Milken Institute School of Public Health Poster Presentations (Marvin Center & Video)
Document Type
Poster
Status
Graduate Student - Masters
Abstract Category
Prevention and Community Health
Keywords
Latino, chronic disease, immigration, acculturation, socioeconomic
Streaming Media
Publication Date
Spring 2019
Abstract
A critical analysis of chronic disease among Latino immigrants demonstrates the interplay between the individual, socioeconomic, and pathophysiological mediators of disease. To identify the major factors involved, a conceptual framework was developed to explain the relationship between Latino immigration to the US and the manifestation of diabetes and cardiovascular disease. Mediating factors include: self-efficacy, stress, social support, access to healthcare, pathophysiological risk factors and the familial and cultural environment. As the Latino population is the fastest growing and largest minority group in America, increased support among the identified factors will target interventions with broad health and economic implications for the entire nation.
Objective:
Latinos are the largest minority group in the United States and are anticipated to represent 25% of the population by 2050. Latinos as a whole collectively experience a disproportionate burden of poverty and poor health outcomes, when compared to the rest of the national population. A heavy burden of disease among the largest minority group in America creates a compelling argument for resource application and investment to reduce the overall impending strain on an already strained healthcare system. The specific aim of the critical analysis was to development a conceptual framework clarifying the root causes and associated factors that contribute to Latino immigrant health. Creating a robust conceptual framework contributes to future academia and builds a base and springboard for future research. Doing so ultimately facilitates the development of program plans and grant proposals for future interested researchers and community clinics, as they develop calls for action and plan interventions and programs. By creating a comprehensive and thorough conceptual framework via critical analysis, the research contributes to the larger discussion of immigrant health. It strengthens and validates the argument that a further investment of resources, time and passion among researchers is needed to improve immigrant health outcomes. The overarching goal is for the critical analysis to be fundamentally useful for community clinics to develop public health programs, provide concrete evidence, and direct their efforts to improve Latino immigrant health.
Methods:
The main procedure for reviewing literature and conducting the critical analysis involves searching online journals. The primary research journals and search platforms used include: Google Scholar, PubMed, Medline, JSTOR, Scientific American, American Journal of Clinical Nutrition, SAGE Journals, Springer, NCBI and the Lancet.
The literature review was conducted with strict research criteria. Criteria include publication data range, study design type, search terms, and inclusion and exclusion criteria. The inclusion and exclusion criteria comprise the most critical component of critical analysis. Having strict definitions of what articles can be included will facilitate data collection, analysis, and the final write up. Specific research criteria will guide the literature review and analysis. Research criteria concerns specifications for data range, study design, search terms, inclusion/exclusion criteria and databases used.
Data Range Limitations: The data range was limited to publications from 1990-present, emphasizing publications from 2008 to the present. Older articles, prior to 2008, may be used to develop baseline data.
Study Design Limitations: The study designs of analyzed research papers include: longitudinal case-control or cohort studies. The longitudinal observational studies can be used for socioeconomic, psychological, behavioral, biological and environmental factors. Participant samples must be: of Latino or Hispanic backgrounds, immigrants or first-generation families, and have chronic health conditions, such as Type II diabetes, obesity, cardiovascular disease.
Search terms: diabetes, cardiovascular disease, hypertension, chronic disease, immigrant, Latino, hormonal imbalance, insulin, glucagon, inflammation, diabetic nephropathy/retinopathy, socioeconomic status, poverty, broken window syndrome, environment, stress, chronic stress, depression
Studies eligible for inclusion had to meet the following selection criteria: - Exposure variable: social, economic, or behavioral experiences of Latino or Hispanic patients - Outcome variable: chronic disease - Designed as a longitudinal case-control or cohort study - Community or population based
Selection of Literature The primary literature collection and review yielded 112 articles pertaining to the specific search criteria. After title and abstract review, 63 were selected for relevancy. Full text evaluation and data collection yielded 46 articles. 40 papers were finally selected, after excluding 6 for insufficient sample size, data, or being incomplete longitudinal studies.
Results:
Critical analysis of the selected literature gave evidence of an interconnected relationship among individual and socioeconomic factors and the pathophysiology of diabetes and CVD.
INDIVIDUAL FACTORS - Race and Ethnicity: Race and ethnicity classification is a primary measure influencing a person’s world-view and interaction with society or health problems. Identifying as Latino affects the lived experience of disease and how Latinos in the US navigate chronic disease control, maintenance, and prevention. Understanding chronic disease among Latinos in the US poses significant challenges.
- Acculturation and Self-Efficacy: Acculturation, or the process of social and psychological change from blending native and host cultures, has been used as a measurement of immigrant adaptation status Indicative of language and culture adoption, acculturation level is associated with depression, socioeconomic standing, education, social isolation and health care navigation. Less fluent linguistic capabilities may prevent opportunities for financial or socioeconomic advancement, by inhibiting successful negotiation of educational or job opportunities. Language barriers particularly impair immigrant advancement, promoting social isolation and preventing integration into the dominant host culture. Less acculturated immigrants face more barriers to health care, are less likely to have health insurance, and may not be educated about chronic disease risk factors compared to their more acculturated counterparts.
- Personal Stressors: Immigrants experience a myriad of personal stressors from both the immigration process and cultural assimilation. The analysis of personal stress among US Latinos indicated a consistent association with increased chronic stress, CVD and major CVD risk factors, such as diabetes and smoking.
Conclusion: The conceptual framework explains the relationship between Latino immigration to the US and the manifestation of diabetes and cardiovascular disease. By identifying the unique components that contribute to the lived disease experience of Latinos, public health interventions and community programs may target potential areas of the acculturation experience to improve immigrant health. If acculturation can be reframed as a more positive experience, with adoption of healthier activities, then minority and national health overall may improve.
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
Open Access
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(VIDEO) Latino Immigration and Chronic Disease: A Critical Analysis of Socioeconomic and Psychological Mediators
A critical analysis of chronic disease among Latino immigrants demonstrates the interplay between the individual, socioeconomic, and pathophysiological mediators of disease. To identify the major factors involved, a conceptual framework was developed to explain the relationship between Latino immigration to the US and the manifestation of diabetes and cardiovascular disease. Mediating factors include: self-efficacy, stress, social support, access to healthcare, pathophysiological risk factors and the familial and cultural environment. As the Latino population is the fastest growing and largest minority group in America, increased support among the identified factors will target interventions with broad health and economic implications for the entire nation.
Objective:
Latinos are the largest minority group in the United States and are anticipated to represent 25% of the population by 2050. Latinos as a whole collectively experience a disproportionate burden of poverty and poor health outcomes, when compared to the rest of the national population. A heavy burden of disease among the largest minority group in America creates a compelling argument for resource application and investment to reduce the overall impending strain on an already strained healthcare system. The specific aim of the critical analysis was to development a conceptual framework clarifying the root causes and associated factors that contribute to Latino immigrant health. Creating a robust conceptual framework contributes to future academia and builds a base and springboard for future research. Doing so ultimately facilitates the development of program plans and grant proposals for future interested researchers and community clinics, as they develop calls for action and plan interventions and programs. By creating a comprehensive and thorough conceptual framework via critical analysis, the research contributes to the larger discussion of immigrant health. It strengthens and validates the argument that a further investment of resources, time and passion among researchers is needed to improve immigrant health outcomes. The overarching goal is for the critical analysis to be fundamentally useful for community clinics to develop public health programs, provide concrete evidence, and direct their efforts to improve Latino immigrant health.
Methods:
The main procedure for reviewing literature and conducting the critical analysis involves searching online journals. The primary research journals and search platforms used include: Google Scholar, PubMed, Medline, JSTOR, Scientific American, American Journal of Clinical Nutrition, SAGE Journals, Springer, NCBI and the Lancet.
The literature review was conducted with strict research criteria. Criteria include publication data range, study design type, search terms, and inclusion and exclusion criteria. The inclusion and exclusion criteria comprise the most critical component of critical analysis. Having strict definitions of what articles can be included will facilitate data collection, analysis, and the final write up. Specific research criteria will guide the literature review and analysis. Research criteria concerns specifications for data range, study design, search terms, inclusion/exclusion criteria and databases used.
Data Range Limitations: The data range was limited to publications from 1990-present, emphasizing publications from 2008 to the present. Older articles, prior to 2008, may be used to develop baseline data.
Study Design Limitations: The study designs of analyzed research papers include: longitudinal case-control or cohort studies. The longitudinal observational studies can be used for socioeconomic, psychological, behavioral, biological and environmental factors. Participant samples must be: of Latino or Hispanic backgrounds, immigrants or first-generation families, and have chronic health conditions, such as Type II diabetes, obesity, cardiovascular disease.
Search terms: diabetes, cardiovascular disease, hypertension, chronic disease, immigrant, Latino, hormonal imbalance, insulin, glucagon, inflammation, diabetic nephropathy/retinopathy, socioeconomic status, poverty, broken window syndrome, environment, stress, chronic stress, depression
Studies eligible for inclusion had to meet the following selection criteria: - Exposure variable: social, economic, or behavioral experiences of Latino or Hispanic patients - Outcome variable: chronic disease - Designed as a longitudinal case-control or cohort study - Community or population based
Selection of Literature The primary literature collection and review yielded 112 articles pertaining to the specific search criteria. After title and abstract review, 63 were selected for relevancy. Full text evaluation and data collection yielded 46 articles. 40 papers were finally selected, after excluding 6 for insufficient sample size, data, or being incomplete longitudinal studies.
Results:
Critical analysis of the selected literature gave evidence of an interconnected relationship among individual and socioeconomic factors and the pathophysiology of diabetes and CVD.
INDIVIDUAL FACTORS - Race and Ethnicity: Race and ethnicity classification is a primary measure influencing a person’s world-view and interaction with society or health problems. Identifying as Latino affects the lived experience of disease and how Latinos in the US navigate chronic disease control, maintenance, and prevention. Understanding chronic disease among Latinos in the US poses significant challenges.
- Acculturation and Self-Efficacy: Acculturation, or the process of social and psychological change from blending native and host cultures, has been used as a measurement of immigrant adaptation status Indicative of language and culture adoption, acculturation level is associated with depression, socioeconomic standing, education, social isolation and health care navigation. Less fluent linguistic capabilities may prevent opportunities for financial or socioeconomic advancement, by inhibiting successful negotiation of educational or job opportunities. Language barriers particularly impair immigrant advancement, promoting social isolation and preventing integration into the dominant host culture. Less acculturated immigrants face more barriers to health care, are less likely to have health insurance, and may not be educated about chronic disease risk factors compared to their more acculturated counterparts.
- Personal Stressors: Immigrants experience a myriad of personal stressors from both the immigration process and cultural assimilation. The analysis of personal stress among US Latinos indicated a consistent association with increased chronic stress, CVD and major CVD risk factors, such as diabetes and smoking.
Conclusion: The conceptual framework explains the relationship between Latino immigration to the US and the manifestation of diabetes and cardiovascular disease. By identifying the unique components that contribute to the lived disease experience of Latinos, public health interventions and community programs may target potential areas of the acculturation experience to improve immigrant health. If acculturation can be reframed as a more positive experience, with adoption of healthier activities, then minority and national health overall may improve.
Comments
Presented at Research Days 2019.