Tuesday, July 2, 2019

Immigrant and Minority Health

Correction to: The Effects of Hispanic Immigrant Mother's Resiliency on Children's Dietary Adjustment

The original version of this article unfortunately contained errors in Affiliation 3, Acknowledgement, Table 1 and in the text under Methods section. Also, a Co-corresponding author has to be included in the article.



Cardiovascular Disease Screening Among Immigrants from Eight World Regions

Abstract

Inequalities between native-born and foreign-born individuals in screening rates for a variety of conditions have been well-documented in literature on immigrant health. A preponderance of this research focuses on the Latin American case and on cancer-specific screening. This study seeks to expand knowledge of such preventative-health screening differences by analyzing screening rates for blood sugar, blood pressure, and serum cholesterol among nine groups overall and (for immigrants) at various stages of US residency. Using nationally representative data from the National Health Interview Survey, we find that immigrants from eight geographic regions receive preventative care at lower rates than US-born Whites and that preventative screening is generally higher after 15 years than during the first 4 years of residency in the United States. Importantly, our data also show that screening patterns and trends vary based on region of origin and outcome. These findings improve our understanding of immigrant health and health care use in the United States.



Exploring the 'Patient Experience' of Individuals with Limited English Proficiency: A Scoping Review

Abstract

Individuals with limited English proficiency (LEP) face barriers to safe and high-quality health care. 'Patient-experience' is increasingly viewed as an important component of health care quality. However, the impact of language proficiency on 'patient-experience' is not well-described. This scoping review mapped the literature on the patient experience of individuals with LEP. We reviewed sixty qualitative and mixed-methods studies from EMBASE and MEDLINE published between 2007 and 2017. We identified four major themes: (1) Communication, language barriers, and health literacy, (2) Relationships with health care professionals, (3) Discrimination and intersection with other dimensions of identity, and (4) Cultural safety. We also identified factors that may improve LEP patient experience, including: mitigating language barriers through interpretation or language-concordant providers, offering translated patient resources, and educating health care professionals about cultural safety.



Oral Health Status of Refugee Children in Montreal

Abstract

This study aimed to assess the oral health status of refugee children in comparison with that of Canadian children. In addition, we investigated the extent to which demographic factors are associated with caries experience in this population. Children with a confirmed refugee status and Canadian children (control group) matched for age and sex composed the study population. A comprehensive review of dental charts was completed to assess children's demographic data, caries experience, oral hygiene and gingival health status. The majority of refugee children had never seen a dentist before their arrival to Canada. Refugee children had significant higher dmft/DMFT scores than Canadian children (7.29 ± 5.1 and 4.47 ± 5, respectively; p < 0.0001). Furthermore, individual factors, such as refugee status (OR = 5.08; 95% CI = 2.31–11.1) and child age (OR = 2.17; 95% CI = 1.04–4.51) were significantly associated with caries experience. Access to appropriate dental care to refugee children should be a key priority for health care providers and policy makers.



Cumulative Stress and Trauma from the Migration Process as Barriers to HIV Testing: A Qualitative Study of Latino Immigrants

Abstract

Immigrants are at increased risk for late HIV testing; however, there is limited understanding of how migration to the United States shapes HIV testing behaviors. This study examined the relationship between the migration process and HIV testing among Latino immigrants. Semi-structured, in-depth interviews were conducted in March and April 2017 with 34 Latino immigrants in New York City. Grounded theory guided analysis of the qualitative data. Results indicated that Latino immigrants experienced cumulative stress and trauma throughout the migration process that contributed to significant emotional and psychological consequences. Stress and trauma accumulated from the migration process posed barriers to HIV testing as Latino immigrants sought to avoid activities perceived as stressful, including learning one's HIV status. Targeted interventions that ameliorate the stressful effects of migration may facilitate preventive health behaviors among Latino immigrants.



Polyvictimization, Related Symptoms, and Familial and Neighborhood Contexts as Longitudinal Mediators of Racial/Ethnic Disparities in Violence Exposure Across Adolescence

Abstract

African American and Hispanic adolescent experience more violence exposure relative to White youth. The present study examined the mediating role of posttraumatic stress symptoms (PTSS), delinquency, earlier victimization, and familial and neighborhood factors in disparities in future victimization. The study utilized data from the National Survey of Adolescents-Replication (N = 3,312), which consists of three waves of data collected approximately 1 year apart. A series of path models, tested polyvictimization, PTSS, delinquency, familial socioeconomic factors, and neighborhood safety as mediators of disparities in new polyvictimization. All cross-lagged and autoregressive paths positively predicted past-year polyvictimization and mediated longitudinal disparities. Familial socioeconomic variables and neighborhood safety mediated initial violence exposure disparities. Overall, results indicate that prior violence exposure, related mental health symptoms, and familial and neighborhood factors account for significant portions of disparities in new violence exposure across adolescence.



A Pilot Study Evaluating Organochlorine and Organophosphate Pesticide Exposure in Children and Adolescents of Mexican Descent Residing in Hidalgo County, Texas

Abstract

Children and adolescents of Mexican descent residing in Hidalgo County (TX) were evaluated for exposure to organochlorine (OC) and organophosphate (OP) pesticides. A convenience sample of 60 participants enrolled in our pilot study. The lipid-adjusted serum concentrations of nine OC metabolites and creatinine-adjusted urinary concentrations of six OP metabolites were measured and compared with data from the Centers for Disease Control and Prevention's Fourth Report on Human Exposure to Environmental Chemicals. Descriptive statistics were used to summarize the concentration levels for each metabolite. Study participants were aged 5–18 years. For most of the OC and OP metabolites, our findings showed that participants had concentration levels within the distributional range of the national data. However, notable outlying levels (greater than the 95th percentile in the Fourth Report) were identified for the following OC metabolites: gamma-hexachlorocyclohexane, p,p′-dichlorodiphenyldichloroethene, and p,p′-dichlorodiphenyltrichloroethane. Among the children aged 5–11 years, one child had an outlying value for the OP metabolite: dimethylphosphate. Our findings on the levels of OC and OP pesticide exposure enhances the credibility of national estimates, and can serve as baselines for children and adolescents of Mexican descent residing in Lower Rio Grande Valley. Furthermore, our study contributes to the lacunae of knowledge regarding environmental exposures and presses further investigation of outlying OC and OP exposure levels.



Cardiovascular Risk Factors and Events in Iranian Immigrants Versus Other Immigrants from the Middle East

Abstract

We report the incidence of cardiovascular events, mortality and risk factors (diabetes and hypertension) in immigrants from Iran and in non-Iranian immigrants from the Middle East. Using population-based healthcare administrative data, all immigrants from the Middle East and the non-immigrant population of Ontario, Canada as of July 2012 were identified. Baseline differences in diabetes and hypertension prevalence were compared. Outcomes were ascertained through March 2016 and included the incidence of acute coronary events, ischemic heart disease mortality, all-cause mortality, and incident diabetes and hypertension. The study population included 55,539 Iranian immigrants, 106,926 non-Iranian Middle Eastern immigrants, and 6,967,132 non-immigrants. Non-immigrants had the highest crude baseline prevalence of diabetes and hypertension. Compared to non-immigrants, Iranian and non-Iranian Middle Eastern immigrants had significantly lower incidence rate of acute coronary events, ischemic heart disease mortality and all-cause mortality. Both Iranian and non-Iranian Middle Eastern immigrants had better cardiovascular health status than non-immigrants.



Factors Associated with the Presence of Strong Social Supports in Bhutanese Refugee Women During Pregnancy

Abstract

Social support may mitigate stress related to the refugee experience, including during resettlement. For refugee women, social support can play an important role during pregnancy. In-depth interviews were conducted within a sample of 45 Bhutanese refugee women. Perceived social support was measured using the Norbeck Social Support Questionnaire. Averaged social support scores are reported to account for personal network size. Participants were identified as "low support" and "high support" based on their reported score. The mean social support score reported was 18.9. Participants experiencing a secondary resettlement within the U.S. were 4.52 (95% CI 1.19–17.15) times as likely to report a "high support" network compared to participants who resettled directly from Nepal. Personal social networks are an important source of support for resettled refugee women during pregnancy in the U.S.. Refugee women who experience secondary resettlement may perceive stronger support from their personal connections.



Acculturation and Dental Caries Among Children in Spain

Abstract

This study explored the relationship between different indicators of acculturation and children's caries experience. Data from 313 children attending the Dental Clinic of the European University of Madrid were analysed. Acculturation was measured via generational status, age at arrival, length of residence and language spoken at home. The association between each indicator of acculturation and caries experience was assessed in Poisson regression models adjusting for confounders. First- and second-generation migrant children had greater caries experience than Spanish-born children. These differences only persisted for first-generation migrant children after adjustment for confounders. Children who arrived in Spain before age 6 years, who lived in Spain for 10 or more years and who spoke a language other than Spanish at home had greater caries experience than Spanish-born children. Inequalities in caries experience between migrant and native children were evident (favouring the local children) and independent of family's socioeconomic circumstances.



Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480

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