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Few reliable estimates have been available for assessing the impact of the COVID-19 pandemic on mortality among Native Americans. Using deidentified publicly available data on deaths and populations by age, we estimated life expectancy for the years 2019-2022 for single-race non-Hispanic Native Americans. Life expectancy in 2022 was 67.8 years, 2.3 years higher than in 2021 but a huge 4-year loss from 2019. Although our life expectancy estimates for 2022 varied under different assumptions about racial/ethnic classification and age misreporting errors, all estimates were lower than the average for middle-income countries. Estimates of losses and gains in life expectancy were consistent across assumptions. Large reductions in COVID-19 death rates between 2021 and 2022 were largely offset by increases in rates of death from unintentional injuries (particularly drug overdoses), chronic liver disease, diabetes, and heart disease, underscoring the difficulties facing Native Americans in achieving reductions in mortality, let alone returning to levels of mortality prior to the pandemic. Serious data problems have persisted for many years, but the scarcity and inadequacy of estimates during the pandemic have underscored the urgent need for timely and accurate demographic data on the Native American population. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has had overwhelming global impacts with deleterious social, economic, and health consequences. To assess the COVID-19 death toll, researchers have estimated declines in 2020 life expectancy at birth (e0). When data are available only for COVID-19 deaths, but not for deaths from other causes, the risks of dying from COVID-19 are typically assumed to be independent of those from other causes. In this research note, we explore the soundness of this assumption using data from the United States and Brazil, the countries with the largest number of reported COVID-19 deaths. We use three methods: one estimates the difference between 2019 and 2020 life tables and therefore does not require the assumption of independence, and the other two assume independence to simulate scenarios in which COVID-19 mortality is added to 2019 death rates or is eliminated from 2020 rates. Our results reveal that COVID-19 is not independent of other causes of death. The assumption of independence can lead to either an overestimate (Brazil) or an underestimate (United States) of the decline in e0, depending on how the number of other reported causes of death changed in 2020. [ABSTRACT FROM AUTHOR]

COVID-19 has resulted in a staggering death toll in the United States: over 215,000 by mid-October 2020, according to the Centers for Disease Control and Prevention. Black and Latino Americans have experienced a disproportionate burden of COVID-19 morbidity and mortality, reflecting persistent structural inequalities that increase risk of exposure to COVID-19 and mortality risk for those infected. We estimate life expectancy at birth and at age 65 y for 2020, for the total US population and by race and ethnicity, using four scenarios of deaths--one in which the COVID-19 pandemic had not occurred and three including COVID-19 mortality projections produced by the Institute for Health Metrics and Evaluation. Our medium estimate indicates a reduction in US life expectancy at birth of 1.13 y to 77.48 y, lower than any year since 2003. We also project a 0.87-y reduction in life expectancy at age 65 y. The Black and Latino populations are estimated to experience declines in life expectancy at birth of 2.10 and 3.05 y, respectively, both of which are several times the 0.68-y reduction for Whites. These projections imply an increase of nearly 40% in the Black-White life expectancy gap, from 3.6 y to over 5 y, thereby eliminating progress made in reducing this differential since 2006. Latinos, who have consistently experienced lower mortality thanWhites (a phenomenon known as the Latino or Hispanic paradox), would see their more than 3-y survival advantage reduced to less than 1 y. [ABSTRACT FROM AUTHOR]

Objective: We compare physical performance from three U.S. national surveys and nationally representative surveys in England, Taiwan, and Costa Rica. Method: For each performance test, we use local mean smoothing to plot the age profiles by sex and survey wave and then fit a linear regression model to the pooled data, separately by sex, to test for significant differences across surveys controlling for age and height. Results: Age profiles of performance vary across U.S. surveys, but levels of lung function (peak expiratory flow) and handgrip strength in the United States are as high as they are in the other three countries. Americans also perform as well on the chair stand test as the English and Costa Ricans, if not better, but exhibit slower gait speed than the English at most ages. Discussion: With the exception of walking speed, we find little evidence that older Americans have worse physical performance than their peers. [ABSTRACT FROM AUTHOR]

We demonstrate widening socioeconomic disparities in perceived economic distress among Americans, characterized by increasing distress at the bottom and improved perceptions at the top of the socioeconomic ladder. We then assess the extent to which hardships related to the Great Recession account for the growing social disparity in economic distress. Based on the concept of loss aversion, we also test whether the psychological pain associated with a financial loss is greater than the perceived benefit of an equivalent gain. Analyses are based on longitudinal survey data from the Midlife Development in the US study. Results suggest that widening social disparities in perceived economic distress between the mid-2000s and mid-2010s are explained in part by differential exposure to hardships related to the Great Recession, the effects of which have lingered even four to five years after the recession officially ended. Yet, auxiliary analyses show that the socioeconomic disparities in economic distress widened by nearly as much (if not more) during the period from 1995–96 to 2004–05 as they did during the period in which the recession occurred, which suggests that the factors driving these trends may have already been in motion prior to the recession. Consistent with the loss aversion hypothesis, perceptions of financial strain appear to be somewhat more strongly affected by losses in income/assets than by gains, but the magnitude of the differentials are small and the results are not robust. Our findings paint a dismal portrait of a growing socioeconomic divide in economic distress throughout the period from the mid-1990s to the mid-2010s, although we cannot say whether these trends afflict all regions of the US equally. Spatial analysis of aggregate-level mortality and objective economic indicators could provide indirect evidence, but ultimately economic “despair” must be measured subjectively by asking people how they perceive their financial situations. [ABSTRACT FROM AUTHOR]

Objective: The increased risk for poor physical and mental health outcomes for older parents in Mexico who have an adult child living in the United States may contribute to an increased risk for cognitive impairment in this population. The objective of this study was to examine if older adults in Mexico who have one or more adult children living in the United States are more or less likely to develop cognitive impairment over an 11-year period compared to older adults who do not have any adult children living in the United States. Design: Data for this study came from Wave I (2001) and Wave III (2012) of the Mexican Health and Aging Study. The final sample included 2609 participants aged 60 and over who were not cognitively impaired in 2001 and had one or more adult children (age ≥15). Participants were matched using a propensity score that was estimated with a multivariable logistic regression model that included sociodemographic characteristics and migration history of the older parents. Results: Having one or more adult children living in the United States is associated with lower socioeconomic status and higher number of depressive symptoms, but greater social engagement for older parents living in Mexico. No significant differences in the odds for developing cognitive impairment according to having one or more adult children living in the United States were detected. Conclusion: In summary, having one or more adult children living in the United States was associated with characteristics that may increase and decrease the risk for cognitive impairment. This may contribute to the non-significant relationship between migration status of adult children and likelihood for cognitive impairment for older parents living in Mexico. [ABSTRACT FROM AUTHOR]

Persons of Mexican origin and some other Latino groups in the United States have experienced a survival advantage compared with their non-Latino White counterparts, a pattern known as the Latino, Hispanic, or epidemiological paradox. However, high rates of obesity and diabetes among Latinos relative to Whites and continued increases in the prevalence of these conditions suggest that this advantage may soon disappear. Other phenomena, including high rates of disability in the older Latino population compared with Whites, new evidence of health declines shortly after migration to the United States, increasing environmental stressors for immigrants, and high-risk values of inflammatory markers among Latinos compared with Whites support this prediction. One powerful counterargument, however, is substantially lower smoking-attributable mortality among Latinos. Still, it is questionable as to whether smoking behavior can counteract the many forces at play that may impede Latinos from experiencing future improvements in longevity on a par with Whites. [ABSTRACT FROM AUTHOR]

We use data from three rounds of the Mexican Family Life Survey to examine whether migrants in the United States returning to Mexico in the period 2005-2012 have worse health than those remaining in the United States. Despite extensive interest by demographers in health-related selection, this has been a neglected area of study in the literature on U.S.-Mexico migration, and the few results to date have been contradictory and inconclusive. Using five self-reported health variables collected while migrants resided in the United States and subsequent migration history, we find direct evidence of higher probabilities of return migration for Mexican migrants in poor health as well as lower probabilities of return for migrants with improving health. These findings are robust to the inclusion of potential confounders reflecting the migrants' demographic characteristics, economic situation, family ties, and origin and destination characteristics. We anticipate that in the coming decade, health may become an even more salient issue in migrants' decisions about returning to Mexico, given the recent expansion in access to health insurance in Mexico. [ABSTRACT FROM AUTHOR]

Although many studies have attempted to examine the consequences of Mexico-U.S. migration for Mexican immigrants' health, few have had adequate data to generate the appropriate comparisons. In this article, we use data from two waves of the Mexican Family Life Survey (MxFLS) to compare the health of current migrants from Mexico with those of earlier migrants and nonmigrants. Because the longitudinal data permit us to examine short-term changes in health status subsequent to the baseline survey for current migrants and for Mexican residents, as well as to control for the potential health selectivity of migrants, the results provide a clearer picture of the consequences of immigration for Mexican migrant health than have previous studies. Our findings demonstrate that current migrants are more likely to experience recent changes in health status-both improvements and declines-than either earlier migrants or nonmigrants. The net effect, however, is a decline in health for current migrants: compared with never migrants, the health of current migrants is much more likely to have declined in the year or two since migration and not significantly more likely to have improved. Thus, it appears that the migration process itself and/or the experiences of the immediate post-migration period detrimentally affect Mexican immigrants' health. [ABSTRACT FROM AUTHOR]

Abstract: We evaluated the association between two aspects of social relationships and six inflammatory markers in Taiwan and the U.S. These two countries share similar levels of current life expectancy, but exhibit important differences in social structure. The data comprised population based samples from Taiwan (aged 53+; n =962) and the U.S. (aged 35–86; n =990) collected between 2003 and 2009. Circulating levels of interleukin-6 (IL-6), C-reactive protein (CRP), fibrinogen, and soluble forms of intercellular adhesion molecule 1, E-selectin, and IL-6 receptor (sIL-6R) were measured in fasting blood samples. A social integration score was based on marital status, contact with family and friends, church attendance, and other social participation. A perceived social support index was based on questions regarding the availability of care and support from family and friends. Linear regression models tested the association between these two measures and each inflammatory marker controlling for sociodemographic characteristics, obesity, medication use, and baseline health status. After adjusting for potential confounders, social integration had a significant but weak inverse association with CRP in Taiwan. Perceived social support was significant in two of 12 models, and the coefficient was positive (i.e., higher support was associated with higher CRP and sIL-6R in the U.S.). We found no evidence that the coefficients for social relationship measures varied by sex or age. Our results yielded limited evidence of a weak association between two dimensions of social relationships and six inflammatory markers in Taiwan and the U.S. Given that the literature suggests a strong link between social relationships and mortality, and that inflammation plays an important role in the leading causes of death, we had expected to find consistent and moderately strong associations between social relationships and inflammatory markers. The small effect sizes and lack of robustness across markers were surprising. [Copyright &y& Elsevier]

Abstract: Over the course of the 20th century, Mexico-U.S. migration has emerged as an important facet of both countries, with far reaching economic and social impacts. The health of Mexican immigrants in the U.S. has been well studied, but relatively less is known about the health of returned migrants to Mexico. The objectives of this paper are twofold. Relying on health data pertaining to two stages of the life course, early life health (pre-migration) and adult health (post-migration) from the Mexican Migration Project gathered between 2007 and 2009, we aim to assess disparities in adult health status between male returned migrants and male non-migrants in Mexico, accounting for their potentially different early life health profiles. While we find evidence that returned migrants had more favorable early life health, the results for adult health are more complex. Returned migrants have a higher prevalence of heart disease, emotional/psychiatric disorders, obesity, and smoking than non-migrants but no differences are found in self-rated health, diabetes, or hypertension. [Copyright &y& Elsevier]

Abstract: Greater educational attainment is consistently associated with lower mortality and better health, a pattern known as the social gradient. However, recent research suggests that Mexican-origin adults in the US have weak or flat gradients, in contrast to steep gradients for non-Hispanic whites. In this study we evaluate one hypothesis for this finding: Is the relative weakness of education gradients in health behaviors observed among Mexican-origin adults in the US due to weak gradients in the sending population? We test this “imported gradients” hypothesis with data from two nationally-representative datasets: the US National Health Interview Survey (NHIS) and the Mexican National Health Survey (ENSA 2000). We compare education gradients in smoking and obesity for recently-arrived Mexican immigrants in the US to the corresponding gradients in high-migration regions of Mexico. Results partially support the imported gradients hypothesis and have implications for health education and promotion programs targeted to immigrant populations to reduce racial and ethnic disparities in health in the US. [Copyright &y& Elsevier]

Objectives. We used nationally representative longitudinal data from the Mexican Family Life Survey to determine whether recent migrants from Mexico to the United States are healthier than other Mexicans. Previous research has provided little scientific evidence that tests the "healthy migrant" hypothesis. Methods. Estimates were derived from logistic regressions of whether respondents moved to the United States between surveys in 2002 and 2005, by gender and urban versus rural residence. Covariates included physical health measurements, self-reported health, and education measured in 2002. Our primary sample comprised 6446 respondents aged 15 to 29 years. Results. Health significantly predicted subsequent migration among females and rural males. However, the associations were weak, few health indicators were statistically significant, and there was substantial variation in the estimates between males and females and between urban and rural dwellers. Conclusions. On the basis of recent data for Mexico, the largest source of migrants to the United States, we found generally weak support for the healthy migrant hypothesis. (Am J Public Health. 2008;98:78-84. doi:10.2105/AJPH.2006. 098418) [ABSTRACT FROM AUTHOR]

Abstract: Despite the health and survival advantages of Hispanics relative to non-Hispanic whites in the USA, Hispanics report themselves to be in worse health than whites. Prior research indicates that these ethnic differences in self-rated health (SRH), measured by a simple question asking individuals to assess their overall health status, persist in the presence of an extensive set of explanatory variables. In this paper we use data from the first wave of the Los Angeles Family and Neighborhood Survey (L.A.FANS-1) to test three hypotheses regarding Hispanic–white differences in SRH. We evaluate whether poorer health reports among Hispanics result from: (1) acculturation and language-related differences in reports; (2) measures of socioeconomic status (SES) that are often omitted in other studies; and (3) somatization of emotional distress by Hispanics. Our results provide new insights into the validity of these explanations and suggest avenues for future research. First, they underscore the importance of language of interview over other measures of acculturation, suggesting that translation issues between the Spanish and English versions of the SRH question may give rise to some of the differences. Second, adjustment for SES—especially years of schooling—narrows, but does not eliminate, the gap between whites’ and Hispanics’ SRH. Finally, although respondents who are depressed are more likely to report poor SRH, this study provides little evidence to support the somatization hypothesis. The second wave of L.A.FANS incorporates new questions that are likely to permit more in-depth assessments of these hypotheses in future analyses. [Copyright &y& Elsevier]

Objectives. This study examined socioeconomic differentials in mortality among Hispanics in the United States, focusing on the older ages. We address previous research suggesting that social disparities in health are smaller for Hispanics than for non-Hispanic Whites and examine whether these differentials in survival are related to the mortality advantage that characterizes the older Hispanic population (i.e., the Hispanic paradox). Methods. We used Poisson regression models based on data from the 1989 to 1994 waves of the National Health Interview Survey, with linked mortality through 1997, to estimate death rates for Hispanics and non-Hispanic Whites by age, gender, and socioeconomic status. Results. Deaths rates varied significantly (p < .05) by education and income for Whites and Hispanic subgroups defined by nativity (U.S. born and foreign born) and nationality (Mexican, Puerto Rican, and other Hispanic). However, with the exception of Puerto Ricans, the effects of education were significantly smaller for Hispanics than for Whites. The ethnic differences in mortality patterns by income were not statistically significant. Discussion. The findings reveal that the mortality advantage for Hispanics is concentrated at lower levels of socioeconomic status, with little or no advantage at higher levels. We propose several mechanisms related to immigration and assimilation patterns that may underlie these patterns of mortality. [ABSTRACT FROM AUTHOR]

Focuses on the views of the American Statistical Association (ASA) Technical Panel on the Census Undercount concerning Census Bureau procedures and plans in the fall of 1982 in the United States. Need for the panel to give technical advice on measurement and estimation problems; Proposals for handling undercount issue; Analytical methods for the Census counts.

A new interpretation of mathematical formulas developed by Keyfitz illustrates how the concept of entropy (H) can be applied to the analysis of marriage dissolution. The quantities H(divorce) and H(widowhood) indicate the changes in marriage duration which would result from small, constant changes in duration-specific divorce and widowhood rates, respectively. An examination of values for the United States, Nepal and Colombia illustrates the utility of H(i) in assessing the impact of changes in widowhood and divorce and clarifies the relationship between H and changes in life expectancy. [ABSTRACT FROM AUTHOR]

Using formulas which measure life cycle characteristics of widowhood as a function of life table survivorship and age at marriage, we illustrate changes in patterns of widowhood and widowerhood since 1950, as well as differences by race, by age of bride and of groom, and by age differences between spouses. Although the current inequality in the risks of widowhood and widowerhood for the average couple is mostly due to sex differences in mortality, a one year age difference between spouses has about the same impact as does a one year difference in life expectancy. Calculations based on current distributions of age of groom by age of bride indicate that the older the age of groom, the greater the age difference between spouses and the higher the likelihood of a woman outliving her husband: the typical groom who marries in his fifties faces a 4 to 1 chance that he will be outlived by his spouse. [ABSTRACT FROM AUTHOR]

Researchers often rely on respondents' self-rated health (SRH) to measure social disparities in health, but recent studies suggest that systematically different reporting styles across groups can yield misleading conclusions about disparities in SRH. In this study, we test whether this finding extends to ethnic differences in self-assessments of health in particular domains. We document differences between US-born whites and four Latino subgroups in respondents' assessments of health in six health domains using data from the second wave of the Los Angeles Family and Neighborhood Survey (N = 1468). We use both conventional methods and an approach that uses vignettes to adjust for differential reporting styles. Our results suggest that despite consistent evidence from the literature that Latinos tend to rate their overall health more poorly than whites, and that Latino immigrants report worse SRH than US-born Latinos, this pattern is not true of self-reports in individual health domains. We find that at the bivariate level, US-born whites (and often US-born Mexicans) have significantly more pessimistic reporting styles than Latino immigrants. After adding controls, we find evidence of significantly different reporting styles for only one domain: US-born Mexicans and whites consistently interpret head pain more severely than the other Latino subgroups. Finally, we find that both before and after adjusting for differences in rating styles across groups, non-Mexican Latino immigrants report better social and physical functioning and less pain than other groups. Our findings underscore the advantages of domain-specific ratings when evaluating ethnic differences in self-assessments of health. We encourage researchers studying social disparities in health to consider respondents' self-assessments in a variety of domains, and to also investigate (when possible) potential biases in their findings due to different reporting styles. The anchoring vignettes approach we use is one potential method for overcoming biases due to different rating styles across groups. [ABSTRACT FROM AUTHOR]

Large numbers of foreign-born residents in the United States mean that many people receive at least part of their education abroad. Despite this fact, our understanding of nativity differences in the success of adults and their children is based on research that does not empirically consider variation in the benefits to schooling depending on where it is received. We use data from the Los Angeles Family and Neighborhood Survey (L.A. FANS) to examine: (a) whether the socioeconomic and cognitive returns to education depend on whether it is received in the U.S. or abroad; and (b) whether schooling location partially accounts for nativity differences in these returns. We find that the returns to schooling are generally largest for adults who receive at least some of their highest level of education in the U.S. The beneficial effects of U.S. schooling are more pronounced at higher levels of educational attainment. Schooling location accounts for a sizeable fraction of the lower socioeconomic and cognitive returns of the foreign-born, relative to natives; some meaningful differences remain, however. In addition, the higher cognitive skills of the children of foreign-born adults remain unexplained. Although we cannot distinguish among the possible pathways underlying these associations (e.g., school quality, transferability of credentials, the timing of immigration) our findings suggest the importance of considering factors related to schooling location as predictors of socioeconomic and cognitive success in the United States. [Copyright &y& Elsevier]

This study examines changes in the sociodemographic patterns of deportation and voluntary return of undocumented immigrants from the United States to Mexico during three US presidential administrations (2001 to 2019) with different immigration policies. Most previous studies examining these migration flows for the United States as a whole have relied exclusively on counts of deportees and returnees, thereby ignoring changes over the past 20 y in the characteristics of the undocumented population itself, i.e., the population at risk of deportation or voluntary return. We estimate Poisson models based on two data sources that permit us to compare changes in the sex, age, education, and marital status distributions of both deportees and voluntary return migrants with the corresponding changes in the undocumented population during the Bush, Obama, and Trump administrations: the Migration Survey on the Borders of Mexico-North (Encuesta sobre Migración en las Fronteras de México-Norte) for counts of deportees and voluntary return migrants and the Current Population Survey's Annual Social and Economic Supplement for estimated counts of the undocumented population living in the United States. We find that whereas disparities by sociodemographic characteristics in the likelihood of deportation generally increased beginning in Obama's first term, sociodemographic disparities in the likelihood of voluntary return generally decreased over this period. Despite heightened antiimmigrant rhetoric during the Trump administration, the changes in deportation and voluntary return migration to Mexico among the undocumented during Trump's term were part of a trend that began early in the Obama administration.

COVID-19 had a huge mortality impact in the US in 2020 and accounted for most of the overall reduction in 2020 life expectancy at birth. There were also extensive racial/ethnic disparities in the mortality impact of COVID-19 in 2020, with the Black and Latino populations experiencing reductions in life expectancy at birth over twice as large as that of the White population. Despite continued vulnerability of these populations, the hope was that widespread distribution of effective vaccines would mitigate the overall mortality impact and reduce racial/ethnic disparities in 2021. In this study, we quantify the mortality impact of the COVID-19 pandemic on 2021 US period life expectancy by race and ethnicity and compare these impacts to those estimated for 2020. Our estimates indicate that racial/ethnic disparities have persisted, and that the US population experienced a decline in life expectancy at birth in 2021 of 2.2 years from 2019, 0.6 years more than estimated for 2020. The corresponding reductions estimated for the Black and Latino populations are slightly below twice that for Whites, suggesting smaller disparities than those in 2020. However, all groups experienced additional reductions in life expectancy at birth relative to 2020, and this apparent narrowing of disparities is primarily the result of Whites experiencing proportionately greater increases in mortality in 2021 compared with the corresponding increases in mortality for the Black and Latino populations in 2021. Estimated declines in life expectancy at age 65 increased slightly for Whites between 2020 and 2021 but decreased for both the Black and Latino populations, resulting in the same overall reduction (0.8 years) estimated for 2020 and 2021., Competing Interests: The authors have declared that no competing interests exist.

Researchers and journalists have argued that work-related factors may be partly responsible for disproportionate COVID-19 infection and death rates among vulnerable groups. We evaluate these issues by describing racial and ethnic differences in the likelihood of work-related exposure to COVID-19. We extend previous studies by considering 12 racial and ethnic groups and five types of potential occupational exposure to the virus: exposure to infection, physical proximity to others, face-to-face discussions, interactions with external customers and the public, and working indoors. Most importantly, we stratify our results by occupational standing, defined as the proportion of workers within each occupation with at least some college education. This measure serves as a proxy for whether workplaces and workers employ COVID-19-related risk reduction strategies. We use the 2018 American Community Survey to identify recent workers by occupation, and link 409 occupations to information on work context from the Occupational Information Network to identify potential COVID-related risk factors. We then examine the racial/ethnic distribution of all frontline workers and frontline workers at highest potential risk of COVID-19, by occupational standing and by sex. The results indicate that, contrary to expectation, White frontline workers are often overrepresented in high-risk jobs while Black and Latino frontline workers are generally underrepresented in these jobs. However, disaggregation of the results by occupational standing shows that, in contrast to Whites and several Asian groups, Latino and Black frontline workers are overrepresented in lower standing occupations overall and in lower standing occupations associated with high risk, and thus may be less likely to have adequate COVID-19 protections. Our findings suggest that greater work exposures likely contribute to a higher prevalence of COVID-19 among Latino and Black adults and underscore the need for measures to reduce potential exposure for workers in low standing occupations and for the development of programs outside the workplace., Competing Interests: The authors have declared that no competing interests exist.

Latinos in the US live significantly longer than non-Latino whites, but spend more years disabled. Differentials in socioeconomic status account for part, but not all, of the difference in older age disability between Latinos and whites. We hypothesize that a factor often ignored in the literature-the fact that Latinos, on average, have more physically strenuous jobs than non-Latino whites-contributes to the higher Latino risk of functional limitations at older ages. We use longitudinal data from the 1998-2014 Health and Retirement Study (HRS) comprising 17,297 respondents. Compared to US-born whites, Latinos, especially Latino immigrants, report substantially higher levels of physical effort at work. Latino-black differences are much smaller than Latino-white differences. As hypothesized, physical work effort is strongly related to functional limitations. However, differentials in physical work effort for Latinos and whites in their fifties and early sixties are weakly related to Latino-white differentials in FL at later ages., Competing Interests: The authors have declared that no competing interests exist.

Background: The disproportionate burden of more aggressive breast cancer subtypes among African American/Black women may stem from multilevel determinants. However, data are limited regarding the impacts of neighborhood social environmental characteristics among Black women., Methods: We evaluated the association between neighborhood-level socioeconomic status (nSES) and breast cancer subtypes in the Women's Circle of Health and Women's Circle of Health Follow-up Study, which included 1,220 Black women diagnosed from 2005 to 2017 with invasive breast cancer. nSES at diagnosis was measured using NCI's census tract-level SES index. We used multilevel multinomial logistic regression models to estimate the association of nSES with breast cancer subtypes [triple-negative breast cancer (TNBC), HER2-positive vs. luminal A], adjusting for individual-level SES, body mass index, and reproductive factors. We tested for interactions by neighborhood racial composition., Results: Compared with census tracts characterized as high nSES, the relative risk ratios (RRR) for TNBC were 1.81 [95% confidence interval (CI): 1.20-2.71] and 1.95 (95% CI: 1.27-2.99) for women residing in areas with intermediate and low nSES, respectively ( P trend = 0.002). Neighborhood racial composition modified the association between nSES and TNBC; the highest relative risk of TNBC was among women residing in low nSES areas with low proportions of Black residents., Conclusions: Black women residing in socioeconomically disadvantaged neighborhoods may have an increased risk of TNBC, particularly in areas with lower proportions of Black residents., Impact: Places people live may influence breast tumor biology. A deeper understanding of multilevel pathways contributing to tumor biology is needed., (©2020 American Association for Cancer Research.)

Background: Foreign-born women have heavier infants than US-born women, but it is unclear whether this advantage persists across generations for all races and ethnicities., Methods: Using 1971-2015 Florida birth records, we linked records of female infants within families to assess intergenerational changes in birthweight and prevalence of low birthweight by grandmother's race/ethnicity and foreign-born status. We also assessed educational gradients in low birthweight in two generations., Results: Compared with daughters of US-born black women, daughters of foreign-born black women had substantially higher birthweights (3,199 vs. 3,083 g) and lower prevalence of low birthweight (7.8% vs. 11.8%). Daughters of foreign-born Hispanic women had moderately higher birthweights (3,322 vs. 3,268 grams) and lower prevalence of low birthweight (4.5% vs. 6.2%) than daughters of US-born Hispanic women. In the next generation, a Hispanic foreign-origin advantage persisted in low birthweight prevalence (6.1% vs. 7.2%), but the corresponding black foreign-origin advantage was almost eliminated (12.2% vs. 13.1%). Findings were robust to adjustment for sociodemographic and medical risk factors. In contrast to patterns for other women, the prevalence of low birthweight varied little by maternal education for foreign-born black women. However, a gradient emerged among their US-born daughters., Conclusions: The convergence of birthweight between descendants of foreign-born and US-born black women is consistent with theories positing that lifetime exposure to discrimination and socioeconomic inequality is associated with adverse health outcomes for black women. The emergence of a distinct educational gradient in low birthweight prevalence between generations underscores hypothesized adverse effects of multiple dimensions of disadvantage.

Telomere length has generated substantial interest as a potential predictor of aging-related diseases and mortality. Some studies have reported significant associations, but few have tested its ability to discriminate between decedents and survivors compared with a broad range of well-established predictors that include both biomarkers and commonly collected self-reported data. Our aim here was to quantify the prognostic value of leukocyte telomere length relative to age, sex, and 19 other variables for predicting five-year mortality among older persons in three countries. We used data from nationally representative surveys in Costa Rica (N = 923, aged 61+), Taiwan (N = 976, aged 54+), and the U.S. (N = 2672, aged 60+). Our study used a prospective cohort design with all-cause mortality during five years post-exam as the outcome. We fit Cox hazards models separately by country, and assessed the discriminatory ability of each predictor. Age was, by far, the single best predictor of all-cause mortality, whereas leukocyte telomere length was only somewhat better than random chance in terms of discriminating between decedents and survivors. After adjustment for age and sex, telomere length ranked between 15th and 17th (out of 20), and its incremental contribution was small; nine self-reported variables (e.g., mobility, global self-assessed health status, limitations with activities of daily living, smoking status), a cognitive assessment, and three biological markers (C-reactive protein, serum creatinine, and glycosylated hemoglobin) were more powerful predictors of mortality in all three countries. Results were similar for cause-specific models (i.e., mortality from cardiovascular disease, cancer, and all other causes combined). Leukocyte telomere length had a statistically discernible, but weak, association with mortality, but it did not predict survival as well as age or many other self-reported variables. Although telomere length may eventually help scientists understand aging, more powerful and more easily obtained tools are available for predicting survival.

In recent decades there has been an increasing interest in understanding the role of social and physical contexts in influencing health behaviors and outcomes. This is especially true for weight, which is considered to be highly dependent on environmental factors. The evidence linking neighborhood characteristics to weight in the United States, however, is mixed. Many studies in this area are hampered by cross sectional designs and a limited scope, insofar as they investigate only one dimension of neighborhood context. It is also unclear to what extent neighborhood characteristics account for racial/ethnic disparities in weight. Using longitudinal data from the Los Angeles Family and Neighborhood Survey (L.A. FANS), we compare patterns of weight change between Hispanics and other racial and ethnic groups in order to evaluate whether we observe a pattern of unhealthy assimilation in weight among Hispanic immigrants and to identify differences in the rate at which different groups gain weight over time. We also explore the extent to which patterns of weight change are related to a wider range of community characteristics. We find that weight increases across all groups between the two study waves of L.A. FANS and that the increases are significant except for Asians/Pacific Islanders. With respect to differences in the pace of weight change, second and higher generation Hispanic women and black men gain weight more rapidly than their first generation Hispanic counterparts. Although the evidence presented indicates that first generation Hispanics gain weight, we do not find evidence for convergence in weight since the U.S.-born gain weight at a more rapid rate. The inclusion of community-level variables does not alter the relationships between the race, ethnicity, and immigrant generation categories and weight change. Of the six types of community characteristics considered, only collective efficacy is consistently and significantly associated with weight change, although the protective effect of neighborhood collective efficacy is seen only among women., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Allostatic load theory implies a relationship between exposure to psychological stress and multi-system physiological dysregulation. We used data from population-based samples of men and women in Russia (Moscow; n = 1800; age, mean 68.6 years), Taiwan (n = 1036; 65.6 years) and the United States (US; n = 1054; 58.0 years) -- which are likely to vary widely with respect to levels of stress exposure and biological markers -- to determine the magnitude of the association between perceived stress and physiological dysregulation. The measure of overall dysregulation was based on 15 markers including standard cardiovascular/metabolic risk factors as well as markers of inflammation and neuroendocrine activity. Subjective psychological stress was measured by the perceived stress scale. Only the Moscow sample demonstrated a positive association with overall dysregulation in both sexes. In the US, we found an association among women but not men. Among the Taiwanese, who report the lowest perceived stress, there was no association in women but an unexpected inverse relationship in men. The effects also varied across system-level subscores: the association with perceived stress was most consistent for standard cardiovascular/metabolic factors. Perceived stress was associated with inflammation and neuroendocrine activity in some samples. Although the evidence that perceived stress is the primary source of physiological dysregulation is generally modest, it was stronger in Russia where the level of perceived stress was particularly high. For Russia only, we had information about heart function based on a 24 h ambulatory electrocardiogram; perceived stress was consistently associated with heart rate dysregulation in Russian men and women.

Using the Los Angeles Family and Neighborhood Survey (L.A.FANS-2; n = 1610), we explore the link between Mexican immigrant acculturation, diet, exercise and obesity. We distinguish Mexican immigrants and 2nd generation Mexicans from 3rd+ generation whites, blacks and Mexicans. First, we examine variation in social and linguistic measures by race/ethnicity, duration of residence and immigrant generation. Second, we consider the association between acculturation, diet and exercise. Third, we evaluate the degree to which acculturation, diet, exercise, and socioeconomic status explain the association between race/ethnicity, immigrant exposure to the US (duration since immigration/generation), and adult obesity. Among immigrants, we find a clear relationship between acculturation measures, exposure to the US, and obesity-related behaviors (diet and exercise). However, the acculturation measures do not clearly account for the link between adult obesity, immigrant duration and generation, and race/ethnicity., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Despite a myriad of studies examining the relationship between socioeconomic status and health outcomes, few have assessed the extent to which biological markers of chronic disease account for social disparities in health. Studies that have examined this issue have generally been based on surveys in wealthy countries that include a small set of clinical markers of cardiovascular disease. The availability of recent data from nationally representative surveys of older adults in Costa Rica and Taiwan that collected a rich set of biomarkers comparable to those in a recent US survey permits us to explore these associations across diverse populations. Similar regression models were estimated on three data sets - the Social Environment and Biomarkers of Aging Study in Taiwan, the Costa Rican Study on Longevity and Healthy Aging, and the Health and Retirement Study in the USA - in order to assess (1) the strength of the associations between educational attainment and a broad range of biomarkers; and (2) the extent to which these biomarkers account for the relationships between education and two measures of health status (self-rated health, functional limitations) in older populations. The estimates suggest non-systematic and weak associations between education and high risk biomarker values in Taiwan and Costa Rica, in contrast to generally negative and significant associations in the US, especially among women. The results also reveal negligible or modest contributions of the biomarkers to educational disparities in the health outcomes. The findings are generally consistent with previous research suggesting stronger associations between socioeconomic status and health in wealthy countries than in middle-income countries and may reflect higher levels of social stratification in the US. With access to an increasing number of longitudinal biosocial surveys, researchers may be better able to distinguish true variations in the relationship between socioeconomic status and health across different settings from methodological differences., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

The inclusion of biomarkers in social surveys such as the Panel Study of Income Dynamics (PSID) has the potential to answer many elusive questions in social science and public health, including the much-studied relationship between socioeconomic status and health. This article reviews the potential inclusion of biomarkers of cardiovascular and metabolic risk in the PSID. We first discuss the considerable analytical benefits of adding these biomarkers to the PSID, including the exploration of life course hypotheses and the potential to test causal relationships between the social environment and biological systems. Next, we review evidence on the reliability of self-reports of cardiovascular and metabolic risk factors, concluding that the potential bias from relying on self-reports may be substantial. Based on evidence of biological importance as well as practical considerations of ease of in-home collection, our first tier of recommended biomarkers includes measured height, weight, waist and hip circumference, diastolic and systolic blood pressure, resting heart rate, total and high-density lipoprotein (HDL) cholesterol, glycosylated hemoglobin (HbA1c), C-reactive protein (CRP), and cystatin C. Additional markers of secondary priority are also discussed.

Using pooled data from the 2000-2006 National Health Interview Survey, we document how the relationship between education and a broad range of health measures varies by race/ethnicity and nativity. We found that education is a more powerful determinant of health behaviors and outcomes for some groups than it is for others. In addition, the education differentials for foreign-born groups are typically more modest than those for corresponding native-born populations. We also show how the education-health relationship varies across Hispanic and Asian subgroups. We argue that any intervention for eliminating health disparities must take these patterns into account.

Orientation questions are readily incorporated into longitudinal population surveys, but their value as a screening tool for cognitive impairment is uncertain. We evaluated the screening value of four orientation-to-time items (TTO) from the Mini-Mental State Examination (MMSE) by determining their association with full-scale MMSE scores. Data collected under protocols with strict eligibility criteria in the US (64 normal elderly, 242 persons with probable Alzheimer's disease) and Taiwan (241 persons with probable Alzheimer's disease) were analyzed. The TTO and full-scale MMSE scores were significantly correlated (p < 0.05) in persons with a Clinical Dementia Rating (CDR) score of 0 or 1; this was not significant in persons with a CDR of >1 (p > 0.05). Both TTO and MMSE were significantly associated with education in persons with 0-7 years of education; some MMSE items, but none of the TTO items, were associated with education in persons with more than 7 years of education. TTO may be a useful component of cognitive screening efforts.