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Objectives: To determine the rates and risk factors associated with hip fractures in the community-dwelling older Mexican-American population., Design: A prospective survey of a regional probability sample of older Mexican Americans aged 65 and over., Setting: The 1993-1996 Hispanic Established Population for the Epidemiologic Study of the Elderly (H-EPESE), a probability sample of noninstitutionalized Mexican Americans, aged 65 and over, living in the Southwestern states of Texas, New Mexico, Colorado, Arizona, and California., Participants: In 1993-1994 and in 1995-1996, 2895 persons, aged 65 and over, considered Mexican American, were selected at baseline as a weighted probability sample. Sample weights were used to extrapolate to the estimated 498,176 older Mexican Americans residing in the Southwest US., Measurements: Self-reported hip fracture and functional measures by in home interviews., Results: Hip fracture prevalence was 4.0% at baseline. The overall incidence of hip fractures for women was 9.1 fractures/1000 person-years. The incidence rate for men was 4.8 fractures/1000 person-years. Extrapolation from these data to the entire older Mexican American population indicated that approximately 5162 new fractures occurred in the population during the 2 year study period. In women, hip fractures were associated independently with advanced age, not being married/living alone, having had a stroke, limitations with activities of daily living and instrumental activities of daily living. In men, only the latter limitations were associated independently with hip fracture., Conclusions: This study indicates that older Mexican American people may have hip fracture incidence rates that place them at highest risk among the Hispanic subgroups. In light of a sparse literature on this population, the fracture estimates derived from this work contributes to our understanding of the true fracture estimates in this population. Based on the extrapolated population rates, hip fracture in this population is a significant public health problem. Adequate preventive measures need to be implemented in this growing US population.

Objective: To determine the 10-year changes in blood pressure and cardiovascular risk factors among older Mexican-Americans., Design: Comparative analyses of the Hispanic Health and Nutrition Examination Survey (HHANES) and the Hispanic EPESE (Established Populations for Epidemiologic Studies of the Elderly). Both of these were population-based studies using a multistage stratified probability sampling design of noninstitutionalized persons., Setting: Five US states in the southwest: Arizona, California, Colorado, New Mexico, and Texas., Participants: A total of 216 Mexican-Americans aged 65 to 74 from the 1982-1984 HHANES and 3050 Mexican-Americans aged 65+ from the 1993-1994 Hispanic EPESE., Measurements: Mean systolic and diastolic blood pressure; cigarette smoking; high levels of alcohol use; body mass index and obesity; self-reported heart attack, stroke, and diabetes; hypertension., Results: Among 65- to 74-year-old Mexican-Americans, there was a decrease over time in the percent of those who smoked cigarettes from 27.60% to 13.96% and a decrease in mean systolic blood pressure level. The percent of subjects categorized as obese or severely obese increased significantly, as did the prevalence of diagnosed diabetes, increasing from 20.06% in 1982-1984 to 29.82% in 1993-1994. Mean diastolic blood pressure increased from 77.15 mm Hg in 1982-1984 to 81.21 mm Hg in 1993-1994., Conclusions: Our findings suggest major changes in cardiovascular risk factors between 1982-1984 and 1993-1994 among older Mexican-Americans.

This study examined the effects of religious attendance on three dimensions of psychological well-being using panel data from a three-generations study of Mexican Americans from Texas (N = 624). Well-being dimensions included life satisfaction (the 13-item LSIA), and respective seven- and four-item depressed and positive affect subscales of the CES-D. Two-wave path analyses revealed a cross-sectional association between religious attendance and life satisfaction in the two oldest generations, and a salutary longitudinal effect of religious attendance on subsequent depressed affect in the youngest generation. Findings for life satisfaction and depressed affect withstood controlling for health and five sociodemographic correlates of religious attendance and well-being.

Previous studies have demonstrated a strong association between breastfeeding incidence and ethnic background, indicating the presence of strong cultural influences on infant-feeding patterns within ethnic groups. This study analyzed the relationship of acculturation into the United States, one aspect of ethnicity, to the initiation of breastfeeding among a sample of 213 women recruited approximately 2 months prenatally in the United States-Mexico border city of Brownsville, Texas. An in-depth, structured interview was conducted at that time (n = 213), at the time of birth (n = 207), and 2 to 3 weeks postnatally (n = 206). In addition, male partners of the mothers were interviewed prenatally when available (n = 119). Acculturation scores and demographic characteristics were tested relative to breastfeeding initiation. The degree of acculturation, age, and marital status were associated significantly with breastfeeding initiation (with breastfeeding continued at 2 to 3 weeks postnatally), but occupational status, education, and income were not. Breastfeeding incidence was highest among older, married, or low-acculturated, Anglo mothers. These data suggest that women being assimilated into the United States are inhibited in the initiation of breastfeeding. These findings suggest that to be successful, intervention programs to increase breastfeeding incidence must consider the cultural adaptation of different groups as they meld with the larger population.

Determinants of physician utilization were examined using a three-generational sample of Mexican-Americans in San Antonio. A typical version of Andersen's causal behavioral model was moderately successful in predicting physician utilization in the middle and older generations and less successful in the younger generation. Consistent with the literature, need factors (health indicators) tended to affect utilization most directly. The authors also examined whether acculturation into the larger society positively influenced utilization regardless of need, as the literature suggested. While three separate measures of acculturation had no independent effects on physician utilization, acculturation did affect utilization indirectly via the need variables in the middle generation, although these effects were not consistently in the direction of greater utilization. Generational differences in determinants of physician utilization are discussed particularly in relation to the model's greater relevance for the middle and older generations.

A set of double jeopardy hypotheses predicting there is a double health disadvantage in growing old and being a member of an ethnic minority, female, of lower socioeconomic status, and unmarried is tested with data from a 4-yr longitudinal study of older Mexican Americans and Anglos. With the exception of socioeconomic status, little support is found for the double jeopardy predictions in a multivariate analysis of change in health. When subjects who died during the study interval were included in the analysis by assigning them the lowest score on health, the results changed somewhat: the relationship between age and decline in health was strengthened and the effect of sex changed from a direction suggesting that women show greater declines in health with age to a direction suggesting that men experience greater declines in health with age. Implications of the effect of decreased dropouts for studies on aging and health are discussed.

Smoking behavior was investigated with data from a three-generation study of Mexican Americans in San Antonio, Texas. Rates of smoking among the men were found to be higher than rates for other White men obtained in previous studies, while rates for women were slightly lower than those reported for other White women. However, the percentage of light smokers was considerably higher among Mexican Americans than among other groups. There was no evidence that acculturation was a consistent predictor of greater likelihood of smoking. However, there was evidence that the smoking behavior of younger Mexican Americans, particularly the women, was associated with the smoking behavior of their parents.

Results are presented from the Galveston Low Birthweight Survey (GLOWBS) Study, a tri-ethnic survey (N = 1,179) of live, single births, conducted in Galveston, Texas, from 1986 to 1987. Four principal findings emerged pointing to a persistent black risk for low birthweight (less than 2,500g). First, black infants (2,997g) have significantly lower mean birthweight than either Anglos (3,281g) or Hispanics (3,270g). Second, blacks are at significantly higher risk of low birthweight than nonblacks (risk ratio = 1.71). Third, despite controlling for a variety of pregnancy- and health-related, psychosocial, socioeconomic, and health services factors (including even gestational length), being black still exerts a significant, inverse effect on birthweight (beta = -0.137). Fourth, of the above factors only gestational length (R2 = 0.39) accounts for more than a negligible amount of the total variance in birthweight among blacks. These findings are discussed, and several lines of follow-up research are proposed.

The distribution of depressive symptoms and rates of high depressive symptomatology are examined with data from a three-generation study of 1,074 Mexican Americans conducted in San Antonio, Texas, during 1981 and 1982. The purpose of this analysis is to contribute to the available data on the mental health status of Mexican Americans as well as to compare the effects of several relevant sociodemographic factors on prevalence of depressive symptoms as measured by the Center for Epidemiologic Studies Depression Scale in different generations. In general, previous findings with respect to the associations between sociodemographic variables and depressive symptoms are replicated, although this sample of Mexican Americans experiences comparatively low levels of depressive symptoms, particularly among males. However, the results indicate that interaction effects may exist between generations and other relevant variables typically found to be related to distribution of depressive symptoms in the general population.

A path analysis model of life satisfaction is proposed and applied to data from interviews with 141 persons aged 60 years and over. Predictor variables examined are self-reported health, income, education and an activity index. The analysis was conducted separately for the two sexes. Health and activityemerge as strong predictors of life satisfaction while income influences life satisfaction indirectly via activity. The importance of investigating direct and indirect effects of variables via path analysis is discussed.

The negative health consequences of alcohol consumption are well established. The present study examines whether alcohol consumption is also associated with a series of self-reported physical symptoms. Analyses were performed on data from a three-generation study of Mexican Americans. Using four measures of alcohol consumption we found that alcohol consumption was related to physical symptoms only in the younger generation. While drinking levels in the older generation did not have sufficient variance to enable the assessment of their effects on symptoms, drinking levels in the middle generation were comparable to those in the younger generation. We hypothesized that the lack of association in the middle generation may reflect increased tolerance due to longer exposure to alcohol, to possible reduction of alcohol consumption by some middle-aged persons because of health problems, and to due possible removal from observation of certain middle-aged men whose heavy drinking led to health problems. Although alcohol consumption in the younger generation was not strongly associated with either psychosomatic or infectious symptoms, it was strongly related to upper respiratory symptoms among younger males. Among younger women, alcohol consumption was moderately related to physical symptoms with no symptom constellation having a particularly strong association with alcohol consumption.

Data from a three-generation study of Mexican Americans conducted in the San Antonio, Texas area are utilized to examine the influence of acculturation into the larger society on alcohol consumption. Acculturation was not related to alcohol consumption in the older generation. In the middle generation, it was related to lower alcohol consumption among men, as well as among women. In the younger generation, acculturation was related to more drinking among women, but not among men. Within-family analysis showed that the alcohol consumption of members of the younger generation was associated with the consumption of their parents, particularly in the case of younger women.