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PubMed1990

Oral health status of Mexican-Americans with low and high acculturation status: findings from southwestern HHANES, 1982-84.

This article presents the results of a cross-sectional analysis of the prevalence of dental caries and periodontal disease, as well as the use of dental services, among 395 low acculturated dentate Mexican-Americans, 12-74 years of age, examined during the southwestern portion of the Hispanic Health and Nutrition Examination Survey (HHANES). Comparisons were carried out with 1,894 dentate Mexican-Americans who had high acculturation status. Mexican-American adolescents and adults with low acculturation status had 73 and 116 percent higher mean number of decayed and missing teeth, respectively, compared with those with high acculturation status. The differences between the two groups, however, did not remain statistically significant when the confounding effects of age, sex, education, and income status were taken into account. Gingivitis and periodontal pocketing were highly prevalent in both groups, but those with low acculturation status had significantly higher disease levels than those with high acculturation status. Despite the unmet dental needs and the higher prevalence of dental caries and periodontal disease, Mexican-Americans with low acculturation status were significantly less likely than those with high acculturation status to have dental insurance and to have visited the dentist as frequently.

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PubMedDate not supplied

Acculturation and diabetes among Hispanics: evidence from the 1999-2002 National Health and Nutrition Examination Survey.

OBJECTIVE: Hispanic individuals in the United States have a greater prevalence of diabetes mellitus than non-Hispanic white individuals; however, it is unclear whether Hispanics' risk of diabetes differs based on their level of acculturation. The purpose of our research was to examine acculturation among Hispanic Americans with respect to prevalence and control of diabetes. METHODS: We conducted an analysis of the National Health and Nutrition Examination Survey (NHANES), 1999-2002, a nationally representative sample of the noninstitutionalized U.S. population. We evaluated data on Hispanic adults (> or = 18 years of age, unweighted n=2,696), analyzing diagnosed diabetes, glycemic blood pressure and lipid control, and diabetes complications according to acculturation as measured by language and birth outside the United States. RESULTS: Hispanics with low acculturation were more likely to be without a routine place for health care, have no health insurance, and have low levels of education. In adjusted analyses, individuals with low acculturation, measured by language, were more likely to have diabetes (odds ratio [OR] 1.90, 95% confidence interval [CI] 1.02, 3.54). Among individuals with diagnosed diabetes, no significant association was yielded between acculturation and diabetes control. However, individuals with low language acculturation were more likely to have the diabetes complication of peripheral neuropathy (OR 4.01, 95% CI 1.40, 11.48). CONCLUSIONS: Acculturation as measured through language is associated with diabetes and complications among Hispanics even after controlling for a variety of demographic characteristics including health insurance and education. The findings suggest that even within a "single" minority ethnic group, there are differences in disease prevalence and complications and access to health care.

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PubMed1997

The impact of the Wellness Guide/Guía on Hispanic women's well-being-related knowledge, efficacy beliefs, and behaviors: the mediating role of acculturation.

This study examined how acculturation mediated the impact of the California Wellness Guide/La Guía del Bienestar on Hispanic women's knowledge, efficacy beliefs, and behaviors. Knowledge gaps were found between acculturated and less acculturated women. Acculturated mothers had more confidence in their abilities to acquire wellness-related information both before and after Guide/Guía distribution and also had more assistance-seeking efficacy. Guide/Guía recipients were more knowledgeable, had greater confidence in their knowledge and their abilities to acquire information, and possessed better information acquisition strategies than nonrecipients. The publication also enhanced low-acculturated recipients' assistance-seeking self-efficacy. High-acculturated and low-acculturated recipients of the Guide/Guía were equally likely to have retained and used their copies, to anticipate using the publication in the future, and to have made a change in behavior as a result of the guide. Finally, the Guide/Guía did not increase the knowledge gap between high- and low-acculturated guide recipients.

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PubMed2006

Toward a theory-driven model of acculturation in public health research.

Interest in studying the impact of acculturation on immigrant health has increased in tandem with the growth of the Latino population in the United States. Linear assimilation models continue to dominate public health research despite the availability of more complex acculturation theories that propose multidimensional frameworks, reciprocal interactions between the individual and the environment, and other acculturative processes among various Latino groups. Because linear and unidimensional assessments (e.g., nativity, length of stay in the United States, and language use) provide constricted measures of acculturation, the rare use of multidimensional acculturation measures and models has inhibited a more comprehensive understanding of the association between specific components of acculturation and particular health outcomes. A public health perspective that incorporates the roles of structural and cultural forces in acculturation may help identify mechanisms underlying links between acculturation and health among Latinos.

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PubMed2004

Comparing acculturation models in evaluating dietary habits among low-income Hispanic women.

OBJECTIVES: Studies have demonstrated that Hispanic women in the United States who are more acculturated tend to consume fewer fruits and vegetables, and more fat, compared to less acculturated women. However, some studies have found an opposite trend. Such discrepancies could be caused by inconsistencies in the assessment of acculturation. The goal of the current study was to determine whether different methods of defining acculturation could identify dietary fat use practices among Hispanic women living in the United States. DESIGN: One hundred nineteen Hispanic women were recruited from adult education vocational rehabilitation classes, and completed questionnaires assessing dietary fat practices, acculturation, and demographic information. RESULTS: Years living in the United States was not associated with higher or lower fat use in this sample. A preference for speaking English at home was significantly associated with less consumption of beans and peas. Being born in the United States was significantly associated with greater consumption of convenience foods and chocolate candy. Being born in the United States and exhibiting a preference for English were significantly associated with greater consumption of convenience foods and salty snacks, as well as greater frequency of eating higher fat foods, overall. CONCLUSIONS: The operational definition of acculturation significantly influences whether acculturation is associated with dietary fat practices in low-income Hispanic women. The discrepancies in the conclusions about dietary fat practices between these 4 methods demonstrate the need for a better understanding of cultural influences on dietary habits, as well as a consistent measure of acculturation in this field.

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PubMed1993

Acculturation and hypertension in Mexican Americans.

In this analysis, we employ data from the Hispanic Health and Nutrition Examination Survey to examine the association between level of acculturation into the larger society and rates of hypertension in Mexican Americans. Analyses conducted separately by gender in three broad age groups (ages 20 to 39, 40 to 59, and 60 to 74 years) fail to indicate a linear effect of acculturation on hypertension after controlling for age, education, marital status, employment, smoking, alcohol consumption, and body mass index. A nonlinear hypothesis was subsequently examined and found partial support among middle-aged men. Other things equal, middle-aged men at the middle of the acculturation continuum have significantly higher rates of hypertension than persons at the low end of the continuum. Lower rates are also observed among men at the high end of the acculturation continuum, but these rates are not significantly lower than those among men in the middle acculturation group when other variables are controlled. These findings for middle-aged men support an "acculturative stress" model that suggests that stress is higher at the middle of the acculturation continuum. Research on the influence of acculturation on health outcomes should go beyond simply examining linear effects to investigate the viability of nonlinear effects.

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PubMedDate not supplied

Acculturation and attitudes about contraceptive use among Latina women.

Previous studies have shown that acculturation among Latinos is associated with increases in health-risk behaviors. This study examined associations between acculturation and contraceptive use among 291 low- to moderately acculturated Latina women. Respondents completed a survey assessing acculturation, contraceptive use, and related attitudes. Moderately acculturated women expressed lower intentions to use contraceptives, were less certain that they would be able to use contraceptives consistently for the next 6 months, and reported lower social support for contraceptive use, than did unacculturated women. Unacculturated women expressed more traditional cultural attitudes favoring large families than did moderately acculturated women. Social norms and low self-efficacy may place moderately acculturated Latinas at high risk for unintended pregnancy and STDs.

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PubMed2005

Acculturation as a predictor of the onset of sexual intercourse among Hispanic and white teens.

OBJECTIVE: To investigate ethnic differences in onset of sexual intercourse among Hispanic/Mexican American and white adolescents based on acculturation. DESIGN/METHODS: Preprogram survey data from 7270 Hispanic or white teens in 7th to 12th grade involved in the Arizona Abstinence-Only Education Program were used to predict the probability of onset of sexual intercourse based on age, sex, family structure, program location, religiosity, free school lunch, grades, rural residence, acculturation, and ethnicity. Specific attention was given to the influence of acculturation among Hispanic teens. The primary language spoken by the respondents (English, Spanish, or both) was used as a proxy measure for acculturation. RESULTS: Hispanic youth were at a greater risk for experiencing onset of intercourse than white youth, while controlling for all other predictors (odds ratio [OR], 1.40 [95% confidence interval (CI), 1.21-1.63]). This risk was amplified for highly acculturated Hispanic teens (OR, 1.69 [95% CI, 1.43-1.99]). However, less acculturated Hispanic youth were actually less likely to have experienced first intercourse than white youth (OR, 0.59 [95% CI, 0.42-0.82]), English-speaking Hispanic youth (OR, 0.35 [95% CI, 0.25-0.49]), or bilingual Hispanic youth (OR, 0.45 [95% CI, 0.31-0.64]). CONCLUSIONS: Low acculturation emerges as a significant protective factor while controlling for other social and cultural factors, in spite of the increased risk of initiating sexual intercourse for Hispanic teens overall. Hispanic Spanish speakers were least likely to have initiated intercourse, while Hispanic English speakers were the most likely.

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PubMed2003

Acculturation and eating disorder symptomatology in Black men and women.

OBJECTIVE: We assessed the prevalence of eating disorder symptoms in Black South African men and also explored their possible links with acculturation. METHOD: The Eating Disorders Inventory (EDI) and the South African Acculturation Scale (SAAS) were administered to a sample of undergraduate students consisting of 50 Black women, 50 Black men and 50 White men. RESULTS: The Black men had significantly higher scores than the White men on the psychological subscales of the EDI and higher than cut-off scores on perfectionism, interpersonal distrust and maturity fears subscales. There were marginal racial differences in the average acculturation scores, whereas gender appeared to have a variable effect on acculturation attitudes. Specific acculturation strategies were found to be differentially associated with the EDI subscales. The association between acculturation and eating disorder symptoms in Black men was significantly higher than that in White men. DISCUSSION: Our results indicate that there is a higher prevalence of eating disorder pathology in Black men than in White men. This lends support to the possible association between acculturation and eating disorders, and challenges the assumption that non-Western individuals--and Black men in particular--are protected from body image disturbances and disordered eating patterns.

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PubMed1995

Acculturation as a risk factor for chronic disease among Cambodian refugees in the United States.

Although the concept of acculturation originated within anthropology, in recent years it has assumed a prominent role within epidemiology as a risk factor for chronic disease. However, these studies often consider acculturation in structural terms, reflected in differences between groups assumed to lie along the same continuum, all moving in the same direction toward greater acculturation to the values and behaviors of the dominant society. This paper addresses how acculturation should be conceptualized when examining it as a potential risk factor for chronic disease and how it should be measured so that it becomes both theoretically and clinically meaningful. Four case studies of Cambodian refugees of San Diego, California are used to illustrate the following: (1) the importance of integrating an acculturation-as-process perspective with an acculturation-as-structure perspective; (2) viewing acculturation as both individual and group experience of conflict and negotiation between two systems of behavior and belief; (3) measuring it longitudinally and as narrative; and (4) understanding that rather than being an inherent health risk, it may also promote health by creating access to certain forms of health care unavailable in the country of origin and by contributing to the abandonment of risky health-related behaviors and the adoption of behaviors that promote good health.

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PubMed2006

Recognition of depressive symptoms by Chinese subjects: the influence of acculturation and depressive experience.

BACKGROUND: We have previously found that the level of acculturation in Chinese subjects influences reporting of depression. It is not clear to what extent such differences in reporting are a consequence of differences in the recognition of depressive symptoms. This study examined the influence of acculturation and personal depressive experience on recognition of depressive symptoms in a sample of Chinese subjects and controls in a western region. METHOD: A 35-item Depressive Symptom Questionnaire was given to 385 Chinese subjects, grouped according to their language preference, and 143 non-Chinese Controls all recruited from general practices. Subjects rated recognition of symptoms on a 3-point scale according to the likelihood of someone who had depression experiencing each of the 35 symptoms. Three symptom dimensions were extracted using factor analysis: core, cognitive and somatic symptoms. The influence of acculturation and previous experience of depression on these symptom dimensions was examined. RESULTS: The level of acculturation in the Chinese influenced the recognition of 'somatic' and 'cognitive' symptoms, but the Chinese groups did not differ from Controls in recognition of 'core' symptoms. Previous experience of depression led to greater recognition of all three dimensions of symptoms, regardless of level of acculturation. CONCLUSIONS: Westernized Chinese, despite varying levels of acculturation, appeared capable of recognizing depressive symptoms as well as Control subjects. This suggests that the influence of acculturation on reporting on depressive symptoms may be due to factors other than the recognition of depression. This study has implications for the early detection of depression among the Chinese in differing geographical regions.

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PubMed2005

Do healthy behaviors decline with greater acculturation? Implications for the Latino mortality paradox.

Relative to non-Latino whites, Latinos in the United States have a lower socioeconomic status (SES) profile, but a lower all-cause mortality rate. Because lower SES is associated with poorer overall health, a great deal of controversy surrounds the Latino mortality paradox. We employed a secondary data analysis of the 1991 National Health Interview Survey to test the health behavior and acculturation hypotheses, which have been proposed to explain this paradox. These hypotheses posit that: (1) Latinos have more favorable health behaviors and risk factor profiles than non-Latino whites, and (2) Health behaviors and risk factors become more unfavorable with greater acculturation. Specific health behaviors and risk factors studied were: smoking, alcohol use, leisure-time exercise activity, and body mass index (BMI). Consistent with the health behaviors hypothesis, Latinos relative to non-Latino whites were less likely to smoke and drink alcohol, controlling for sociodemographic factors. Latinos, however, were less likely to engage in any exercise activity, and were more likely to have a high BMI compared with non-Latino whites, after controlling for age and SES. Results provided partial support for the acculturation hypothesis. After adjusting for age and SES, higher acculturation was associated with three unhealthy behaviors (a greater likelihood of high alcohol intake, current smoking, a high BMI), but improvement in a fourth (greater likelihood of recent exercise). Gender-specific analyses indicated that the observed differences between Latinos and non-Latino whites, as well as the effects of acculturation on health behaviors, varied across men and women. Results suggest that the health behaviors and acculturation hypotheses may help to at least partially explain the Latino mortality paradox. The mechanisms accounting for the relationship between acculturation and risky behaviors have yet to be identified.

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PubMed2001

Acculturation and interrelationships between problem and health-promoting behaviors among Latino adolescents.

PURPOSE: To examine: (a) the effects of acculturation on a healthy lifestyle including problem behaviors (substance use and sex acts) and health-promoting behaviors (e.g., seat belt use, vitamin intake, hours of sleep per night) and (b) the interrelationships among problem and health-promoting behaviors among Latino adolescents. METHODS: Face-to-face interviews were conducted with Latino adolescents (n = 609) with questions covering the following areas: acculturation, sociodemographics, problem behaviors, and health-promoting behaviors. The participants ranged in age from 11 to 19 (mean = 15) years. Bivariate correlations and factor analyses were used to examine the relationship between problem and health-promoting behaviors. A combination of one-way analyses of variance (ANOVAs), Chi-square tests, and Student's t-tests were used to analyze the effects of acculturation on problem and health-promoting behaviors. RESULTS: Higher levels of acculturation were associated with an increased likelihood of exhibiting problem behaviors and a decreased likelihood of exhibiting certain health-promoting behaviors. Foreign-born Latinos were significantly less likely to engage in problem behaviors. Problem behaviors were likely to co-occur; however, the co-occurrence of health-promoting behaviors was not evident. The results also revealed the co-occurrence of problem behaviors with selected health-promoting behaviors. CONCLUSIONS: Among Latino adolescents, there seems to be evidence that problem behaviors and certain health-promoting behaviors do co-occur. To the extent that "healthy lifestyles" are conceptualized as the presence of health-promoting behaviors and the absence of problem behaviors, less acculturated Latino adolescents seem to fare better than those that are more acculturated. Interventions to promote "healthy lifestyles" among Latino adolescents should be tailored to take into consideration the effect of acculturation.

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PubMed1990

Acculturation and psychiatric disorder: a study of Greek Cypriot immigrants.

Data are presented from a study of acculturation and psychiatric disorder in 291 Greek Cypriot immigrants from the general population of Camberwell, south London. We hypothesized that 'pre-acculturation' would protect against mental disorder, that difficulties in the period immediately after migration would increase the risk of disorder, and that disorder would be least common among those in the middle range of the acculturation spectrum. Of pre-acculturation factors, only previous knowledge of English was associated with reduced prevalence. Difficulties in the settling-in period were clearly related to current disorder. No relationship was apparent between present acculturation and disorder, but this disguised an interesting but unpredicted gender effect: in males, disorder was most prevalent in the highly acculturated; in females, in the least acculturated.

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PubMed2005

Intergenerational perceptions of body image in hispanics: role of BMI, gender, and acculturation.

OBJECTIVE: To assess role of BMI, gender, and acculturation on maternal and children's perception of body size, body ideal, and attractiveness. RESEARCH METHODS AND PROCEDURES: Eighty mothers and their 6- to- 12-year-old children (41 boys, 39 girls) participated. Maternal and children's perceptions of body size (actual and ideal) and attractiveness were assessed through a pictorial instrument. Mother and child height and weight, demographic, and acculturation characteristics were also assessed. RESULTS: Seventy-nine percent of the mothers were overweight, and 32% of the boys and 34% of the girls were overweight or at-risk for overweight. BMI influenced the children's selection of perceived ideal size. Overweight or at-risk for overweight children were more likely to select thinner figures as the ideal size than non-overweight children. Gender and acculturation differences concerning children's perceptions of body size and attractiveness were also found. Girls perceived the obese figure as being less attractive than did the boys. More acculturated children were likely to select thinner figures as more attractive than their less acculturated counterparts. Maternal acculturation was associated positively with the girls' choice of thinner figures as an ideal body size, but not with the boys. Mothers viewed their daughters' actual body size and BMI as ideal, although 34% of the girls were at-risk for overweight. Mothers perceived average body size figures as more attractive for their sons. DISCUSSION: Findings from this study provide empirical data about the role of BMI, gender, acculturation, and familial influences on children's perceptions of actual and ideal body sizes and attractiveness.

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PubMed2006

Acculturation and self-esteem among older Mexican Americans.

Several researchers have examined how acculturation shapes the self-esteem of adolescents, but few studies have looked at the influence of acculturation for older Mexican Americans. The aim of this study was to examine how language acculturation shaped the self-esteem of older Mexican Americans. The data come from the baseline wave (N=3050) of the ongoing Hispanic Established Populations for the Epidemiologic Studies of the Elderly (H-EPESE), a multistage area probability sample conducted in 1993 and 1994. Research revealed that language acculturation is positively associated with self-esteem. However, depressive symptoms mediate and moderate the association of acculturation on self-esteem. Language acculturation among older Mexican Americans is positively associated with self-esteem, even when individuals experience depressive symptoms. Findings suggest that acculturation influences multiple dimensions of mental health.

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PubMed1990

Hypertension and acculturation in elderly Mexican Americans: results from 1982-84 Hispanic HANES.

The purpose of our study was to describe the relationship between acculturation and hypertension in elderly Mexican Americans. Two age groups, 55-64 and 65-74, were examined from data provided in the Hispanic Health and Nutrition Examination Survey (HHANES). The prevalence of hypertension among subgroups of different acculturation was ascertained based on the modified Cuellar Acculturation Scale. Each age group was also stratified using the HHANES poverty index, with those above the index compared to those below. A stepwise logistic regression was performed among the variables of poverty, gender, age, and acculturation in relation to hypertension. The results indicate that acculturation and age are stronger predictors of hypertension than poverty in elderly Mexican Americans, with acculturation being a stronger predictor among those age 55-64. Factors related to acculturation may have a stronger influence on the prevalence of hypertension in older Mexican Americans than differences related to socioeconomic status.

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PubMed2006

Acculturation, parent-adolescent conflict, and adolescent adjustment in Mexican American families.

We tested an acculturation model in a community sample of Mexican American families (146 mothers, 137 fathers, and 146 adolescents) that proposed that differences between parents and adolescents in acculturation would be associated with parent-adolescent conflict and adolescent adjustment problems. Contrary to hypotheses, we found that families who exhibited an acculturation gap were not more likely to report parent-adolescent conflict or adolescent adjustment problems. In fact, familial conflict and adolescent sexual experience were associated with high levels of acculturation among adolescents and their parents. Pending replication, these findings suggest that both parent and children acculturation may independently predict familial processes and youth outcomes, irrespective of an acculturation gap. Future research should consider other factors aside from acculturation differences that might account for parent-adolescent conflict and adolescent adjustment in Mexican American families.

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