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Previous studies have found increased acculturation to the US lifestyle increases risk for obesity in Latinos. However, methodologies differ, and results in children are inconsistent. Moreover, previous studies have not evaluated risk factors within the heterogeneous US population. We recruited 144 self-identified Latino school children and their mother or father in grades 4–6 in San Francisco parochial schools and South San Francisco public schools using an information letter distributed to all students. Children and parents had weights, heights, demographic information, dietary patterns and lifestyle variables collected in English or Spanish through an interview format. A high percentage of our children were overweight [≥85th percentile body mass index (BMI)] (62.5%) and obese (≥95th percentile BMI) (45.2%). Correspondingly parents also had a high percentage of overweight (BMI ≥ 25 & <30) (40.8%) and obesity (BMI ≥ 30) (45.3%). Mexico was the country of origin for 62.2% of parents, and 26.6% were from Central or South America. In multivariate logistic analysis, speaking Spanish at home was an independent risk factor for obesity [odds ratio (OR) 2.97, 95% confidence interval (CI) 1.28–6.86]. Eating breakfast daily (OR 0.34, 95% CI 0.15–0.78) and consumption of tortas (a Mexican fast food sandwich) (OR 0.45, 95% CI 0.21–1.00) were associated with decreased risk. In stratified analysis, significant differences in risk factors existed between Mexican origin versus Central/South American Latino children. The processes of acculturation likely impact eating and lifestyle practices differentially among Latino groups. Interventions should focus on ensuring that all children eat a nutritious breakfast and take into consideration ethnicity when working with Latino populations.

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In Mexico, higher socioeconomic status (SES) has been found to be associated with increased risk for obesity in children. Within developed urban areas, however, there may be increased risk among lower SES children. Students in grades 4-6 from five public schools in Tijuana and Tecate, Mexico, were interviewed and weight, height and waist circumference (WC) measurements were taken. Interviews consisted of questions on food frequency, food insecurity, acculturation, physical activity and lifestyle practices. Multivariate logistic models were used to assess risk factors for obesity (having a body mass index [BMI] ≥95th percentile) and abdominal obesity (a WC >90th percentile) using Stata 11.0. Five hundred and ninety students were enrolled; 43.7% were overweight or obese, and 24.3% were obese and 20.2% had abdominal obesity. Independent risk factors for obesity included watching TV in English (odds ratio [OR] 1.60, 95% confidence interval [CI] 1.06-2.41) and perceived child food insecurity (OR 1.57, 95% CI 1.05-2.36). Decreased risk for obesity was associated with female sex (OR 0.64, 95% CI 0.43-0.96), as was regular multivitamin use (OR 0.63, 95% CI 0.42-0.94). Risk obesity was also decreased with increased taco consumption (≥1×/week; OR 0.64, 95% CI 0.43-0.96). Independent risk factors for abdominal obesity included playing video games ≥1×/week (OR 1.18, 95% CI 1.11-2.96) and older age group (10-11 years, OR 2.47, 95% CI 1.29-4.73 and ≥12 years, OR 2.21, 95% CI 1.09-4.49). Increased consumption of tacos was also associated with decreased risk for abdominal obesity (≥1×/week; OR 0.56, 95% CI 0.40-1.00). We found a bimodal distribution for risk of obesity and abdominal obesity in school aged children on the Mexican border with the United States. Increased risk for obesity and abdominal obesity were associated with factors indicative of lower and higher SES including watching TV in English, increased video game playing and perceived food insecurity. Increased consumption of tacos (≥1×/week) was associated with decreased risk, possibly suggesting an association with children from middle income families. Regular multivitamin use was protective and future studies may focus on micronutrient supplementation as a means to prevent obesity in children or further investigate factors associated with vitamin use. Additionally, future studies need to examine the processes of acculturation on both sides of the US-Mexican border that contribute to increased risk for obesity in children in relation to SES.

California's San Joaquin Valley, one of the most highly productive—and contaminated—agricultural regions in the world, is beset by some of the nation's worst air quality and high rates of childhood asthma. Children of Mexican-origin farmworkers in the San Joaquin Valley have exceptionally high rates of asthma compared with children of Mexican descent in both the United States and Mexico. We suggest that public health paradigms, which posit that Mexican-American children are at relatively low risk of developing childhood asthma, do not apply to the population of children of Mexican immigrant farmworkers in the San Joaquin Valley. Combining ethnographic and photovoice methods, we demonstrate how industrial farming conditions systematically expose children of farmworkers to environmental insults over which they have little or no control, including pesticide exposure, bovine contamination, agricultural field burning, and substandard housing, all of which contribute to high prevalence of asthma among children. We argue that the application of structural vulnerability, structural violence, and ecosyndemic frameworks can be used to better explicate complex environmental injustices that might otherwise be overlooked by more reductionistic theories.

Nearly one in five Mexican American children residing in California's San Joaquin Valley (the Valley) in 2007 had an asthma attack at some point in their life. Numerous epidemiological studies have suggested that compared with other ethnic groups and Latino subgroups residing in the United States, Mexican origin children have the lowest rates of pediatric asthma. Ethnographic research conducted in central California, however, suggests otherwise. Known for its agricultural produce, extreme poverty, and poor air quality, the Valley is a magnet for the Mexican immigrant farm worker population. We conducted an exploratory ethnographic study to examine health disparities, social suffering, and childhood asthma in the Valley. Many Valley residents believe that their children's health concerns are being ignored. Open-ended interviews uncovered a largely rural community suffering not only from the effects of childhood asthma but the inability to have their experiences taken seriously.

Children with asthma living on the northern Mexico border suffer not only from the physical aspects of this condition, but also from the lack of a clear biomedical definition and treatment plan for the illness. An ethnographic study involving participant observation and focused interviews in Tijuana, Mexico, sought to understand the intersection of diagnostic uncertainties surrounding childhood asthma on the part of parents, particularly mothers, living in acute poverty. Environmental factors such as dust and insects in impoverished homes probably acted as asthma triggers among many of the children in the study. Furthermore, management of children's asthma took place not only in biomedical clinics, but also in homes, traditional medical settings, and pharmacies, where mothers often sought remedies for their children's asthma attacks on an emergency basis. In all treatment settings, including biomedical ones, they often faced significant barriers to effective care, including the misuse of antibiotics. Thus, the role of pharmaceutical sales clerks, as well as pediatric asthma specialists, is explored in this article.

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