A simple scale for quantifying English use among Mexican Americans was constructed from four brief questions which proved to have excellent scaling characteristics by Guttman Scalogram Analysis in two independent data sets. Construct validity was established by significant associations of the scale with ethnicity, place of birth, generation within the United States, and type of neighborhood. Highly significant associations were found between IntroductionThe distinctive language and culture of Mexican Americans pose a variety of challenges to health care providers and investigators. [1][2][3] The effects of language use on health behavior and health care delivery have been widely discussed,4'5 but actual data are few.6 There is some evidence that fluency has important effects on doctor-patient interactions7 8 and the use of certain health services.9 In a larger sense, language use is an important component of "acculturation",5 which is thought to be an important correlate of health behavior but difficult to define operationally.In our clinical setting there are many Mexican American patients. We therefore sought to design a simple scale which would allow us to examine the relationship between English language use, acculturation, and health behavior. Because of the nature of our population, and our intention to use the scale in a clinical setting, we required that a scale incorporate the following features:* characterize varying degrees of English language use; * be brief, so that it would not significantly increase interviewing time when used clinically or with behavioral or epidemiologic questionnaires; * be independent of the subjective assessment of an interviewer; * correlate in the expected directions with other aspects of acculturation and health behavior; * be useful in an indigent population with low educational attainment; and * be non-threatening (for example, questions regarding place of birth or nationality might be seen as threatening, since a number of residents in our region or their families do not have legal citizenship). This paper describes the development and validation of such a scale, and illustrates its applicability to the study of health behavior and attitudes.

No abstract

No abstract

No abstract

Gallbladder disease (GBD) is one of the major digestive diseases. Its risk factors include age, sex, obesity, type 2 diabetes, and metabolic syndrome (MS). The prevalence of GBD is high in minority populations, such as Native and Mexican Americans. Ethnic differences, familial aggregation of GBD, and the identification of susceptibility loci for gallstone disease by use of animal models suggest genetic influences on GBD. However, the major susceptibility loci for GBD in human populations have not been identified. Using ultrasound-based information on GBD occurrence and a 10-cM gene map, we performed multipoint variance-components analysis to localize susceptibility loci for GBD. Phenotypic and genotypic data from 715 individuals in 39 low-income Mexican American families participating in the San Antonio Family Diabetes/Gallbladder Study were used. Two GBD phenotypes were defined for the analyses: (1) clinical or symptomatic GBD, the cases of cholecystectomies due to stones confirmed by ultrasound, and (2) total GBD, the clinical GBD cases plus the stone carriers newly diagnosed by ultrasound. With use of the National Cholesterol Education Program/Adult Treatment Panel III criteria, five MS risk factors were defined: increased waist circumference, hypertriglyceredemia, low high-density lipoprotein cholesterol, hypertension, and high fasting glucose. The MS risk-factor score (range 0-5) for a given individual was used as a single, composite covariate in the genetic analyses. After accounting for the effects of age, sex, and MS risk-factor score, we found stronger linkage signals for the symptomatic GBD phenotype. The highest LOD scores (3.7 and 3.5) occurred on chromosome 1p between markers D1S1597 and D1S407 (1p36.21) and near marker D1S255 (1p34.3), respectively. Other genetic locations (chromosomes 2p, 3q, 4p, 8p, 9p, 10p, and 16q) across the genome exhibited some evidence of linkage (LOD >or=1.2) to symptomatic GBD. Some of these chromosomal regions corresponded with the genetic locations of Lith loci, which influence gallstone formation in mouse models. In conclusion, we found significant evidence of major genetic determinants of symptomatic GBD on chromosome 1p in Mexican Americans.