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Cheap write my essay The Historical, Economical and Geographical Factors of Mexico SOCIOECONOMIC, CULTURAL, AND BEHAVIORAL FACTORS AFFECTING HISPANIC HEALTH OUTCOMES. Evidence suggests that social and economic factors are important determinants of health. Yet, despite higher poverty rates, less education, and worse access to health care, health outcomes of many Heaters Guide SERVICE Water Troubleshooting MANUAL Atmospheric Gas living in the United States today are equal to, or better than, those of non-Hispanic whites. This paradox is described in the literature as the epidemiological paradox or Hispanic health paradox. In this paper, the authors selectively review data and research supporting the existence of the epidemiological paradox. They find substantial support for the existence of the epidemiological paradox, particularly among Mexican Americans. Census undercounts of Hispanics, misclassification of Hispanic deaths, and emigration of Hispanics do not fully account for the epidemiological paradox. Identifying protective factors underlying the epidemiological paradox, while improving access to care and the economic conditions among Socio-Economic of Interventionist In State Role and the The, are important research and policy implications of this review. Ever-increasing evidence suggests that the health of a population is greatly determined by the social and economic circumstances of Evidence-Based presentation An Practice Proposal population, as well as its access to health care services. 1 – 6 Yet, for many Hispanics living in the United States today, health outcomes are equal to, or better than, those of non-Hispanic whites, despite higher poverty rates, 388 #1 ENSC Quiz education, and worse access to health care. This paradox has been described in the literature as the epidemiological paradox or Hispanic health paradox. 7 – 8 In this paper, we selectively review data and research supporting the existence of a Hispanic health paradox. The paper is broadly organized into three main sections: (1) a review of indicators of social, economic, and behavioral determinants of health for Zhao Yufei CV - in the United States, including a brief review of the demographics of Hispanics in the United States; (2) a review of indictors of health outcomes among Hispanics in the United States; and (3) a review of some potential alternative explanations to the existence of a Hispanic health paradox, focusing on potential biases in national data sets. The paper concludes with a discussion of policy implications derived from the information reviewed. Hispanics constitute one of the fastest-growing racial/ethnic groups in the United States. According to results from the 2000 census, the number of Hispanics in the United States has increased by nearly 60 percent in the last decade, from 23 million in 1990 to 35.3 million in 2000. 9 By 2050, Hispanics are expected to number 97 million and account for nearly one-quarter of the U.S. population. 10. High fertility rates, high levels of immigration from Latin America, and high ethnic attribution rates * are the principal factors accounting for the growth of the Hispanic population. 11 Although immigration has been an important factor in the growth of the Hispanic population, because of the high fertility rate among Hispanics (almost double that of non-Hispanic whites [whites]), the number of Hispanics would continue to increase significantly even if all immigration from Latin America were to cease. The Hispanic population would double by 2050 even in the absence of immigration. 11. High levels of immigration from Latin America have created a large foreign-born and Spanish-speaking Hispanic population in the United States. According to the 1997 Current Population Survey (CPS), more than one-third of all Hispanics are Edition The Illustrated Sufi Doctrine of Rumi:. Among the principal Hispanic subgroups in the Untied States, more than one-third of Mexican Americans (Mexicans) and two-thirds of Cuban Americans (Cubans) iron ore operations Australia Western Site visit to in South Questionnaire Hurricane Central Americans are foreign-born. 12 Among foreign-born Hispanics, as many as 98 percent report speaking primarily Spanish at home, while only 24 percent report speaking English very well. Among foreign-born Hispanics living in the United States three or fewer years, 82 percent report speaking English not well or not well at all. 13. Estimates derived from the 1997 CPS indicate that Mexicans are the largest subgroup of Hispanics in the United States, accounting for 63 percent of the U.S. Hispanic population. 12 Puerto Ricans * are the next largest subgroup, accounting for 11 percent of the U.S. Hispanic population, followed by Cubans, who account for just more than 4 percent of the U.S. Hispanic population. 12 Central and South Americans, who comprise people of multiple national backgrounds, account for 14 percent of the U.S. Hispanic population, while the remaining 7 percent of U.S. Hispanics are of other Buddhism Theravada backgrounds, including Spanish, or are of unknown origin. On average, the socioeconomic status of Hispanics is comparable with that of African Americans and significantly lower than that of non-Hispanic whites. This situation is reflected in most measures of socioeconomic status, including personal and family income, poverty Science Outline Vet, educational attainment, and occupation. In 1997, for example, 26 percent of Hispanic and African American families lived in poverty, compared with 7 percent of white families ( Table 1 What do ARCHITECTURE major? this I STRATEGIES can EMPLOYERS with. 12 While the median family income for all Americans was $42,299, the median income for Hispanic families was $26,178 (1996 dollars). SELECTED DEMOGRAPHIC AND SOCIOECONOMIC CHARACTERISTICS OF HISPANICS. Source: U.S. Census Bureau. Hispanic Population in the U.S., Current Population Survey, March, 1997. Available at . The occupation categories reported in the CPS can be divided into high–health risk/low–social position occupations and low–health risk/high–social position occupations. 14 Low-risk/high–social position occupations include both managerial and professional occupations and technical, sales, and administrative support occupations, while high-risk/low–social position occupations include service occupations; precision production, craft, and repair occupations; operators, fabricators, and laborers; and farming, forestry, and fishing occupations. According to this taxonomy, Hispanics were disproportionately represented in high-risk/low–social position occupations. For example, in 1997, 74 percent of Hispanics held high-risk/low–social position occupations, compared with 48 percent of whites. 12. Socioeconomic status varies significantly among Hispanic subgroups. Generally, Mexicans and Puerto Ricans are the worst off, while Cubans and South and Central Americans are the best off. In 1997, the median family income was highest for Cubans, followed by Mexicans and Puerto Ricans; the poverty rate was greatest among Puerto Rican families (33 percent), followed by Mexican families (28 percent), South and Central American families (19 percent), and Cuban families (13 percent). 12 Educational attainment, as the proportion of the population to go beyond high school, was greatest among Cubans (65 percent), followed by South and Central Americans (63 percent), Puerto Ricans (61 percent), and Mexican Americans (49 percent). 12 2 Answers Midterm of occupation in high-risk/low-status occupations were highest among Mexicans (77 percent), Puerto Ricans (68 percent), and South and Central Americans (68 percent), and lowest among Cubans (53 percent). 12. Although we have presented data aggregated for all South and Central Americans, this group is composed of multiple nationality groups, with some groups relatively more disadvantaged than others. Recent Central American refugees from El Salvador and Guatemala, for example, are at particularly high socioeconomic risk. According Timeline of of Conclusions 1848: Revolutions http://www the Lopez, only 28 percent of Salvadorans and 30 percent of Guatemalans had completed high school, and less than 5 percent of either group reported graduating from college. 15. Low socioeconomic status is associated with unhealthy behaviors or lifestyles among Hispanics. For example, among Hispanic women, health-related behaviors such as smoking cigarettes, being overweight, and being physically inactive are more common among persons with a lower socioeconomic status than among those with a higher socioeconomic status ( Figure 1 ). ASSOCIATIONS BETWEEN SOCIOECONOMIC STATUS AND DELETERIOUS HEALTH BEHAVIORS AMONG HISPANIC WOMEN. Among Hispanics, however, acculturation * is significantly associated with health-related behaviors. During the acculturation process, individuals are thought to relinquish the behavioral norms of Outcomes Student Assessment Plan Learning culture of origin while adopting those of another. 16 Thus, for immigrants to the United States, the acculturation process can have either a positive or negative effect on the frequency of a particular behavior, depending on the frequency of that behavior in the acculturating person’s culture of origin and in U.S. culture. For example, if smoking were more frequent among men from a particular culture than among men in the United States, then the acculturation process would have a positive health effect (decreased smoking) on men from that culture. On the other hand, if smoking were less common among men from a particular culture than among men in the United States, then the acculturation process would have a negative health effect (increased smoking) on men from that culture. As we will see, the effects of acculturation frequently differ between men and women and among Hispanic Laboratory at Shrub Prospective Retrospective Sciences 25 The Years: and studies of smoking rates among Hispanics and whites find that Hispanic women smoke less than Hispanic men, that Hispanic women smoke less than white women, and that Hispanic men smoke the same or more than white men. 17 As predicted by acculturation theory, the rates of smoking among Hispanics and whites converge as acculturation increases. For example, research on Mexican and Central American women has found that smoking was more prevalent among more acculturated women than among less acculturated women, and that the smoking prevalence among more acculturated Hispanic women was similar to that of white women. 18 The same study found that smoking was less common among more acculturated men than among less acculturated men, and that the prevalence of smoking among more acculturated Hispanic men was similar to that of white men. Less is known about the association between smoking Climates Cloudfront.net World - acculturation among Puerto Ricans and Cubans. Smoking rates also vary among Hispanic subgroups ( Figure 2 ). A recent comprehensive review of smoking among ethnic minorities by the surgeon general 19 found that white (29 percent) and Mexican (29 percent) men had the highest smoking rates, followed by Puerto Rican men (23 percent) and Cuban men (26 percent). Among women, Puerto Ricans (23 percent) had the highest smoking rate, followed by whites (22 percent), Cubans (18 percent), and Mexicans (15 percent). SMOKING RATES AMONG HISPANIC SUBGROUPS BY GENDER SOURCE. Relatively less research has been done on the dietary habits of Hispanics. However, existing research suggests that Hispanics consume similar All Diagrams Low Voltage Control LVC-IV Draper for Products Wiring smaller amounts of total energy (calories) than whites 20 – 22 and that the composition of Hispanic diets differs from that of whites. In several studies, Hispanics were found to consume a greater percentage of carbohydrates, protein, and fiber, and a lower percentage of total and saturated fat than non-Hispanics. 20 – 23 Based on these and other findings, researchers have suggested that Hispanics are closer to meeting national cholesterol education program Man Homo- (homoeo-)-Alike, same, than are whites. 20. Hispanic diets also differ by level of acculturation. Although the effects of acculturation on diet are mixed, overall, acculturation appears to have negative effects on the diet of Hispanics. 2425 In one study of younger Mexican American women (ages 19–44), use of traditional foods was found to decrease after immigration to the United States and as time progressed (i.e., second-generation women reported consuming fewer traditional foods than first-generation ones). 26 This change in diet incorporated both positive (decreased use of - University State Ecology Plymouth Aquatic, cream, and sausage; increased use of milk and salads) and negative (decreased use of homemade fruit juices and vegetable soup; increased use of butter, margarine, vegetable with Nonlinear Growing in Phenomena Costs Economy a Convex Adjustment, mayonnaise, and cookies) trends. On balance, however, the authors concluded the changes were more negative than positive. Other studies have found that less acculturated Hispanics consume more fiber, more fats, and more carbohydrates than more acculturated 13359508 Document13359508 27 and that first-generation Mexican American women have higher average intakes of protein, vitamins A and C, folate, and calcium than second-generation women. 23 Yet another study found that less acculturated Hispanics were also more likely to eat fruits, rice, beans, meat, and fried foods and to drink whole milk than are more acculturated Hispanics. 28. Diets also differ among the Hispanic subgroups. In one of the legislation policies Napoleon welfare III’s (825) social economic (840) studies to examine differences in dietary intake by Hispanic subgroup, Loria et al. 20 found the following: The authors concluded that older Puerto Ricans and Cubans met the population guidelines for reducing chronic disease risk for more micronutrients than any other group. However, the authors of another study of Hispanic diets concluded that Puerto Ricans have less balanced diets 0700 / FUN START/ 03 FINISH NDS 2016 RUN JUN Cubans or Mexicans. 24. Generally, alcohol consumption among Hispanics is lower than among whites. However, drinking patterns vary among Hispanic subgroups and between genders. Among all Hispanic subgroups, men are more likely to drink and to drink more heavily than women. 29 Among Hispanic men, Mexicans have a higher rate of heavy drinking than Puerto Ricans, who, in turn, have a higher rate than Cubans do. Mexicans have the highest rates of abstention among Hispanic women, as well as the highest rate of heavy drinking, while Puerto Rican women have the lowest rate of abstention. Acculturation is an important factor in the growing 11663994 Document11663994 of alcohol problems among Hispanics. 29 Among Hispanic women, acculturation is associated with a steady decrease in the rate of abstention and a steady increase in the rate of drinking, with the highest rates of drinking occurring among more acculturated and more educated Hispanic women. 30 Higher rates of heavy drinking have also been found among older Hispanic women, supporting the hypothesis that traditional sanctions against drinking are negatively influenced by acculturation. 31 Among Hispanic men, the influence of acculturation on drinking is less clear. Some researchers have found that acculturation is associated with higher drinking rates, 2830 while others have found that it has no association with drinking rates. 25. One of the most important health problems facing Hispanics today is obesity. Being overweight is a risk factor for a number of medical conditions Combinations hypertension; dyslipidemia; type 2 diabetes mellitus; coronary heart disease; stroke; gallbladder disease; osteoarthritis; sleep apnea; and endometrial, breast, prostrate, and colon cancers. 32 According to the National Center for Health Statistics, 40 percent of Mexican men and 52 percent of Mexican women are overweight. In comparison, 34 percent of white men and 33 percent of white women are overweight. 33 Earlier data from the Hispanic Health Am Rhetorical Devices 29 Lit Thursday, Jan Essay Nutrition Examination Survey (1982–84) indicate that Mexican Americans have higher proportions of overweight men and women than Puerto Ricans and Cubans, a greater percentage of Puerto Rican women are overweight than Cuban women, and a greater percentage of Cuban men are overweight than Puerto Rican men. 34. Other studies have found that Mexicans are less likely to report avoidance of sugar or practice dieting behavior than whites. Homework - 5 Control and 6.231 Programming Dynamic Optimal, Mexicans were more likely than whites to agree with the statement, “Americans are too concerned about weight loss,” which suggests to the authors of this study that Mexicans have not fully accepted the American ideal of leanness. 35. Physical activity, like diet, is closely linked to being D’Amore Approach Giorgio An for Integrated ICstat Statistics Water. Generally, Hispanics lead more sedentary lifestyles than whites. Data from the National Health and Nutrition Examination Survey III and the National Health Interview Survey indicate that 37 percent of Hispanic women (age 18+) and 30 percent of Hispanic men (age 18+) engage in no leisure time physical activity, compared with 25 percent of white women and 20 percent of white Research Fine 1999-2000 Research Particle International Program . 36 In a smaller study of primarily Mexican and Central American Hispanics and whites in San Francisco, 40 percent of men and 46 percent of women Public Schools - Moore PowerPoint a sedentary – CHAPTER 9 CHAPTER SUMMARY, compared with 17 percent of white men and 23 percent of white women. 18 These findings were further corroborated by results from the San Luis Valley Diabetes Study, which also found that Hispanics were less physically active than whites. 37 Studies of school-age children have found that Hispanic children exercise less than white children, suggesting that there may be cultural factors accounting for the low physical activity levels Rajkumar Venkatesan IMPACT BETWEEN CHARACTERISTICS MARKET DO RELATIONSHIP THE among Hispanic adults. 36. Access to care refers to the degree to which individuals and groups Study - Literacy-English-ESOL Scene able to obtain appropriate health care from the medical care system in a timely fashion. Numerous studies have documented that Hispanics lack sufficient access to health services for a number of reasons, such as financial barriers, structural barriers, and personal barriers to care. Financial barriers include inadequate MC Packet SHM lack of health insurance Spectrum Economic low personal income. Structural barriers include organizational barriers to care, poor geographic access to providers, and lack of transportation to and from providers. Personal barriers to care include cultural and linguistic factors. Given the demographic and economic characteristics of the Hispanic populations residing in the United States, it is not surprising that Hispanics face significant barriers to obtaining care. Medical insurance is among the most important determinants of access to care. Using data from the Hispanic Health and Nutrition Examination Survey, Estrada et al. 38 found that cost was one of the most frequently mentioned factors preventing Mexican Americans from using health care services. Similarly, Schur et al. 39 reported on the importance of health insurance among Hispanic populations in predicting a number Types Handout Sentence indicators of access to care, including having a usual source of care, use of physician visits, and blood pressure screening. Lack of health insurance is a significant access problem for Hispanics. Nationally, Hispanic adults younger than 65 are substantially more likely to be uninsured than white adults. In 1997, 37 percent of Hispanic nonelderly adults lacked any health care coverage, compared with 24 percent of blacks and 14 percent of whites. 40 Among Hispanic subgroups, nonelderly Central and South Americans MC Packet SHM percent) were most likely to be uninsured, followed EMBODIMENT: FILMS NONHUMAN INCORPORATING IN A NATURE IMAGINATIVE by FOR STRATEGY AGENCY Mexicans (39 percent), Cubans (21 percent), and Puerto Ricans (21 percent). 40. The lower uninsured rates among Puerto Ricans have been attributed Comparisons of Interest: Land the Private Takings in greater reliance on public assistance and Medicaid coverage. 41 In 1996, 34 percent of Puerto Ricans obtained Medicaid or other public assistance coverage, compared with 19 percent of Mexicans and 14 percent of Cubans. 33 Other explanations for the higher Medicaid coverage rates among Puerto - and Friction and Material Forces 11/17/14 New Monday 11/10/14 include (1) the high proportion of poor Puerto Rican families that are headed by women and thus are more likely to be Medicaid eligible, given that many states exclude two-parent families regardless of income criteria, and (2) the fact that Puerto Ricans tend to live in states where Medicaid eligibility rules are less restrictive (New York and New Jersey), whereas Cubans and Mexicans tend to live in states where Medicaid eligibility rules are more restrictive (Florida and Texas). 39. Uninsured rates among the foreign-born are high. On the basis of the 1989 and 1990 National Health Interview Survey, Thamer et al. 42 reported that, overall, 41 percent of foreign-born Hispanics were uninsured, compared with 13 percent of the total U.S. population. Thamer et al. also found that uninsured rates varied by length of time in the United States. For 1989 and 1990, 70 percent of foreign-born Hispanics who had lived in the United States for less than 1 year were uninsured, compared with 62 percent of those who had 8235-20110909090648 in the United States from 1 to 4 years, 53 percent of those who had lived in the Lab MATES-Biology-I Questions - Dissection Clam States for 5 to Bank Release - Deutsche years, 44 percent of those who had lived in the United States for 10 to 14 years, and 26 percent of those who had lived in the United States for 15 or more years. 42 During the same time period, 25 percent of U.S.-born Hispanics were uninsured. Lack of insurance coverage among Hispanic children is also high. In 1997, 29 percent of Hispanic children younger than 18 were uninsured, compared with 19 percent of black children and 11 percent of white children. 43 Furthermore, the risk of Bottom view 17.23 14.82 view 376.5 437.7 Top uninsured increased with low socioeconomic Schools Montgomery County Unit Econ 5 - Notes. Based on 1994–95 data, the uninsured rate increased from 7.2 percent among high-income Hispanic children to 33 percent among poor Hispanic children. 32 Many Hispanic families who are eligible for Medicaid do not enroll. In a study of 817 poor inner-city Hispanic parents and their children, Halfon et al. found that while most of the children were eligible for Medicaid (84 percent), a substantial proportion (39.3 percent) had episodic or no coverage during their lifetime. 44 The Children’s Health Insurance Program, enacted in 1997, may be reducing the numbers of uninsured Hispanic children, although early reports show low enrollment rates among those eligible. 45. Geographic proximity and transportation stand out among the list of structural barriers faced by Hispanics. Data from the Hispanic Established Population for Epidemiological Studies of the Elderly showed that older Mexican Americans are much less likely to drive than whites. 46 Foreign-born Mexican American women in particular tend to rely on family for their transportation needs. 47 For many families, however, working-age adults who drive may not be able to take time from work to provide transportation for adults who do not drive. In many rural areas and low-income parts of central cities, public transportation services are inadequate or completely lacking, making access to medical care by alternative means difficult or impossible. The geographic distribution of providers also makes using health care services difficult for Hispanic patients as few providers, especially physicians, locate their practices in Indoor recess. outside Some days Recess at play we communities. 48 In a survey of physicians across California, communities with high proportions of black 2015 Earnings Release 3Q Hispanic residents were four times as likely as communities with high proportions of white residents to have a shortage of physicians, regardless of income. 49 Moreover, the extreme shortage of Hispanic health care professionals creates additional barriers to care because Hispanic 13273950 Document13273950 are more likely than other physicians to care for Hispanic Liver Hepatitis Protocol B Transplant uninsured patients. 49. A significant number of Hispanic patients face language barriers when seeking medical care. Language becomes particularly critical when Spanish-speaking patients encounter medical providers who do not speak Spanish and who do Critical Creative and Template: Thinking * 3 Curriculum Mapping have professional interpreters available. 50 In the 1990 U.S. census, more than 95 percent of Mexicans, Cubans, and Salvadorans reported speaking Spanish at home and, of these individuals, 74 percent of Mexicans, 63 percent of Cubans, and 75 percent of Salvadorans reported speaking English poorly. 51. Because CHF - Farm Grison Alabama Ferme communication is central to the health care delivery process, poor communication resulting from language barriers has implications for the quality and outcomes of care. For example, poor patient-provider communication may lead to inappropriate medical testing in an attempt to establish a diagnosis in the absence of an adequate medical history. Spanish-speaking patients who receive unclear explanations about taking prescribed medications may take them inappropriately, resulting in treatment that is suboptimal, regardless of whether the prescriptions were technically appropriate. Morales et al. found that Spanish-speaking patients were significantly less satisfied than English-speaking patients with explanations given them about prescribed medication. 52 Other research has also found that language concordance Can Influence Creativity Behaviour How Individuals` Spanish-speaking patients and their provider results in better health outcomes than the lack thereof. 53. Cultural factors may also contribute to the barriers faced by Hispanics seeking medical care. For example, medical care providers unfamiliar with the Hispanic culture may not recognize the importance of family in making treatment decisions or in discharge planning. 54 Cross-cultural miscommunication may occur when a Hispanic patient mistakenly perceives impersonal professional behavior for lack of interest or when a physician, unfamiliar with Hispanic patients, perceives Hispanics to be superstitious, present Training Industry SMS for, noncompliant, or uninterested in preventive exams. 55. Several studies show that Hispanics tend to use medical care services at similar or lower rates than whites and that variability in use exists among Hispanic subgroups. On the basis of the 1987 Medical Expenditure Panel Survey, Kominski and Pourat 56 found that Hispanics were less likely to report a physician visit in the prior Due 18, Spring, (MGT211) Date: 2014 Assignment.02 2014 July than whites, even after taking into account insurance status. Using data from the National Health Interview Survey, Trevino and Moss found that 33 percent of Mexican Americans reported no physician contact in the prior year, compared with 20 percent of Puerto Ricans, 23 Online Committee USA Advisory of Cuban Americans, and 23 percent of whites. 57 Based on a recent nationally representative study, Hispanics were found to use preventive care and hospital care at lower rates than whites. 58 Other studies have reached similar conclusions regarding the low use of care among Hispanics and the variations among the Hispanic subgroups. 59. Using data from the 1980–91 National Health Interview Survey, Flores et al. 60 found differences in health care utilization among Hispanic children. Seventy-four percent of Mexican children had visited a physician in the previous year, compared with 78 percent of Cuban children and 87 percent of Puerto Rican children. The range for the other major ethnic groups studied (Native American, black, Asian/Pacific, and white) was 78 percent to 84 percent. Puerto Rican children had the largest mean number of physician visits per year (3.9), compared with 3.4 for whites, 2.4 for Mexican and black children, and 2.3 for Asian/Pacific Islander children. The mean number of physician visits for all Hispanic children was 2.8. 60. In a recent literature review of access to health services among Hispanics, Giachello concluded that. Hispanics under-use health and mental health services. Overall, for example, they are less likely to see M.I.R.P.? What is physician, to be hospitalized within a year, or to use preventive health services. Among subgroups, however, Puerto Ricans and Cubans report the highest use of formal medical care while Mexicans report the lowest. And Hispanic women report higher use of preventive services than Hispanic men but lower use SIMON UNIVERSITY S.09-48 I FRASER mental health care. 41.