Journal of immigrant health最新文献

Nontraditional health care resources available to Mexican Americans are many. The Mexican culture is rich with alternative health and illness beliefs and remedies which have their origins in ancient Mestizo/Indian folklore which viewed the causes of illness to include social, spiritual, and physical forces. This perception calls for culturally relevant folk practitioners who can treat all aspects of the perceived illness. This study of 70-Mexican American women explored their knowledge of and use of alternative Mexican folk medical practitioners in their own health maintenance. Results provided some evidence that, even among highly assimilated Mexican American women, there persist traditional, indigenous beliefs, and practices.

Acculturation is typically defined in terms of individual responses to a dominant culture. In the present study, we examined the effects of different levels of acculturation among family members. Specifically, we looked at the health and risk behavior in Mexican-American children as related to a variety of psychosocial predictors, especially the differences in orientation toward Mexican- and Anglo-American cultures between them and their parents. Mother and child pairs (n = 106) noted their orientation toward both Anglo and Mexican cultures. Children's dietary and sedentary behaviors, tobacco and alcohol use (and susceptibility to use), and depressive symptoms were also measured. Males were more likely to be sedentary and consume higher levels of total fat and saturated fat, whereas girls reported higher levels of depression. Anglo-oriented youth consumed lower levels of calories from fat but also more alcohol than did their Mexican-oriented counterparts. The latter was particularly the case among those children who were relatively more Anglo oriented than were their parents. Parent-child acculturation differential in terms of the differences in Mexican orientation, in comparison, predicted susceptibility to tobacco use. However, the sum of the absolute values of these two differences predicted only lifetime alcohol use, and in a counter-intuitive direction. This familial measure of acculturation shows some promise, but additional formative research is needed to operationalize this construct.

Foreign-born women and, in particular, Hispanic foreign-born women, are less likely to have insurance, are less likely to have insurance that covers prenatal care, and are less likely to utilize prenatal care compared with US-born Hispanic women. Significant concern has been raised regarding the ability of immigrant women to access prenatal care services because of severe restrictions imposed on immigrants' eligibility for Medicaid-funded services following the passage in 1996 of the federal Personal Responsibility and Work Opportunity Reform Act (PRWORA) and the Illegal Immigration Reform and Immigrant Responsibility Act (IIRAIRA). We conducted an interview-based study of prenatal care utilization with women of Mexican ethnicity and diverse immigration statuses in San Diego County, California. Our findings indicate that, despite increased levels of fear associated with recent immigration and with undocumented status, there were no statistically significant differences across immigration statuses in length of time to receipt of medical care for gynecological events and for prenatal care.

Debilitating mental illness is treatable if found. There is no validated self-administered mental illness evaluation tool for immigrant Hispanic farm workers with variable literacy levels. This study tested sensitivity and specificity of an audiotaped survey developed for low literacy levels compared with standard interview instruments. Subjects from 11 migrant camps completed a self-administered audiotaped survey in Spanish to diagnose major depression, substance abuse, panic and generalized anxiety, and domestic violence. Primary care clinics assisted in finding camps and provided follow-up treatment. For 154 men and 156 women, the audio tool was most sensitive for major depression and specific for anxiety disorder, alcohol abuse, and domestic violence. Seventy percent of those diagnosed with major depression received appropriate treatment. This study validated an inexpensive, self-administered audio tool to evaluate the mental health of immigrant Hispanic farm workers with a wide range of literacy levels.

Immigration scholars have demonstrated the increasing importance of transnational activities among contemporary immigrants. While much of the previous research has emphasized social and economic outcomes, very little attention has been paid to psychological well-being or mental health. Using a community sample of West Indian immigrants, we developed an empirical measure of the nature and frequency of transnational practices. The resulting Transnationalism Scale is examined for psychometric properties using an exploratory principal components factor analysis, and bivariate correlations with pre-existing measures of psychological well-being, perceived social support, and ethnic identity. Results reveal five factors, some of which are significantly correlated with measures of psychological well-being, social support, and ethnic identity. Findings suggest that transnationalism, as a construct, is a valid measure for this population. We argue that transnational ties shape various aspects of immigrants' lives.

Post-immigration adjustment is affected by demographic and health characteristics, as well as national resources. Since 1989, more than a million people emigrated from the former Soviet Union (FSU) to the United States and Israel. These countries differ substantially in health systems and immigrant benefits. The purpose of this study is to compare depressed mood between midlife women from the FSU who reside in the United States and Israel, controlling for demographic and health characteristics. The analysis includes 72 women, 36 from each country, who comprise subsets of larger studies and were matched on age and years since immigration. Women were aged 42-70, and immigrated fewer than 8 years prior to recruitment. Using multiple regression analyses it was found that living in the United States, having lower self-reported health status, and having arthritis predicted higher depression scores. Future cross-national interdisciplinary research should be directed toward identifying specific contextual factors that will guide interventions and influence health policy for new immigrants.

The number of Latinos in North Carolina grew by almost 400% between 1990 and 2000. The rapid change in demographics in this state and other southeastern states has caught healthcare providers unprepared. Lack of ability to communicate with Latino patients may result in errors in diagnosis or reduced compliance with recommended treatments. The Culturally and Linguistically Appropriate Services (CLAS) Standards, published in 2001, mandate culturally and linguistically appropriate services for persons with limited English proficiency. This paper describes an innovative strategy to promote Spanish and culture-learning skills of healthcare providers and presents results of the evaluation conducted to determine its impact on access to quality care. The evaluation used a 360 degrees case study design, at 1-year follow-up. Use of Spanish language health-related materials is key to the training's success. The authors make recommendations for replication of the integrated language and culture-training model in other new settlement areas, especially those in the southeast of the United States.

The disproportionate impact of HIV/AIDS on Hispanic women in the United States has been variously attributed to a failure to utilize protective measures due to low levels of HIV knowledge, a denial or minimization of risk, and conflicts with cultural norms. It has been hypothesized that women's relative lack of power in relationships may be associated with higher risk sexual behavior. We examined the relationship between higher risk sexual behavior and perceived locus of control in sexual relationships among a sample of Puerto Rican and Mexican women. We interviewed 71 women of self-reported Mexican ethnicity in San Diego, California, and 79 women of self-reported Puerto Rican ethnicity in Cleveland, Ohio, to examine the relationship between HIV risk, HIV knowledge, and locus of control. Univariate logistic regression indicates that among Puerto Rican women, the perception that locus of control in a sexual relationship resides in the male partner was significantly associated with increased HIV risk, while younger age was significantly associated with increased risk among Mexican women only. In a combined sample of both Puerto Rican and Mexican women, multiple logistic regression analysis indicates that younger age, increased length of residence in the United States, and an other-focused locus of control are significantly associated with increased HIV risk. Women who have been in the United States for relatively longer periods of time may be more likely to integrate U.S. sexual norms into their own behavior and may, as a consequence, be at higher risk of HIV infection. Increased HIV prevention efforts must be made available to Mexican and Puerto Rican women born outside of the United States. These prevention efforts must necessarily focus not only on HIV prevention strategies, but also on the dynamics within male-female intimate relations. Increased attention to younger Puerto Rican and Mexican women is also needed.

Survivors of torture are very likely to have been beaten repeatedly around the head. Apparent brief losses of consciousness are not uncommon following torture, and they may be associated with signs that suggest temporal lobe epilepsy (TLE). The relative risk of developing posttraumatic seizures (PTS) is increased by about 50% after a single head injury involving a brief loss of consciousness. It is 2.9 if that loss of consciousness lasts for more than about 30 min. Thus, patients who have been tortured are at increased risk of seizures. TLE is difficult to diagnose and needs specialist investigations, and other conditions that are not uncommon in survivors of torture, such as panic attacks, posttraumatic stress disorder, dissociation, and syncope can all present with similar pictures. This paper addresses the differential diagnosis of posttraumatic epilepsy in survivors of torture.

The aim of this was to examine rates and determinants of depressive symptomatology in the immediate postpartum period among Hispanic women in the United States. A total of 3952 Hispanic women who had delivered infants (parturients) were interviewed in postpartum wards in Miami, New York City and San Francisco. Symptoms of depression were regressed onto a series of social, psychological, and socioeconomic variables. Results showed that 42.6% of participants were probable cases of depression (CES-D > or = 16). Depression was negatively associated with perceived level of social support (adjusted OR = 0.59, 95% CI: 0.53-0.67) and health insurance coverage (adjusted OR = 0.68, 95% CI: 0.49-0.95), but not with the degree of acculturation or immigration status. It was found that depressive symptoms are common among Hispanic parturients. Pregnant Hispanic women should be carefully monitored for signs of depression and appropriate preventive measures are needed.