Journal of immigrant health最新文献

The study was conducted to investigate the impact of an Interpreter Service on intensity of Emergency Department (ED) services, utilization, and charges. This study describes the effects of language barriers on health care service delivery for the index ED visit and a subsequent 90-day period. In all 26,573 ED records from July to November, 1999, resulted in a data set of 500 patients with similar demographic characteristics, chief complaint, acuity, and admission rate. Noninterpreted patients (NIPs) who did not speak English had the shortest ED stay (LOS) and the fewest tests, IVs and medications; English-speaking patients had the most ED services, LOS, and charges. Subsequent clinic utilization was lowest for NIPs. Among discharged patients, return ED visit and ED visit charges were lowest for interpreted patients (IPs). Use of trained interpreters was associated with increased intensity of ED services, reduced ED return rate, increased clinic utilization, and lower 30-day charges, without any simultaneous increase in LOS or cost of visit.

Mothers of 8-16-month-old infants were surveyed to examine infant feeding practices and maternal dietary intake associated with increased years of residency by Mexican immigrant families (n = 1093 mother-infant pairs). Mothers were recruited from San Diego and Contra Costa counties in California during 1992-93. Twenty-nine percent of Mexican mothers living in the United States for <6 years breastfed their infants exclusively for at least 16 weeks; only 20% of mothers living in the United States between 6 and 15 years and 17% of mothers residing in the United States for over 15 years engaged in exclusive breastfeeding. Neither breastfeeding duration nor the introduction of solids differed by years of residency. In contrast, maternal dietary intake varied markedly. Second generation mothers and those living in the United States the longest had significantly higher intakes of vegetables, low fat milk, salty snacks, animal protein, and cereals. Beyond early caregiving practices, the influence of years of residency on the diets of toddlers is less than that of the mothers.

The objective of the study was to develop a culturally relevant video and a pamphlet for use as a cervical cancer screening educational intervention among North-American Chinese women. The project conducted 87 qualitative interviews and nine focus groups to develop a culturally tailored intervention to improve Pap testing rates. The intervention consisted of an educational/motivational video, a pamphlet, and home visits. Less acculturated Chinese women draw on a rich tradition of herbal knowledge and folk practices historically based on Chinese medical theory, now mixed with new information from the media and popular culture. The video, the pamphlet, and the outreach workers knowledge base were designed using these results and combined with biomedical information to address potential obstacles to Pap testing. Culturally relevant information for reproductive health promotion was easily retrieved through qualitative interviews and used to create educational materials modeling the integration of Pap testing into Chinese women's health practices.

The purpose of this paper was to review the literature on Hispanic populations to outline: 1) demographics; 2) general health status; 3) cervical cancer incidence and mortality; 4) Pap smear screening rates; and 5) barriers to preventive care services. The methods: MEDLINE, Med66, Med75, and Med85 files, from 1966 to 1999, were searched for key words Hispanic health, cervical cancer and Hispanics, cervical cancer and Mexico, migrants and health, agricultural occupational health, farmworkers and cancer, and farmworker health. AGRICOLA (1982-98) was searched for key words farmworker health, agricultural workers and health, and agriculture and cancer. The results show that Hispanic immigrant women may have cervical cancer incidence rates ranging between the California rates for 1991-93 (19.8/100,000) and for Mexico in 1990 (115-220 per 100,000). Mortality rates for the same periods were 3.9/100,000 and 16.11/100,000 respectively. While survey results report Hispanic Pap smear rates above 70%, these surveys count urban women who do not share the barriers to care experienced by poor rural Hispanics. Since validated self-reports of survey responses are 20-50% lower than reported lower rates and Pap smear screening persist in Hispanic Pap evaluations and are reflected in higher morbidity and mortality from cervical cancer. That targeted community interventions have been successful in raising Pap smear rates among poor Spanish-speaking women. Such interventions should be a priority for preventive health care policy and practice.

An increasing body of literature documenting what has become known as "the Epidemiological Paradox" has shown that some immigrant groups to the United States tend to have healthier birth outcomes than would be expected given their sociodemographic profiles. Furthermore, the children of these immigrants do not seem to enjoy the same advantage in reproductive health that their parents did. This phenomenon, though amply documented in the literature, has not been sufficiently explained. We investigate the role of assimilation in this paradox, and we do so within a spatial framework. We examine the effect of residence in a Mexican enclave in the attenuation of risk of low birth weight (LBW) for Mexican-origin mothers in San Diego County, California. We find that Mexican-origin women do seem to enjoy a reduced risk of giving birth to an LBW baby when they live in a Mexican enclave.

The purpose of this study was to test the reliability and validity of a brief language usage scale as a measure of acculturation in 197 Central American immigrant women. This study presents an analysis of cross-sectional survey data collected during face-to-face interviews conducted in Spanish as part of the program evaluation of the Infant Feeding for Hispanic Supplemental Nutrition Program for Women, Infants, and Children (WIC) Populations a Peer Education Model. The Short Acculturation Scale, a four-item language usage scale exploring the participants' language preferences, was used as a measure of acculturation. The participant's age, length of time in the United States, and perceived social support for breastfeeding were used as validation measures. Results demonstrated good internal reliability for the acculturation summary scale. Consistent with previous studies, significant correlations (p < 0.01) were found between acculturation and mother's age, perceived social support for breastfeeding, and mother's length of time in the United States. The reliability and validity data from this group of Central American immigrants support the continued use of this brief measure of acculturation in diverse Latino subpopulations when multidimensional measures are neither practical nor feasible.

The last two decades have been marked by substantial immigration to the United States. As a result of this movement, the foreign-born population is growing rapidly. Previous studies have shown that the foreign-born population is much more likely than the native-born one to be without health insurance. The present analysis focuses on factors that distinguish the insured from the uninsured, utilizing nativity status (foreign born versus native born) as one of the independent variables in a set of logistic regression models. Results show that even after controlling for income, employment status, and other variables known to be associated with health insurance status, the foreign born are twice as likely to be without health insurance than are their native-born counterparts. Among the foreign born, recency of arrival emerges as an important factor in distinguishing the insured from the uninsured. Public policies intended to address the problem of health insurance in the foreign-born population must go beyond being based only on economic considerations and take into account factors such as cultural background and health-related attitudes to be effective.

An empirical measure of East Asian ethnic identity was developed and evaluated. One hundred and fifty nonclinical East Asian immigrants (75 males and 75 females) were administered the East Asian Ethnic Identity Scale (EAEIS) and a psychometrically established measure of self-construal. Satisfactory reliability is reported for the overall EAEIS as well as its three factor analytically derived scales, including family values, ethnic pride (language, sense of belonging), and interpersonal distance. While EAEIS and independent self-construal were not associated, individuals who endorsed EAEIS were more likely to report an interdependent self-construal. The findings suggest that the EAEIS may be a useful tool for researchers and clinicians to investigate potentially important themes and individual differences in the experiences of East Asian immigrants.

AIDS has a disproportionate effect on persons of Latino origin, who have lower knowledge of AIDS than other ethnic groups. This study assessed AIDS knowledge among Latino adults in New Jersey according to acculturation and socioeconomic status. Data on 121 Latino adults were collected in spring 2000 using bilingual telephone interviews. Respondents were selected using the Census' Latino surname methodology. Items were adapted from the National Health Interview Survey Supplement on AIDS Knowledge and Attitudes and the Marin acculturation scale. AIDS knowledge was more strongly associated with language exposure than with self-assessed English or Spanish language abilities. Low educational attainment and bilingual language exposure were associated with lower AIDS knowledge; when other factors were controlled, place of schooling, length of time in the United States, age and gender were not statistically significant. Transmission of HIV via casual contact was widely misunderstood, but general facts about AIDS and likely means of HIV transmission were well known. AIDS education materials should be designed in both English and Spanish and should take into account the lower educational attainment of recent Latino immigrants.