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Examines how 1980 Census data can be used in: (1) estimating Hispanic Americans' health care needs; (2) identifying Hispanic subgroups with special health care problems; and (3) designing other local social surveys of Hispanics. Discusses problems in using census data for Hispanic health services research, and explores strategies for dealing with such problems. (Author/MJL)

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.

The aim of this study was to examine perceptions including knowledge, attitudes, and beliefs about e-cigarettes among ethno-culturally diverse Latino adults living in the US, a rapidly growing minority group for which we know little about their e-cigarette perceptions. A total of 25 focus groups with Latinos (n = 180; ages 18–64 years) were conducted in 2014. E-cigarettes users and non-users were recruited via purposive sampling techniques. Participants completed brief questionnaires on sociodemographic factors and tobacco use. Focus group discussions were conducted in English and Spanish, audio-recorded, and transcribed. Data were analyzed using thematic analysis procedures. Participants were of diverse Latino backgrounds. Over one-third (35%) reported current cigarette smoking and 8% reported current e-cigarette or hookah use. Nonsmokers reported experimenting with e-cigarettes and hookah during social occasions. Participants' perceptions towards e-cigarettes were generally formed in comparison to conventional cigarettes. Perceived benefits of using e-cigarettes included their utility as a smoking cessation aid, higher social acceptability, and lower harm compared to conventional cigarettes. Negative perceptions of e-cigarettes included lower overall satisfaction compared to conventional cigarettes and high content of toxins. Socio-cultural factors (e.g. gender roles, familismo, and simpatía) also influenced perceptions of e-cigarette of study participants. Overall, Latino adults knew relatively little about the potential health risks associated with e-cigarette use. The limited knowledge about and misinformation of e-cigarettes among this rapidly growing minority group have important public health implications. Findings may inform culturally tailored health communication campaigns, which are much needed among underserved US Latino populations in light of low effectiveness of tobacco control and regulatory efforts. [ABSTRACT FROM AUTHOR]

Inclusion of historically underrepresented populations in biomedical research is critical for large precision medicine research initiatives. Among 13,721 Hispanic Community Health Study/Study of Latinos (HCHS/SOL) enrollees, we used multivariable-adjusted prevalence ratios to describe characteristics associated with participants' willingness to consent to different levels of biospecimen and genetic data analysis and sharing. At baseline (2008-2011), HCHS/SOL participants almost universally consented to the use of biospecimens and genetic data by study investigators and their collaborators (97.6%; 95%CI: 97.1, 98.0). Fewer consented to biospecimen and genetic data sharing with investigators not affiliated with the HCHS/SOL research team (81%, 95%CI: 80, 82) or any data sharing with commercial/for-profit entities (75%, 95%CI: 74, 76). Those refusing to share their data beyond the study investigators group were more often females, Spanish language-speakers and non-US born individuals. As expected, participants who were retained and reconsented at the six-year follow up visit tended to embrace broader data sharing, although this varied by group. Over time, Puerto Ricans and Dominicans were more likely to convert to broader data sharing than individuals of a Mexican background. Our analysis suggests that acculturation and immigration status of specific Hispanic/Latino communities may influence decisions about participation in genomic research projects and biobanks. [ABSTRACT FROM AUTHOR]

We aimed to examine the retention of Hispanics/Latinos participating in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a prospective cohort study of 16,415 adults in 4 US cities who were enrolled between 2008 and 2011. We summarized retention strategies and examined contact, response, and participation rates over 5 years of annual follow-up interviews. We then evaluated motivations for participation and satisfaction with retention efforts among participants who completed a second in-person interview approximately 6 years after their baseline interview. Finally, we conducted logistic regression analyses estimating associations of demographic, health, and interview characteristics at study visit 1 (baseline) with participation, high motivation, and high satisfaction at visit 2. Across 5 years, the HCHS/SOL maintained contact, response, and participation rates over 80%. The most difficult Hispanic/Latino populations to retain included young, single, US-born males with less than a high school education. At visit 2, we found high rates of motivation and satisfaction. HCHS/SOL participants primarily sought to help their community and learn more about their health. High rates of retention of Hispanics/Latinos can be facilitated through the employment of bilingual/bicultural staff and the development of culturally tailored retention materials. [ABSTRACT FROM AUTHOR]

The relationship between loneliness and both cardiovascular disease (CVD) and diabetes mellitus (DM) has been understudied in U.S. Hispanics, a group at high risk for DM. We examined whether loneliness was associated with CVD and DM, and whether age, sex, marital status, and years in U.S moderated these associations. Participants were 5,313 adults (M (SD) age = 42.39 (15.01)) enrolled in the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study. Loneliness was assessed via the 3-item Revised UCLA Loneliness Scale. Level of reported loneliness was low. Loneliness was significantly associated with CVD: OR 1.10 (CI 1.01–1.20) and DM: OR 1.08 (CI 1.00–1.16) after adjusting for depression, demographics, body mass index, and smoking status. Age, sex, marital status, and years in U.S. did not moderate associations. Given that increased loneliness is associated with higher cardiometabolic disease prevalence beyond depressive symptoms, regardless of age, sex, marital status, or years in the U.S., Hispanic adults experiencing high levels of loneliness may be a subgroup at particularly elevated risk for CVD and DM. [ABSTRACT FROM AUTHOR]

Objective(s): Cross-sectional and longitudinal studies have yielded inconsistent findings on the associations of social support networks with cardiovascular health in Hispanic/Latino adults with diabetes. We examined the cross-sectional associations of structural social support and traditional cardiovascular disease (CVD) risk factors in a diverse sample of Hispanic/Latino adults with diabetes. Research Design and Methods: This analysis included 2994 adult participants ages 18-74 with diabetes from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL - 2008-2011). Select items from the Social Network Inventory (SNI) were used to assess indices of structural social support, i.e. network size (number of children, parents, and in-laws) and frequency of familial contact. Standardized methods were used to measure abdominal obesity, BMI, hypertension, hypercholesterolemia, and smoking status. Multivariate regression was used to examine associations of structural support with individual CVD risk factors with demographics, acculturation, physical health, and psychological ill-being (depressive symptoms and anxiety) included as covariates. Results: There were no significant cross-sectional associations of structural support indices with abdominal obesity, hypertension, hypercholesterolemia, or smoking status. There was a marginally significant (OR: 1.05; 95%CI 0.99-1.11) trend toward higher odds of obesity in participants reporting a larger family unit (including children, parents, and in-laws) and those with closer ties with extended family relatives (OR: 1.04; 95%CI 0.99-1.09). Conclusions: Structural social support was marginally associated with higher odds of obesity in Hispanic/Latino adults with diabetes. Alternate forms of social support (e.g. healthcare professionals, friends, peers) should be further explored as potential markers of cardiac risk in Hispanics/Latinos with diabetes. [ABSTRACT FROM AUTHOR]

Objective: To determine whether, after adjustment for glycemia and other selected covariates, hemoglobin A1c (HbA1c) differed among adults from six Hispanic/Latino heritage groups (Central American, Cuban, Dominican, Mexican, Puerto Rican, and South American) and between Hispanic/Latino and non-Hispanic white adults without self-reported diabetes.Research Design and Methods: We performed a cross-sectional analysis of data from 13,083 individuals without self-reported diabetes from six Hispanic/Latino heritage groups, enrolled from 2008 to 2011 in the Hispanic Community Health Study/Study of Latinos, and 2,242 non-Hispanic white adults enrolled during the 2007-2012 cycles of the National Health and Nutrition Examination Survey. We compared HbA1c levels among Hispanics/Latinos and between Hispanics/Latinos and non-Hispanic whites before and after adjustment for age, sex, fasting (FPG) and 2-h post-oral glucose tolerance test (2hPG) glucose, anthropometric measurements, and selected biochemical and hematologic variables and after stratification by diabetes status: unrecognized diabetes (FPG ≥7.1 mmol/L or 2hPG ≥11.2 mmol/L), prediabetes (FPG 5.6-7.0 mmol/L or 2hPG 7.8-11.1 mmol/L), and normal glucose tolerance (FPG <5.6 mmol/L and 2hPG <7.8 mmol/L).Results: Adjusted mean HbA1c differed significantly across all seven groups (P < 0.001). Non-Hispanic whites had significantly lower HbA1c (P < 0.05) than each individual Hispanic/Latino heritage group. Upon stratification by diabetes status, statistically significant differences (P < 0.001) in adjusted mean HbA1c persisted across all seven groups.Conclusions: HbA1c differs among Hispanics/Latinos of diverse heritage groups and between non-Hispanic whites and Hispanics/Latinos after adjustment for glycemia and other covariates. The clinical significance of these differences is unknown. [ABSTRACT FROM AUTHOR]

The article focuses on a research in which researchers analyses the prevalence of major cardiovascular diseases (CVD) risk factors and CVD (coronary heart disease [CHD] and stroke) among U.S. Hispanic or Latino individuals of different backgrounds. The researchers analyzed the adverse CVD risk factors defined using national guidelines for hypercholesterolemia, hypertension, obesity, diabetes, and smoking. They found that age-standardized prevalence of CVD risk factors varied by Hispanic or Latino background. The study showed that obesity and current smoking rates were the highest among Puerto Rican participants and hypercholesterolemia prevalence was highest among Central American men and Puerto Rican women.

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. Individuals with "metabolically healthy obesity" (MHO) phenotype (i.e., obesity and absence of cardiometabolic abnormalities: favorable levels of blood pressure, lipids, and glucose) experience lower risk of cardiovascular disease compared with those with "metabolically at-risk obesity" (MAO) phenotype (i.e., obesity with concurrent cardiometabolic abnormalities). Among Hispanic/Latino women and men with obesity, limited data exist on the correlates of and body composition measures associated with obesity phenotypes. Methods. Data from the Hispanic Community Health Study/Study of Latinos (2008–2011) were used to estimate the age-adjusted distribution of obesity phenotypes among 5,426 women and men (aged 20–74 years) with obesity (BMI ≥ 30 kg/m2) and to compare characteristics between individuals with MHO and MAO phenotypes. Weighted Poisson regression models were used to examine cross-sectional associations between 1-standard deviation (SD) increase in body composition measures (i.e., body fat percentage, waist circumference, and body lean mass) and MHO phenotype prevalence. Results. The age-adjusted proportion of the MHO phenotype was low (i.e., 12.5% in women and 6.5% in men). In bivariate analyses, women and men with the MHO phenotype were more likely to be younger, have higher education and acculturation levels, report lower lifetime cigarette use, and have fasting insulin and waist circumference levels than MAO. Adjusting for sociodemographic and lifestyle factors, among women, each 1-SD increase in body fat percentage, waist circumference, and lean body mass was, respectively, associated with a 21%, 33%, and 31% lower prevalence of the MHO phenotype. Among men, each 1-SD increase in waist circumference and lean body mass was, respectively, associated with a 20% and 15% lower prevalence of the MHO phenotype. Conclusions. We demonstrated that higher waist circumference and higher lean body mass were independently associated with a lower proportion of the MHO phenotype in Hispanic/Latino women and men. Findings support the need for weight reduction interventions to manage cardiometabolic health among Hispanics/Latinos. [ABSTRACT FROM AUTHOR]

The objectives of this analysis were to compare the ability of fasting plasma glucose (FPG), post oral load plasma glucose (2hPG), and hemoglobin A1c (HbA1c) to identify U.S. Hispanic/Latino individuals with prediabetes, and to assess its cardiovascular risk factor correlates. This is a cross-sectional analysis of baseline data from 15,507 adults without self-reported diabetes mellitus from six Hispanic/Latino heritage groups, enrolled in the Hispanic Community Health Study/Study of Latinos, which takes place in four U.S. communities. The prevalence of prediabetes was determined according to individual or combinations of ADA-defined cut points: FPG=5.6-7.0mmol/L, 2hPG=7.8-11.1mmol/L, and HbA1c=5.7%-6.4% (39-46mmol/mol). The sensitivity of these criteria to detect prediabetes was estimated. The prevalence ratios (PRs) for selected cardiovascular risk factors were compared among alternative categories of prediabetes versus normoglycemia [FPG<5.6mmol/L and 2hPG<7.8mmol/L and HbA1c<5.7% (39mmol/mol)]. Approximately 36% of individuals met any of the ADA prediabetes criteria. Using 2hPG as the gold standard, the sensitivity of FPG was 40.1%, HbA1c was 45.6%, and that of HbA1c+FPG was 62.2%. The number of significant PRs for cardiovascular risk factors was higher among individuals with isolated 2hPG=7.8-11.1mmol/L, FPG=5.6-7.0mmol/L+HbA1c=5.7%-6.4%, or those who met the three prediabetes criteria. Assessing FPG, HbA1c, and cardiovascular risk factors in Hispanics/Latinos at risk might enhance the early prevention of diabetes mellitus and cardiovascular complications in this young and growing population, independent of their heritage group. [ABSTRACT FROM AUTHOR]

Studies show that cardiovascular disease (CVD) risk factors are correlated with psychological distress, yet research examining these relationships among Hispanic/Latinos is lacking. The population-based Hispanic Community Health Study/Study of Latinos enrolled a cohort of Hispanic/Latino adults (N=16,415) 18-74years of age at the time of recruitment, from four US metropolitan areas, between March 2008 and June 2011. Psychological distress (i.e., 10-item Center for Epidemiological Studies Depression Scale, 10 item Spielberger Trait Anxiety Scale, and a combined depression/anxiety score), socio-demographics (i.e., age, education, income, insurance, sex, and Hispanic/Latino background), acculturation (i.e., country of birth and language preference), and traditional CVD risk factors (i.e., dyslipidemia, obesity, current cigarette smoking, diabetes, and hypertension) were assessed at baseline. Associations between CVD risk factors and psychological distress measures by sex were examined using multiple linear regression models, accounting for complex survey design and sampling weights and controlling for socio-demographic and acculturation covariates. In adjusted analyses, all three psychological distress measures were significantly related to smoking. For females, greater psychological distress was significantly related to obesity and current smoking. For males, diabetes and current smoking were associated with psychological distress. For males and females, dyslipidemia and hypertension were not associated with psychological distress after adjusting for other factors. Elevated depression and anxiety symptoms were associated with CVD risk factors for Hispanic/Latino men and women. However, these results were not consistent across Hispanic/Latino groups. As promoted by the integrative care model, psychosocial concerns should be considered in research on CVD risk and chronic disease prevention. [ABSTRACT FROM AUTHOR]