultural background on performance on the NIH Toolbox Cognition Battery (NIHTB-CB). Method: Participants included healthy, primarily English-speaking Hispanic (n = 93; Hispanic-English), primarily Spanish-speaking Hispanic (n = 93; Hispanic-Spanish), and English speaking Non-Hispanic white (n = 93; NH white) adults matched on age, sex, and education levels. All participants were in the NIH Toolbox national norming project and completed the Fluid and Crystallized components of the NIHTB-CB. T-scores (demographically-unadjusted) were developed based on the current sample and were used in analyses. Results: Spanish-speaking Hispanics performed worse than English-speaking Hispanics and NH whites on demographically unadjusted NIHTB-CB Fluid Composite scores (ps < .01). Results on individual measures comprising the Fluid Composite showed significant group differences on tests of executive inhibitory control (p = .001), processing speed (p = .003), and working memory (p < .001), but not on tests of cognitive flexibility or episodic memory. Test performances were associated with language/cultural backgrounds in the Hispanic-Spanish group: better vocabularies and reading were predicted by being born outside the U.S., having Spanish as a first language, attending school outside the U.S., and speaking more Spanish at home. However, many of these same background factors were associated with worse Fluid Composites within the Hispanic-Spanish group. Conclusions: On tests of Fluid cognition, the Hispanic-Spanish group performed the poorest of all groups. Socio-demographic and linguistic factors were associated with those differences. These findings highlight the importance of considering language/cultural backgrounds when interpreting neuropsychological test performances. Importantly, after applying previously published NIHTB-CB norms with demographic corrections, these language/ethnic group differences are eliminated.     

A Quantitative Analysis of Latino Acculturation and Alcohol Use: Myth Versus Reality

Research on health among Latinos often focuses on acculturation processes and the associated stressors that influence drinking behavior. Given the common use of acculturation measures and the state of the knowledge on alcohol‐related health among Latino populations, the current analyses tested the efficacy of acculturation measures to predict various indicators of alcohol consumption. Specifically, this quantitative review assessed the predictive utility of acculturation on alcohol consumption behaviors (frequency, volume, and quantity). Two main analyses were conducted—a p‐curve analysis and a meta‐analysis of the observed associations between acculturation and drinking behavior. Results demonstrated that current measures of acculturation are a statistically significant predictor of alcohol use (Z = ?20.75, p < 0.0001). The meta‐analysis included a cumulative sample size of 29,589 Latino participants across 31 studies. A random‐effects model yielded a weighted average correlation of 0.16 (95% confidence interval = 0.12, 0.19). Additional subgroup analyses examined the effects of gender and using different scales to measure acculturation. Altogether, results demonstrated that acculturation is a useful predictor of alcohol use. In addition, the meta‐analysis revealed that a small positive correlation exists between acculturation and alcohol use in Latinos with a between‐study variance of only 1.5% (τ² = 0.015). Our analyses reveal that the association between current measures of acculturation and alcohol use is relatively small.     

Association between acculturation and childhood vaccination coverage in migrant populations: a population based study from a rural region in Bavaria, Germany

OBJECTIVES: The aim of our analysis was to investigate the association between acculturation and the vaccination coverage among pre-school children. METHODS: We performed a study of vaccination status for measles-mumps-rubella and hepatitis B among pre-school children, during mandatory school entry examinations, in a district of Bavaria, Germany, in 2004 and 2005 (N = 2,043). Prior to the examinations, parents were asked to fill out a self-administered questionnaire assessing socio-demographic information, including variables related to migration background (response rate 73 %, N = 1,481). We used Categorical Principal Component Analysis (CATPCA) to create an acculturation index and assessed the association between the acculturation and vaccination status for both vaccines. RESULTS: We found no difference in vaccination status with the measles-mumps-rubella vaccine in relation to acculturation. The coverage with at least three doses of hepatitis B vaccine was similar among migrants and in the indigenous population, but the risk of incomplete (1 or 2 doses) versus full vaccination was higher (OR = 2.74, 95%CI 1.34-5.61) and the risk of lacking vaccination lower (OR = 0.30, 95%CI 0.12-0.77) among less acculturated migrants compared to the indigenous population. CONCLUSIONS: For multi-dose vaccines lower acculturation was associated with incomplete vaccination, but the partial protection in this group was higher compared to indigenous population.     

Reproductive Health of the Rapidly Growing Hispanic Population: Data from the Pregnancy Risk Assessment Monitoring System, 2002

Objectives One in five US babies are Hispanic, and many Hispanics are recent immigrants. This study’s goal is to compare reproductive health characteristics between Hispanic and non-Hispanic White (NHW) mothers and to determine whether those characteristics differ by Hispanic birth increases. Methods State-based Pregnancy Risk Assessment Monitoring System 2002 data were used to compare Hispanic and NHW mothers of live-born infants overall and in tertiles of states with the highest and lowest Hispanic birth increases during 1998–2002. We calculated crude and adjusted risk ratios (RR) for each characteristic for Hispanics (N = 5,104) relative to NHWs (N = 22,608) and conducted t-tests to compare the RRs in high and low tertile groups. Results Hispanic mothers are younger, of lower socioeconomic status, and less likely to receive early prenatal care. They smoke and drink less, breastfeed their infants more often, and report less preterm labor and hypertension during pregnancy, but may be at greater risk of gestational diabetes. When compared to states with smallest birth increases, Hispanics in states with the largest increases are more likely than NHWs to report healthy behavior, e.g., continued breastfeeding and normal BMI. However, they are more likely to report late prenatal care, hospitalization during pregnancy, and low socioeconomic status. A lower risk of hypertension is reported only by Hispanics in states with small birth increases. Conclusions Reproductive health characteristics among Hispanic and NHW women differ, but Hispanic women more closely resemble NHW women in states with small increases in Hispanic births. Percent increase in Hispanic births may be a useful measure for states planning future program needs among Hispanic women and infants. The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.     

Associations of vitamin C, calcium and protein with bone mass in postmenopausal Mexican American women

We investigated the associations of vitamin C, calcium and protein intakes with bone mass at the femoral neck and lumbar spine in postmenopausal Mexican American women. Bone mass was measured by dual-energy X-ray absorptiometry (DXA) and expressed as areal (BMD, g/cm²) and volumetric (bone mineral apparent density or BMAD, g/cm³) bone mineral density. Diet was assessed using a modified version of the National Cancer Institute Food Questionnaire, which was administered by trained bilingual interviewers familiar with Mexican dietary practices. Data gathered from 125 subjects were analyzed using multiple linear regression analysis with age, body mass index (BMI), acculturation, years of estrogen use, physical activity, total energy intake, and the nutrient of interest as independent variables. Neither calcium nor calcium/protein ratio was associated with bone mineral density. There was evidence of a positive association between dietary vitamin C intake and femoral neck BMD (β=0.0002 g/cm² per mg/day, SE=0.0001,p=0.07) and BMAD (β=0.0001 g/cm³ per mg/day, SE=0.00006,p<0.05), but vitamin C was not associated with lumbar spine bone mass. Further investigation of the role of vitamin C in skeletal health is warranted.     

Adverse Birth Outcomes Among Mexican-Americans: Are US-Born Women at Greater Risk than Mexico-Born Women?

Objective. We examined adverse birth outcomes among Mexican-Americans to determine the effect of country of maternal birth, a measure of acculturation. Design. We conducted a retrospective cohort analysis of birth outcomes among 4800 Mexico-born and 4800 US-born Mexican-American women using Washington State birth certificate data from 1989 to 1994. Length of residence at current address was used to help refine our measure of acculturation. Results. US-born women had a slightly increased risk of preterm birth relative to Mexico-born women [relative risk (RR) 1.18, 95% confidence interval (CI) 1.04-1.33]. Among Mexico-born women, the risk of preterm birth increased with greater duration of current residence. Conclusions. US-born Mexican-American women had a slightly increased risk of preterm birth despite having more adequate prenatal care, more education, and higher socioeconomic indicators. This may be due to acculturation factors, such as earlier pregnancy, loss of social support systems, and increased smoking or alcohol use. Reducing this risk depends on recognition among health care workers and policy-makers of the potential influence of acculturation on health in this population .     

Acculturation is Not Related to Physical Activity Stage of Change for Children in Hawai‘i

The relationship between acculturation and physical activity stages of change is unexplored. Stages of change conceptualize behavior change as a progression through a series of five stages indicating the readiness to change behavior. The level of acculturation can be assessed using the Ethnocultural Identity Behavioral Index (EIBI) which is based on three factors: Cultural Activities, Social Interaction and Language Opportunities. The purpose of this project was to explore the relationship between parental acculturation and physical activity stages of change in Hawai‘i children. Participants (N = 85; 62% female; aged 5–8 years; 22% Native Hawaiian or Other Pacific Islanders, 42% Asian, 25% White, and 11% Other) completed the EIBI and a physical activity stages of change measure. Acculturation factor means were: Cultural Activities = 4 (SD = 1.26), Social Interaction = 3 (SD = 1.04), and Language Opportunities = 4 (SD = 1.29). The physical activity stages of change distribution was Precontemplation = 11 (13%), Contemplation/Preparation = 15 (18%), and Action/Maintenance = 59 (69%). Analysis of covariance (ANCOVA) for Cultural Activities F(3, 81) = 0.77, P = .47, Social Interaction F(3, 81) = 0.93, P = .40; and Language Opportunities F(3, 81) = 1.34, P = .27 showed no significant differences between physical activity stages of change. The results of our study do not show an association between acculturation and readiness to change for physical activity. The lack of differences may be due to participants being moderately acculturated, possibly lessening the differentiation of acculturation by physical activity stages of change.