A Systematic Review of Physical Health Consequences and Acculturation Stress Among Latinx Individuals in the United States.
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ABSTRACT:
SUBMITTER: Gonzalez-Guarda RM
PROVIDER: S-EPMC8755947 | biostudies-literature | 2021 Jul
REPOSITORIES: biostudies-literature
Publications
A Systematic Review of Physical Health Consequences and Acculturation Stress Among Latinx Individuals in the United States.
Gonzalez-Guarda Rosa M RM Stafford Allison M AM Nagy Gabriela A GA Befus Deanna R DR Conklin Jamie L JL
Biological research for nursing 20201103 3
The health of Latinx immigrants decays over time and across generations. Acculturation stress influences decays in behavioral and mental health in this population, but the effect on physical health outcomes is less understood. This systematic review synthesizes findings from 22 studies that examined the influence of acculturation stress on physical health outcomes among Latinx populations in the United States. The Society-to-Cell Resilience Framework was used to synthesize findings according to ...[more]
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Project description:BackgroundUS federal and subfederal immigrant-related policy activity has increased in recent years. We hypothesize that these policies are structural determinants of health for Latinx communities, operating through access to resources, discriminatory enforcement, and stress.MethodsWe searched seven databases for quantitative studies, published as of September 2021, examining the association between the presence of federal, state, or local immigrant-related policy(ies), over time or cross-sectionally, and mental or physical health outcomes among immigrant or US-born Latinx adults. We rated studies on methodologic quality.ResultsEleven studies were included. Policies included federal and state policies. Health outcomes included mental health (seven studies), self-rated health (n = 6), and physical disability (n = 1). Among immigrant, noncitizen, or Spanish-preferring Latinx adults, exclusionary policies were associated with poor self-rated health, physical disability, and poor mental health. Inclusive policies were associated with better health, although null findings were more common than among studies of exclusionary policies. Only three studies separately examined policy effects on US-born or citizen Latinx adults and these findings were often null. All studies received a weak overall study quality rating; among quality domains, studies were strongest in confounding control and weakest in outcome information bias and reporting missing data approaches.ConclusionsThese results support the hypothesis that immigrant-related policies, especially exclusionary policies, are structural drivers of health for immigrant or noncitizen Latinx adults. However, evidence is scant among US-born or citizen Latinx adults. Studies of policies and physical health outcomes besides disability are lacking, as are results disaggregated by nativity and/or citizenship status.
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Project description:ObjectivePhysical symptoms are common and a leading reason for primary care visits; however, data are lacking on their prevalence among racial/ethnic minorities in the United States. This study aimed to compare the prevalence of physical symptoms among White, Latino and Asian Americans, and examine the association of symptoms and acculturation.MethodsWe analyzed data from the National Latino and Asian American Study, a nationally representative survey of 4864 White, Latino and Asian American adults. We compared the age- and gender-adjusted prevalence of 14 physical symptoms among the racial/ethnic groups and estimated the association between indicators of acculturation (English proficiency, nativity, generational status and proportion of lifetime in the United States) and symptoms among Latino and Asian Americans.ResultsAfter adjusting for age and gender, the mean number of symptoms was similar for Whites (1.00) and Latinos (0.95) but significantly lower among Asian Americans (0.60, P<.01 versus Whites). Similar percentages of Whites (15.4%) and Latinos (13.0%) reported three or more symptoms, whereas significantly fewer Asian Americans (7.7%, P<.05 versus Whites) did. In models adjusted for sociodemographic variables and clinical status (psychological distress, medical conditions and disability), acculturation was significantly associated with physical symptoms among both Latino and Asian Americans, such that the most acculturated individuals had the most physical symptoms.ConclusionsThe prevalence of physical symptoms differs across racial/ethnic groups, with Asian Americans reporting fewer symptoms than Whites. Consistent with a "healthy immigrant" effect, increased acculturation was strongly associated with greater symptom burden among both Latino and Asian Americans.
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Project description:BackgroundCulture shapes how people understand illness and death, but few studies examine whether acculturation influences patients' end-of-life treatment preferences and medical care.Methods and findingsIn this multi-site, prospective, longitudinal cohort study of terminally-ill cancer patients and their caregivers (n?=?171 dyads), trained interviewers administered the United States Acculturation Scale (USAS). The USAS is a 19-item scale developed to assess the degree of "Americanization" in first generation or non-US born caregivers of terminally-ill cancer patients. We evaluated the internal consistency, concurrent, criterion, and content validity of the USAS. We also examined whether caregivers' USAS scores predicted patients' communication, treatment preferences, and end-of-life medical care in multivariable models that corrected for significant confounding influences (e.g. education, country of origin, English proficiency). The USAS measure was internally consistent (Cronbach ??=?0.98); and significantly associated with US birthplace (r?=?0.66, P<0.0001). USAS scores were predictive of patients' preferences for prognostic information (AOR?=?1.31, 95% CI:1.00-1.72), but not comfort asking physicians' questions about care (AOR 1.23, 95% CI:0.87-1.73). They predicted patients' preferences for feeding tubes (AOR?=?0.68, 95% CI:0.49-0.99) and wish to avoid dying in an intensive care unit (AOR?=?1.36, 95% CI:1.05-1.76). Scores indicating greater acculturation were also associated with increased odds of patient participation in clinical trials (AOR?=?2.20, 95% CI:1.28-3.78), compared with lower USAS scores, and greater odds of patients receiving chemotherapy (AOR?=?1.59, 95% CI:1.20-2.12).ConclusionThe USAS is a reliable and valid measure of "Americanization" associated with advanced cancer patients' end-of-life preferences and care. USAS scores indicating greater caregiver acculturation were associated with increased odds of patient participation in cancer treatment (chemotherapy, clinical trials) compared with lower scores. Future studies should examine the effects of acculturation on end-of-life care to identify patient and provider factors that explain these effects and targets for future interventions to improve care (e.g., by designing more culturally-competent health education materials).
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Project description:We conducted a systematic review to assess outcomes in Hispanic donors and explore how Hispanic ethnicity was characterized. We searched PubMed, EMBASE, and Scopus through October 2021. Two reviewers independently screened study titles, abstracts, and full texts; they also qualitatively synthesized results and independently assessed quality of included studies. Eighteen studies met our inclusion criteria. Study sample sizes ranged from 4007 to 143,750 donors and mean age ranged from 37 to 54 years. Maximum follow-up time of studies varied from a perioperative donor nephrectomy period to 30 years post-donation. Hispanic donors ranged between 6% and 21% of the donor populations across studies. Most studies reported Hispanic ethnicity under race or a combined race and ethnicity category. Compared to non-Hispanic White donors, Hispanic donors were not at increased risk for post-donation mortality, end-stage kidney disease, cardiovascular disease, non-pregnancy-related hospitalizations, or overall perioperative surgical complications. Compared to non-Hispanic White donors, most studies showed Hispanic donors were at higher risk for diabetes mellitus following nephrectomy; however, mixed findings were seen regarding the risk for post-donation chronic kidney disease and hypertension. Future studies should evaluate cultural, socioeconomic, and geographic differences within the heterogeneous Hispanic donor population, which may further explain variation in health outcomes.
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Project description:A bidimensional acculturation framework cannot account for multiple destination cultures within contemporary settlement societies. A tridimensional model is proposed and tested among Jamaican adolescent-mother dyads in the United States compared to Jamaican Islander, European American, African American, and other Black and non-Black U.S. immigrant dyads (473 dyads, M adolescent age = 14 years). Jamaican immigrants evidence tridimensional acculturation, orienting toward Jamaican, African American, and European American cultures. Integration is favored (70%), particularly tricultural integration; moreover, Jamaican and other Black U.S. immigrants are more oriented toward African American than European American culture. Jamaican immigrant youth adapt at least as well as nonimmigrant peers in Jamaica and the United States. However, assimilated adolescents, particularly first generation immigrants, have worse sociocultural adaptation than integrated and separated adolescents.
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Project description:ObjectivesStudies have demonstrated that Latinx populations face significant health disparities in access to mental health care. The objective of this study was to describe the impact of the COVID-19 pandemic on the mental health needs of Latinx families, from the perspectives of direct service providers working with Latinx communities.MethodsTwenty-one semi-structured interviews were conducted virtually with direct service providers to the Latinx community from August to October 2020. Interviews were transcribed verbatim and analyzed using thematic analysis.ResultsTwo-thirds of providers were female, with a median age of 33 years, and provided direct services to Latinx clients and had extensive experience working with immigrant families, particularly in Massachusetts. Key themes identified describing the impact of COVID-19 on the mental health needs of Latinx families included: (1) exacerbation of mental health symptoms, (2) financial stressors, (3) preoccupation regarding transnational lives, (4) secondary needs becoming more salient, and (5) immigration status as a main driver of inequality.ConclusionsOur findings highlight the importance of focusing on the mental health needs of Latinx immigrants and ensuring their access to mental health services. Telehealth seems to be a potential tool that promotes mental health access among Latinx clients. Future research needs to continue investigating the role of telehealth in decreasing mental health access disparities.
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