Low health literacy is a significant barrier to healthcare access and service utilization; however, there are few studies that have evaluated the factors associated with having low health literacy, especially among immigrant minority populations. This exploratory study aimed to assess the key determinants of low health literacy among immigrant Hispanic adults in California using the California Health Interview Survey, the largest population-based state health survey in the United States. Analysis accounted for complex survey design, allowing generalizations to the entire state of California. Low health literacy was associated with living in poverty (OR = 1.63), lacking consistent health insurance (OR = 1.40), and limited English language proficiency (OR = 3.22), while women were less likely than men (OR = 0.59) to report low health literacy. The results of this study demonstrate that language proficiency, in addition to other key sociodemographic variables, can significantly posit limitations to health literacy. Future efforts should address providing linguistically competent health literacy interventions in order to improve associated health outcomes.

Results highlighted several sociodemographic correlates to not meeting 5-a-day requirement among six Asian-American subgroups. Targeted health promotion measures for such at-risk groups should be implemented to improve dietary practices.

Purpose The purpose of this study was to assess the prevalence of low self-esteem among college students and how exogenous and endogenous factors, such as experiences of discrimination and psychological distress, respectively, impact such an outcome. Design/methodology/approach General education courses were used to conduct a quantitative cross-sectional study among undergraduate college students. The primary outcome variable of interest in this study was self-esteem, which was measured using the Rosenburg’s self-esteem scale. Primary independent variable was psychological distress (measured using Kessler 6 scale). Discrimination experiences were measured using the Everyday Discrimination Scale (EDS). Descriptive, bivariate and multiple linear regressions were conducted to find associations among such variables. Findings Among 308 young adults in this study, psychological distress was significantly related to low self-esteem (ß = −6.50, p < 0.001). In addition, increasing EDS score (ß = −0.37, p = 0.019) and women gender (ß = −1.29, p = 0.038) were also associated with low self-esteem. Research limitations/implications The study was cross-sectional and thus cannot provide causal relationship. The self-reported data is susceptible to recall bias. College students continue to face negative social experiences that impact their self-esteem, and discrimination plays a substantial role. Practical implications Gender-specific self-esteem coaching is needed among college students with psychological distress and among those with experiences of discrimination. Social implications The results of the current study provide information for understanding the role of discrimination and psychological well-being on self-esteem of college students, and thus further address the importance of social determinants of health and well-being. Originality/value This study provides a unique insight into the disparities faced by college students. Understanding self-esteem at the individualistic and collectivistic levels will allow for the planning and implementation of comprehensive interventions that address gender differences and psychological distress that will increase the positive health outcomes and decrease the negative health outcomes.

Background: Experiences of discrimination are prevalent among minority populations, although often empirical evidence does not provide depth into the source and types of discrimination, such as racial/ethnic, gender-based, age, etc. The goal of this study was to assess the unique patterns, types, and sources of discrimination experiences that college students face and explore the role these experiences play in their mental health. Methods: An explanatory sequential mixed-methods study was utilized. Quantitative assessment of college students from a Hispanic and minority-serving institution was conducted to evaluate experiences of discrimination and its association to physical health and mental health (including psychological distress), as well as food insecurity, a marker for poverty. Next, qualitative data were thematically analyzed to further provide an in depth understanding on the sources of such experiences, types of discriminations, as well as the impact on mental health. Results: Results of the quantitative assessment highlight that discrimination was prevalent among the population with a higher everyday discrimination score significantly associated with serious psychological distress, low mental health status, low physical health status, and being food insecure. Further, most of the participants reported that they felt discriminated due to their appearance, with race/ethnicity and skin color as next most commonly cited reasons. Qualitative assessment further demonstrates distinct types of discrimination experiences from a variety of sources. Within a family, colorism and having an American accent while speaking a native language was a predominant source, while among peers, having a non-American accent was a primary source of discrimination experiences. Such experiences based on elitism, gender, and age (being younger) from the workplace were prevalent among the target population. Finally, feelings of isolation, not belonging, as well as negative impact on self-efficacy and self-worth were noted. Conclusion: Experiences of discrimination are prevalent among college students, including from within family and peers. To improve mental health outcomes of such a population, campus-based measures are needed to promote resiliency and social support, as well as community-based initiatives to promote workplace training to create inclusive environments for younger generations entering the workforce.

Background: Tobacco smoke has been associated with negative health outcomes, including those with chronic respiratory illnesses, such as asthma. This study aimed to assess the relationship between exposure to environmental tobacco smoke (ETS), as well as tobacco use (cigarette and electronic cigarettes), on asthma severity among adults with current asthma, with stratification by sex to understand potential biological sex differences. Methods: The study population consisted of Californian adults 18 years or older with self-reported physician/health care diagnosis of asthma and still having current asthma from 2020 California Health Interview Survey. All descriptive statistics and analyses were sex-stratified and survey-weighted. Crosstabulations were used to understand the association between asthma attack and ETS or firsthand smoke exposure, while binary logistic regression models were used to assess the effect of ETS exposure, current smoking status, and control variables on asthma attack in the past 12 months, with a sub-analysis among non-smoking adults with asthma. Results: Among the primary variable of interest, 35% of males and 30% of females reported ETS exposure in the past 12 months, while 13% of males and 6% of females reported being a current smoker. Past year asthma attack was reported among 43% and 55% of males and females, respectively. Among males, after adjusting for all control variables, asthma attack was significantly higher among those with ETS exposure (OR: 1.75, 95% CI: 1.01–3.02) and among current smokers (OR: 3.82, 95% CI: 1.49, 9.81). Male non-smokers with ETS exposure had a 109% higher odds of asthma attack, compared to non-exposure individuals. Conclusion: Using a population-based survey, our results highlight the ongoing burden of tobacco use and exposure particularly among males with current asthma, further corroborate the literature on the relationship between tobacco and asthma, and highlight putative sex-specific outcomes.