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AimsTo examine among Hispanics in the U.S., a population with increased reliance on informal healthcare support structures, (1) the association between cognitive function and control of diabetes; and (2) whether this association is modified by family support.MethodsThe Digit Symbol Substitution Test (DSST), word fluency, and learning and delayed recall components of the Spanish English Verbal Learning Test were administered to 1794 Hispanic adults aged 45-76years with diagnosed diabetes. An executive function index and global cognitive function index (GCFI) were derived. Uncontrolled diabetes (HbA1c⩾7% [53mmol/mol]) was compared across quartiles of cognitive function using multivariable logit models with interaction terms for cognitive function and family support.ResultsAfter adjustment, lower DSST scores were associated with uncontrolled diabetes (P=0.03). Family support modified the relationship between other measures of cognition and diabetes control (Pinteraction: 0.002, 0.09). Among individuals with low family support, as cognitive function declined, the odds of uncontrolled diabetes increased (P-trend across quartiles of the GCFI, 0.015). Among those with low family support, persons in the lowest quartile of global cognitive function were more than twice as likely to have uncontrolled diabetes as those in the highest performing quartile (OR=2.31; 95% CI: 1.17, 4.55). There was no similar effect among those with high family support.ConclusionsFamily support may buffer the negative association between low cognitive functioning and diabetes control in US Hispanics/Latinos. Educational programs targeted at family members of middle-age and older persons with diabetes regardless of neurocognitive status may help improve population-level glycemic control.

BackgroundPrior national surveys capture smoking behaviors of the aggregated U.S. Hispanic/Latino population, possibly obscuring subgroup variation.PurposeTo describe cigarette use among Hispanic/Latino adults across subgroups of age, gender, national background, SES, birthplace, and degree of acculturation to the dominant U.S. culture.MethodsA cross-sectional survey of 16,322 participants in the Hispanic Community Health Study/Study of Latinos aged 18-74 years, recruited in Bronx NY, Chicago IL, Miami FL, and San Diego CA, was conducted during 2008-2011.ResultsPrevalence of current smoking was highest among Puerto Ricans (men, 35.0%; women, 32.6%) and Cubans (men, 31.3%; women, 21.9%), with particularly high smoking intensity noted among Cubans as measured by pack-years and cigarettes/day. Dominicans had the lowest smoking prevalence (men, 11.0%; women, 11.7%). Individuals of other national backgrounds had a smoking prevalence that was intermediate between these groups, and typically higher among men than women. Non-daily smoking was common, particularly although not exclusively among young men of Mexican background. Persons of low SES were more likely to smoke, less likely to have quit smoking, and less frequently used over-the-counter quit aids compared to those with higher income and education levels. Smoking was more common among individuals who were born in the U.S. and had a higher level of acculturation to the dominant U.S. culture, particularly among women.ConclusionsSmoking behaviors vary widely across Hispanic/Latino groups in the U.S., with a high prevalence of smoking among population subgroups with specific, readily identifiable characteristics.

Sociocultural risk and protective factors for developing the metabolic syndrome (MetS), a risk factor for cardiovascular disease (CVD), have not been well studied in Hispanics/Latinos residing in the United States (U.S.). Religiosity and/or spirituality (R/S), important aspects of Hispanic/Latino culture, have been inversely associated with CVD and multiple CVD risk factors. Cross-sectional associations between dimensions of R/S and prevalent MetS, and its five individual components were examined using multiple logistic and linear regression, among 3278 U.S., middle-aged and older Hispanic/Latino adults from the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study. Dimensions of R/S were not associated with presence of the MetS. Certain dimensions of Spiritual Well-being (Meaning, Peace, Faith), and frequency of non-organizational religious activity were weakly but significantly associated with one or more MetS components including waist circumference, diastolic blood pressure, and systolic blood pressure. R/S variables were not associated with triglycerides, fasting glucose or HDL cholesterol levels. Prospective, longitudinal studies are needed to gain a deeper understanding of the nature of the relationship between R/S and health risk factors in U.S. Hispanics/Latinos., Author(s): Carrie E. Brintz [sup.1] , Orit Birnbaum-Weitzman [sup.2] , Maria M. Llabre [sup.2] , Sheila F. Castañeda [sup.3] , Martha L. Daviglus [sup.4] , Linda C. Gallo [sup.5] , [...]

OBJECTIVE: We investigated associations of living in a doubled-up household (i.e., adults living with adult children, other related adults, or other unrelated adults) with diabetes self-management behaviors, occurrence of diabetes preventive care services, and hospital use by Hispanic/Latino adults with diabetes. RESEARCH DESIGN AND METHODS: We analyzed data from the second clinical visit (2014–2017) through subsequent annual follow-up interviews completed through January 2020 of all participants with diabetes in the Hispanic Community Health Study/Study of Latinos. Multivariable regression was used to test associations between doubled-up status with diabetes self-management behaviors (i.e., checking blood glucose level, checking feet for sores), diabetes preventive care services done by a doctor (i.e., dilated-eye examination, feet checked, hemoglobin A1c measured, urine analysis for kidney function), and hospital use (i.e., emergency department [ED] visits and hospitalizations). RESULTS: Hispanic/Latino adults living doubled up were less likely to have their urine checked by a doctor for kidney disease compared with adults not in doubled-up households. Doubled-up status was not associated with diabetes self-management behaviors. Adults living doubled up in a household with other related adults had a 33% increased risk of ED visits compared with adults living doubled up in a household with adult children. CONCLUSIONS: Health care settings where Hispanic/Latino adults with diabetes receive trusted care should add housing characteristics such as doubled-up status to social-needs screening to identify residents in need of connecting with housing or social services and more targeted diabetes management services. [ABSTRACT FROM AUTHOR]

INTRODUCTION Youth are at risk for tobacco use, and previous research has pointed to increased vulnerabilities associated with sexual minority identity. For example, LGB youth have increased odds for using tobacco than their heterosexual peers, and bisexual youth have higher odds of smoking than other sexual identity groups. As new tobacco products proliferate and health risks from dual/poly use grow, increased understanding of tobacco use patterns by sexual minority youth is needed. METHODS For 3117 youth, aged 13-18 years, who completed an online questionnaire in 2017 and identified their sexual orientation [minority (e.g. lesbian/gay, bisexual, or pansexual) vs majority (heterosexual)] and gender, we classified current tobacco use into four categories: e-cigarette only, other product only (such as cigarette, cigar, or smokeless tobacco; not an e-cigarette), dual/poly use, and no use. Analyses were conducted separately for male and female participants. Multinomial logistic regression was employed. RESULTS Female sexual minority youth had nearly twofold odds of dual/poly tobacco use (OR=1.95; 95% CI: 1.12-3.40), compared to their heterosexual counterparts. For male youth, sexual minority identification was not significantly associated with dual/poly use. No significant differences were found in sexual minority and heterosexual youth e-cigarette only or other tobacco only use groups. Tobacco use patterns also significantly differed by age, race, place of residence, and parental education level. CONCLUSIONS Study findings reveal greater odds of dual/poly tobacco use for female sexual minority youth. Tailored tobacco prevention and cessation programs or interventions are needed for sexual minority youth most at risk of tobacco use, especially multiple product use. [ABSTRACT FROM AUTHOR]

INTRODUCTION Despite decreases in the overall US smoking rate, tobacco use remains more common in some areas and by some groups. Deeper understanding of group differences is needed in order to tailor public health campaigns to the interests, perceptions and experiences of targeted audiences. Although some differences have been identified across African American and Caucasian smokers in the United States, additional insight is needed regarding factors that differentiate these groups. This study examined tobaccorelated perceptions and practices, with an emphasis on identifying differences across African American and Caucasian smokers. Toward this goal, we examined key demographic variables of race and age, and tobacco use characteristics. METHODS The sample consisted of 284 people from the Jackson, Mississippi area who participated in focus groups and completed surveys addressing a variety of tobaccorelated topics, including knowledge and perceptions of products as well as use and health information seeking behavior. The selection criteria and recruitment approach ensured a balance across race (black, white), age (18-34, >35 years), sex, and cigarette smoking status (current, former, never). Statistical analyses were performed using SAS (v.9.4). RESULTS Differences were observed across demographic subgroups regarding type and pattern of tobacco products used (e.g. mentholated, markers of nicotine dependence, hookah). Differences in preferred sources of health information based on age as well as perceptions of risk as a function of age, smoking status and race were also noted. Exposure to secondhand smoke and perceptions of its risks, quitting efforts and cessation methods differed by race. CONCLUSIONS Study findings suggest key differences across important subgroups. Knowledge of such differences has the potential to improve strategic public health messaging, allowing health campaigns to more effectively prevent tobacco product uptake as well as promote interest in quitting tobacco. [ABSTRACT FROM AUTHOR]

Abstract: The 1980 Census data provide a valuable resource for health services research on Hispanics. Hispanics are the fastest growing minority group in the United States and yet there is a paucity of large-scale empirical research on their health care and access needs. This paper describes how the census can assist in: 1) estimating the overall health care needs of this group. 2) identifying target groups within the Hispanic population who may have special health care problems (e.g., children, elderly, pregnant women. etc.); and 3) using other data sources to improve the quality of studies carried out on Hispanics. It also discusses problems in using the census for Hispanic health services research and some strategies for dealing with these problems. [ABSTRACT FROM AUTHOR]

Background: Cigarette smoking has been reported to be high among Lesbian, Gay, Bisexual, Transgendered and Queer (LGBTQ) populations. However, in-depth information on perception, knowledge, attitudes and behaviors, is limited. Methods: We analyzed 2016 data from the AHA-Tobacco Regulatory Addiction Center (A-TRAC) study on multi-ethnic LGBTQ groups living primarily in Chicago and New York City, ages 18-64, smokers and non-smokers. Twenty-nine focus groups and 99 individual surveys were conducted to obtain socio-demographic-economic characteristic and in-depth information on tobacco use, including cigarette smoking. Atlas.ti and SAS 9.4 were used for data analyses. Results: Of 99 participants, 58.8% of LGBTQ individuals reported smoking 100+ cigarettes during their life time; 49.5% (n=49) reported current cigarette smoking; and 17% reported frequent or occasional use of e-cigarette, e-hookah and/or other types of vaping. Age (25+) and low household income (<$20,000) were significantly associated with the use of cigarette smoking. While 70.2% stated that cigarette smoking is very dangerous to health and 43.2% of respondents said that tobacco use is a very serious problem in the LGBTQ community, current smokers were unlikely to quit smoking (67%). Focus group discussions revealed that smoking a cigarette is a form of stress relief, a way of "expressing yourself", and a way of "fitting in". Heavy marketing by the tobacco industry as well as stress associated with social discrimination, family and friend rejections and limited income, were also factors identified with tobacco use. These findings were particularly true among transgender women and bisexual men and women. Conclusions: Cigarette smoking was high among the LGBTQ individuals in our sample and they seems unlikely to quit. Social stressors appear to be a strong contributing factor. Educational efforts and culturally appropriate messages to this population, are critical. [ABSTRACT FROM AUTHOR]