ACCULTURATION AND LATINO HEALTH IN THE UNITED STATES: A Review of the Literature and its Sociopolitical Context

Lara, Marielena; Gamboa, Cristina; Kahramanian, M. Iya; Morales, Leo S.; Bautista, David E. Hayes

doi:10.1146/annurev.publhealth.26.021304.144615

Cited by 1,310 publications

(1,328 citation statements)

References 149 publications

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“…We were only able to draw comparisons in rates between Latinos, Euro-Americans, and African Americans due to the literature generally lacking adherence investigations in other ethnic groups. The US Latino population is quite heterogeneous both culturally and in important indicators of population health (24, 28). Many of these studies were conducted with Mexican-Americans and VA populations, so the results are likely not applicable to all Latino communities living in the United States.…”

Section: Discussionmentioning

confidence: 99%

Psychotropic Medication Nonadherence Among United States Latinos: A Comprehensive Literature Review

Lanouette¹,

Folsom²,

Sciolla³

et al. 2009

Psychiatric Services

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Objective Psychotropic medication nonadherence is a major public health problem, but few studies have focused on Latinos. We systematically reviewed the literature on rates of and factors influencing antipsychotic, antidepressant, or mood stabilizer nonadherence among United States (US) Latinos. Methods Data Sources: MEDLINE and PsycINFO were searched using keywords adherence, compliance, Latino, Hispanic, psychotropic, and related terms, as well as bibliographies from relevant reviews and studies. Study Selection: 21 studies met inclusion criteria: published since 1980 in English or Spanish; measured psychotropic medication nonadherence rates among US Latino adults. Data Abstraction: We examined articles for study design and objective, location, population, medication type, participant demographics, adherence measure, adherence rates, and factors related to adherence. Results and Conclusions In studies including Latinos and other ethnic groups, mean nonadherence rates were 41%, 31%, and 43% among Latinos, Euro-Americans, and African Americans respectively, with an overall effect size of 0.64 between Latinos and Euro-Americans. In studies including only Latinos, the mean nonadherence rate was 44%. Ten of 16 studies found Latinos had significantly lower adherence rates than Euro-Americans. Risk factors for nonadherence included being monolingual Spanish speaking, lacking health insurance, experiencing barriers to quality care, and having lower socioeconomic status. Protective factors included family support and psychotherapy. Rates of nonadherence to psychotropic medications were higher for Latinos than for Euro-Americans. Further investigation is needed into the potentially modifiable individual and societal level mechanisms of this discrepancy. Clinical and research interventions to improve adherence should be culturally appropriate and incorporate identified factors.

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Section: Discussionmentioning

confidence: 99%

Psychotropic Medication Nonadherence Among United States Latinos: A Comprehensive Literature Review

Lanouette¹,

Folsom²,

Sciolla³

et al. 2009

Psychiatric Services

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“…Acculturation can be defined as "the acquisition of the cultural elements of the dominant society" (Lara, Gamboa, Kahramanian, Morales, & Bautista, 2005), including norms, values, ideas and behaviors. Since acculturation is an intangible process, researchers often rely on English-language proficiency as a proxy for cultural integration into U.S. society (Blank & Torrechila, 1998).…”

Section: Acculturation Enculturation and The Bicultural Model Of Adamentioning

confidence: 99%

“…For example, bicultural individuals (those who have both acculturated to the dominant culture and retained ethnic identity through enculturation) may be able to contend with the demands of both cultures, leading to better mental health (LaFromboise, Coleman, & Gerton, 1993). Both the acquisition of U.S. cultural norms and values related to acculturation (Lara et al, 2005) and the maintenance of native cultural values, or enculturation, have been hypothesized to be linked to the mental health outcomes of different ethnic groups such as Native Americans, Asians and Latinos (Kim & Ominzo, 2006).…”

Section: Acculturation Enculturation and The Bicultural Model Of Adamentioning

confidence: 99%

Understanding differences in past year psychiatric disorders for Latinos living in the US

Alegrı́a

Shrout

Woo

et al. 2007

Social Science & Medicine

221

239

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This study seeks to identify risk factors for psychiatric disorders that may explain differences in nativity effects among adult Latinos in the USA. We evaluate whether factors related to the processes of acculturation and enculturation, immigration factors, family stressors and supports, contextual factors, and social status in the U.S. account for differences in twelve-month prevalence of psychiatric disorders for eight subgroups of Latinos. We report results that differentiate Latino respondents by country of origin and age at immigration (whether they were U.S.-born or arrived before age 6 [IUSC] or whether they arrived after age 6 [LAI]). After age and gender adjustments, LAI Mexicans and IUSC Cubans reported a significantly lower prevalence of depressive disorders than IUSC Mexicans. Once we adjust for differences in family stressors, contextual factors and social status factors, these differences are no longer significant. The risk for anxiety disorders appears no different for LAI Correspondence to: Margarita Alegria. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access Author ManuscriptSoc Sci Med. Author manuscript; available in PMC 2008 July 1. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript compared to IUSC Latinos, after age and gender adjustments. For substance use disorders, family factors do not offset the elevated risk of early exposure to neighborhood disadvantage, but coming to the U.S. after age 25 does offset it. Family conflict and burden were consistently related to the risk of mood disorders. Our findings suggest that successful adaptation into the U.S. is a multidimensional process that includes maintenance of family harmony, integration in advantageous U.S. neighborhoods, and positive perceptions of social standing. Our results uncover that nativity may be a less important independent risk factor for current psychiatric morbidity than originally thought.

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“…Nevertheless, inclusion of additional variables such as income and health-care access serve to strengthen the proxy measures through contextualisation (62,63) .…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Predictors of trying to lose weight among overweight and obese Mexican-Americans: a signal detection analysis

Bersamin

Hanni

Winkleby

2009

Public Health Nutr.

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Objective: Signal detection analysis, a form of recursive partitioning, was used to identify combinations of sociodemographic and acculturation factors that predict trying to lose weight in a community-based sample of 957 overweight and obese Mexican-American adults (ages 18-69 years). Design: Data were pooled from the 2004 and 2006 Behavioral Risk Factor Surveillance System conducted in a low-income, semi-rural community in California. Results: Overall, 59 % of the population reported trying to lose weight. The proportion of adults who were trying to lose weight was highly variable across the seven mutually exclusive groups identified by signal detection (range 30-79 %). Significant predictors of trying to lose weight included BMI, gender, age and income. Women who were very overweight (BMI . 28?5 kg/m 2 ) were most likely to be trying to lose weight (79 %), followed by very overweight higher-income men and moderately overweight (BMI 5 25?0-28?5 kg/m 2 ) higher-income women (72 % and 70 %, respectively). Moderately overweight men, aged 28-69 years, were the least likely to be trying to lose weight (30 %), followed by moderately overweight lower-income women (47 %) and very overweight lower-income men (49 %). The latter group is of particular concern since they have characteristics associated with medical complications of obesity (low education and poor access to medical care). Conclusions: Our findings highlight opportunities and challenges for public health professionals working with overweight Mexican-American adults -particularly lower-income adults who were born in Mexico -who are not trying to lose weight and are therefore at high risk for obesity-related co-morbidities. Keywords Signal detection analysisMexican-Americans Weight lossThe high prevalence of obesity among Mexican-Americans is a major public health concern. Recent estimates indicate that more than 75 % of Mexican-American adults in the USA are overweight or obese -less than 25 % are at a healthy, normal weight (1) . These statistics may be a gauge of poor access to and/or lack of effective weightloss strategies and are a stark reminder of how much more progress is needed to reach the Healthy People 2010 target goal of increasing the proportion of adults at a healthy weight to 60 % (2) . Despite the well-recognised benefits of intentional weight loss among overweight and obese individuals (3)(4)(5)(6)(7) , less than 60 % of overweight and obese Latinos are currently trying to lose weight (8) ; this may be an indicator of a low level of readiness for weight loss and therefore has important implications for the success of weight-loss interventions. While previous studies have examined sociodemographic and acculturative correlates of obesity (9,10) and individual responses to weight-loss interventions (11) , few studies (8,12) have examined sociodemographic and acculturative factors in relation to trying to lose weight. To our knowledge none of these studies have examined interactions between these factors or focused on Latino populations,...

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ACCULTURATION AND LATINO HEALTH IN THE UNITED STATES: A Review of the Literature and its Sociopolitical Context

Cited by 1,310 publications

References 149 publications

Psychotropic Medication Nonadherence Among United States Latinos: A Comprehensive Literature Review

Psychotropic Medication Nonadherence Among United States Latinos: A Comprehensive Literature Review

Understanding differences in past year psychiatric disorders for Latinos living in the US

Predictors of trying to lose weight among overweight and obese Mexican-Americans: a signal detection analysis

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