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Smoking, acculturation and family cohesion in Mexican-American women.

OBJECTIVE: To compare the characteristics of smokers and non-smokers in a setting that includes predominately Mexican-American women, with particular attention to acculturation, nativity and family cohesion. DESIGN: Cross-sectional survey in a public hospital women's clinic. METHODS: A self-administered survey was completed by gynecologic patients. It assessed: demographics, acculturation, birthplace and family cohesion. Comparisons of ever/never smokers and current/non-smokers were made using chi-square tests. Stratified analysis was used to assess for confounding. RESULTS: Smoking was very common in the white non-Hispanic group (ever smoking 86%, current smoking 70%). High rates were also seen among certain subgroups of Mexican-American women: US-born (ever smoking 65%, current smoking 44%), high acculturation (ever smoking 57%, current smoking 40%) and those with less cohesive families (ever smoking 67%, current smoking 67%). Stratified analysis revealed that place of birth and family cohesion, controlling one for the other, had adjusted prevalence ratios for current smoking of 3.7 (95% CI 1.5, 9.0) and 3.2 (95% CI 1.3, 8.1) respectively. CONCLUSION: Very high rates of smoking were observed among white non-Hispanic patients and certain subgroups of Latino subjects in this population. In Latinos, being US-born and having membership in a less cohesive family unit were independently associated with smoking.

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Self-reports of stress in Asian immigrants: effects of ethnicity and acculturation.

INTRODUCTION: Although the concept of stress is hard to define or measure, it is a phenomenon associated with a number of health conditions, including hypertension, heart disease, and decreased immunocompetency. Events such as migration are known to create stress; researchers refer to this as acculturative stress. Given that cultural background might influence a patient's recognition, interpretation, and coping mechanisms for stress, we wondered how self-reports of stress by Asian immigrants compare with those of non-Hispanic Whites, and how these self-reports vary with years since immigration, a proxy for acculturation. METHODS: Data from the National Health Information Survey for 1993 and 1995 were analyzed for six groups of Asian national origin, and were compared with non-Hispanic Whites. Using ordered logistic regression, we examined self-reports of stress over two weeks and twelve months, as well as the changes in these self-reports with years since immigration. RESULTS: Adjusted for age, income, educational level, marital status, and gender, Asian immigrants were uniformly less likely to report stress over a two-week period than were non-Hispanic Whites (OR ranges: 0.34[Asian Indian]-0.59[Korean], P values<.05). There were no significant differences in reported stress among Asian ethnic groups. Compared with immigrants who have lived in the United States for at least 15 years, recent immigrants (<1 year) were likely to report less stress over two weeks and twelve months, OR = 0.13 and 0.23, respectively, P values<.005. CONCLUSIONS: Despite their status as immigrants, Asians report less stress than non-Hispanic Whites. These reports of stress increase as years since immigration increase. One potential explanation for these discrepancies is under-reporting, which might reflect underlying cultural differences in the perception or definition of stress, differences that may diminish with "acculturation."

Acculturation↗

Effects of acculturation and psychosocial factors in Latino adolescents' TB-related behaviors.

OBJECTIVE: To determine the effect of acculturation and psychosocial factors (self-esteem, social support, mastery, and self-efficacy of medication taking) on Latino adolescents' adherence (completion of treatment, percent of appointments kept, number of treatment weeks, and number of days missed medication in past week) to tuberculosis (TB) treatment. METHODS: Participants (N = 618) were recruited from two clinics located in Los Angeles, California, after receiving a positive diagnosis for Class II TB. RESULTS: Adolescents with high linguistic acculturation and ethnic identification had high mastery, self-esteem and self-efficacy. Teens with high ethnic identification perceived more support from parents. Almost 81% of participants completed treatment and the percentage of appointments kept was 76.3%. A high proportion of those completing the treatment regimen had their parents helping them to remember to take the medication. Older teens were less acculturated, less likely to complete treatment, and had a lower rate of appointment keeping. Age and difficulty in getting to the clinics were predictors of adherence. CONCLUSIONS: This study highlights the importance of parental support and sociocultural factors in adherence to TB treatment in this population.

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Toward a reconciliation of "assimilation" and "pluralism": the interplay of acculturation and ethnic retention.

"The reconciliation between ¿assimilation' and ¿pluralism' is sought to help prevent further polarization among immigration researchers and is based mainly on two arguments. First, if assimilation and acculturation are distinguished, acculturation has proceeded more quickly than assimilation in both ¿old' and ¿new' immigrations. This reconciles traditional assimilationist theory with current pluralist--or ethnic retention--theory, which admits that acculturation (and accommodation) are occurring but without assimilation. Second, the reconciliation can also be advanced by the recognition that the researchers of the old and new immigrations have studied different generations of newcomers and have approached their research with ¿outsider' and ¿insider' values, respectively." The geographical focus is on the United States.

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The relationship between violent video games, acculturation, and aggression among Latino adolescents.

Multiple factors are involved in the occurrence of aggressive behavior. The purpose of this study was to evaluate the hypotheses that Latino middle school children exposed to higher levels of video game playing will exhibit a higher level of aggression and fighting compared to children exposed to lower levels and that the more acculturated middle school Latino children will play more video games and will prefer more violent video games compared to less acculturated middle school Latino children. This study involved 5,831 students attending eight public schools in Texas. A linear relationship was observed between the time spent playing video games and aggression scores. Higher aggression scores were significantly associated with heavier video playing for boys and girls (p < 0.0001). The more students played video games, the more they fought at school (p < 0.0001). As Latino middle school students were more acculturated, their preference for violent video game playing increased, as well as the amount of time they played video games. Students who reported speaking more Spanish at home and with their friends were less likely to spend large amounts of time playing video games and less likely to prefer violent video games (p < 0.05).

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[The absence of risk factors for coronary disease in Yanomami Indians and the influence of acculturation on arterial pressure].

PURPOSE: To investigate the hypothesis that hypertension and coronary heart disease are "civilization diseases", analyzing the distribution of their antecedents in an Indian population and observing the influence of acculturation on blood pressure. METHODS: Seven hundred and twenty-five Yanomami Indians of both sexes, ages above 14 years, inhabitants of eight villages in Roraima and Amazonas states were examined. Measures related to all classical coronary risk factors were carried out and urine samples were collected to measure electrolytes. RESULTS: None of the known coronary risk factors were found. The blood pressure levels were low and did not increase with increasing age. There was influence of acculturation on blood pressure and it was in part mediated by increase in body weight and sodium intake. CONCLUSION: The absence of hypertension and other coronary risk factors and the increase of blood pressure with acculturation, among an isolated population, strongly suggest that these diseases are "civilization diseases".

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Acculturation and psychological problems of adolescents from Bosnia and Herzegovina during exile and repatriation.

AIM: To estimate the frequency, type, and severity of psychological trauma among Bosnian refugee adolescents during the process of repatriation after the 1992-1995 war in Bosnia and Herzegovina. METHODS: A sample of 239 pupils (120 girls and 119 boys), with a mean age (+/-standard deviation) of 15.2+/-2.1 years were assessed for war traumatic events, acculturation and repatriation maladjustments, school behavioral problems, and presence of post-traumatic stress disorder (PTSD). The sample consisted of adolescents who were in the process of repatriation after exile in a foreign country (n=120) and internally displaced adolescents (n=119). RESULTS: Adolescents who had been exposed to severe psychological war trauma still had high level of trauma more than three years after the end of war. The level of recalling traumas they experienced (mean+/-standard deviation=3.9+/-1.2 on a scale from 0 to 5) and frequency of PTSD symptoms (1.5+/-1.0 on a scale from 0-5) were significantly lower among repatriated than internally displaced adolescents (4.4+/-0.7 and 2.2+/-1.1, respectively; P<0.001). The prevalence of PTSD did not differ between repatriated (56.7%) and internally displaced adolescents (68.1%). Returnees with more acculturation problems reported more functional and relational problems after return but less psycho-emotional dysfunctions. Those who adapted to the culture in the exile country had difficulties in adapting back to the culture in the home country. CONCLUSIONS: PTSD was still very frequent among Bosnian refugee adolescents 3.5 years after the end of war. Adolescents who had spent more than five years as refugees in foreign countries had significantly lower level of experienced trauma recall and frequency of PTSD symptoms, as well as less anxious/depressed and withdrawn/depressed behavioral problems, and somatic complaints. Returnees who had more acculturation problems in exile reported more functional and relational problems but less psycho-emotional problems after repatriation. Schools and other institutions involved in the education of adolescents should develop programs to address these issues.

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Initial acculturation and HIV risk among new Hispanic immigrants.

PURPOSE: Research on the initial stage of acculturation of new immigrants is crucial for identifying AIDS prevention policies and priorities for this vulnerable population. METHODS: This study employed an exploratory approach and qualitative data collection methods to identify and describe social and behavioral factors influencing risk for HIV infection among recent Hispanic immigrants (<3 years in the United States). Immigrants from Guatemala, El Salvador, Honduras, the Dominican Republic and Mexico were interviewed in urban, suburban and semirural settings in the New York Metropolitan Area. Data were collected through ethnographic fieldwork, in-depth interviews (N=51), focus groups (N=11; total number of participants=86) and individual interviews with health and social service providers (N=26). RESULTS: Initial stages of acculturation for immigrants reflect both retention and change in attitudes and behaviors involving their mental health, gender role norms, social and sexual behavior, and alcohol and other drug use. Current living environments may introduce conditions affecting HIV risk and prevention, while sustained connections to countries of origin may support retention of attitudes and behaviors with positive and negative risk implications. CONCLUSIONS: Specific epidemiological, environmental, economic, social and psychosocial factors are identified that provide the context for risk and prevention. The challenges and opportunities faced by these new communities must be distinguished from those of more acculturated immigrant populations if culturally appropriate interventions are to be developed.

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Acculturation and adaptation: health consequences of culture contact among circumpolar peoples.

An overview is presented of the processes of acculturation and adaptation. Research with a variety of acculturating groups (including Refugees, Immigrants, Sojourners, Native Peoples and Ethnic Groups) shows that satisfactory adaptations are possible given appropriate conditions in the host or settlement countries. These conditions are largely under the potential control of policy makers and programm developers, and hence healthy outcomes are within reach. When these findings and conclusions are applied to Native Peoples in Circumpolar regions, some particular experiences stand out, resulting in the potential for difficult social and psychological adaptations. However, the literature shows that like all other acculturating groups, successful adaptations are possible for Circumpolar peoples, especially when they are in a position to understand and control the process.

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Epidemiologic studies among Amerindian populations of Amazonia. III. Intestinal parasitoses in newly contacted and acculturating villages.

The prevalences of intestinal parasites among the residents of three South American Indian villages in the process of acculturation were compared with those found in earlier unpublished surveys in two newly contracted village.s Although one individual in an acculturating village harbored 11 different intestinal parasites, in general the average number of different parasitic species carried per person was somewhat higher in the newly contacted villages. Helminth egg counts, performed on direct smears of each specimen from one newly contacted village, were low. There were no sex-associated differences in prevalences. The overall prevalences, unadjusted for age, were among the highest recorded for Amerindians. No Taenia species were present. Balantidium coli was present in two acculturating villages, concomitant with the beginning of agricultural practices which include raising swine. No cases of moderate or severe protein-calorie malnutrition was observed in any of the villages during the surveys. These limited data provide a baseline for future comparisons and, perhaps, a glimpse into the past.

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[Acculturation, identity and well-being: the adjustment of Somalian refugees].

This study examines the links between acculturation and psychological adjustment of 94 Somalian refugee women. On a group level, the preferred mode of acculturation is integration. Somalian women who have lived the longest in Canada identify more as Canadians and perceive more discrimination against themselves and against Somalians in general. Moreover, the endorsement of the mode of acculturation by integration implies a refusal of other modes such as assimilation, rejection and marginalization. Important links are also established between age, the desire to take part in Canadian society and mental health. Young women especially distinguish themselves from the group as they have a tendency to have a higher level of depression. Moreover, those refugees who have emigrated for political reasons wish to return to their homeland and are less satisfied with their life in Canada.

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Suicidality among acculturating Mexican Americans: current knowledge and directions for research.

Despite the dramatic increase in Mexican-American immigration over the past two decades, the acculturative experience and its relationship to suicide risk have received little attention within the field of suicidology. This paper summarizes findings from community-based studies that have explored suicide and risk factors among immigrant and Mexican-American groups, and suggests directions for future research. Most of these studies have been epidemiologic, and relatively few have addressed risk and protective factors within well-defined acculturating groups. Further study of the full continuum of suicidal thoughts and behaviors that examines precise cultural risk factors, and uses methodologies that combine quantitative and qualitative data, may improve our understanding of suicide risk among acculturating Mexican Americans.

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Blood pressure in Hispanic women: the role of diet, acculturation, and physical activity.

The role of diet, acculturation, and physical activity on systolic and diastolic blood pressure was examined among 1,420 Mexican American, 388 Cuban American, and 542 Puerto Rican women who responded to the Hispanic Health and Nutrition Examination Survey collected in 1982-4. Dietary intake measures included sodium, potassium, calcium, magnesium, fiber, ethanol, and total kilocalories as estimated from 24-hour recall data. Serum sodium/potassium ratio was included as a measure of metabolic function. Acculturation was measured using language preference, speaking, reading and writing. Physical activity included recreational and non-recreational activities. Other correlates included age, education, and body composition. Final models indicated that age and body composition were significantly associated with blood pressure across all three Hispanic subgroups. Among Mexican-American women, acculturation had an impact on both systolic and diastolic blood pressure that was independent of diet, body composition, and physical activity. Furthermore, the dietary intake of specific nutrients such as sodium and potassium did not appear to be as important as the way the individual metabolized those nutrients, as indicated by the serum sodium/potassium ratio. The strong association of body mass index with both systolic and diastolic blood pressure among all three ethnic groups reinforces the need to maintain an appropriate body weight.

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Relationship between acculturation and mental health for Asian Indian immigrants in the United States.

A community sample of Indian immigrants in the United States (N = 195) completed a survey to assess the relationship between acculturation and mental health. The relationship among several social and demographic variables, three aspects of acculturation (perception of acceptance, cultural orientation, and language usage), and three aspects of mental health (psychological distress, acculturative stress, and satisfaction) were examined. Multiple regression analyses were used to identify statistical predictors of a composite index of mental health. Results indicated that acceptance and cultural orientation play crucial roles in mental health, independent of various social and demographic variables. Feeling accepted by the host society and being involved with Americans and U.S. culture were related to better mental health.

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Acculturative stress, anxiety, and depression among Mexican immigrant farmworkers in the midwest United States.

No previous studies have examined the psychological functioning of immigrant farmworkers in the midwest United States. The purposes of the present study were threefold: (1) to assess the prevalence levels of anxiety and depression in a sample of Mexican immigrant farmworkers in the midwest United States; (2) to explore the relationships among acculturative stress, anxiety, and depression; and (3) to examine the variables that best predict anxiety and depression. The overall sample revealed elevated levels of anxiety and depression. Immigrant farmworkers with heightened levels of acculturative stress reported high levels of anxiety and depression. Family dysfunction, ineffective social support, low self-esteem, lack of choice in the decision to immigrate and live a migrant farmworker lifestyle, high education levels, and low levels of religiosity were significantly associated with high levels of anxiety and depression. The overall findings suggest that Mexican immigrant farmworkers who experience elevated levels of acculturative stress may be "at risk" for experiencing high levels of anxiety and depression. The findings highlight the importance of establishing prevention and treatment services for migrant farmworkers that aim to increase levels of emotional support, self-esteem, and coping skills.

Journal Article↗

Tobacco use and acculturation among Californians of Korean descent: a behavioral epidemiological analysis.

This study presents population estimates of cigarette use among adults of Korean descent residing in California. Data were drawn from telephone interviews with adults (N=2,830) developed from a random sampling of listed persons in California with Korean surnames. A total of 86% of attempted interviews were completed, and 85% of the interviews were conducted in Korean. Less acculturated men and more acculturated women reported higher present and predicted future rates of smoking after multivariate statistical controls were applied. Sharply divergent rates of cigarette use were found between the genders. Although men did not smoke their first cigarette or smoke cigarettes regularly earlier than women, both groups began smoking later than adults born in the United States. To be effective, tobacco intervention efforts must be tailored specifically to cultures of each minority. Results suggest that acculturation processes influence tobacco use differentially by gender, and future research is needed to identify the implications of processes in tobacco initiation and cessation.

Adult↗

Barriers to medical care of Mexican-Americans: the role of social class, acculturation, and social isolation.

Literature on medical care utilization by Mexican-Americans suggests that patterns of utilization can be explained, in part, by acculturation, social class and social isolation. The relative importance of these variables is explored in a survey of a rural Mexican-American community in Southern Texas. Data on 152 families are analyzed using a logit analysis, with utilization as the outcome variable. The results suggest that acculturation has a direct effect, while social class and social isolation interact to have a weak effect independent of acculturation. These results confirm the importance of understanding all three variables in planning and implementing medical care programs in Mexican-American communities.

Adult↗

Arguments for testing ethnic identity and acculturation as factors in risk judgments.

Understanding of risk views in multiethnic societies and in a globalizing world may be enhanced by use of measures of ethnic identity and acculturation. Ethnic identity includes such attributes as positive attitudes about one's ethnic group and a sense of belonging to it, voluntary and frequent association with other ethnic group members, and ethnic practices (preferred music, food, language; attendance at ethnic festivities). Acculturation is absorption of the "host" society's cultural norms, beliefs, attitudes and behavior patterns by immigrants, or by other groups historically excluded from the larger society. Both generic and ethnicity-specific measures of these concepts are available in the literature. This Perspective reviews the literature on risk implications of these concepts, how the nature of these measures presents both opportunities and challenges to risk researchers, and the degree to which ethnic identity and acculturation may be correlated with sociodemographic factors. Conceptual and methodological suggestions are made for risk research using these concepts, and hypotheses are offered about what such research might find.

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