Journal articles on the topic 'Hispanics United'
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Mendes de Leon, Carlos F., Karl Eschbach, and Kyriakos S. Markides. "Population Trends and Late-Life Disability in Hispanics From the Midwest." Journal of Aging and Health 23, no. 7 (August 29, 2011): 1166–88. http://dx.doi.org/10.1177/0898264311422100.
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Objectives: To describe the growth of the Hispanic population in the Midwest states of the United States, to present disability levels in older Mexican and non-Mexican-origin Midwest Hispanics by place of birth and poverty status, and compare disability levels among older Midwest Hispanics with those among Southwest Hispanics as well as non-Hispanics Whites and African Americans in each region. Method: Population data come from decennial U.S. Census Bureau surveys. Disability data for adults ≥ 50 years old come from the 2008 American Community Survey. Results: The Hispanic population in the Midwest has tripled since 1980 and now constitutes 6.6% of the entire Midwest population. Older Midwest Hispanics are somewhat younger, have a higher male–female ratio, and are more likely to be born outside the continental United States than Southwest Hispanics. In the Midwest, foreign-born Mexican American men report the lowest disability levels. Foreign-born Hispanic women of non-Mexican origin report the highest disability levels. Overall, older Hispanics have intermediate disability levels relative to non-Hispanic Whites and African Americans. Midwest Hispanics report less disability than Southwest Hispanics. Discussion: There is substantial heterogeneity in late-life disability among Midwest Hispanics, which may be related to place of birth and of origin. Future research is needed to examine age at immigration and health selection as potential reasons for low disability levels among foreign-born Mexican American men.
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D'Alonzo, Karen T., and Marie K. Saimbert. "Hispanic Women and Physical Activity: An Integrative Review." Annual Review of Nursing Research 31, no. 1 (October 2013): 209–34. http://dx.doi.org/10.1891/0739-6686.31.209.
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Hispanics/Latinos represent the largest, fastest growing, and youngest minority group in the United States. Although data suggest that most Hispanics/Latinos in the United States tend to be in better health than non-Hispanic Whites (the so-called "Hispanic Paradox"), these relative advantages in health status decrease markedly with the number of years of residence in the United States. Hispanic women or Latinas, in general, report less than recommended levels of physical activity (PA), putting them at greater risk for the development of cardiovascular disease (CVD) and other chronic illnesses associated with sedentary lifestyles.
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Ortiz, Blanca I., Kelly M. Shields, Kevin A. Clauson, and Patrick G. Clay. "Complementary and Alternative Medicine Use Among Hispanics in the United States." Annals of Pharmacotherapy 41, no. 6 (June 2007): 994–1004. http://dx.doi.org/10.1345/aph.1h600.
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OBJECTIVE: To review the use of complementary and alternative medicine (CAM) in Hispanics in the US and highlight the modalities most likely to be unfamiliar to healthcare practitioners. DATA SOURCES: A search of the literature published in English and a subsequent bibliographic search were conducted using MEDLINE, International Pharmaceutical Abstracts, EMBASE, Cumulative Index of Nursing and Allied Health Literature, and Manual Alternative and Natural Therapy Index System (1980– March 2007). Primary search terms included, but were not limited to, Hispanic, Latino, complementary and alternative medicine, and dietary supplements. Studies that assessed or evaluated the use of CAM in the Hispanic population were reviewed. Articles that included both Hispanics and non-Hispanics were also included. STUDY SELECTION AND DATA EXTRACTION: The literature search yielded 42 articles focused on the use of CAM by Hispanics. Survey was the most common method used in these studies, although some hybrid interviews were also conducted. DATA SYNTHESIS: Hispanics were identified homogenously in some studies and more correctly as a heterogeneous population in others. Some trials examined overall CAM use, whereas others looked at specific dietary supplements and herbs. Most reports found a higher than expected rate of CAM use in Hispanics (50–90%). A number of products potentially unfamiliar to healthcare practitioners, such as linden, sapodilla, and star anise, were reported as commonly used in several studies. Many studies were limited by the sample size or use of only one Hispanic subgroup. CONCLUSIONS: Hispanics use a wide range of CAM therapies, including several that may be unfamiliar to healthcare practitioners. Understanding the rationale, motivations, and history of Hispanics' use of CAM will enhance the cultural competence of healthcare professionals and help address these patients' medical needs. TRASFONDO: El uso de terapias de medicina complementaria y alternativa (CAM) es común entre los pacientes y se cree que la etnicidad influye en la frecuencia y extensión de su uso. Los pacientes de origen Hispano son una sub-población en rápido crecimiento. Con el fin de proveer efectivamente cuidado a este grupo de pacientes, es importante entender el papel de las terapias CAM en los tratamientos de esta población.
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Wang, Sharron Xuanren, and Arthur Sakamoto. "Can Higher Education Ameliorate Racial/Ethnic Disadvantage? An Analysis of the Wage Assimilation of College-Educated Hispanic Americans." SAGE Open 11, no. 2 (April 2021): 215824402110091. http://dx.doi.org/10.1177/21582440211009197.
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Hispanics are the largest minority group in the United States, but quantitative research on the various components of this population has not received extensive investigation. College-educated Hispanics have been particularly neglected due to exaggerated and negative stereotypes. This present study uses data from the 2010 National Survey of College Graduates to investigate wage attainments among college-educated Hispanics. Hispanic Americans are categorized based on their place of birth and age in which they entered the U.S. education system. Results indicate that native-born and foreign-born Hispanic women who have at least a college degree have reached approximate wage parity with comparable native-born non-Hispanic White women. By contrast, native-born Hispanic men face a 10% wage penalty relative to comparable native-born non-Hispanic White men. In addition, foreign-born Hispanic men who immigrated as adults and obtained their college degree outside of the United States face larger wage penalties that are augmented by a lack of citizenship. Theoretical and empirical implications are discussed.
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Kedia, Sapna, Brandon Edward Rose, Samuel A. Kareff, Estelamari Rodriguez, and Asos Mahmood. "Perceptions of palliative care knowledge among Hispanics in the United States: An analysis of the Health Information National Trends Survey data." JCO Oncology Practice 19, no. 11_suppl (November 2023): 270. http://dx.doi.org/10.1200/op.2023.19.11_suppl.270.
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270 Background: Patient knowledge of palliative care (PC) has been demonstrated to improve the quality of end-of-life care. Current evidence indicates decreased knowledge of PC and decreased utilization of services such as hospice and advanced directives among Latinos in the US. Hispanic Americans make up 18.9 % of the US population, however, categories of Latino and Hispanic are broad and encompass different ethnic groups, each with unique cultures and experiences. Previous research has demonstrated different ethnicities have differing perspectives on end-of-life care. In this study, we aim to investigate variations in knowledge of PC between different Latino ethnic subgroups in the US. Methods: We employed data from the National Cancer Institute’s Health Information National Trends Survey (HINTS5–Cycle 2; 2018) for a nationally-representative sample of 3,504 adults (aged ≥18 years). Lack of knowledge of PC was assessed by respondents’ selecting “I’ve never heard of it” when asked, “How would you describe your level of knowledge about palliative care?” We performed a binomial regression assessing knowledge of PC and comparing this answer choice between Hispanic and non-Hispanic respondents as well as a Wilcoxon-Mann-Whitney test to compare among Hispanic subgroups. Results: Of all 3,504 survey respondents, 13.07% self-identified as Hispanic, and 65.2% stated they had never heard of palliative care. In the ethnic subgroups analyzed, 173 (79.4%) Mexicans, 33 (71.7%) Puerto Ricans, and 11 (55%) Cubans reported they had never heard of PC compared to 689 (62.2%) of non-Hispanics. We used a binomial regression to compare this response in Hispanics vs. non-Hispanics and found a significant difference in PC knowledge between Hispanics and non-Hispanics (p < 0.001), with an OR of 0.469 between the lack of PC knowledge answer choice and selecting Hispanic (95% CI 0.37-0.6). A Wilcoxon-Mann-Whitney comparing PC knowledge by subgroups found a significant difference between non-Hispanics and Mexicans (p< 0.001) but no differences between Hispanic sub-groups. Conclusions: Hispanics had lower levels of knowledge of PC than non-Hispanics. When stratified by Hispanic subgroups, only Mexicans had significantly lower PC knowledge than non-Hispanics. This calls for further research into why this ethnic group has lower knowledge of PC and what potential moderating factors could affect this association. Additionally, we need more studies on US Hispanics’ level of PC knowledge to assess if the trends seen between Hispanic subgroups in this survey are replicated.
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Rennison, Callie Marie. "Reporting to the Police by Hispanic Victims of Violence." Violence and Victims 22, no. 6 (December 2007): 754–72. http://dx.doi.org/10.1891/088667007782793110.
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Though reporting violence to the police has been extensively investigated, the nature of Hispanic reporting of victimization has not. This is surprising because Hispanics are the fastest growing and largest ethnic group in the United States. Using over a decade of data from the National Crime Victimization Survey, this article investigates Hispanic reporting of victimization relative to non-Hispanic Whites, Blacks, American Indians, and Asians. Findings show that Hispanics are significantly less likely to report the most serious of violence compared to non-Hispanic Whites, but are more likely than non-Hispanic Whites to report simple assaults. Few reporting differences between Hispanics and other victim groups were observed. In addition, analyses indicate a positive relationship between educational attainment and reporting by Hispanics—a predictor not shared by any other group.
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Bremer, Michelle N., Garrick J. Gama, Omkar Rao, Eugene Golts, Deepa Kurup, Aarya Kafi, Christine M. Lin, Gordon Yung, and Kamyar Afshar. "Robust Outcomes for Hispanic Lung Transplant Recipients in the United States." OBM Transplantation 07, no. 02 (April 10, 2023): 1–20. http://dx.doi.org/10.21926/obm.transplant.2302180.
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Race, while a social construct, has a strong effect on a person’s health. There is limited data on racial disparities within lung transplantation (LTx), especially for Hispanic recipients. Therefore, the aim of this study was to identify inequalities that may involve this population. We analyzed historical data from the Organ Procurement and Transplantation Network (OPTN) and performed a retrospective review of Hispanic and Caucasian patients who underwent lung transplantation in the United States between May 4, 2005 and October 31, 2019. We compared pre-transplant health status to that of survival outcomes for both Caucasians and Hispanics using Kaplan-Meier survival analyses and Cox proportional hazards modeling to controlling for age, gender, pre-LTx diagnosis, and type of LTx. During this timeframe, 1,934 Hispanics and 22,767 Caucasians underwent lung transplantation. A statistically significant difference was seen between the two groups regarding age (p < 0.0001), body mass index (BMI) (p < 0.0001), type of lung transplant (bilateral versus single, p < 0.0001), and pre-transplant diagnoses (p < 0.0001). In all included pre-LTx health measures, Hispanics were significantly worse (p ≤ 0.0001-0.0410). Interestingly, it was found that Hispanics have better survival rates at 1 year and 3 years (p < 0.0001) with an associated hazards ratio of 0.927[0.868, 0.991] in comparison to Caucasians. Hispanics are underrepresented among LTx recipients, transplanted in worse health, and for diseases that have been noted to have the worst long-term survival outcomes. Despite these factors, Hispanics have a better long-term survival rate post-LTx.
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Liu, Xuefeng, Yali Liu, Dennis Tsilimingras, and Kendall M. Campbell. "Racial Disparity in the Associations of Microalbuminuria and Macroalbuminuria with Odds of Hypertension: Results from the NHANES Study in the United States." ISRN Hypertension 2013 (December 12, 2013): 1–8. http://dx.doi.org/10.5402/2013/390109.
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Background. Limited information is available on whether the associations of microalbuminuria and macroalbuminuria with the odds of hypertension differ among non-Hispanic Whites, non-Hispanic Blacks, and Hispanics. Methods. Cross-sectional data of 24,949 participants aged ≥18 years were collected from the National Health and Nutrition Examination Survey (NHANES) 1999–2008. Odds ratios of hypertension for microalbuminuria and macroalbuminuria were estimated by conducting weighted multiple logistic regression models. Results. After adjustment for extensive confounding factors, microalbuminuria is 1.45 (95% confidence interval (CI) [1.17, 1.80]), 2.07 (95% CI [1.52, 2.83]) and 2.81 (95% CI [2.06, 3.84]) times more likely to be associated with hypertension, and macroalbuminuria is 4.08 (95% CI [1.98, 8.38]), 8.62 (95% CI [3.84, 19.35]), and 4.43 (95% CI [2.13, 9.21]) times in non-Hispanic Whites, non-Hispanic Blacks, and Hispanics, respectively. The odds of hypertension for microalbuminuria (versus normalbuminuria) were 52% higher in non-Hispanic Blacks and 98% higher in Hispanics than in non-Hispanic Whites; the odds of hypertension for macroalbuminuria (versus normalbuminuria) did not differ among racial groups. Conclusion. Racial differences in the relation between microalbuminuria and hypertension are prevalent among non-Hispanic Whites, non-Hispanic Blacks, and Hispanics. More screening efforts should be encouraged in normotensive non-Hispanic Blacks and Hispanics with microalbuminuria.
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Porter, Sonya R., and C. Matthew Snipp. "Measuring Hispanic Origin: Reflections on Hispanic Race Reporting." ANNALS of the American Academy of Political and Social Science 677, no. 1 (April 25, 2018): 140–52. http://dx.doi.org/10.1177/0002716218767384.
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There are more than 50 million Hispanics in the United States, composing 16 percent of the population. Hispanics are also one of the fastest-growing race and ethnic groups. The American public often views and treats Hispanics as a racial group; yet 47 years after a Hispanic origin measure was added to the 1970 U.S. decennial census, and after numerous tests aimed at ameliorating racial measurement issues related to Hispanics, we continue to struggle with defining and measuring this population. In this article, we review literature about conceptual and measurement issues regarding Hispanic race reporting, evaluate public tabulations from one of the largest Census Bureau studies conducted in the 2010 Census to test strategies to improve race reporting for Hispanics, and discuss the opportunities and challenges of changing the race question on the decennial census to incorporate Hispanics.
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Galbraith, Quinn, and Adam Callister. "Why Would Hispanics Vote for Trump? Explaining the Controversy of the 2016 Election." Hispanic Journal of Behavioral Sciences 42, no. 1 (January 11, 2020): 77–94. http://dx.doi.org/10.1177/0739986319899738.
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Donald Trump was particularly vocal in shaping his presidential campaign around policies perceived as being anti-immigration. Consequently, many were shocked that Hispanic support for the Republican Party did not drop in the 2016 presidential election. In fact, our survey, which consisted of 1,080 people of Hispanic descent living in the United States, found that 74% of Hispanic Trump voters were in favor of generally deporting all illegal immigrants. Our results suggest that the population of Hispanics who voted in the 2016 presidential election was, on average, more conservative than the overall population of Hispanics living in the United States. Furthermore, our analysis suggests that issues such as the economy, health care, and education were more important to Hispanic voters than were issues related to immigration.
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Ibeanu, Okechukwu A., and Teresa P. Díaz-Montes. "Outcomes in Ovarian Cancer among Hispanic Women Living in the United States: A Population-Based Analysis." Pathology Research International 2013 (February 20, 2013): 1–5. http://dx.doi.org/10.1155/2013/672710.
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Introduction. Ovarian cancer is the deadliest gynecologic cancer in the United States. There is limited data on presentation and outcomes among Hispanic women with ovarian cancer. Objective. To investigate how ovarian cancer presents among Hispanic women in the USA and to analyze differences in presentation, staging, and survival between Hispanic and non-Hispanic women with ovarian cancer. Methods. Data from January 1, 2000 to December 31, 2004 were extracted from the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) database. Results. The study sample comprised 1215 Hispanics (10%), 10 652 non-Hispanic whites (83%), and 905 non-Hispanic blacks (7%). Hispanic women were diagnosed with ovarian cancer at a younger age and earlier stage when compared to non-Hispanic whites, non-Hispanic blacks; . Similar proportion of Hispanics (33%), non-Hispanic whites (32%), and non-Hispanic blacks (24%) underwent lymphadenectomy; . Hispanics with epithelial ovarian cancer histology had longer five-year survival of 30.6 months compared to non-Hispanic whites (22.8 months) and non-Hispanic blacks (23.3 months); . Conclusion. Hispanic women with ovarian cancer have a statistically significantly longer median survival compared to whites and blacks. This survival difference was most apparent in patients with epithelial cancers and patients with stage IV disease.
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Antman, Francisca M., Brian Duncan, and Stephen J. Trejo. "Hispanic Americans in the Labor Market: Patterns over Time and across Generations." Journal of Economic Perspectives 37, no. 1 (February 1, 2023): 169–98. http://dx.doi.org/10.1257/jep.37.1.169.
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This article reviews evidence on the labor market performance of Hispanics in the United States, with a particular focus on the US-born segment of this population. After discussing critical issues that arise in the US data sources commonly used to study Hispanics, we document how Hispanics currently compare with other Americans in terms of education, earnings, and labor supply, and then we discuss long-term trends in these outcomes. Relative to non-Hispanic Whites, US-born Hispanics from most national origin groups possess sizeable deficits in earnings, which in large part reflect corresponding educational deficits. Over time, rates of high school completion by US-born Hispanics have almost converged to those of non-Hispanic Whites, but the large Hispanic deficits in college completion have instead widened. Finally, from the perspective of immigrant generations, Hispanics experience substantial improvements in education and earnings between first-generation immigrants and the second-generation consisting of the US-born children of immigrants. Continued progress beyond the second generation is obscured by measurement issues arising from high rates of Hispanic intermarriage and the fact that later-generation descendants of Hispanic immigrants often do not self-identify as Hispanic when they come from families with mixed ethnic origins.
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Assari, Shervin, and Mohsen Bazargan. "Second-Hand Smoke Exposure at Home in the United States; Minorities’ Diminished Returns." International Journal of Travel Medicine and Global Health 7, no. 4 (November 5, 2019): 135–41. http://dx.doi.org/10.15171/ijtmgh.2019.28.
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Introduction: Educational attainment and poverty status are two strong socioeconomic status (SES) indicators that protect individuals against exposure to second-hand smoke. Minorities’ Diminished Returns (MDRs), however, refer to smaller protective effects of SES indicators among ethnic minority groups such as Hispanics and Blacks, compared to non-Hispanic Whites. This study explored ethnic differences in the effects of educational attainment and poverty status on second-hand smoke exposure in the homes of American adults. Methods: This cross-sectional study included 18,274 non-smoking adults who had participated in the Population Assessment of Tobacco and Health (PATH; 2013). The independent variables were educational attainment and poverty status. The dependent variable was secondhand smoke exposure at home. Age and region of residence were the covariates. Ethnicity was the moderator. Results: Overall, individuals with a higher educational attainment (odds ratio [OR] = 0.76, 95% CI = 0.74-0.79) and those who lived out of poverty (OR = 0.56, 95% CI =0.51-0.62) had lower odds of second-hand smoke exposure at home. Hispanic ethnicity showed significant interactions with both SES indicators, suggesting that the protective effects of education and poverty on second-hand smoke exposure at home are smaller for Hispanics (ORs for interaction with education and poverty status = 1.30 and 1.26, P < 0.05) than for Non-Hispanics. Conclusion: In the US, high SES Hispanics remain at high risk of exposure to second-hand smoke at home despite a high education and income. High SES better reduces environmental exposures for non-Hispanic than for Hispanic individuals.
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Ponce, Sonia G., Jeffrey Norris, Diane Dodendorf, Melissa Martinez, Bart Cox, and Warren Laskey. "Impact of Ethnicity, Sex, and Socio-Economic Status on the Risk for Heart Failure Readmission: The Importance of Context." Ethnicity & Disease 28, no. 2 (April 26, 2018): 99. http://dx.doi.org/10.18865/ed.28.2.99.
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<p><strong>Background: </strong>Hispanics are a fast-growing minority in the United States and have a high risk for the development of heart failure (HF). Hispanics have higher HF-related hospital readmission rates compared with non-Hispanics. However, the risk of readmission in a largely disadvantaged and majority Hispanic population has not been evaluated.</p><p><strong>Methods: </strong>We analyzed data for patients discharged with a principal discharge diagnosis of HF from the University of New Mexico Hospital from 2010–2014. Student t-test and chi-square analysis were used to assess the unadjusted associations between baseline characteristics and 30- day readmission rate. Multivariable logistic regression modeling evaluated the associations between 30-day hospital readmission rate, socio-demographic characteristics, and clinical variables.</p><p><strong>Results: </strong>A total of 1,594 patients were included in our analysis. Mean age (SD) was 63.1 ± 14 and 62.9 ±13.8 (P=.07) for Hispanics and non-Hispanics, respectively. Sixty percent of Hispanics had HF with reduced ejection fraction compared with 53.9% of non-Hispanics (P=.012). In unadjusted analysis, Hispanic ethnicity was associated with a two-fold increase in HF readmission rate compared with non-Hispanic ethnicity (OR 2.0, 95% CI 1.5–2.7). In fully adjusted models, Hispanic ethnicity showed an 80% increase in HF readmission rate compared with non-Hispanic ethnicity (OR 1.8, 95% CI 1.2–2.6).</p><p><strong>Conclusion: </strong>Among patients from a socioeconomically disadvantaged background living in a Hispanic-majority area, being Hispanic is associated with higher odds of 30-day hospital re-admission after adjusting for demographic, clinical and socioeconomic covariates. Our findings show that further research is needed to understand disparities in Hispanic’s heart failure-related outcomes.</p><p><em>Ethn Dis. </em>2018;28(2):99-104; doi:10.18865/ed.28.2.99.</p>
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Santiago-Rivas, Marimer, Chang Wang, and Lina Jandorf. "Sun Protection Beliefs among Hispanics in the US." Journal of Skin Cancer 2014 (2014): 1–10. http://dx.doi.org/10.1155/2014/161960.
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Purpose. We reviewed the literature on sun protection beliefs in Hispanics living in the United States to explore what challenges are faced by area of research.Method. A review of PubMED, PsycINFO, and CINAHL databases was performed. Studies were published in peer-reviewed journals (in all years available) and written in English. The search terms used were [“skin cancer” OR “sun protection”] AND [“Latino” OR “Hispanic”] AND “beliefs.” Eligible papers were included in the final analysis after meeting the following inclusion criteria: (1) the records had to quantitatively examine and report sun protection beliefs in Hispanics, (2) the number of Hispanic participants in the sample had to be clearly specified, and (3) studies reporting differences in sun protection beliefs between Hispanics and other racial and ethnic groups were included in the review.Results. Of the 92 articles identified, 11 met inclusion criteria and addressed sun protection beliefs regarding skin cancer seriousness and susceptibility, and benefits and barriers of sun protection and skin cancer risk behaviors. Characteristics of studies and results were examined.Conclusion. There is insufficient evidence to determine a pattern of sun protection beliefs among Hispanics in the United States. More quality studies are needed which focus on sun protection beliefs in Hispanics.
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Patel, Manali I., Clayton W. Schupp, Scarlett L. Gomez, Ellen T. Chang, and Heather A. Wakelee. "How Do Social Factors Explain Outcomes in Non–Small-Cell Lung Cancer Among Hispanics in California? Explaining the Hispanic Paradox." Journal of Clinical Oncology 31, no. 28 (October 1, 2013): 3572–78. http://dx.doi.org/10.1200/jco.2012.48.6217.
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Purpose Hispanics in the United States have lower age-adjusted mortality resulting from non–small-cell lung cancer (NSCLC) compared with non-Hispanic whites (NHWs). The purpose of this study was to evaluate individual, clinical, and neighborhood factors in survival among Hispanics with NSCLC. Patients and Methods We performed a retrospective analysis of NHWs and Hispanics with NSCLC between 1998 and 2007 in the California Cancer Registry (follow-up to December 2009). Kaplan-Meier curves depict survival by nativity for Hispanics with NSCLC. Cox proportional hazards models estimated hazard of mortality by race with adjustment for individual (age, sex, marital status), clinical (histologic grade, surgery, irradiation, chemotherapy), and neighborhood factors (neighborhood socioeconomic status, ethnic enclave). Results We included 14,280 Hispanic patients with NSCLC. Foreign-born Hispanics had 15% decreased risk of disease-specific mortality resulting from NSCLC compared with NHWs (hazard ratio [HR], 0.85; 95% CI, 0.83 to 0.88) after adjustment for individual, clinical, and neighborhood factors. After adjustment for individual factors, compared with US-born Hispanics, foreign-born Hispanics had 10% decreased risk of disease-specific mortality (HR, 0.90; 95% CI, 0.87 to 0.96). Clinical and neighborhood factors slightly moderated the survival benefit for foreign-born patients. A modestly more pronounced survival advantage was seen for foreign-born Hispanics living in low socioeconomic and high Hispanic enclave neighborhoods as compared with US-born Hispanics (HR, 0.86; 95% CI, 0.81 to 0.90). Conclusion Foreign-born Hispanics with NSCLC have a decreased risk of disease-specific mortality compared with NHWs and US-born Hispanics with NSCLC. Neighborhood factors slightly moderate this survival advantage. This survival advantage is slightly more pronounced in lower socioeconomic and higher Hispanic enclave neighborhoods.
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Avila, Jaqueline, Rebeca Wong, and Rafael Samper Ternent. "The Association Between Diabetes and Cognition Among Older Hispanics in the United States and Mexicans in Mexico." Innovation in Aging 4, Supplement_1 (December 1, 2020): 159. http://dx.doi.org/10.1093/geroni/igaa057.517.
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Abstract The objective is to assess if the effect of diabetes on cognition differs by race/ethnicity in the U.S. and how this association differs between older Hispanics in the U.S. and older Mexicans in Mexico. Data comes from a sample of older adults 50 and older with direct interviews from the 2012 waves of the Health and Retirement Study (N=17,810) and the Mexican Health and Aging Study (N=13,270). Cognition was measured as a total cognition score. OLS regressions were used to test the association between diabetes and cognition by race/ethnicity in the U.S. and among older Mexicans in Mexico. Results showed that Non-Hispanic Whites (NHW) had the highest cognition scores in the U.S., followed by Hispanics and non-Hispanic blacks (NHB). Mean cognition score of older Mexicans was higher than for NHB and Hispanics in the U.S. but lower than NHWs. The prevalence of diabetes was highest among Hispanics (32.3%), followed by NHB (30.6%) and NHW (19.9%). The prevalence of diabetes in Mexico was like those NHW in the U.S. (19.9%). In the U.S., the effect of being NHB and Hispanic (compared to white) on cognition was equivalent to having 5.3 and 2.4 fewer years of education, respectively. However, the effect of diabetes on cognition did not differ by race/ethnicity. The final analysis will include a direct comparison between Hispanics in the U.S. and a matched sample of older adults in Mexico with similar sex and age to test differences in the effect of diabetes on cognition between these two samples.
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González, Justo L. "Hispanics in the United States." Listening 27, no. 1 (1992): 7–16. http://dx.doi.org/10.5840/listening199227112.
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Meyers, J. L., Q. Brown, B. F. Grant, and D. Hasin. "Religiosity, race/ethnicity, and alcohol use behaviors in the United States." Psychological Medicine 47, no. 1 (September 26, 2016): 103–14. http://dx.doi.org/10.1017/s0033291716001975.
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BackgroundReligiosity is a protective factor against many health problems, including alcohol use disorders (AUD). Studies suggest that religiosity has greater buffering effects on mental health problems among US Blacks and Hispanics than Whites. However, whether race/ethnic differences exist in the associations of religiosity, alcohol consumption and AUD is unclear.MethodUsing 2004–2005 NESARC data (analytic n = 21 965), we examined the relationship of public religiosity (i.e. frequency of service attendance, religious social group size), and intrinsic religiosity (i.e. importance of religious/spiritual beliefs) to frequency of alcohol use and DSM-IV AUD in non-Hispanic (NH) Blacks, Hispanics and NH Whites, and whether associations differed by self-identified race/ethnicity.ResultsOnly public religiosity was related to AUD. Frequency of religious service attendance was inversely associated with AUD (NH Whites β: −0.103, p < 0.001; NH Blacks β: −0.115, p < 0.001; Hispanics β: −0.096, p < 0.001). This association was more robust for NH Blacks as compared with NH Whites and Hispanics (interaction β: 0.025, p < 0.001). Among NH Whites, higher intrinsic religiosity was inversely associated with alcohol use frequency (β: −0.143, p < 0.001). These effects were more robust among NH Whites (interaction (β: 0.072, p < 0.033) than for NH Blacks (β: −0.080, p > 0.05) or Hispanics (β: −0.002, p > 0.05).ConclusionsUS adults reporting greater public religiosity were at lower risk for AUD. Public religiosity may be particularly important among NH Blacks, while intrinsic religiosity may be particularly important among NH Whites, and among Hispanics who frequently attend religious services. Findings may be explained by variation in drinking-related norms observed among these groups generally, and in the context of specific religious institutions.
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Zarrinkhoo, Erfan, Kyle D. Klingbeil, Shreya Condamoor, Joon Park, Nicholas Jackson, Victor Chiu, and Brian E. Kadera. "Multi-hospital retrospective study comparing gastric adenocarcinoma in Hispanic versus non-Hispanic patients." Journal of Clinical Oncology 41, no. 16_suppl (June 1, 2023): e16027-e16027. http://dx.doi.org/10.1200/jco.2023.41.16_suppl.e16027.
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e16027 Background: Gastric cancer is one of the most prevalent malignancies in the United States and carries a particularly high rate of mortality. In the United States, the overall gastric cancer rate continues to decline amongst Caucasian and African American patients; however, it remains static amongst Hispanic patients. While numerous studies have been conducted to better understand the underlying causes leading to the disproportionate incidence of gastric cancer among Hispanics, it is still not well understood. This retrospective study sought to compare the clinicopathological features and overall survival of Hispanic patients with gastric adenocarcinoma with non-Hispanic patients treated in three safety-net county hospitals in Southern California. Methods: This is a retrospective cohort study of 123 patients with newly diagnosed gastric adenocarcinoma who were treated at three safety-net county hospitals in Southern California between 2010 and 2022. The subjects were categorized as Hispanic and non-Hispanic. Clinical, pathological, and survival data were obtained from the patient chart and compared. Results: Of the 123 patients included in the study, 87 (71%) were Hispanic. At time of diagnosis, Hispanic patients were found to be significantly younger than non-Hispanics (55.4 +/- 13.5 vs 60.8 +/- 12.2, p-value 0.03). They were also more likely to be misdiagnosed (defined as greater than one prior encounter of misdiagnosis within six months) relative to non-Hispanics (26% vs 14%, p-value 0.007) despite no differences in insurance/PCP status. Hispanic patients were more likely to present with metastatic disease (65% vs 30%, p-value <0.001), and were found to have a higher rate of peritoneal carcinomatosis (30% vs 8%, p-value 0.01). Hispanics were also more likely to present with disease in the gastric antrum (47% vs 19%, p-value 0.004) and have a higher rate of diffuse subtype histology (32% vs 22%, p-value 0.05). Similar rates of Helicobacter pylori infection were found within the tissue biopsy sample using Warthin Starry stain amongst Hispanic and non-Hispanic patients (17% vs 17%). Lastly, the mortality rate was higher in Hispanics relative to non-Hispanics at time of last contact (65% vs 35%, p-value <0.001). Conclusions: Upon comparing clinicopathological features and mortality among gastric cancer patients who were treated in multiple safety net county hospitals, there were significant differences noticed in Hispanic American patients. Relative to non-Hispanics, Hispanic patients were more likely to be misdiagnosed, more likely to present with metastatic disease, and have higher rates of mortality despite no disparities in insurance and PCP status. Further investigation is warranted regarding possible risk factors including exposures to possible environmental triggers or if there is a genetic predisposition in Hispanic populations.
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Wommack, Joel C., R. Jeanne Ruiz, C. Nathan Marti, Raymond P. Stowe, Charles E. L. Brown, and Christina Murphey. "Interleukin-10 Predicts Preterm Birth in Acculturated Hispanics." Biological Research For Nursing 15, no. 1 (August 5, 2011): 78–85. http://dx.doi.org/10.1177/1099800411416225.
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Objective:Among Hispanics living in the United States, acculturation is associated with an increased risk for preterm birth. Inflammatory pathways are also associated with preterm birth. As such, the current study sought to investigate the potential relationships among preterm birth, acculturation of Hispanic women, and inflammatory markers.Study Design:The authors performed an observational study on pregnant Hispanic women in Texas at 22–24 weeks' gestation ( n = 470). The authors obtained demographic data prenatally as well as birth outcome data from the medical chart after delivery. The authors obtained venous blood and used plasma to assay interleukin-1 receptor antagonist (IL-1RA), interleukin-6 (IL-6), and interleukin-10 (IL-10). The authors used logistic regression to understand whether the presence or the absence of IL-10 levels was related to acculturation and the risk of preterm birth.Results:The authors observed interactions between undetectable IL-10 levels and years in the United States and undetectable IL-10 levels and being born in the United States in models predicting preterm birth. Follow-up probes of these interactions suggested that when IL-10 was undetectable, preterm birth became more likely as time living in the United States increased, χ2= 5.15 (1, 416), p = .020, odds ratio (OR) = 3.17, and was more likely in participants born in the United States than in those born elsewhere, χ2= 5.35 (1, 462), p = .020, OR = 16.78. The authors observed no interactions among acculturation, preterm birth, and IL-1RA and IL-6 levels.Conclusion:Acculturated Hispanics who lack the protective effects of IL-10 experience a markedly higher risk of preterm birth than nonacculturated Hispanics.
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Brenes, Francisco, and Federico Henriquez. "Hispanics, Addictions, and the Opioid Epidemic: Brief Report." Hispanic Health Care International 18, no. 1 (November 20, 2019): 40–43. http://dx.doi.org/10.1177/1540415319888437.
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Opioid addiction is a public health concern. Opioid overdose death rates account for one third to a half of all global substance-related deaths. Opioid mortality rates increased nearly fivefold in the United States between 1999 and 2016. Recent research has found health care disparities in the United States among minority populations with opioid use disorder, particularly Hispanics. Current literature also suggests that a number of social and cultural factors, including the stigma linked to mental illness and treatment in the Hispanic culture, may further negatively contribute to the problem. This brief report pays close attention to the opioid epidemic in the United States and addresses issues related to the crisis among Hispanics. Recommendations for clinical practice, research, and health care policy are also discussed.
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BRESLAU, JOSHUA, KENNETH S. KENDLER, MAXWELL SU, SERGIO GAXIOLA-AGUILAR, and RONALD C. KESSLER. "Lifetime risk and persistence of psychiatric disorders across ethnic groups in the United States." Psychological Medicine 35, no. 3 (September 29, 2004): 317–27. http://dx.doi.org/10.1017/s0033291704003514.
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Background. Recent research in the United States has demonstrated striking health disparities across ethnic groups. Despite a longstanding interest in ethnic disadvantage in psychiatric epidemiology, patterns of psychiatric morbidity across ethnic groups have never been examined in a nationally representative sample.Method. Ethnic differences in psychiatric morbidity are analyzed using data from the National Comorbidity Survey (NCS). The three largest ethnic groups in the United States – Hispanics, Non-Hispanic Blacks and Non-Hispanic Whites – were compared with respect to lifetime risk and persistence of three categories of psychiatric disorder: mood disorder, anxiety disorder, and substance use disorder.Results. Where differences across ethnic groups were found in lifetime risk, socially disadvantaged groups had lower risk. Relative to Non-Hispanic Whites, Hispanics had lower lifetime risk of substance use disorder and Non-Hispanic Blacks had lower lifetime risk of mood, anxiety and substance use disorders. Where differences were found in persistence of disorders, disadvantaged groups had higher risk. Hispanics with mood disorders were more likely to be persistently ill as were Non-Hispanic Blacks with respect to both mood disorders and anxiety disorders. Closer examination found these differences to be generally consistent across population subgroups.Conclusions. Members of disadvantaged ethnic groups in the United States do not have an increased risk for psychiatric disorders. Members of these groups, however, do tend to have more persistent disorders. Future research should focus on explanations for these findings, including the possibility that these comparisons are biased, and on potential means of reducing the disparity in persistence of disorders across ethnic groups.
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McConnel, Charles E., and Rosemary W. Wilson. "Racial and Ethnic Patterns in the Utilization of Prehospital Emergency Transport Services in the United States." Prehospital and Disaster Medicine 14, no. 4 (December 1999): 28–31. http://dx.doi.org/10.1017/s1049023x00027680.
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AbstractIntroduction:This descriptive research used a large, urban population-based data set for prehospital emergency medical transports to examine racial/ethnic patterns of access and utilization for several broad categories of emergency medical transport services.Methods:Fire department files of approximately 39,000 reports on service provision were used to establish rates of transport utilization per 1,000 population in 1990, the most recent year for which reliable citylevel census data were available. Data were categorized by three age groups (< 25 years 25–64years,≥ 65years), three racial/ethnic groups (non-Hispanic whites, African-Americans, Hispanics), and gender. Transport rates were computed for total utilization, trauma incidents, and incidents due to medical conditions. Racial/ethnic rates were analyzed for each age and gender group and age- and gender-standardized rates were analyzed and presented in a graphical comparison. Statistical analyses of racial/ethnic differences were conducted using Tukey-type tests of multiple comparisons of proportions, with significant differences evaluated at the p = 0.001 level of significance.Results:Significant differences between racial/ethnic groups in the utilization of emergency transport services existed for all pair-wise comparisons including comparisons by each of the three age groups and gender. For total utilization, unadjusted rates are highest for African-Americans (65.9/1,000) and lowest for Hispanics (25.8/1.000). Likewise, African-American rates were substantially higher for both gender groups and across all age groups. Categorized by gender and age group under age ≥ 65 years, non-Hispanic whites are observed to have the lowest rates for both males and females under the age 65 years, while Hispanics have the lowest rates in the group 65 years old However, when rates are age- and gender- standardized, compared to African-Americans and Hispanics, rates for non-Hispanic whites are significantly lower for total transports and for trauma and medically related transports (p = 0.001).Conclusion:Age- and gender- standardized rates for emergency medical transport were found to be lowest for non-Hispanic whites, moderately higher for Hispanics, and subsantially higher for African-Americans, who experienced transport rates nearly three times higher than were the rates for non-Hispanic whites. Further research is required to establish the extent to which racial/ethnic differences observed in this geographically restricted study reflect variations between racial/ethnic groups in the underlying need for services.
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Alcalay, Rina, Fabio Sabogal, Gerardo Marin, Eliseo Perez-Stable, Barbara Van Oss Marin, and Regina Otero-Sabogal. "Patterns of Mass Media Use among Hispanic Smokers: Implications for Community Interventions." International Quarterly of Community Health Education 8, no. 4 (January 1988): 341–50. http://dx.doi.org/10.2190/cdhp-b1aq-e9xl-t50v.
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A relatively large percentage of Hispanics in the United States smoke. Yet a large proportion of Hispanics are light smokers, smoking ten or fewer cigarettes per day. Previous research has shown that most light smokers quit smoking on their own and that health education and an environment conducive to non-smoking can have a significant impact in reducing smoking rates. Given the current smoking patterns of Hispanics, culturally appropriate media-based community intervention to promote smoking cessation can have a significant impact. This study identified patterns of media use and language preference among a sample of 263 Hispanic smokers from the San Francisco Bay Area. Based on this study, recommendations to reach Hispanic smokers with a series of communication strategies are suggested.
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Wayner, Linda Maria. "The Affirmatively Hispanic Judge: Modern Opportunities for Increasing Hispanic Representation on the Federal Bench." Texas Wesleyan Law Review 16, no. 4 (July 2010): 535–60. http://dx.doi.org/10.37419/twlr.v16.i4.2.
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There is an abundance of literature on how race shapes, or has the potential to shape, judicial decision-making. Rather than looking to what occurs once a Hispanic judge dons his or her robes, this Article examines the how and why of getting that judge appointed. Part I of this Article will review both the statistics of the general Hispanic population in the United States and examine how demographic changes warrant a renewed commitment to a diversified judiciary, and similarly review the current Hispanic composition serving on the federal bench. Part II will discuss why we should aim for representational parity between the percentage of Hispanics on the federal bench and the percentage of Hispanics residing in the United States. Part III will conclude that the Obama administration has the opportunity and mandate to aggressively promote Hispanic candidates to the federal judiciary, with the goal of continuing the upward trajectory that most recently occurred during the presidential administrations of Bill Clinton and George W. Bush.
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Lin, Daniel, Andreas Kaubisch, Sanjay Goel, Yungtai Lo, and Santiago Aparo. "Survival analysis of Hispanics with hepatocellular carcinoma at a large academic institution." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): e14682-e14682. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.e14682.
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e14682 Background: Hepatocellular carcinoma (HCC) appears to have worse prognosis among Hispanics in the United States who have a higher mortality when compared toBlacks and Non-Hispanic Whites based on statistics from the Surveillance Epidemiology and End Results (SEER) database. There is paucity of data directly comparing Hispanics vs. Non-Hispanics. The aim of this study is to compare the overall survival (OS) of Hispanics and Non-Hispanics with HCC at a large academic institution. Methods: Men and women diagnosed and treated for HCC at Montefiore Medical Center (MMC) from 2000 to 2009 were identified using data from the MMC Cancer Registry. Patient’s characteristics obtained included age at diagnosis, gender, race, tumor stage, Model for End-stage Liver Disease (MELD) scores, Hepatitis B, C and HIV status, alcohol use, presence of cirrhosis, alpha-feto protein levels, performance status and treatment. A Cox proportional-hazard model was used to assess survival differences between Hispanics and Non-Hispanics adjusting for clinically relevant and statistically significant variables. Results: A total of 513 patients were identified from the Cancer Registry database. 76 patients were excluded (58 due to inability to confirm the diagnosis of HCC based on current radiologic criteria, 18 due to unavailable ethnicity data). The remaining 437 patients were used for modeling and final analysis. Of the final cohort of 437 patients, 49% (n=212) were Hispanic and 51% (n=225) were Non-Hispanic. Among Non-Hispanics, 55% were Black, 35% were White and 10% were “other” race. Median time of follow up for Hispanics was 13.5 months and for Non-Hispanics was 12.1 months. The median OS among Hispanics was 14.5 months and was not statistically different from the Non-Hispanic group (median OS of 13.1 months) with a p value of 0.49. In a multivariate analysis model the hazard ratio (HR) for survival among Hispanics was 0.81 (95% CI 0.61 to 1.07, p= 0.15) when compared to Non-Hispanics; after adjusting for gender, age at diagnosis, tumor stage, treatment, alpha-feto protein levels and MELD scores. Conclusions: Hispanics diagnosed and treated with HCC at Montefiore Medical Center do not seem to have worse survival when compared to Non-Hispanics.
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Monge, Cecilia, Tim Greten, Katherine McGlynn, and Alberto Maldonado. "Abstract 44: Hispanic Liver Cancer Patients are Underrepresented in Phase III Clinical Trials Conducted in the Last 10 Years." Cancer Epidemiology, Biomarkers & Prevention 32, no. 6_Supplement (June 1, 2023): 44. http://dx.doi.org/10.1158/1538-7755.asgcr23-abstract-44.
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Abstract Purpose: Hispanics bear the largest burden of liver cancer and are currently the largest subpopulation after non-Hispanic Whites in the United States (US). We aim to further characterize this burden and the inclusion of Hispanics in multinational phase III advanced liver cancer clinical trials. Methods and Results: Amongst the ten most common types of cancer in the US; we analyzed which cancer had the highest relative frequency in Hispanics compared to non-Hispanic Whites (NHW). We obtained the percentages of Hispanic individuals affected by liver cancer through the National Cancer Institute (NCI) Surveillance, Epidemiology, and End Results Program and used the Center for Disease Control and Prevention (CDC), United States Cancer Statistics (USCS) as a second database for comparison. We performed a database search using PubMed, Embase, and Web of Science: Core Collection to identify phase III clinical trials studying advanced liver cancer in the last 10 years and collected information about enrollment of Hispanic patients. A total of 13113 patients were included in phase III multinational clinical trials studying liver cancer in the last ten years. The percentage of Hispanic patients was 1.63%, 1.34% of the trial participants were NHB, 31.06 % were NHW and 46.89 % were Asian; while 32.1% had unknown racial/ethnic characteristics. However, from 2012 to 2019 the proportion HCC and BTC occurring in Hispanics was 23.2% and 22.6% respectively. Conclusions: Hispanics are disproportionately affected by liver cancer and are underrepresented in multinational phase III clinical trials in the last ten years despite having the highest relative incidence rates among the three major racial/ethnic groups in the US. Citation Format: Cecilia Monge, Tim Greten, Katherine McGlynn, Alberto Maldonado. Hispanic Liver Cancer Patients are Underrepresented in Phase III Clinical Trials Conducted in the Last 10 Years [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 44.
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Hunt, Bijou R. "Breast Cancer Prevalence and Mortality among Hispanic Subgroups in the United States, 2009–2013." Journal of Cancer Epidemiology 2016 (2016): 1–5. http://dx.doi.org/10.1155/2016/8784040.
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Background. This paper presents data on breast cancer prevalence and mortality among US Hispanics and Hispanic subgroups, including Cuban, Mexican, Puerto Rican, Central American, and South American.Methods. Five-year average annual female breast cancer prevalence and mortality rates for 2009–2013 were examined using data from the National Health Interview Survey (prevalence) and the National Center for Health Statistics and the American Community Survey (mortality rates).Results. Overall breast cancer prevalence among US Hispanic women was 1.03%. Although the estimates varied slightly by Hispanic subgroup, these differences were not statistically significant. The breast cancer mortality rate for Hispanics overall was 17.71 per 100,000 women. Higher rates were observed among Cubans (17.89), Mexicans (18.78), and Puerto Ricans (19.04), and a lower rate was observed among Central and South Americans (10.15). With the exception of the rate for Cubans, all Hispanic subgroup rates were statistically significantly different from the overall Hispanic rate. Additionally, all Hispanic subgroups rates were statistically significantly higher than the Central and South American rate.Conclusion. The data reveal significant differences in mortality across Hispanic subgroups. These data enable public health officials to develop targeted interventions to help lower breast cancer mortality among the highest risk populations.
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Santos-Lozada, Alexis R. "Self-rated mental health and race/ethnicity in the United States: support for the epidemiological paradox." PeerJ 4 (September 22, 2016): e2508. http://dx.doi.org/10.7717/peerj.2508.
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This paper evaluates racial/ethnic differences in self-rated mental health for adults in the United States, while controlling for demographic and socioeconomic characteristics as well as length of stay in the country. Using data from the 2010 National Health Interview Survey Cancer Control Supplement (NHIS-CCS), binomial logistic regression models are fit to estimate the association between race/ethnicity and poor/fair self-reported mental health among US Adults. The size of the analytical sample was 22,844 persons. Overall prevalence of poor/fair self-rated mental health was 7.72%, with lower prevalence among Hispanics (6.93%). Non-Hispanic blacks had the highest prevalence (10.38%). After controls for socioeconomic characteristics are incorporated in the models, Hispanics were found to have a lower probability of reporting poor/fair self-rated mental health in comparison to non-Hispanic whites (OR= 0.70; 95% CI [0.55–0.90]). No difference was found for other minority groups when compared to the reference group in the final model. Contrary to global self-rated health, Hispanics were found to have a lower probability of reporting poor/fair self-rated mental health in comparison to non-Hispanic whites. No difference was found for non-Hispanic blacks when they were compared to non-Hispanic whites. Self-rated mental health is therefore one case of a self-rating of health in which evidence supporting the epidemiological paradox is found among adults in the United States.
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Samson, Frank L. "Perceptions of Racialized Opportunities and Hispanics’ Political Attitudes." American Behavioral Scientist 56, no. 11 (October 10, 2012): 1525–64. http://dx.doi.org/10.1177/0002764212458278.
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In an attempt to understand Hispanics’ political incorporation as the United States becomes a “majority-minority” nation, I explore some of the social-psychological processes that shape Hispanics’ political attitudes. Specifically, I draw on the segmented-assimilation literature’s notion of “modes of incorporation” to argue that immigrants develop perceptions of racialized opportunities (PROPs) as they confront America’s segmented opportunity structure. Because of the durability of these racialized mobility trajectories, I propose that PROPs play an important part in the formation of Hispanics’ political attitudes. I test the PROPs mechanism using the 2006 Latino National Survey with a sample of 8,634 Hispanic respondents. Ordinal logistic regression models, estimating Hispanics’ support for school vouchers and government intervention in health care, indicate that PROPs are related to Hispanics’ political attitudes, especially in regard to support for school vouchers. Moreover, this social-psychological mechanism informs the political attitudes of both U.S.-born and foreign-born Hispanics.
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Bridges, Ana J., Marie E. Karlsson, Jennifer C. Jackson, Arthur R. Andrews, and Bianca T. Villalobos. "Barriers to and Methods of Help Seeking for Domestic Violence Victimization: A Comparison of Hispanic and Non-Hispanic White Women Residing in the United States." Violence Against Women 24, no. 15 (February 6, 2018): 1810–29. http://dx.doi.org/10.1177/1077801218754409.
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This study examined strategies Hispanic and non-Hispanic White victims of domestic violence use to manage violence and leave their relationships. Participants ( N = 76, 41% Hispanic) completed self-report questionnaires and a semistructured interview with a language-congruent research assistant. Hispanics reported child care needs and fears of social embarrassment as barriers to leaving, while non-Hispanic Whites reported fewer social supports as a barrier. Hispanics were more likely to use legal resources for help, while non-Hispanic Whites used more informal resources. Recognizing unique barriers to leaving abusive relationships and accessing help can guide service providers and others to target vulnerable populations more effectively.
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Demeke, Hanna B., Qingwei Luo, Ruth E. Luna-Gierke, Mabel Padilla, Gladys Girona-Lozada, Sandra Miranda-De León, John Weiser, and Linda Beer. "HIV Care Outcomes among Hispanics/Latinos with Diagnosed HIV in the United States by Place of Birth-2015–2018, Medical Monitoring Project." International Journal of Environmental Research and Public Health 17, no. 1 (December 25, 2019): 171. http://dx.doi.org/10.3390/ijerph17010171.
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Relocation from one’s birthplace may affect human immunodeficiency virus (HIV) outcomes, but national estimates of HIV outcomes among Hispanics/Latinos by place of birth are limited. We analyzed Medical Monitoring Project data collected in 2015–2018 from 2564 HIV-positive Hispanic/Latino adults and compared clinical outcomes between mainland US-born (referent group), Puerto Rican (PR-born), and those born outside the United States (non-US-born). We reported weighted percentages of characteristics and used logistic regression with predicted marginal means to examine differences between groups (p < 0.05). PR-born Hispanics/Latinos were more likely to be prescribed antiretroviral therapy (ART) (94%) and retained in care (94%) than mainland-US-born (79% and 77%, respectively) and non-US-born (91% and 87%, respectively) Hispanics/Latinos. PR-born Hispanics/Latinos were more likely to have sustained viral suppression (75%) than mainland-US-born Hispanics/Latinos (57%). Non-US-born Hispanics/Latinos were more likely to be prescribed ART (91% vs. 79%), retained in care (87% vs. 77%), and have sustained viral suppression (74% vs. 57%) than mainland-US-born Hispanics/Latinos. Greater Ryan White HIV/AIDS-funded facility usage among PR-born, better mental health among non-US-born, and less drug use among PR-born and non-US-born Hispanics/Latinos may have contributed to better HIV outcomes. Expanding programs with comprehensive HIV/AIDS services, including for mental health and substance use, may reduce HIV outcome disparities among Hispanics/Latinos.
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Sokov, Il'ya A. "Justice, Power and Policy towards the Ethnics in the Sunbelt region of the USA. Review of the collective monograph: Chase, R.T., ed. Caging Borders and Carceral States: Incarcerations, Immigration Detentions, and Resistance. Chapel Hill: University of North Carolina Press, 2019." Historia provinciae – the journal of regional history 4, no. 4 (2020): 1419–43. http://dx.doi.org/10.23859/2587-8344-2020-4-3-11.
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The work is devoted to the analysis of a collection prepared by a group of American researchers on the historical past and present of the situation of Hispanic population in the United States of America, which raises the problem of segregation of Hispanics at the federal level. In the 21st century, ethnic Hispanics are becoming one of the largest population groups in the United States, and Spanish is the second most widely used language after English in this country, which makes the issue raised in the monograph under review very relevant. The authors of the collection focused their research on the features of segregation of Latin Americans in the states of the Sunbelt, thereby clearly limiting the regional scope of their research. By their publications, they prove that the southern states of the United States have turned into carceral states for Latin Americans.
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Saxena, Monica Rakesh, Albee Y. Ling, Eli Carrillo, Al'ai Alvarez, Maame Yaa A. B. Yiadom, Christopher L. Bennett, and Moises Gallegos. "Trends of Academic Faculty Identifying as Hispanic at US Medical Schools, 1990-2021." Journal of Graduate Medical Education 15, no. 2 (April 1, 2023): 175–79. http://dx.doi.org/10.4300/jgme-d-22-00384.1.
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ABSTRACT Background According to recent census data, Hispanic and Latino populations comprise the largest minority group in the United States. Despite ongoing efforts for improved diversity, equity, and inclusion, Hispanics remain underrepresented in medicine (UIM). In addition to well-established benefits to patient care and health systems, physician diversity and increased representation in academic faculty positively impact the recruitment of trainees from UIM backgrounds. Disproportionate representation (as compared to increases of certain underrepresented groups in the US population) has direct implications for recruitment of UIM trainees to residency programs. Objective To examine the number of full-time US medical school faculty physicians who self-identify as Hispanic in light of the increasing Hispanic population in the United States. Methods We analyzed data from the Association of American Medical Colleges from 1990 to 2021, looking at those academic faculty who were classified as Hispanic, Latino, of Spanish Origin, or of Multiple Race—Hispanic. We used descriptive statistics and visualizations to illustrate the level of representation of Hispanic faculty by sex, rank, and clinical specialty over time. Results Overall, the proportion of faculty studied who identified as Hispanic increased from 3.1% (1990) to 6.01% (2021). Moreover, while the proportion of female Hispanic academic faculty increased, there remains a lag between females versus males. Conclusions Our analysis shows that the number of full-time US medical school faculty who self-identify as Hispanic has not increased, though the population of Hispanics in the United States has increased.
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Gosnell, Joseph Matthew, George Golovko, Esteban Arroyave, Akshata Moghe, Michael L. Kueht, Omar Abdul Saldarriaga, Kevin H. McKinney, Heather L. Stevenson, and Monique R. Ferguson. "Disparate outcomes in Hispanic patients with metabolic dysfunction-associated steatotic liver disease/steatohepatitis and type 2 diabetes: Large cohort study." World Journal of Diabetes 15, no. 5 (May 15, 2024): 886–97. http://dx.doi.org/10.4239/wjd.v15.i5.886.
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BACKGROUND Metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction-associated steatohepatitis (MASH) are a growing health burden across a significant portion of the global patient population. However, these conditions seem to have disparate rates and outcomes between different ethnic populations. The combination of MASLD/MASH and type 2 diabetes increases the risk of hepatocellular carcinoma (HCC), and Hispanic patients experience the greatest burden, particularly those in South Texas. AIM To compare outcomes between Hispanic and non-Hispanic patients in the United States, while further focusing on the Hispanic population within Southeast Texas to determine whether the documented disparity in outcomes is a function of geographical circumstance or if there is a more widespread reason that all clinicians must account for in prognostic consideration. METHODS This cohort analysis was conducted with data obtained from TriNetX, LLC (“TriNetX”), a global federated health research network that provides access to deidentified medical records from healthcare organizations worldwide. Two cohort networks were used: University of Texas Medical Branch (UTMB) hospital and the United States national database collective to determine whether disparities were related to geographic regions, like Southeast Texas. RESULTS This study findings revealed Hispanics/Latinos have a statistically significant higher occurrence of HCC, type 2 diabetes mellitus, and liver fibrosis/cirrhosis in both the United States and the UTMB Hispanic/Latino groups. All-cause mortality in Hispanics/Latinos was lower within the United States group and not statistically elevated in the UTMB cohort. CONCLUSION This would appear to support that Hispanic patients in Southeast Texas are not uniquely affected compared to the national Hispanic population.
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Drake, Jasmine, Creaque Charles, Jennifer W. Bourgeois, Elycia S. Daniel, and Melissa Kwende. "Exploring the impact of the opioid epidemic in Black and Hispanic communities in the United States." Drug Science, Policy and Law 6 (January 2020): 205032452094042. http://dx.doi.org/10.1177/2050324520940428.
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Context: In recent years, due to an alarming increase in the number of opioid-related overdose fatalities for White, Non-Hispanics in rural and suburban communities across the United States, they have been considered as the face of this epidemic. However, there has also been a staggering rise in the number of opioid overdoses in urban, minority communities, which have not been thoroughly addressed by the literature. Methods We reviewed deaths where opioid-related substances were reported as the leading cause of death to the Centers of Disease Control Multiple Cause of Death database from 1999 to 2017. Deaths were analyzed by year, State, drug type, and race and ethnicity. Results There were 399,230 total opioid-related deaths from 1999 to 2017 amongst all ethnic groups in the U.S. During this timeframe, approximately 323,939 total deaths were attributed to White, Non-Hispanics, while 75,291 were attributed to all other ethnicities. Examination of opioid-related overdose death data by ethnicity reveals that while White, Non-Hispanics have experienced the largest numbers of opioid-related overdose deaths in the U.S with up to 37,113 deaths occurring during 2017, there has also been a sharp rise in the number of opioid-related overdose deaths for minorities. opioid-related overdose deaths for Black, Non-Hispanics climbed from 1130 deaths in 1999 to 5513 deaths in 2017, while opioid-related overdose deaths for Hispanics climbed from 1058 in 1999 to 3932 in 2017. According to the Centers for Disease Control and Prevention, over the past 19 years, age-adjusted opioid-related deaths for Hispanics have climbed from 3.5 overdoses per 100,000 in 1999 to 6.8 overdoses per 100,000 in 2017. However, greater increases have been reported for Blacks during the same 19-year timeframe with age-adjusted rates of 3.5 overdoses per population of 100,000 in 1999 to 12.9 overdoses per population of 100,000 in 2017. Conclusion While Opioid-related overdoses have overwhelmingly plagued rural and suburban White, Non-Hispanic communities, there has been a surge in the number of deaths in Black and Hispanic Minority communities in recent years. Although there have been significant increases in the number of opioid-related overdose deaths in Black and Hispanic communities, the media narrative for this epidemic is often portrayed as a White, Non-Hispanic rural and suburban crisis. As a result, intervention strategies and policies have failed, both, to assess the severity of the problem in minority communities and to offer culturally sensitive preventative and treatment solutions. In this paper, the impact of the opioid epidemic on Black and Hispanic minority communities will be presented. Racial disparities in the U.S. Government’s current approach to an epidemic, which plagues rural and suburban White America, will be compared to its past criminal justice response to drug pandemics in urban minority communities. Culturally sensitive policy considerations and recommendations that can be used to, both, mitigate and offer treatment options for the opioid epidemic in these minority communities will also be addressed.
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Weatherby, Norman L., H. Virginia McCoy, Keith V. Bletzer, Clyde B. McCoy, James A. Inciardi, Duane C. McBride, and Mary Ann Forney. "Immigration and HIV among Migrant Workers in Rural Southern Florida." Journal of Drug Issues 27, no. 1 (January 1997): 155–72. http://dx.doi.org/10.1177/002204269702700111.
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We studied HIV seropositivity among a targeted sample of migrant workers who used drugs, primarily crack cocaine, and their sexual partners in rural southern Florida from 1993 to 1995. We enrolled men and women who were born in the United States (n = 369) or in other countries (n = 174). Overall, 11.2% of the sample were HIV positive, including 18% of Blacks from the United States, and about 8% of non-Hispanic whites from the United States, Blacks from the Caribbean, and persons from Central or South America. No Hispanics from the United States or the Caribbean, but 3.4% of Hispanics from Mexico, were HIV positive. In logistic regression analyses, race/ethnicity, gender, and age were most highly associated with HIV seropositivity. Immigration status, current drug use, and current sexual activity were not related to HIV seropositivity. HIV prevention programs must help reduce heterosexual transmission of HIV associated with drug use both locally and where migrants travel and work.
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Contreras, Jennifer, Alexandra Fincannon, Tasneem Khambaty, and Ester Villalonga-Olives. "Emergent Social Capital during the Coronavirus Pandemic in the United States in Hispanics/Latinos." International Journal of Environmental Research and Public Health 20, no. 8 (April 11, 2023): 5465. http://dx.doi.org/10.3390/ijerph20085465.
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The coronavirus pandemic has drastically impacted many groups that have been socially and economically marginalized such as Hispanics/Latinos in the United States (U.S.). Our aim was to understand how bonding social capital, bridging social capital, and trust played a role in Hispanics/Latinos over the course of the COVID-19 outbreak, as well as explore the negative consequences of social capital. We performed focus group discussions via Zoom (n = 25) between January and December 2021 with Hispanics/Latinos from Baltimore, MD, Washington, DC, and New York City, NY. Our findings suggest that Hispanics/Latinos experienced bridging and bonding social capital. Of particular interest was how social capital permeated the Hispanic/Latino community’s socioeconomic challenges during the pandemic. The focus groups revealed the importance of trust and its role in vaccine hesitancy. Additionally, the focus groups discussed the dark side of social capital including caregiving burden and spread of misinformation. We also identified the emergent theme of racism. Future public health interventions should invest in social capital, especially for groups that have been historically marginalized or made vulnerable, and consider the promotion of bonding and bridging social capital and trust. When prospective disasters occur, public health interventions should support vulnerable populations that are overwhelmed with caregiving burden and are susceptible to misinformation.
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Brenes, Francisco. "Hispanics, Mental Health, and Discriminating Policies: Brief Report." Hispanic Health Care International 17, no. 4 (September 23, 2019): 178–80. http://dx.doi.org/10.1177/1540415319875103.
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Hispanics, the largest minority group in the United States, are a heterogeneous group that contains a large portion of immigrants from Latin America. Recently, anti-immigrant policies and anti-Hispanic discriminatory practices have heightened at state and national levels. These policies and practices serve to endanger the mental health of Hispanics and play a major role in health care disparities. Positive correlations have been found between chronic discrimination and depression as well as other comorbid conditions, such as anxiety and substance use, and physical disorders. This report provides an overview of the changes in law/policy in recent history that negatively affect the well-being of Hispanics. Recommendations for health care professionals, educators, and researchers are presented.
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Acosta, Sam, Gustavo Hernandez, Lucille S. Groh, and Barbara Rathbone. "Counseling Hispanics in the United States." Journal of Pastoral Care 44, no. 1 (March 1990): 33–41. http://dx.doi.org/10.1177/002234099004400106.
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Patel, Neela K., Robert C. Wood, and David V. Espino. "Cultural Considerations: Pharmacological and Nonpharmacological Means for Improving Blood Pressure Control among Hispanic Patients." International Journal of Hypertension 2012 (2012): 1–6. http://dx.doi.org/10.1155/2012/831016.
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Cardiovascular disease is a leading cause of morbidity and mortality in the United States, and its prevention and treatment remain a priority for the medical community. Ethnic variations account for some differences in the prevalence of hypertension and blood pressure (BP) control rates among Hispanics, indicating the need for culturally appropriate management models. Aggressive treatment strategies are key to achieving optimal BP control in high-risk Hispanic patients. Hypertension in this ethnic group continues to be a major health concern. Of note, when provided access to comprehensive care, Hispanics demonstrate similar response rates to treatment as the majority of non-Hispanic whites. This highlights the importance of effective, culturally responsive hypertension management among high-risk Hispanic patients for achieving observable, positive health outcomes.
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Defreitas, Gregory. "Unionization among Racial and Ethnic Minorities." ILR Review 46, no. 2 (January 1993): 284–301. http://dx.doi.org/10.1177/001979399304600205.
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Using data on 23–30-year-olds from the National Longitudinal Survey of Youth, the author presents the first comparative economic analysis of union coverage among black, Hispanic, Asian, and white workers in the United States. Coverage is found to be highest in this age group for blacks, followed by Hispanics, non-Hispanic whites, and Asians. Contrary to common belief, immigrants average higher rates of unionization than natives. Once the regression analysis takes into account the larger proportions of urban, immigrant, and less-educated workers in the Hispanic sample, the differences in demand for unionization among comparable whites, Asians, and Hispanics fall to insignificance. Blacks tend to exhibit a markedly stronger demand for representation than comparable workers from other groups.
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Rifai, Lara, Kayla Kotalik, Nisha Kajani, and Charles J. Golden. "A-210 The Effects of Language on Arithmetic and Problem-Solving Abilities in Hispanics." Archives of Clinical Neuropsychology 37, no. 6 (August 17, 2022): 1366. http://dx.doi.org/10.1093/arclin/acac060.210.
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Abstract Objective: To identify differences between Hispanics and Caucasians in mathematics and problem-solving abilities using the KeyMath-3. Methods: The data for this study was derived from a large de-identified database. The sample contained two groups: the Hispanic group, (n=38; 64.4% female; mean age=29.9, SD=10.46; mean education=12.89, SD=10.46) and the Caucasian group (n=72; 65.8% female; mean age=31, SD=13.27; mean education=13.25, SD=1.38). The mean scaled scores for the KeyMath-3 subtests were calculated using independent sample t-tests. Results: Results showed no significant differences between Hispanics and Caucasians on Numeration, Algebra, Geometry, Measurement, Data Analysis, Basic Concepts, Mental Computation, Addition and Subtraction, or Multiplication and Division subtests. However, significant differences were found between the two groups on Foundations of Problem Solving [Caucasian M=9.92, SD=6.32; Hispanics M=7.23, SD=2.39; t(108)=6.913, p=.010] and Applied Problem Solving [Caucasian M=12.28, SD=12.8; Hispanics M=7.71, SD=3.09; t(108)=8.73, p=.004]. Conclusion: Results indicate Hispanics underperform compared to Caucasians on subtests requiring verbal comprehension, suggesting problem-solving performance is affected by a disadvantage in language and not mathematical ability. Hispanics may underperform on verbal comprehension related tasks due to less exposure to English. This finding demonstrates Hispanics are at a disadvantage under circumstances requiring the application of math concepts in the context verbal comprehension problems (i.e., Graduate Record Examination). No differentiation could be made between Hispanics who have immigrated and those born in the United States to Hispanic parents. Therefore, future research should identify these differences.
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Cardenas, Valeria, Susan Enguidanos, and Gillian Fennell. "Hispanics and Hospice Care: A Systematic Review." Innovation in Aging 4, Supplement_1 (December 1, 2020): 329–30. http://dx.doi.org/10.1093/geroni/igaa057.1056.
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Abstract Hospice care has demonstrated improved pain and symptom relief for patients at end-of-life, however, Hispanics have significantly lower rates of hospice use compared to Whites. Moreover, few studies have examined factors associated with these lower enrollment rates and barriers to hospice care experienced by Hispanics. This systematic literature review aims to provide a comprehensive overview of studies examining Hispanic hospice use. We conducted a comprehensive search using three electronic databases (Ovid Medline, EMBASE, and CINAHL) from January 1946 to March 2019 using MESH terms for Hispanics, hospice, and end-of-life care. Our review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P). Studies of Hispanic adults living in the United States that examined hospice use, outcomes of care, or knowledge and attitudes towards hospice were included. Commentaries, case studies, editorials, literature reviews were excluded. Of the 4,230 abstracts reviewed, 43 peer-reviewed articles met the inclusion criteria. Among these studies, barriers to hospice among Hispanics included lack of hospice knowledge and awareness, language barriers, and cultural barriers. Among most studies, Hispanics were less likely to receive hospice care than Whites, although some studies found that among those that enrolled in hospice, Hispanics had longer lengths of stay than whites. Overall few studies examined Hispanics use of hospice, and among those we found most were of moderate and low quality. More research is needed to understand the full range of Hispanics experiences of hospice care. Such research could guide efforts to develop culturally tailored care for this community.
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Hummer, Robert A., and Mark D. Hayward. "Hispanic Older Adult Health & Longevity in the United States: Current Patterns & Concerns for the Future." Daedalus 144, no. 2 (April 2015): 20–30. http://dx.doi.org/10.1162/daed_a_00327.
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The Hispanic population aged sixty-five and over – the most socioeconomically disadvantaged subset of America's elderly – is projected to quintuple between 2012 and 2050. While current longevity patterns for Hispanics relative to whites are favorable, old-age functioning and disability patterns for Hispanics are unfavorable and have serious implications for caregivers; families; and local, state, and federal governments. Troubling signs for the future Hispanic population (which are shared to varying degrees with other vulnerable groups) include the unresolved legal status of unauthorized immigrants, continued low levels of insurance coverage even after health care reform, some unfavorable trends in health behaviors, and continued disadvantages in educational attainment and income relative to whites. We urge policy-makers to deal with these potentially problematic health and well-being issues. Not doing so could have detrimental consequences for the future of the Hispanic population as well as other at-risk groups and, by extension, the U.S. elderly population as a whole.
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Kamath, Sonia, Kimberly A. Miller, and Myles G. Cockburn. "Current Data on Risk Factor Estimates Does Not Explain the Difference in Rates of Melanoma between Hispanics and Non-Hispanic Whites." Journal of Skin Cancer 2016 (2016): 1–8. http://dx.doi.org/10.1155/2016/2105250.
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United States Hispanics have seven times lower melanoma incidence rates than non-Hispanic whites (NHW). It is unclear whether this difference can be explained solely by phenotypic risk factors, like darker skin, or whether modifiable risk factors, like sun exposure, also play a role. The purpose of this paper is to summarize what is currently known about melanoma risk factors among Hispanics and NHWs, and whether or not those differences could explain the difference in melanoma incidence. Through literature review, relative risks and prevalence of melanoma risk factors in Hispanics and NHWs were identified and used to calculate the expected rate in Hispanics and rate ratio compared to NHWs. We found that melanoma risk factors either have similar frequency in Hispanics and NHWs (e.g., many large nevi) or are less frequent in Hispanics but do not explain a high proportion of disease variation (e.g., red hair). Considering current knowledge of risk factor prevalence, we found that melanoma incidence rates in the two groups should actually be similar. Sun exposure behavior among Hispanics may contribute to the explanation for the 7-fold difference in melanoma rates. Currently, limited data exist on sun exposure behavior among Hispanics, but possibilities for improving primary prevention by further studying these practices are substantial.
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Echeverria, Stephanie L., Alfredo J. Mena Lora, Rodrigo M. Burgos, Emad Hammode, Benjamin Ihms, John Ashurst, and Anthony Santarelli. "Addressing COVID-19 Disparities Between Hispanic and Non-Hispanic White Populations of Arizona." Journal of the National Hispanic Medical Association 1, no. 1 (April 27, 2023): 4–12. http://dx.doi.org/10.59867/nhma0101.
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Introduction: The coronavirus disease (COVID-19) pandemic1,2 contributed to over 1.03 million deaths in the United States (U.S.) and 30,768 deaths in Arizona3. Nationwide, Hispanics are at increased risk for infection, hospitalization, and death, when compared to non-Hispanic White (NHW)4. Although Hispanic COVID-19 disparities are clear in the U.S., study of Hispanic COVID-19 disparities in Arizona are less clear. Objective: To compare COVID-19 interventions and clinical outcomes between Hispanic and NHW populations in rural and urban healthcare settings of Arizona. Methods: A retrospective cohort of COVID-19 patients from January 1, 2020 through June 17, 2022 admitted to hospitals affiliated with the Midwestern University Graduate Medical Education consortium were assessed. Data was abstracted to counterbalance NHW and minority patients by date of admission. Data collected included patient demographics, presenting symptoms, vital signs, laboratory values at the time of emergency department presentation, treatment modalities, and clinical outcomes. Results: A total of 627 patients were analyzed with 31.7% (199/627) identifying as Hispanic, 41.8% (262/627) female, and 61.9% (388/627) allocated to the rural hospital group. No difference in mortality was seen in the rural or urban setting and there was no difference in administered COVID-19 therapeutics. Kaplan-Meier curves were parallel between Hispanic and NHW patients who survived COVID-19 with no difference in the length of stay (LOS) days. Kaplan-Meier curves differed between Hispanics and NHW patients who expired from COVID-19 with Hispanics at a greater LOS prior to mortality. Differences between Hispanic and NHW mortality patients included Hispanics presenting at a younger age, increased CRP elevations, and a greater delay between symptom onset and COVID-19 testing. Hispanics who expired were more likely to present with shortness of breath, hypoxia, and a documented bacterial infection during hospitalization as compared to Hispanics who survived. Conclusion: Following admission, patients regardless of Hispanic or NHW identification, received equitable care in our Arizona subset which resulted in comparable rates of mortality. Hispanics initially presented at increased disease severity, which is suggestive of factors outside of the hospital, prior to admission, responsible for the disparities seen at the national level with variation between states.
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Vélez-McEvoy, Margarita. "Faculty Role in Retaining Hispanic Nursing Students." Creative Nursing 16, no. 2 (May 2010): 80–83. http://dx.doi.org/10.1891/1078-4535.16.2.80.
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Hispanics, the fastest-growing minority population in the United States, make up only 5% of the nursing workforce. To help eliminate health care disparities, recruiting and retaining Hispanic nursing students is a necessary step. This article discusses barriers that Hispanic students encounter and responsibilities of nursing faculty in retaining Hispanic students, and proposes the use of frameworks that enhance a new paradigm to encourage more inclusive teaching in a positive environment.
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Case, Anne, and Angus Deaton. "Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century." Proceedings of the National Academy of Sciences 112, no. 49 (November 2, 2015): 15078–83. http://dx.doi.org/10.1073/pnas.1518393112.
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This paper documents a marked increase in the all-cause mortality of middle-aged white non-Hispanic men and women in the United States between 1999 and 2013. This change reversed decades of progress in mortality and was unique to the United States; no other rich country saw a similar turnaround. The midlife mortality reversal was confined to white non-Hispanics; black non-Hispanics and Hispanics at midlife, and those aged 65 and above in every racial and ethnic group, continued to see mortality rates fall. This increase for whites was largely accounted for by increasing death rates from drug and alcohol poisonings, suicide, and chronic liver diseases and cirrhosis. Although all education groups saw increases in mortality from suicide and poisonings, and an overall increase in external cause mortality, those with less education saw the most marked increases. Rising midlife mortality rates of white non-Hispanics were paralleled by increases in midlife morbidity. Self-reported declines in health, mental health, and ability to conduct activities of daily living, and increases in chronic pain and inability to work, as well as clinically measured deteriorations in liver function, all point to growing distress in this population. We comment on potential economic causes and consequences of this deterioration.