Mexico–United States Migration and the Prevalence of Obesity: A Transnational Perspective

Abstract

However, neither therapy was provided in 15.4 million visits, accounting for 36% of visits and not varying significantly over time (P= .76). Comment.In this nationally representative sample of adult ambulatory visits, visits involving a substance use disorder increased substantially between 2001 and 2009. Opioid use disorders accounted for a markedly increased share of visits over time. This finding is consistent with trends in substance use disorder-related utilization at the nation's community health centers and emergency departments and, sadly, use of its morgues. 2,7,8 Our study provides reason for optimism, however. Visits involving provision of pharmacotherapy increased as well, likely driven by the use of buprenorphine. Increasing recognition of previously undiagnosed disorders, improving familiarity with and use of available medications, and more frequent ambulatory care by individuals with substance use disorders all likely contribute to the trend of increasing visits over time. As millions of visits did not involve treatment, there remains both an opportunity and a need for further expansion of treatment within ambulatory settings.Our study has several limitations. First, the crosssectional, visit-based nature of the data precludes causal inferences. Residual confounding is possible, and underdiagnosis is likely. Finally, the NAMCS/NHAMCS lacks detailed clinical information, so we could not assess the appropriateness of management decisions by health care providers.The Mental Health Parity and Addiction Equity Act of 2008 (Pub L No. 110-343) and the Patient Protection and Affordable Care Act of 2010 will provide increased support for the management of substance use disorders in ambulatory settings. 4 Our study provides an important assessment of the national impact of substance use disorders in ambulatory care at a time when these laws have the potential to transform the US health care system's ability to care for the millions of Americans struggling with these disorders.

Obesity in American Indian and Mexican American Men and Women: Associations with Blood Pressure and Cardiovascular Autonomic Control

“…The prevalence of obesity and increased risk of cardiovascular diseases have been reported in both American Indians and Mexican Americans [1–3, 5, 8]. Studies suggest that when compared to other race/ethnic groups, American Indians have one of the highest rates of cardiovascular disease and the highest prevalence of stroke in noninstitutionalized adults [52–54].…”

“…This increase in the incidence of obesity in American Indians may be due in part to the relative abundance of high fat, high calorie food, and a shift from an active to a more sedentary lifestyle [2]. There is also evidence of greater odds of obesity among US-born Mexican Americans, in comparison to first generation Mexican Americans [5]. The National Health and Nutrition Examination Survey (1999–2002) reported a 40% prevalence of overweight in Mexican-origin children between the ages of 6 and 19 (versus 28% for non-Hispanic whites) [6].…”

Latino Immigrants, Acculturation, and Health: Promising New Directions in Research

“…Among daily smokers, US-born Mexicans smoked more cigarettes per day than did Mexicans who had a migrant in their family and Mexican men with migration experience. Flórez et al (47) found a similar relationship with obesity, such that respondents living in Mexico who had a family member in the United States were more likely to be obese compared with those who had no migrants in their family; however, this relationship was only significant among men.…”

“…Yet public health research using a transnational perspective is still in its infancy (3, 83, 109, 116), and large quantitative sources for this type of study are rare (3, 47, 83, 109, 111, 116). Furthermore, research using this approach would benefit from focusing on Latino groups (other than Mexicans) with important circular patterns of migration (e.g., the “air bridge” between New York City and the Dominican Republic).…”

Risk Factors for Overweight and Obesity among Mexican Children in New York

“…In middle income countries, like Mexico, rates of being overweight or obese are the highest in more developed regions and among the poor [8,9]; these groups may be especially prone to migration. In developed countries, like the United States, the prevalence is the greatest among low-income people as well as minority and migrant populations [10]. Among migrants, the high prevalence of being overweight or obese is best explained by sudden changes in diet, in both the preparation and consumption of food, changes that expose migrants to what some describe as an "accelerated nutritional transition" [11].…”