Obesity is a leading preventable cause of cardiometabolic diseases and mortality, and the increasing prevalence of obesity has become a major public health concern. 1 Defined as a body mass index (BMI) greater than or equal to 30 (calculated as weight in kilograms divided by height in meters squared), obesity is often associated with metabolic abnormalities, including glucose intolerance, type 2 diabetes, dyslipidemia, hypertension, nonalcoholic fatty liver disease, increased inflammation, and metabolic syndrome-all of which increase the risk of cardiovascular diseases (CVD) (ie, coronary heart disease, stroke, and heart failure). 2 Yet, not all individuals meeting the criteria for obesity

Breast cancer incidence is lower in many U.S. ethnic minority and foreign-born population groups. Investigating whether migration and acculturation patterns in risk are reflected in disease biomarkers may help to elucidate the underlying mechanisms. We compared the distribution of breast cancer risk factors across U.S.-born white, African American and Hispanic women, and foreign-born Hispanic women ( = 477, ages 40-64 years, 287 born in Caribbean countries). We used linear regression models to examine the associations of migration history and linguistic acculturation with mammographic breast density (MBD), measured using computer-assisted methods as percent and area of dense breast tissue. The distribution of most breast cancer risk factors varied by ethnicity, nativity, and age at migration. In age- and body mass index-adjusted models, U.S.-born women did not differ in average MBD according to ethnicity, but foreign-born Hispanic women had lower MBD [e.g., -4.50%; 95% confidence interval (CI), -7.12 to -1.89 lower percent density in foreign- vs. U.S.-born Hispanic women]. Lower linguistic acculturation and lower percent of life spent in the United States were also associated with lower MBD [e.g., monolingual Spanish and bilingual vs. monolingual English speakers, respectively, had 5.09% (95% CI, -8.33 to -1.85) and 3.34% (95% CI, -6.57 to -0.12) lower percent density]. Adjusting for risk factors (e.g., childhood body size, parity) attenuated some of these associations. Hispanic women predominantly born in Caribbean countries have lower MBD than U.S.-born women of diverse ethnic backgrounds, including U.S.-born Hispanic women of Caribbean heritage. MBD may provide insight into mechanisms driving geographic and migration variations in breast cancer risk. .

Background-Exposure to childhood adversities (CA) is associated with sleep disturbances; however, evidence has largely been drawn from cross-sectional data and has not addressed the relationship across developmental stages. Also, most studies have primarily focused on non Hispanic White cohorts with a dearth of longitudinal evidence about racial/ethnic minorities. We examined the longitudinal association between CA and sleep disturbances in Puerto Rican youth. Method-The Boricua YouthStudy is a longitudinal study of Puerto Rican youth living in San Juan, Puerto Rico, and the South Bronx, NY (N = 2491). Among youth 5-9 and 10-16 years old, sleep disturbances were assessed through three yearly interviews. Lifetime exposure to CA included parental loss, child maltreatment, parental maladjustment, and exposure to violence. Weighted generalized linear mixed models examined the longitudinal association between CA and sleep disturbances in youth adjusting for sociodemographic and contextual covariates.Results-The prevalence of sleep disturbances was similar in both age groups (ages 5-9 and 10-16). In multivariable mixed models, CA were associated with sleep disturbance across three Waves among 10-16-year-olds. For example, having 2-3 or ≥ 4 types of CA were related to a ✉ Shakira F. Suglia,

Objective Evidence stemming largely from retrospective studies suggests that childhood adversity (CA) is associated with earlier age at menarche, a marker of pubertal timing, among girls. Little is known about associations with pubertal tempo among boys or racial/ethnic minorities. We examined the association between CA and timing and tempo of pubertal development among boys and girls. Methods The Boricua Youth Study is a longitudinal study of Puerto Rican youth residing in the San Juan metro area in Puerto Rico and the South Bronx, New York. CA was based on caretaker reports of parental loss and parental maladjustment and youth reports of child maltreatment and exposure to violence. Youth completed the Pubertal Development Scale (PDS) yearly for 3 years. In linear mixed models stratified by sex, we examined the association between CA and pubertal timing and tempo, adjusting for site, socioeconomic status, and age. Results Among the 1949 children who were 8 years or older by wave 3, cumulative CA was associated with higher PDS scores among girls compared with girls not exposed to CA (PDS score: 2.63 [95% confidence interval {CI} = 2.55–2.71] versus 2.48 [95% CI = 2.37–2.58]). In contrast, among boys, experiencing adversities was associated with lower pubertal developmental stage or later timing (PDS: 1.77 [95% CI = 1.67–1.87] versus 1.97 [95% CI = 1.85–2.10]) compared with those not exposed to adversities. Conclusions Associations between CA and pubertal development may vary by sex. Understanding the etiological role of adversities on pubertal development and identifying targets for intervention are of utmost importance in ameliorating the impact of CA on child health.

Objective Worry about developing breast cancer (BC worry) has been associated with participation in screening and genetic testing and with follow-up of abnormal screening results. Little is known about the scope and predictors of BC worry in Hispanic and immigrant populations. Methods We collected in-person interview data from 250 self-identified Hispanic women recruited from an urban mammography facility (average age 50.4 years; 82% foreign-born). Women reported whether they worried about developing breast cancer rarely/never (low worry), sometimes (moderate worry) or often/all the time (high worry). We examined whether sociocultural and psychological factors (e.g., acculturation, education, perceived risk), and risk factors and objective risk for breast cancer (e.g., family history, Gail model 5-year risk estimates, parity) predicted BC worry using multinomial and binary logistic regression. Results In multivariable models, women who perceived higher absolute breast cancer risk (OR=1.66, 95% CI: 1.28, 2.14 for one unit increase in perceived lifetime risk) and comparative breast cancer risk (e.g., OR=2.37, 95% CI: 1.23, 6.06) were more likely to report high BC worry than moderate or low BC worry. There were no associations between BC worry and indicators of objective risk or acculturation. Conclusions In Hispanic women undergoing screening mammography, higher perceptions of breast cancer risk, on both absolute and comparative terms, were independently associated with high BC worry, and were stronger predictors of BC worry than indicators of objective breast cancer risk, including family history, mammographic density and personal breast cancer risk estimates.

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Background: We investigated the prevalence of and patient characteristics correlated with hypertension control in the Montefiore Health System, a large and predominantly minority healthcare system with locations in New York City and Southern portion of Upstate New York. Methods: Using outpatient care data, we included all individuals with hypertension defined by ICD 9/10 codes during 2018. Treatment and control status were defined by the presence of prescribed antihypertensive medication(s) and measured blood pressure (BP): Joint National Commission (JNC) criteria - < 140 / 90 mmHg; or American Heart Association/American College of Cardiology (AHA/ACC) criteria - <130 / 80 mmHg. We report the distribution of hypertension treatment and control by age, sex, and race/ethnicity. Results: Among 74,487 hypertensive patients [mean age 62 years ±14), 62% female, predominantly Black (42%) and Hispanic (41%), and low SES (-2.91 ±2.90)], 57% were treated, of which 57% had achieved BP control by JNC criteria and 23% by AHA/ACC criteria. Compared with untreated patients, those prescribed treatments were older (61%), more likely to be NH Black or Hispanic (60%), and report one or more comorbidities (76%) (all p<0.0001). Prevalence of BP control by JNC criteria was lowest for NH Black (53%, p<0.0001) and Hispanic (58%, p<0.0001) patients than NH White and Asian (64%), and highest in patients ≥60 years (63%, p<0.0001) and those with comorbidities (89%, p=0.002). Similar discrepancies were apparent at the 130/80 mmHg threshold. BP control characteristics did not vary by sex. Conclusions: Hypertension treatment and control rates in a large, urban health system were significantly lower than reported national averages. Overall, NH Whites had a lower likelihood of hypertension treatment; NH Black and Hispanic patients had significantly lower prevalence of control compared with other racial/ethnic groups, despite having higher treatment rates. Disparities in BP control by patient characteristics was heightened with the AHA/ACC criteria.