The Relationship Between Educational Attainment and Health Care Access and Use Among Mexicans, Mexican Americans, and U.S.-Mexico Migrants.
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ABSTRACT:
SUBMITTER: Langellier BA
PROVIDER: S-EPMC6875690 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Our aim was to examine the effects of food acculturation on Mexican Americans' (MA) diets, taking the Mexican diet as reference. We used nationally representative samples of children (2-11 y) and female adolescents and adults (12-49 y) from the Mexican National Nutrition Survey 1999 and NHANES 1999-2006 to compare the diets of Mexicans (n = 5678), MA born in Mexico (MAMX) (n = 1488), MA born in the United States (MAUS) (n = 3654), and non-Hispanic white Americans (NH-White) (n = 5473). One 24-h diet recall was used to examine the percentage consuming and percentage energy consumed from selected food groups. Most of the food groups analyzed displayed a fairly linear increase or decrease in percent energy/capita intake in this order: Mexican, MAMX, MAUS, NH-White. However, few significant differences were observed among the US subpopulations, especially among MAUS and NH-Whites. Overall, compared to Mexicans, the US subpopulations had greater intakes of saturated fat, sugar, dessert and salty snacks, pizza and French fries, low-fat meat and fish, high-fiber bread, and low-fat milk, as well as decreased intakes of corn tortillas, low-fiber bread, high-fat milk, and Mexican fast food. Furthermore, the patterns were similar in all age groups. Although we found a mix of positive and negative aspects of food acculturation, the overall proportion of energy obtained from unhealthy foods was higher among the US subpopulations. Our findings indicate that within one generation in the US, the influence of the Mexican diet is almost lost. In addition, our results reinforce the need to discourage critical unhealthful components of the American diet among MA.
| S-EPMC3174859 | biostudies-other
Project description:BACKGROUND:There is limited information on physical activity in marginalized older populations like that on the U.S.-Mexico border. This study aims to understand physical activity engagement among older Hispanics residing in two U.S.-Mexico Border counties. METHODS:The International Physical Activity Questionnaire (IPAQ) was used to measure physical activity in El Paso and Cameron County, Texas. Physical activity levels were reported for vigorous, moderate, and walking met/mins. Adjusted and unadjusted modeling was conducted to determine county differences and sociodemographic covariates. RESULTS:There were 784 participants and 92.9% were less than 65 years of age. El Paso participants reported a significantly greater natural log met/mins of vigorous (? = 1.34, p = 0.000) and walking (? = 0.331, p = 0.006). Significant sociodemographic covariates in El Paso for vigorous met/mins were gender (females ? = -1.20, p = 0.003), having a regular doctor (? = -0.779, p = 0.029), and acculturation (? = 0.513, p = 0.019). Significant associations in Cameron County were having a regular doctor (? = -1.03, p = 0.000) and fair/poor health status (? = -0.475, p = 0.001). CONCLUSION:Level of physical activity may differ in older Hispanics by urban context on the U.S.-Mexico border. Future physical activity programs to promote physical activity should take context into consideration.
| S-EPMC6163189 | biostudies-literature
Project description:In this paper, we use survey data from the Mexican Retrospective Demographic Survey (Encuesta Demográfica Retrospectiva) and National Survey of Households (Encuesta Nacional de Hogares) collected in 2017 to examine self-reports of depression, anxiety, chronic fatigue, and pain among domestic migrants, returned U.S. migrants, and non-migrants. Although self-reports do not always correspond to clinical diagnoses, they offer some insight into mental health, especially for those without a diagnosis because of limited access to services or stigma. Regression results reveal that domestic migrants, e.g., those who moved within Mexico, reported more anxiety, chronic fatigue, and pain, but risks for U.S. migrants were comparable to non-migrants, controlling for other characteristics. Findings from the decomposition analysis helps explain these findings. While domestic migrant vs. non-migrant differences result both from different migrant demographic attributes, such as age and gender, and differences in the effects of these characteristics between the groups, U.S. migrant vs. non-migrant differences in anxiety and pain emerge only after allowing for the relationship between each observed characteristic and the mental health outcome to vary. Thus, compared to domestic migrants, U.S. migrants are selected on characteristics associated with good mental health-they are positively selected-but those characteristics are not protective for them.
| S-EPMC7008711 | biostudies-literature
Project description:BACKGROUND:Temporary and unauthorized migrants may face unique obstacles to access health care services in the U.S. OBJECTIVE:This study estimated levels of health care access among Mexican migrants returning to Mexico from the U.S. and factors associated with access to health care, with emphasis on the role of modifiable, enabling factors. METHODS:We conducted a pilot probability health care survey of migrants in the border city of Tijuana, Mexico (N=186). RESULTS:Approximately 42% of migrants reported having used health care services in the U.S. during the past year. Only 38% had a usual source of care and approximately 11% went without needed medical care in the U.S. About 71% of migrants did not have health insurance in the U.S. Lack of health insurance and transportation limitations were significantly related to various access indicators. CONCLUSION:These results have implications for future policies and programs aimed to address modifiable health care access barriers faced by these vulnerable and underserved segments of the Mexican migrant population.
| S-EPMC4213859 | biostudies-literature
Project description:Population-level disparities in later-life cognitive health point to the importance of family resources. Although the bulk of prior work establishes the directional flow of resources from parents to offspring, the "linked lives" perspective raises the question of how offspring resources could affect parental health as well. This paper examines whether adult children's education influences older parents' (aged 50+) cognitive health in Mexico, where schooling reforms have contributed to significant gains in the educational achievements of recent birth cohorts. Harnessing a change in compulsory school laws and applying an instrumental variables approach, we found that each year of offspring schooling was associated with higher overall cognition among parents, but was less predictive across different cognitive functioning domains. More offspring schooling improved parents' cognitive abilities in verbal learning, verbal fluency, and orientation, but not in visual scanning, visuo-spatial ability, or visual memory. The beneficial effects of offspring schooling on those cognitive domains are more salient for mothers compared to fathers, suggesting potential gendered effects in the influence of offspring schooling. The results remained robust to controls for parent-child contact and geographic proximity, suggesting other avenues through which offspring education could affect parental health and a pathway for future research. Our findings contribute to growing research which stresses the causal influence of familial educational attainment on population health.
| S-EPMC7894606 | biostudies-literature
Project description:Education is an important social determinant of many health outcomes, but the relationship between educational attainment and the amount of weight gained over the course of a woman's pregnancy (gestational weight gain [GWG]) has not been established clearly.We used data from 1979 through 2010 for women in the National Longitudinal Survey of Youth (1979) cohort (n = 6,344 pregnancies from 2,769 women). We used generalized estimating equations to estimate the association between educational attainment and GWG adequacy (as defined by 2009 Institute of Medicine guidelines), controlling for diverse social factors from across the life course (e.g., income, wealth, educational aspirations and expectations) and considering effect measure modification by race/ethnicity and prepregnancy overweight status.In most cases, women with more education had increased odds of gaining a recommended amount of gestational weight, independent of educational aspirations and educational expectations and relatively robust to sensitivity analyses. This trend manifested itself in a few different ways. Those with less education had higher odds of inadequate GWG than those with more education. Among those who were not overweight before pregnancy, those with less education had higher odds of excessive GWG than college graduates. Among women who were White, those with less than a high school degree had higher odds of excessive GWG than those with more education.The relationship between educational attainment and GWG is nuanced and nonlinear.
| S-EPMC4958525 | biostudies-literature
Project description:PurposeReceipt of alcohol-related care for alcohol use is particularly low among those residing in the U.S.-Mexico border region. One reason for this disparity may be limited treatment accessibility, making it difficult for those who need it to access needed treatment. The current study assesses whether differences in treatment utilization are mediated by differences in treatment accessibility in cities within and outside of the border region.MethodsWe used data from the U.S.-Mexico Study of Alcohol and Related Conditions involving a probability sample of Mexican-origin adults surveyed in three cities in Texas (2011-2013). We included only participants with a lifetime history of alcohol use disorder (AUD) (n = 792). We examined two lifetime measures of self-reported alcohol treatment utilization: considering getting help for an alcohol problem and receipt of treatment. We geocoded locations of facilities listed in the SAMHSA National Directory of Drug and Alcohol Abuse Treatment Facilities. We considered three types of facilities: any outpatient treatment, programs offering fee assistance, and programs offering Spanish-language services. We measured treatment accessibility by density of treatment (i.e., number of facilities within a 20-mile radius of participant's residence) and proximity to treatment (i.e., travel time to nearest facility). We assessed direct and indirect effects of two cities in the border region (versus one nonborder city) on the outcomes through treatment accessibility using generalized structural equation models that accounted for clustering of respondents in cities and in neighborhoods, weighted for sampling and nonresponse and adjusted for covariates.ResultsOf 792 respondents with lifetime AUD, 22% had considered getting help and 11% had received treatment, with consideration of getting help being less likely in cities in the border region. We observed no significant differences in treatment receipt across cities. Reduced densities of all three types of treatment programs were significant mediators for the effect of residing in a border region on considering getting help. Time to nearest Spanish-language program also mediated the effect of residing in a border region on considering getting help for one city.ConclusionsBorder cities had lower density of treatment and because treatment density was positively associated with considering getting help, residence in a city in the border region was associated with lower odds of considering getting help, regardless of type of treatment. These findings suggest increasing the number of treatment locations available within cities along the U.S.-Mexico border may encourage those with AUD to consider getting help.
| S-EPMC8459699 | biostudies-literature
Project description:Background and objectivesThe growing population of adults surviving past age 85 in the United States and Mexico raises questions about the living arrangements of the oldest old and those living with dementia. This study compares Mexican and Mexican American individuals aged 85 and older to identify associations with cognitive status and living arrangements in Mexico and the United States.Research design and methodsThis study includes 419 Mexican Americans in 5 southwestern states (Hispanic Established Population for the Epidemiologic Studies of the Elderly) and 687 Mexicans from a nationally representative sample (Mexican Health and Aging Study). It examines characteristics associated with living alone using logistic regression and describes the living arrangements of older adults with probable dementia in each country.ResultsOlder adults with dementia were significantly less likely to live alone than with others in the United States while there were no relationships between dementia and living arrangements in Mexico. However, a substantial proportion of older adults with dementia lived alone in both nations: 22% in the United States and 21% in Mexico. Among Mexican Americans with dementia, those living alone were more likely to be women, childless, reside in assisted living facilities, and less likely to own their homes. Similarly, Mexican individuals with dementia who lived alone were also less likely to be homeowners than those living with others.Discussion and implicationsContextual differences in living arrangements and housing between the United States and Mexico pose different challenges for aging populations with a high prevalence of dementia.
| S-EPMC9154059 | biostudies-literature
Project description:Background:Socioeconomic Status (SES) indicators, such as educational attainment, are social determinants of heart disease. Marginalization related Diminished Returns (MDRs) refer to smaller health benefits of high SES for racial and ethnic minorities compared to the majority group. It is still unknown, however, if MDRs also apply to the effects of education on heart disease. Purpose:Using a nationally representative sample, we explored racial/ethnic variation in the link between educational attainment and heart disease among American adults. Methods:We analyzed data (n=25,659) from a nationally representative survey of American adults in 2013. The first wave of the Population Assessment of Tobacco and Health - Adult (PATH-Adult) study was used. The independent variable was education (college graduate, high school graduate, less than a high school diploma). The dependent variable was any heart disease. Age and gender were the covariates. Race, as well as ethnicity, were the moderators. Logistic regressions were used to analyze the data. Results:Individuals with higher educational attainment had lower odds of heart disease. Race and ethnicity showed statistically significant interactions with education, suggesting that the protective effect of higher education on reducing odds of heart disease was smaller for Hispanic and Black people than for non-Hispanic and White individuals. Conclusion:Education reduces the risk of heart disease better among non-Hispanic Whites than for Hispanics and Blacks. Therefore, we may expect a disproportionately higher than expected risk of heart disease in Hispanics and Blacks with high educational attainment. Future research should test if the presence of high levels of environmental and behavioral risk factors contribute to the high risk of heart disease in highly educated Black and Hispanic Americans. Policymakers should not reduce health inequalities to just gaps in SES because disparities are present across SES levels, with high SES Blacks and Hispanics remaining at risk of health problems.
| S-EPMC7217286 | biostudies-literature
Project description:Studies of the early-life origins of adult physical functioning and mortality have found that childhood health and socioeconomic context are important predictors, often irrespective of adult experiences. However, these studies have generally assessed functioning and mortality as distinct processes and used cross-sectional prevalence estimates that neglect the interplay of disability incidence, recovery, and mortality. Here, we examine whether early-life disadvantages both shorten lives and increase the number and fraction of years lived with functional impairment. We also examine the degree to which educational attainment mediates and moderates the health consequences of early-life disadvantages. Using the 1998-2008 Health and Retirement Study, we examine these questions for non-Hispanic whites and blacks aged 50-100 years using multistate life tables. Within levels of educational attainment, adults from disadvantaged childhoods lived fewer total and active years, and spent a greater portion of life impaired compared with adults from advantaged childhoods. Higher levels of education did not ameliorate the health consequences of disadvantaged childhoods. However, because education had a larger impact on health than did childhood socioeconomic context, adults from disadvantaged childhoods who achieved high education levels often had total and active life expectancies that were similar to or better than those of adults from advantaged childhoods who achieved low education levels.
| S-EPMC4465758 | biostudies-literature