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Race Consciousness and the Health of African Americans
Watts, R
Online Journal of Issues in Nursing , 2003,
Abstract: The historical experience of African Americans in our country has been shaped by the institution of slavery, dehumanization of blacks, segregation, pursuit of civil rights, and racism in contemporary American society. Disparities in health care provide compelling evidence that issues of race or skin color for the descendants of slaves and other ethnic minorities persist in the 21st century. Nurses providing care for African Americans must bridge the racial divide and incorporate culturally relevant content in the health history. As an integral aspect of their professional growth as culturally competent health care providers, they must incorporate the idea of race consciousness which is described as an awareness of the historical journey of the group, knowledge of disparities in health care for the people, and a self appraisal of one’s attitudes and biases toward the group.
Religious Involvement Effects on Mental Health in Chinese Americans  [cached]
Bu Huang,Hoa B. Appel,Amy L. Ai,Chyongchiou Jeng Lin
Asian Culture and History , 2012, DOI: 10.5539/ach.v4n1p2
Abstract: Faith has been shown to serve a protective role in the mental health of African Americans and European Americans. However, little research has examined whether any association exists in Asian Americans. Using the National Latino and Asian American Study dataset, we examined the effect of religious attendance on the mental health of Asian Americans in the United States. The present study focused on Chinese Americans because they are the largest Asian American group. The results revealed that almost 80% of the respondents were foreign-born and that their English proficiency had a positive association with their self-rated mental health. Being male correlated significantly to higher levels of mental health self-rating. After controlling for known predictive variables, such as demographics, cultural and immigration variables, more frequent religious attendance significantly predicted higher self-rating of mental health. These findings suggest that faith may have a unique protective role in Chinese Americans’ mental health.
Health promotion for Latin Americans with intellectual disabilities
Frey,Georgia C; Temple,Viviene A;
Salud Pública de México , 2008, DOI: 10.1590/S0036-36342008000800010
Abstract: in response to the emerging global concern regarding health and people with intellectual disabilities (id), several developed countries have established national initiatives to address the unique health needs of this population segment. however, most people with id reside in countries with developing economies, such as many latin american countries, yet there is virtually no information on the health of people with id in these regions. countries with developing economies face distinct challenges in promoting health among this population segment that may preclude adoption or adaptation of policies and practices developed in regions with established economies. this paper will address the issue of health promotion among people with id in latin america, an area that is undergoing significant reforms in both health care and disability rights. information on the social and health status of latin americans with id, as well as research on health promotion best practices, will be used to develop recommendations for promoting health for these individuals.
Depression among Asian Americans: Review and Recommendations  [PDF]
Zornitsa Kalibatseva,Frederick T. L. Leong
Depression Research and Treatment , 2011, DOI: 10.1155/2011/320902
Abstract: This article presents a review of the prevalence and manifestation of depression among Asian Americans and discusses some of the existing issues in the assessment and diagnosis of depression among Asian Americans. The authors point out the diversity and increasing numbers of Asian Americans and the need to provide better mental health services for this population. While the prevalence of depression among Asian Americans is lower than that among other ethnic/racial groups, Asian Americans receive treatment for depression less often and its quality is less adequate. In addition, the previous belief that Asians somatize depression may become obsolete as more evidence appears to support that Westerners may “psychologize” depression. The cultural validity of the current DSM-IV conceptualization of depression is questioned. In the course of the review, the theme of complexity emerges: the heterogeneity of ethnic Asian American groups, the multidimensionality of depression, and the intersectionality of multiple factors among depressed Asian Americans. 1. Introduction The goal of this paper is to provide a review of the prevalence, manifestation, assessment, and diagnosis of depression among Asian Americans. Before the authors discuss these issues, they examine the current demographics of Asian Americans. The review reveals the complexity of depression among Asian Americans, as the disorder seems to be more multifaceted, and the population is more heterogeneous compared to previous conceptualizations of depression among Asian Americans in research and clinical practice. Finally, the authors provide recommendations for future research and practice by emphasizing the heterogeneity of Asian Americans, the multidimensionality of depression, and the intersectionality of various factors that may affect the experience of depression. The current review aims at contributing to the existing literature in several ways. First, there is a dearth of reviews of depression among Asian Americans, and the conducted empirical studies need to be reviewed using existing theoretical frameworks. Second, previous reviews concentrated on Asian American elderly only (e.g., [1]) or provided an extensive list of studies that have been conducted with different age groups (e.g., [2]). Therefore, this review differs by focusing on the manifestation, assessment, and diagnosis of depression among Asian Americans. In addition, the overarching theme of this review is the complexity and multidimensionality of depression among Asian Americans. Lastly, this review not only attempts to combine
Physician contact by older Asian Americans: the effects of perceived mental health need
Duy Nguyen
Clinical Interventions in Aging , 2010, DOI: http://dx.doi.org/10.2147/CIA.S14273
Abstract: ician contact by older Asian Americans: the effects of perceived mental health need Original Research (3623) Total Article Views Authors: Duy Nguyen Published Date November 2010 Volume 2010:5 Pages 333 - 336 DOI: http://dx.doi.org/10.2147/CIA.S14273 Duy Nguyen Silver School of Social Work, New York University, New York, NY, USA Objective: The use of physicians is more common than of behavioral specialists, especially in underserved Asian American communities. Despite a rapidly aging Asian American population, research has overlooked older people. This study examines the way mental health need affects the number of physician contacts by older Asian Americans. Method: This study uses data on self-identified Asian Americans aged over age 50 years derived from the 2001 California Health Interview Survey. A total of 1191 Asian Americans from Chinese, Filipino, Korean, and Vietnamese backgrounds were studied. Replicate weights were applied to account for the survey’s complex sampling methods. Linear regression was used to identify the number of physician contacts. Results: Overall, respondents had seen a doctor an average of five times in the previous 12 months; 7% perceived that they had a mental health need. Perceiving a mental health need was associated with a decreased number of physician contacts for Filipino and Korean Americans. Conclusion: This study revealed interethnic differences among older Asian Americans’ contact with physicians. As older Filipino and Korean Americans who perceive a mental health need have fewer contacts with their physician, correctly identifying mental health needs in the health care system for these groups is crucial. Health and mental health professionals can work toward reducing mental health disparities by accounting for older Asian Americans’ help-seeking patterns when designing evidence-based interventions.
Physician contact by older Asian Americans: the effects of perceived mental health need  [cached]
Duy Nguyen
Clinical Interventions in Aging , 2010,
Abstract: Duy NguyenSilver School of Social Work, New York University, New York, NY, USAObjective: The use of physicians is more common than of behavioral specialists, especially in underserved Asian American communities. Despite a rapidly aging Asian American population, research has overlooked older people. This study examines the way mental health need affects the number of physician contacts by older Asian Americans.Method: This study uses data on self-identified Asian Americans aged over age 50 years derived from the 2001 California Health Interview Survey. A total of 1191 Asian Americans from Chinese, Filipino, Korean, and Vietnamese backgrounds were studied. Replicate weights were applied to account for the survey’s complex sampling methods. Linear regression was used to identify the number of physician contacts.Results: Overall, respondents had seen a doctor an average of five times in the previous 12 months; 7% perceived that they had a mental health need. Perceiving a mental health need was associated with a decreased number of physician contacts for Filipino and Korean Americans.Conclusion: This study revealed interethnic differences among older Asian Americans’ contact with physicians. As older Filipino and Korean Americans who perceive a mental health need have fewer contacts with their physician, correctly identifying mental health needs in the health care system for these groups is crucial. Health and mental health professionals can work toward reducing mental health disparities by accounting for older Asian Americans’ help-seeking patterns when designing evidence-based interventions.Keywords: minority groups, Asians, health service use
Factors Associated With Overweight and Obesity Among Mexican Americans and Central Americans: Results From the 2001 California Health Interview Survey
Janice V. Bowie, PhD, MPH,Hee-Soon Juon, PhD,Juhee Cho, MA,Elisa M. Rodriguez, MS
Preventing Chronic Disease , 2007,
Abstract: IntroductionHispanics are the fastest growing demographic group in the United States; however, “Hispanic” is a broad term that describes people who are from or whose ancestors are from multiple countries of origin. This study examines, separately, the social, cultural, and behavioral factors associated with overweight and obesity among Mexican American adults and among Central American adults. MethodsTo estimate the prevalence of overweight and obesity among Mexican and Central Americans living in California, we conducted a cross-sectional analysis of data from the 2001 California Health Interview Survey using SUDAAN software to account for the survey’s multistage sampling design.ResultsOf the 8304 Mexican Americans participating in the survey, 36.8% were overweight and 26.2% were obese. Of the 1019 Central Americans, 39.2% were overweight and 22.2% were obese. Among Mexican American men, age and marital status were associated with overweight and obesity; and education, acculturation, health insurance status, health status, and use of vitamins were associated with obesity only. Among Mexican American women, age, education, number of children, health status, and health behavior were associated with overweight and obesity. Among Central American men, age, education, and access to health care were associated with overweight, whereas marital status, acculturation, health care, and binge drinking were associated with obesity. Among Central American women, number of children was associated with overweight and obesity; and age and education were associated with obesity only. ConclusionsOur findings of high rates of overweight and obesity among Mexican and Central Americans in California indicate the need for a wide variety of effective weight-loss interventions targeting these populations, and the differences we found in the factors associated with overweight and obesity may suggest the need for unique intervention strategies for different Hispanic subgroups.
Association between Acculturation and Binge Drinking among Asian-Americans: Results from the California Health Interview Survey  [PDF]
Monideepa B. Becerra,Patti Herring,Helen Hopp Marshak,Jim E. Banta
Journal of Addiction , 2013, DOI: 10.1155/2013/248196
Abstract: Objective. Evaluate the association between acculturation and binge drinking among six Asian-American subgroups. Methods. A cross-sectional analysis of public access adult portion of 2007, 2009, and 2011/2012 California Health Interview Survey data was conducted. Univariate and multivariable logistic regression analyses were utilized with any binge drinking in the past year as the outcome variable and language spoken at home and time in USA as proxy measures of acculturation. Results. A total of 1,631 Asian-Americans ( ) were identified as binge drinkers. Binge drinking was positively associated with being first generation South Asian ( , 95% , 5.98) and monolingual (English only) Vietnamese ( ; 95% , 5.70), especially among females. Other factors associated with increased binge drinking were being female (Chinese only), not being current married (South Asian only), and being an ever smoker (all subgroups except South Asians). Conclusion. First generation South Asians and linguistically acculturated Vietnamese, especially females, are at an increased risk of binge drinking. Future studies and preventive measures should address the cultural basis of such health risk behaviors among Asian-American adults. 1. Background The Asian-American racial group is comprised of those having origins or immigrated from the Far East, Southeast East, or the Indian Subcontinent, thus consisting of a vast range of nationalities and reflective of a heterogeneous population. According to the US Census Bureau’s 2010 Census Brief [1], a total of 10.2 million Asian-Americans (excluding those in combination with other races) were reported in 2000 and increased to 14.7 million by 2010, a 43.3% change. Of the Asian-American subgroups with at least one million responses were Chinese, Filipino, Asian-Indian, Vietnamese, Korean, and Japanese, with Asian-Indians experiencing the largest growth. Current estimates further report that by 2050, Asian-Americans are expected to comprise 9% of the entire US population, a rise of 4% compared to 2005 [2]. Such trends are indicative of an urgent need for research and health promotion measures to address the needs of a growing population. The Asian-American population also varies in their socioeconomic status. For example, Asian-Indians are more likely to have a Bachelor’s degree or higher compared to those who are Vietnamese. Similarly median household income can vary among Asian-Americans, ranging from $53,887 among Koreans to that of $90,528 among Asian-Indians [3]. Assessment of the National Health Interview Survey 2004–2006 further
Colorectal Cancer Screening for Average-Risk North Americans: An Economic Evaluation  [PDF]
Steven J. Heitman,Robert J. Hilsden,Flora Au,Scot Dowden,Braden J. Manns
PLOS Medicine , 2010, DOI: 10.1371/journal.pmed.1000370
Abstract: Background Colorectal cancer (CRC) fulfills the World Health Organization criteria for mass screening, but screening uptake is low in most countries. CRC screening is resource intensive, and it is unclear if an optimal strategy exists. The objective of this study was to perform an economic evaluation of CRC screening in average risk North American individuals considering all relevant screening modalities and current CRC treatment costs. Methods and Findings An incremental cost-utility analysis using a Markov model was performed comparing guaiac-based fecal occult blood test (FOBT) or fecal immunochemical test (FIT) annually, fecal DNA every 3 years, flexible sigmoidoscopy or computed tomographic colonography every 5 years, and colonoscopy every 10 years. All strategies were also compared to a no screening natural history arm. Given that different FIT assays and collection methods have been previously tested, three distinct FIT testing strategies were considered, on the basis of studies that have reported “low,” “mid,” and “high” test performance characteristics for detecting adenomas and CRC. Adenoma and CRC prevalence rates were based on a recent systematic review whereas screening adherence, test performance, and CRC treatment costs were based on publicly available data. The outcome measures included lifetime costs, number of cancers, cancer-related deaths, quality-adjusted life-years gained, and incremental cost-utility ratios. Sensitivity and scenario analyses were performed. Annual FIT, assuming mid-range testing characteristics, was more effective and less costly compared to all strategies (including no screening) except FIT-high. Among the lifetimes of 100,000 average-risk patients, the number of cancers could be reduced from 4,857 to 1,782 and the number of CRC deaths from 1,393 to 457, while saving CAN$68 per person. Although screening patients with FIT became more expensive than a strategy of no screening when the test performance of FIT was reduced, or the cost of managing CRC was lowered (e.g., for jurisdictions that do not fund expensive biologic chemotherapeutic regimens), CRC screening with FIT remained economically attractive. Conclusions CRC screening with FIT reduces the risk of CRC and CRC-related deaths, and lowers health care costs in comparison to no screening and to other existing screening strategies. Health policy decision makers should consider prioritizing funding for CRC screening using FIT. Please see later in the article for the Editors' Summary
A Framework to Examine the Role of Epigenetics in Health Disparities among Native Americans  [PDF]
Teresa N. Brockie,Morgan Heinzelmann,Jessica Gill
Nursing Research and Practice , 2013, DOI: 10.1155/2013/410395
Abstract: Background. Native Americans disproportionately experience adverse childhood experiences (ACEs) as well as health disparities, including high rates of posttraumatic stress, depression, and substance abuse. Many ACEs have been linked to methylation changes in genes that regulate the stress response, suggesting that these molecular changes may underlie the risk for psychiatric disorders related to ACEs. Methods. We reviewed published studies to provide evidence that ACE-related methylation changes contribute to health disparities in Native Americans. This framework may be adapted to understand how ACEs may result in health disparities in other racial/ethnic groups. Findings. Here we provide evidence that links ACEs to methylation differences in genes that regulate the stress response. Psychiatric disorders are also associated with methylation differences in endocrine, immune, and neurotransmitter genes that serve to regulate the stress response and are linked to psychiatric symptoms and medical morbidity. We provide evidence linking ACEs to these epigenetic modifications, suggesting that ACEs contribute to the vulnerability for developing psychiatric disorders in Native Americans. Conclusion. Additional studies are needed to better understand how ACEs contribute to health and well-being. These studies may inform future interventions to address these serious risks and promote the health and well-being of Native Americans. 1. Introduction Reservation-based Native Americans live in pervasively adverse social and physical environments that place them at increased risk of exposure to a myriad of stressors during childhood which impact their psychological and physical health over their lifetimes [1]. About 1 of 2.9 million Native Americans that identify as Native American alone resides on reservations [2]. Indian reservations were established by treaty during the Removal and Relocation (1827–1887) period and are lands set aside for tribes in exchange for ceded land and resources. Today there exist 275 Indian land areas in the USA administered as Indian reservations [3]. Of the ten poorest counties in America, five are home to an Indian reservation [4]. Concentrated poverty results in higher crime rates, underperforming public schools, poor housing, and poor health and limits access to many services and job opportunities [5]. Adverse childhood experiences (ACEs) that are substantial contributors to health disparities include childhood physical and sexual abuse, witnessing violence, poverty, and racism. The concept that these experiences become biologically
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