RESUMO
Latin America continues to be severely underrepresented in genomics research, and fine-scale genetic histories and complex trait architectures remain hidden owing to insufficient data1. To fill this gap, the Mexican Biobank project genotyped 6,057 individuals from 898 rural and urban localities across all 32 states in Mexico at a resolution of 1.8 million genome-wide markers with linked complex trait and disease information creating a valuable nationwide genotype-phenotype database. Here, using ancestry deconvolution and inference of identity-by-descent segments, we inferred ancestral population sizes across Mesoamerican regions over time, unravelling Indigenous, colonial and postcolonial demographic dynamics2-6. We observed variation in runs of homozygosity among genomic regions with different ancestries reflecting distinct demographic histories and, in turn, different distributions of rare deleterious variants. We conducted genome-wide association studies (GWAS) for 22 complex traits and found that several traits are better predicted using the Mexican Biobank GWAS compared to the UK Biobank GWAS7,8. We identified genetic and environmental factors associating with trait variation, such as the length of the genome in runs of homozygosity as a predictor for body mass index, triglycerides, glucose and height. This study provides insights into the genetic histories of individuals in Mexico and dissects their complex trait architectures, both crucial for making precision and preventive medicine initiatives accessible worldwide.
Assuntos
Bancos de Espécimes Biológicos , Genética Médica , Genoma Humano , Genômica , Hispânico ou Latino , Humanos , Glicemia/genética , Glicemia/metabolismo , Estatura/genética , Índice de Massa Corporal , Interação Gene-Ambiente , Marcadores Genéticos/genética , Estudo de Associação Genômica Ampla , Hispânico ou Latino/classificação , Hispânico ou Latino/genética , Homozigoto , México , Fenótipo , Triglicerídeos/sangue , Triglicerídeos/genética , Reino Unido , Genoma Humano/genéticaRESUMO
BACKGROUND: Our aim was to examine differences in clinical outcomes between Hispanic subgroups who underwent emergency general surgery (EGS). METHODS: Retrospective cohort study of the HCUP State Inpatient Database from New Jersey (2009-2014), including Hispanic and non-Hispanic White (NHW) adult patients who underwent EGS. Multivariable analyses were performed on outcomes including 7-day readmission and length of stay (LOS). RESULTS: 125,874 patients underwent EGS operations. 22,971 were Hispanic (15,488 with subgroup defined: 7,331 - Central/South American; 4,254 - Puerto Rican; 3,170 - Mexican; 733 - Cuban). On multivariable analysis, patients in the Central/South American subgroup were more likely to be readmitted compared to the Mexican subgroup (OR 2.02; p < 0.001, respectively). Puerto Rican and Central/South American subgroups had significantly shorter LOS than Mexican patients (Puerto Rico -0.58 days; p < 0.001; Central/South American -0.30 days; p = 0.016). CONCLUSIONS: There are significant differences in EGS outcomes between Hispanic subgroups. These differences could be missed when data are aggregated at Hispanic ethnicity.
Assuntos
Tratamento de Emergência/estatística & dados numéricos , Hispânico ou Latino/estatística & dados numéricos , Procedimentos Cirúrgicos Operatórios/estatística & dados numéricos , Adulto , Idoso , América Central/etnologia , Cuba/etnologia , Bases de Dados Factuais , Tratamento de Emergência/mortalidade , Feminino , Cirurgia Geral/estatística & dados numéricos , Hispânico ou Latino/classificação , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , México/etnologia , Pessoa de Meia-Idade , Análise Multivariada , New Jersey , Readmissão do Paciente/estatística & dados numéricos , Porto Rico/etnologia , Estudos Retrospectivos , América do Sul/etnologia , Procedimentos Cirúrgicos Operatórios/mortalidadeRESUMO
PURPOSE: To examine the association between skin color and all-cause and cardiovascular disease (CVD)-related mortality risk before and after adjusting for selected characteristics and risk factors, we used data on 5,304 men with information on skin color at Exam 3 of the Puerto Rico Heart Health program (PRHHP), a longitudinal study of the incidence of coronary heart disease in Puerto Rican men. METHODS: Mortality was ascertained using hospital and physician records, postmortem records, death certificates, and information from the next of kin. RESULTS: Dark-skinned men exhibited higher age-adjusted mortality rates than light skinned men (10.1 vs. 8.8/10,000 population). There was no association between skin color and all-cause and CVD-related mortality. However, the association between skin color and all-cause mortality varied with area of residence (p for interaction = 0.05). Among men living in urban areas, the risk of all-cause mortality was 28% (95% confidence interval, 1.02-1.61) greater among dark-skinned men than their light-skinned counterparts after adjusting for age, education, BMI, physical activity, and the presence of diabetes. There was no association between skin color and CVD mortality in urban men. Neither all-cause nor CVD mortality was associated with skin color among rural men. CONCLUSION: Our results suggest that skin color may be capturing environmental dynamics that may influence mortality risk among Puerto Rican men.
Assuntos
Doença das Coronárias/mortalidade , Hispânico ou Latino/estatística & dados numéricos , Medição de Risco , Pigmentação da Pele , Adulto , Idoso , Índice de Massa Corporal , Causas de Morte , Doença das Coronárias/etnologia , Atestado de Óbito , Comportamentos Relacionados com a Saúde/etnologia , Hispânico ou Latino/classificação , Humanos , Incidência , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Porto Rico/epidemiologia , Características de Residência , Fatores de Risco , Saúde da População Rural/estatística & dados numéricos , Fatores Socioeconômicos , Saúde da População Urbana/estatística & dados numéricosRESUMO
We examine twelve-year trends in the Latino uninsured population by ethnic subgroup and immigration status. From 1993 to 1999, most Latino subgroups, particularly Puerto Ricans, had large decreases in Medicaid coverage. For some subgroups these were offset by increases in employer coverage, but not for Mexicans, resulting in a four-percentage-point increase in their uninsured population. During 2000-2004, Medicaid/SCHIP expansions benefited most subgroups and mitigated smaller losses in employer coverage. However, during 1993-2004, the percentage of noncitizen Latinos lacking coverage increased by several percentage points. This was attributable to Medicaid losses during 1993-1999 and losses in employer coverage during 2000-2004.
Assuntos
Ajuda a Famílias com Filhos Dependentes/tendências , Hispânico ou Latino/classificação , Seguro Saúde/tendências , Medicaid/tendências , Pessoas sem Cobertura de Seguro de Saúde/etnologia , Emigração e Imigração , Pesquisas sobre Atenção à Saúde , Humanos , Massachusetts , Pessoas sem Cobertura de Seguro de Saúde/estatística & dados numéricos , México/etnologia , Porto Rico/etnologia , Fatores Socioeconômicos , Estados UnidosRESUMO
OBJECTIVES: Asthma prevalence for different ethnic groups in the United States, beyond white, black and Hispanic, is seldom reported. We compared the prevalence of asthma diagnosis among various Hispanic and Asian American ethnic subgroups using data collected from the school-based California Healthy Kids Survey. METHODS: The California Healthy Kids Survey was administered to 462 147 public school students in the seventh, ninth, and 11th grades throughout California during the 2001-2002 and 2002-2003 school years. Prevalence of lifetime asthma diagnosis was calculated for 11 Asian American Pacific Islander subgroups and 8 Hispanic subgroups. RESULTS: Asthma prevalence among Hispanic subgroups ranged from 13.2% for Mexican American students to 22.8% for Puerto Rican students and 23.0% among Cuban American students. Lifetime asthma diagnosis among the 11 Asian American Pacific Islander subgroups ranged from 10.9% among Korean American students to 23.8% among Filipino American students. CONCLUSIONS: The survey revealed substantial variation in asthma prevalence between the different Hispanic and Asian American Pacific Islander subgroups and that Pacific Islanders, Filipinos, Cubans, and Puerto Ricans are at elevated risk for asthma. Differences in the distributions of characteristics related to country of birth, residential history, generational status, and/or degree of acculturation might account for much of the observed differences in asthma prevalence between ethnic subgroups. Previous asthma prevalence estimates for Asians or Hispanics are in part a function of the particular ethnic composition of the population under investigation. We suggest that asthma studies that include a substantial number of Asian Pacific Islander and Hispanic persons use a more detailed categorization of race/ethnicity.
Assuntos
Asiático/estatística & dados numéricos , Asma/etnologia , Hispânico ou Latino/estatística & dados numéricos , Havaiano Nativo ou Outro Ilhéu do Pacífico/estatística & dados numéricos , Adolescente , Asiático/classificação , California/epidemiologia , Camboja/etnologia , América Central/etnologia , Criança , China/etnologia , Cuba/etnologia , Feminino , Inquéritos Epidemiológicos , Hispânico ou Latino/classificação , Humanos , Índia/etnologia , Japão/etnologia , Coreia (Geográfico)/etnologia , Laos/etnologia , Masculino , México/etnologia , Havaiano Nativo ou Outro Ilhéu do Pacífico/classificação , Ilhas do Pacífico/etnologia , Filipinas/etnologia , Prevalência , Porto Rico/etnologia , Risco , América do Sul/etnologia , Vietnã/etnologiaRESUMO
Migrant populations have been found to be at risk of HIV/AIDS. The growth in immigrant and migrant Hispanic populations in the United States increases the need to enhance understanding of influences on their HIV-risk behaviors. Four challenges to conducting research among these populations were identified: (1) the need to use multilevel theoretical frameworks; (2) the need to differentiate between Hispanic subgroups; (3) challenges to recruitment and data collection; and (4) ethical issues. This article describes how two studies of Hispanic immigrants and migrants in the New York area addressed these challenges. One study focused on new immigrants from Mexico, the Dominican Republic, El Salvador, Honduras and Guatemala, and a second study focused on Puerto Rican drug users. Both studies incorporated qualitative and quantitative methods to study these hard-to-reach populations. Continued study of the sociocultural and contextual factors affecting HIV risk for mobile populations, and addressing the research challenges, is crucial to developing effective intervention programs.
Assuntos
Atitude Frente a Saúde/etnologia , Emigração e Imigração , Infecções por HIV/etnologia , Comportamentos Relacionados com a Saúde/etnologia , Hispânico ou Latino/psicologia , Migrantes , Adolescente , Adulto , Pesquisa Comportamental , Cultura , Hispânico ou Latino/classificação , Humanos , América Latina/etnologia , New York/epidemiologia , Porto Rico/etnologia , Projetos de Pesquisa , Fatores SocioeconômicosRESUMO
In the USA foreign-born women tend to have fewer low-birthweight births than US-born women from the same ethnicity. This "healthy migrant" effect could be caused by immigration of the fittest or by healthy people being deliberately selected in the immigration process. This study tests these hypotheses by comparing self-reported history of low-birth-weight among foreign-born documented and undocumented Latinas and US-born Latinas. The sample includes 2398 (57.5%) documented foreign-born Latinas, 782 (18.7%) undocumented foreign-born Latinas, and 993 (23.4%) US-born Latinas who initiated prenatal care at MIC-Women's Health Services/MHRA in New York City during 1996-1997. Only women who reported previous live births were included in the sample. Documented foreign-born Latinas were less likely than US-born Latinas to have low-birth-weight babies taking into account parity, age, risk, and education. There were no significant differences between rates of low-birthweight for undocumented foreign-born Latinas and US-born Latinas, or documented foreign-born Latinas. There was, however, a significant trend for rates of low-birthweight to increase from documented foreign-born to undocumented foreign-born to US-born women. This suggests that both official screening and migration of the fittest play a role in lower rates of low-birthweight among foreign-born Latinas compared to US-born Latinas.
Assuntos
Emigração e Imigração/classificação , Hispânico ou Latino/estatística & dados numéricos , Recém-Nascido de Baixo Peso , Resultado da Gravidez/etnologia , Adulto , América Central/etnologia , Emigração e Imigração/legislação & jurisprudência , Feminino , Hispânico ou Latino/classificação , Humanos , Recém-Nascido , Modelos Logísticos , Americanos Mexicanos/estatística & dados numéricos , Cidade de Nova Iorque/epidemiologia , Gravidez , Porto Rico/etnologia , Características de Residência , Fatores de Risco , Autoavaliação (Psicologia) , América do Sul/etnologia , Serviços de Saúde da Mulher/estatística & dados numéricosRESUMO
Lack of health insurance is a serious problem in the United States. Using data from the 1996 Medical Expenditure Panel Survey, this paper examines how insurance varies between black, white, and Latino adults. Because Latino subgroups are not homogeneous, the paper also compares the factors associated with health insurance status for Mexican and Puerto Rican adults. Results indicate that access to private health insurance for Latino adults was more closely associated with workplace characteristics than employment itself. Time lived in the United States was a major factor associated with being uninsured for Mexican adults, while language barriers were a major factor limiting Puerto Rican individuals' access to private health insurance. The paper suggests two approaches for decreasing uninsurance among Latino adults: (1) strengthening the link between employment and private health insurance and (2) addressing disparities in access to public coverage for racial and ethnic groups, including recent immigrants.
Assuntos
Hispânico ou Latino/estatística & dados numéricos , Cobertura do Seguro/estatística & dados numéricos , Seguro Saúde/estatística & dados numéricos , Pessoas sem Cobertura de Seguro de Saúde/estatística & dados numéricos , Americanos Mexicanos/estatística & dados numéricos , Aculturação , Adulto , Feminino , Planos de Assistência de Saúde para Empregados/estatística & dados numéricos , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Pesquisa sobre Serviços de Saúde , Hispânico ou Latino/classificação , Humanos , Modelos Logísticos , Masculino , Americanos Mexicanos/classificação , México/etnologia , Pessoa de Meia-Idade , Porto Rico/etnologia , Fatores de Tempo , Estados UnidosRESUMO
The purpose of this study was to compare the incidence of empirically established prenatal risk factors for low birthweight (LBW) outcomes among two groups of low-income mothers: foreign-born Central American women and nonimmigrant, non-Hispanic women. Two hundred ninety-six women who were part of a larger study of maternal role sufficiency were included in the present study: 127 Central American women and 169 nonimmigrant, non-Hispanic women who identified themselves as Black (n = 59) or White (n = 110). Data were collected by public health nurses (PHNs) during home visits and by research nurses in prenatal health department clinics. Comparisons were made between the two groups in areas of demographic characteristics, prenatal health behaviors, and prenatal stressful life-events. Foreign-born Central American mothers were found to be less educated, more likely to be living with their partners, less likely to engage in prenatal health risk behaviors, and less likely to identify stressors in their lives. The initiation of prenatal PHN services by the target group was similar to the comparison group. Their rate of LBW deliveries did not reflect the protective effect often attributed to foreign-born Hispanic mothers. Findings are discussed in light of the paradox of LBW and Hispanic heritage. Recommendations for practice, clinical research, and public policy are also addressed.
Assuntos
Comportamentos Relacionados com a Saúde/etnologia , Hispânico ou Latino/classificação , Recém-Nascido de Baixo Peso , Cuidado Pré-Natal , Negro ou Afro-Americano/classificação , Negro ou Afro-Americano/psicologia , América Central/etnologia , Feminino , Hispânico ou Latino/psicologia , Humanos , Incidência , Recém-Nascido , Pobreza , Gravidez , Resultado da Gravidez , Enfermagem em Saúde Pública , Medição de Risco , Fatores de Risco , Fatores Socioeconômicos , Estresse Psicológico , Virginia/epidemiologia , População Branca/classificação , População Branca/psicologiaRESUMO
Epidemiologic data from three national surveys conducted in 1988, 1990, and 1991 were used to investigate the association between acculturation and use of crack cocaine among Hispanic Americans living in the United States. Poststratification and conditional logistic regression were used to hold constant shared aspects of neighborhood environment, age, sex, and education. The analyses showed a strong inverse relationship between degree of acculturation and crack smoking among Mexican Americans (relative odds = 0.12, 95% confidence interval = 0.04, 0.34) but not among other Hispanics in the study population. This observed variation within the US Hispanic American population deserves special attention in future research.