Health care experiences of Hispanics in new and traditional U.S. destinations.

Over the past 15 years, striking new settlement patterns have emerged that have brought about unprecedented geographic dispersion in the population of approximately 45 million Hispanics in the United States. In this study, the authors compare the health care experiences of working age U.S.-born Mexican Americans and Mexican immigrants living in new and traditional Hispanic destinations. They use a geocoded version of the Medical Expenditure Panel Survey Household Component linked to contextual data from secondary sources. They characterize destinations as new or traditional using information on the percentage of the population that was Hispanic in 1990 and the growth in percent Hispanic between 1990 and 2000. The authors find that, compared with living in destinations with a well-established Hispanic presence, U.S.-born Mexican Americans living in new destinations have less favorable health care outcomes, including a greater probability of having an unmet need for or delay in receiving medical care and reduced satisfaction with care.

Risk factors for chronic liver disease in Blacks, Mexican Americans, and Whites in the United States: results from NHANES IV, 1999-2004.

OBJECTIVES: Morbidity and mortality due to liver disease and cirrhosis vary significantly by race/ethnicity in the United States. We examined the prevalence of liver disease risk factors among blacks, Mexican Americans, and whites, including elevated aspartate aminotransferase and alanine aminotransferase activity, infection with viral hepatitis B or hepatitis C, alcohol intake, obesity, diabetes, and metabolic syndrome. METHODS: Data were obtained from the Fourth National Health and Nutrition Examination Survey (NHANES IV). A logistic regression was used to examine the association of race/ethnicity to liver disease risk factors, controlling for the demographic and socioeconomic variables. RESULTS: Mexican-American men and women are the most likely to have elevated aminotransferase activity. Among men, Mexican Americans are more likely than whites to be heavy/binge drinkers, and blacks are more likely to have hepatitis B or hepatitis C. Among women, Mexican Americans are more likely than whites to be obese and diabetic, and less likely to be heavy/binge drinkers; blacks are more likely than whites to have hepatitis B or hepatitis C, be obese or diabetic, and less likely to be heavy/binge drinkers. CONCLUSIONS: In this national sample, the prevalence of risk factors for liver disease varies by race/ethnicity. Mexican Americans and blacks have a greater risk of developing liver disease than their white counterparts. These findings are consistent with the observed racial/ethnic disparities in morbidity and mortality due to chronic liver disease and contribute to the efforts to identify the causes of these disparities. This information can be used by health professionals to tailor screening and intervention programs.

Neighborhood socioeconomic status and fruit and vegetable intake among whites, blacks, and Mexican Americans in the United States.

BACKGROUND: Socioeconomic and racial-ethnic disparities in health status across the United States are large and persistent. Obesity rates are rising faster in black and Hispanic populations than in white populations, and they foreshadow even greater disparities in chronic illnesses such as diabetes and cardiovascular disease in years to come. Factors that influence dietary intake of fruit and vegetables in these populations are only partly understood. OBJECTIVES: We examined associations between fruit and vegetable intake and neighborhood socioeconomic status (SES), analyzed whether neighborhood SES explains racial differences in intake, and explored the extent to which neighborhood SES has differential effects by race-ethnicity of US adults. DESIGN: Using geocoded residential addresses from the Third National Health and Nutrition Examination Survey, we merged individual-level data with county and census tract-level US Census data. We estimated 3-level hierarchical models predicting fruit and vegetable intake with individual characteristics and an index of neighborhood SES as explanatory variables. RESULTS: Neighborhood SES was positively associated with fruit and vegetable intake: a 1-SD increase in the neighborhood SES index was associated with consumption of nearly 2 additional servings of fruit and vegetables per week. Neighborhood SES explained some of the black-white disparity in fruit and vegetable intake and was differentially associated with fruit and vegetable intake among whites, blacks, and Mexican Americans. CONCLUSIONS: The positive association of neighborhood SES with fruit and vegetable intake is one important pathway through which the social environment of neighborhoods affects population health and nutrition for whites, blacks, and Hispanics in the United States.

Demographic and socioeconomic factors associated with blood lead levels among Mexican-American children and adolescents in the United States.

OBJECTIVE: This study was designed to assess demographic and socioeconomic differences in blood lead levels (BLLs) among Mexican-American children and adolescents in the United States. METHODS: We analyzed data from the Third National Health and Nutrition Examination Survey, 1988-1994, for 3,325 Mexican-American youth aged 1 to 17 years. The main study outcome measures included a continuous measure (microg/dL) of BLL and two dichotomous measures of BLL (> or =5 microg/dL and > or =10 microg/dL). RESULTS: The mean BLL among Mexican-American children in the United States was 3.45 microg/dL (95% confidence interval [CI] 3.07, 3.87); 20% had BLL > or =5 microg/dL (95% CI 15%, 24%); and 4% had BLL > or =10 microg/dL (95% CI 2%, 6%). In multivariate analyses, gender, age, generational status, home language, family income, education of head of household, age of housing, and source of drinking water were statistically significant independent predictors (p<0.05) of having higher BLLs and of having BLL > or =5 microg/dL, whereas age, family income, housing age, and source of drinking water were significant predictors (p<0.05) of having BLL > or =10 microg/dL. CONCLUSIONS: Significant differences in the risk of having elevated BLLs exist among Mexican-American youth. Those at greatest risk should be prioritized for lead screening and lead exposure abatement interventions.