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1.
J Immigr Minor Health ; 25(2): 382-388, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36050543

RESUMO

Anti-immigrant rhetoric and immigration policy enforcement in the United States over the last 2 decades has increased attention to fear of deportation as a determinant of poor health. We describe its association with mental health outcomes among Middle East and North African (MENA) residents of Michigan. Using a convenience sample of MENA residents in Michigan (n = 397), we conducted bivariate and multiple variable regression to describe the prevalence of deportation worry and examine the relationship between deportation worry and depressive symptoms (PHQ-4 scores). We found that 33% of our sample worried a loved one will be deported. Deportation worry was associated with worse mental health (p < 0.01). Immigration policies are health policies and deportation worry impacts mental and behavioral health.


Assuntos
Deportação , Saúde Mental , População do Oriente Médio , População do Norte da África , Humanos , Medo/psicologia , Política de Saúde , Michigan/epidemiologia , População do Norte da África/psicologia , Estados Unidos , População do Oriente Médio/psicologia
2.
Prev Med ; 159: 107054, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35460718

RESUMO

The cervical cancer screening behaviors of Arab American women are not adequately understood, in part because Middle Eastern North African (MENA) descent is not a US Census category. Others have shown decreased cervical cancer screening in this race of women. Our primary aim is to evaluate the predictors of cervical cancer screening among MENA, White and Black women of southeast Michigan. A community-wide health survey reached MENA, White and Black populations asking self-report questions about health behaviors, attitudes, and medical history. Cervical cancer screening was considered up-to-date if it was reported to have occurred within the past three years. Survey responses were limited to women 30-65 years old and were analyzed with inferential and logistic regression models to determine risk factors for cervical cancer screening. Overall, 78% reported cervical cancer screening within the past three years. MENA women screened less often if time in the US was less than ten years (aOR 0.24 (0.05, 0.76)) compared to more than ten years and if single (aOR 0.27 (0.07, 0.97)) compared to married. Religion was not associated with screening in any study population. Those of all races without insurance screened significantly less often than those with insurance. The barriers to cervical cancer screening among MENA women are not associated with religion but instead with lack of insurance and length of time residing in the US.


Assuntos
Detecção Precoce de Câncer , Neoplasias do Colo do Útero , Adulto , Negro ou Afro-Americano , Idoso , População Negra , Feminino , Humanos , Programas de Rastreamento , Michigan , Pessoa de Meia-Idade , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/prevenção & controle
3.
Ethn Dis ; 32(1): 11-20, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35106040

RESUMO

OBJECTIVE: Cost-related nonadherence to health maintenance behaviors is common in the general population, yet we know little about these behaviors in Middle East and North African (MENA) Americans. We examined cost-related nonadherence (CRN) in the MENA community in SE Michigan to determine demographic predictors, and risk and protective factors. DESIGN SETTING AND PARTICIPANTS: We used data from a cross-sectional convenience sample of MENA adults (N=398) conducted May-September 2019 to identify relevant demographic predictors, as well as the association between individual health, social, and clinical factors and the likelihood of reporting CRN. METHODS AND MEASURES: CRN was defined by whether respondents reported any of the following: that they took less medicine, skipped doses, or delayed getting a prescription filled. Other factors included patient/provider communication and racial concordance, mental health distress, food insecurity and insurance status. We used multivariable logistic regression models to determine association of these health and social factors with CRN. RESULTS: Those with highest incomes were least likely to report CRN. Participants with private insurance and with no coverage were more likely to report CRN compared with those with Medicaid coverage. Risk factors for CRN included food insecurity and mental health distress, though strong patient/provider communication was protective of CRN. DISCUSSION: The risk factors for CRN in the MENA community align with risk factors in the general population. As provider communication is protective of CRN, interventions focused on improving patient/provider communication may serve as a way to protect against financially motivated medication nonadherence.


Assuntos
Cobertura do Seguro , Adesão à Medicação , Adulto , Estudos Transversais , Humanos , Fatores de Proteção , Fatores de Risco , Estados Unidos
4.
J Immigr Minor Health ; 24(2): 376-384, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33704656

RESUMO

Social factors (e.g. housing, food security, etc.) contribute significantly to health. The purpose of this study is to describe social risk and social exclusion factors in one of the largest Middle Eastern and North African (MENA) populations in the U.S. and their association with health outcomes. We conducted a cross-sectional study with a community convenience sample of 412 adults who self-identify as MENA. Weighted, adjusted linear regression models were used to examine relationships of interest. Prevalent social risks included transportation barriers to healthcare (33%), food insecurity (33%), and financial strain (25%). In adjusted models, perception of being treated unfairly (Estimate (SE) 0.08 (0.04), p < 0.05) and fear of deportation (0.26 (0.06), p < 0.001) were associated with more social risk factors. More social risk factors were associated with worse self-reported health (0.09 (0.03), p < 0.01), more chronic conditions (0.11 (0.03), p < 0.004), and more mental health symptoms (0.34 (0.14) p < 0.01).Social risk is high among those perceiving unfairness and fear deportation. Those with more social risk factors reported worse health. These findings have implications for social needs screening and referral models that can best serve U.S. MENA sub-populations.


Assuntos
População Negra , Saúde Mental , Adulto , Estudos Transversais , Humanos , Avaliação de Resultados em Cuidados de Saúde , Fatores de Risco
5.
Elife ; 102021 08 24.
Artigo em Inglês | MEDLINE | ID: mdl-34427182

RESUMO

Background: Women 50-65 years of age have the lowest cervical and colorectal cancer (CRC) screening rates among ages recommended for screening. The primary aim of this work is to determine how cancer risk perceptions and provider communication behaviors, in addition to known demographic factors, influence the uptake of both cervical and CRC screening or a single screen among women in southeast Michigan. Methods: Fourteen health services and communication behavior questions were adapted from the Health Information National Trends Survey (HINTS) and administered to a multiethnic sample of adults in southeast Michigan. The outcome variable was self-reported up-to-date cervical cancer and/or CRC screening as defined by the United States Preventive Services Task Force (USPSTF). Demographic and cancer risk/communication behavior responses of the four screening populations (both tests, one test, no tests) were analyzed with multinomial regression for all comparisons. Results: Of the 394 respondents, 54% were up to date for both cervical and CRC screening, 21% were up to date with only cervical cancer screening and 12% were up to date for only CRC screening. Of the 14 risk perception and communication behavior questions, only 'Did your primary care physician (PCP) involve you in the decisions about your health care as much as you wanted?' was significantly associated with women having both screens compared to only cervical cancer screening (aOR 1.67; 95% CI: 1.08, 2.57). The multivariate model showed age, and Middle East and North African (MENA) ethnicity and Black race, in addition to PCP-patient dyad decision-making to be associated with the cancer screenings women completed. Conclusions: Optimizing PCP-patient decision-making in health care may increase opportunities for both cervical cancer and CRC screening either in the office or by self-sampling. Understanding the effects of age and the different interventional strategies needed for MENA women compared to Black women will inform future intervention trials aimed to increase both cancer screenings. Funding: This work was supported by NIH through the Michigan Institute for Clinical and Health Research UL1TR002240 and by NCI through The University of Michigan Rogel Cancer Center P30CA046592-29-S4 grants.


Assuntos
Neoplasias Colorretais/diagnóstico , Detecção Precoce de Câncer/psicologia , Programas de Rastreamento/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Médicos/psicologia , Neoplasias do Colo do Útero/diagnóstico , Estudos Transversais , Feminino , Comunicação em Saúde , Humanos , Michigan , Pessoa de Meia-Idade , Percepção , Fatores de Risco , Fatores Socioeconômicos
6.
JMIR Public Health Surveill ; 7(5): e26622, 2021 05 10.
Artigo em Inglês | MEDLINE | ID: mdl-33970121

RESUMO

BACKGROUND: Two psychosocial constructs that have shown consistent associations with negative health outcomes are discrimination and perceived unfairness. OBJECTIVE: The current analyses report the effects of discrimination and unfairness on medical, psychological, and behavioral outcomes from a recent cross-sectional survey conducted in a multiethnic sample of adults in Michigan. METHODS: A cross-section survey was collected using multiple approaches: community settings, telephone-listed sample, and online panel. Unfairness was assessed with a single-item previously used in the Whitehall study, and everyday discrimination was assessed with the Williams 9-item scale. Outcomes included mental health symptoms, past-month cigarette use, past-month alcohol use, past-month marijuana use, lifetime pain medication use, and self-reported medical history. RESULTS: A total of 2238 usable surveys were collected. In bivariate analyses, higher unfairness values were significantly associated with lower educational attainment, lower age, lower household income, and being unmarried. The highest unfairness values were observed for African American and multiracial respondents followed by Middle Eastern or North African participants. Unfairness was significantly related to worse mental health functioning, net adjustment for sociodemographic variables, and everyday discrimination. Unfairness was also related to self-reported history of depression and high blood pressure although, after including everyday discrimination in the model, only the association with depression remained significant. Unfairness was significantly related to 30-day marijuana use, 30-day cigarette use, and lifetime opiate use. CONCLUSIONS: Our findings of a generally harmful effect of perceived unfairness on health are consistent with prior studies. Perceived unfairness may be one of the psychological pathways through which discrimination negatively impacts health. Future studies examining the relationships we observed using longitudinal data and including more objective measures of behavior and health status are needed to confirm and extend our findings.


Assuntos
Negro ou Afro-Americano , Nível de Saúde , Saúde Mental , Justiça Social , Adulto , Estudos Transversais , Humanos , Percepção Social , Inquéritos e Questionários
7.
J Racial Ethn Health Disparities ; 8(4): 1067-1078, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32974877

RESUMO

BACKGROUND: Southeast Michigan is home to the second largest Middle Eastern and North African (MENA) US population. There is increasing interest in understanding correlates of psychosocial outcomes and health behaviors in this growing population. One potentially important health correlate is ethnic identity (EI). This paper reports the development, validity, and initial correlates of a new measure of MENA identity named the MENA-IM. METHODS: We used convenience sampling at locations frequented by individuals of MENA descent in southeast Michigan. We also measured EI centrality, religiosity, cultural mistrust, substance use, and health status to assess convergent and divergent validity. Exloratory and Confirmatory Factor Analysis identified three subscales, which were valid for both Arab and Chaldean respondents and were named (1) MENA cultural affiliation, (2) MENA media use, and (3) multicultural affiliation. We also created and tested a 20-item, single-factor version. RESULTS: We obtained data from 378 adults, 73% of whom identified as Arab and 27% as Chaldean. MENA-IM scores were higher among older, lower-educated, lower-income, non-US born, and Arabic-speaking respondents. Arab respondents reported significantly higher scores than Chaldeans. MENA-IM scores were positively associated with EI centrality and religiosity. Higher MENA-IM scores were found among those not reporting use of marijuana, alcohol, and opiates. Higher MENA-IM scores were also found among those without a self-reported history of heart disease and among those with better mental health status. DISCUSSION: The MENA-IM has strong psychometric properties and demonstrated initial evidence of convergent and discriminant validity. In general, values on the measure were associated with better psychosocial and health status. How the measure performs with MENA populations outside of Michigan and how it may relate to other health outcomes merit investigation.


Assuntos
Asiático/psicologia , Negro ou Afro-Americano/psicologia , Identificação Social , Inquéritos e Questionários , Adolescente , Adulto , África do Norte/etnologia , Negro ou Afro-Americano/estatística & dados numéricos , Asiático/estatística & dados numéricos , Feminino , Nível de Saúde , Humanos , Masculino , Michigan , Oriente Médio/etnologia , Psicometria , Reprodutibilidade dos Testes , Fatores Sociodemográficos , Adulto Jovem
8.
BMC Public Health ; 20(1): 1685, 2020 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-33172422

RESUMO

BACKGROUND: Arab-Americans constitute ~ 5% of Michigan's population. Estimates of obesity in Arab-Americans are not up-to-date. We aim to describe the distribution of and factors associated with obesity in an Arab-American population in Southeastern Michigan (SE MI). METHODS: Retrospective medical record review identified n = 2363 Arab-American patients seeking care at an Arab-American serving clinic in SE MI, located in a city which is home to a large proportion of Arab-Americans in the United States (US). Body mass index (BMI) was the primary outcome of interest. Distribution of BMI was described using percentages, and logistic regression models were constructed to examine the association between obesity, other comorbid conditions and health behaviors. This cohort was compared to Michigan's Behavioral Risk Factor Surveillance System (BRFSS) data from 2018 (n = 9589) and to a cohort seeking care between 2013 and 2019 from a free clinic (FC) located in another city in SE MI (n = 1033). RESULTS: Of the 2363 Arab-American patients, those who were older or with HTN, DM or HLD had a higher prevalence of obesity than patients who were younger or without these comorbidities (all p-value < 0.001). Patients with HTN were 3 times as likely to be obese than those without HTN (95% CI: 2.41-3.93; p < 0.001). Similarly, the odds of being obese were 2.5 times higher if the patient was diabetic (95% CI: 1.92-3.16; p < 0.001) and 2.2 times higher if the patient had HLD (95% CI: 1.75-2.83; p < 0.001). There was no significant difference in obesity rates between Arab-Americans (31%) and the BRFSS population (32.6%). Compared to Arab-Americans, patients seen at the FC had a higher obesity rate (52.6%; p < 0.001) as well as significantly higher rates of HTN, DM and HLD (all p < 0.001). CONCLUSION: Overall obesity rates in Arab-Americans were comparable to the population-based BRFSS rates, and lower than the patients seen at the FC. Further studies are required to understand the impact of obesity and the association of comorbidities in Arab-Americans.


Assuntos
Árabes , Diabetes Mellitus , Diabetes Mellitus/epidemiologia , Humanos , Michigan/epidemiologia , Obesidade/epidemiologia , Estudos Retrospectivos , Estados Unidos
9.
Am J Med Genet A ; 128A(4): 374-82, 2004 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-15264282

RESUMO

Acromelic frontonasal dysostosis (AFND) represents a subgroup of patients with frontonasal malformation with limb abnormalities including preaxial polydactyly and tibial hypoplasia. Previous case reports have suggested autosomal recessive inheritance, given parental consanguinity. However, no affected siblings have been described. Longitudinal clinical history is limited as many do not survive the first years of life. The molecular basis of AFND is not known. Previous investigators have proposed that AFND may result from a perturbation in the Sonic Hedgehog pathway. We present clinical and radiographic findings in two unrelated boys, ages 8 and 9 years, with AFND, one of whom has a family history suggesting dominant inheritance. A focused study of genetic marker data and candidate gene mutation analysis in this family is presented.


Assuntos
Anormalidades Múltiplas/genética , Disostose Craniofacial/genética , Genes Dominantes , Anormalidades Múltiplas/diagnóstico por imagem , Criança , Disostose Craniofacial/diagnóstico por imagem , Análise Mutacional de DNA , Feminino , Genótipo , Haplótipos , Humanos , Masculino , Repetições de Microssatélites , Linhagem , Penetrância , Polidactilia/diagnóstico por imagem , Polidactilia/genética , Tíbia/anormalidades , Tíbia/diagnóstico por imagem , Tomografia Computadorizada por Raios X
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