Understanding Immigration as a Social Determinant of Health: Cardiovascular Disease in Hispanics/Latinos and South Asians in the United States

Guadamuz, Jenny S.; Kapoor, Karan; Lazo, Mariana; Eleazar, Andrea; Yahya, Tamer; Kanaya, Alka M.; Cainzos‐Achirica, Miguel; Bilal, Usama

doi:10.1007/s11883-021-00920-9

Cited by 30 publications

(22 citation statements)

References 97 publications

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“…Racial and ethnic inequalities in health outcomes are abundant in the United States—ranging from physical health, such as cardiovascular diseases and asthma, to mental health outcomes, such as PTSD and suicide [ 43 , 44 ]. These disparities exist due to systemic inequalities, such as economic opportunities, segregation, educational attainment, and access to health care [ 45 , 46 ].…”

Section: Introductionmentioning

confidence: 99%

“…These disparities exist due to systemic inequalities, such as economic opportunities, segregation, educational attainment, and access to health care [ 45 , 46 ]. However, some minority groups, such as US Latina/os, face additional burdens that become determinants of health, including language barriers, immigration status, and connections to immigrants [ 17 , 44 , 47 ].…”

Section: Introductionmentioning

confidence: 99%

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Immigration and Gender as Social Determinants of Mental Health during the COVID-19 Outbreak: The Case of US Latina/os

Gómez-Aguiñaga

Dominguez

Manzano³

2021

IJERPH

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While men and women make up a similar number of COVID-19 cases, and are equally likely to know someone who has become ill due to the virus, the gendered and systemic implications of immigration during public health emergencies among minority groups in the United States are empirically underexplored. Using the SOMOS COVID-19 Crisis National Latino Survey, we conduct a series of intersectional analyses to understand the extent to which personal experiences with COVID-19, gendered structural factors, and spillover effects of US immigration policies impact the mental health of US Latina/os during a public health emergency. The results show that among Latinas, knowing an undocumented immigrant and someone ill with COVID-19 increases the probability of reporting worse mental outcomes by 52 percent. Furthermore, being a woman increases the probability of reporting the highest level of mental health problems by 30 percent among Hispanic people who know someone with COVID-19 and an undocumented immigrant. These findings indicate that the effects of the COVID-19 outbreak among US Latinas and Latinos are entrenched in gendered and systemic inequalities.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Immigration and Gender as Social Determinants of Mental Health during the COVID-19 Outbreak: The Case of US Latina/os

Gómez-Aguiñaga

Dominguez

Manzano³

2021

IJERPH

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“…Nationwide, this small BP reduction among African Americans and white US populations aged 45 to 64 years would prevent ~1,868 incident heart failure events annually. It is likely that a similar BP reduction would have a greater impact among Hispanic populations as they are generally exposed to a greater number of coronary heart disease risk factors such as lower socioeconomic status, education, and less access to health care ( 43 ).…”

Section: Discussionmentioning

confidence: 99%

Blood Pressure Changes After a Health Promotion Program Among Mexican Workers

Garcia-Rojas

Omidakhsh

Arah

et al. 2021

Front. Public Health

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Background: Cardiovascular disease is becoming increasingly prevalent in low and middle-income countries (LMIC), and high blood pressure (BP) is one of the main risk factors. The efficacy and sustainability of worksite health promotion (WHP) programs for BP reduction in LMIC have yet to be determined.Methods: This non-randomized company-based trial evaluated 6- and 12-months effects of a WHP intervention on BP among 2,002 participating workers from seven Mexican companies. Intervention and control groups were assigned at the company level. The intervention included nutrition counseling, physical exercise, and stress management components. Mixed models assessed differences in BP change between intervention and control companies in intent-to-treat (ITT), per-protocol (PerP), and as-treated (AsTr) analyses, and also within-group changes stratified by company, intervention component, and baseline cardiovascular risk factor levels. All analyses were adjusted for potential confounders. We accounted for missing data and loss to follow-up using inverse probability of censoring weighting.Results: ITT analyses revealed mean BP change differences of −1.1 mmHg at 12 months (95% CI: −2.9; 0.6) in intervention companies relative to control companies. PerP and AsTr analyses confirmed this finding. Within-group analyses showed consistent BP reductions at both 6 and 12 months. Substantial differences in BP changes ranging from diastolic −6.1 mmHg, (95% CI: −11.2; −1.2) to systolic −13.0 mmHg (95% CI: −16.0; −10.1) were found among individuals with diabetes at baseline in intervention companies relative to control companies.Conclusion: After 1 year, WHP was associated with modest but uncertain BP reductions. Substantial reductions were mainly observed among diabetic workers.

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“…U.S. Latinos comprise more than half the of the total U.S. population growth [ 11 ], and CVD is the leading cause of death amongst Latinos [ 12 , 13 ]. However, correlates of CVD risk are not well understood amongst this population [ 14 – 16 ].…”

Section: Introductionmentioning

confidence: 99%

Psychosocial stressors predict lower cardiovascular disease risk among Mexican-American adults living in a high-risk community: Findings from the Texas City Stress and Health Study

et al. 2021

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The objective of this study was to examine the link between systemic and general psychosocial stress and cardiovascular disease (CVD) risk in a group of U.S. Latinos as a function of acculturation and education within the blended guiding conceptual framework of the biopsychosocial model of the stress process plus the reserve capacity model. We analyzed data from self-identifying Mexican-origin adults (n = 396, 56.9% female, Mage = 58.2 years, 55.5% < 12 years of education, 79% U.S.-born) from the Texas City Stress and Health Study. We used established measures of perceived stress (general stress), neighborhood stress and discrimination (systemic stress) to capture psychosocial stress, our primary predictor. We used the atherosclerotic CVD calculator to assess 10-year CVD risk, our primary outcome. This calculator uses demographics, cholesterol, blood pressure, and history of hypertension, smoking, and diabetes to compute CVD risk in the next 10 years. We also created an acculturation index using English-language use, childhood interaction, and preservation of cultural values. Participants reported years of education. Contrary to expectations, findings showed that higher levels of all three forms of psychosocial stress, perceived stress, neighborhood stress, and perceived discrimination, predicted lower 10-year CVD risk. Acculturation and education did not moderate the effects of psychosocial stress on 10-year CVD risk. Contextualized within the biopsychosocial and reserve capacity framework, we interpret our findings such that participants who accurately reported their stressors may have turned to their social networks to handle the stress, thereby reducing their risk for CVD. We highlight the importance of examining strengths within the sociocultural environment when considering cardiovascular inequities among Latinos.

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Understanding Immigration as a Social Determinant of Health: Cardiovascular Disease in Hispanics/Latinos and South Asians in the United States

Cited by 30 publications

References 97 publications

Immigration and Gender as Social Determinants of Mental Health during the COVID-19 Outbreak: The Case of US Latina/os

Immigration and Gender as Social Determinants of Mental Health during the COVID-19 Outbreak: The Case of US Latina/os

Blood Pressure Changes After a Health Promotion Program Among Mexican Workers

Psychosocial stressors predict lower cardiovascular disease risk among Mexican-American adults living in a high-risk community: Findings from the Texas City Stress and Health Study

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