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População Negra , Genealogia e Heráldica , Plantas Medicinais , Pesquisadores , Humanos , Jamaica/etnologiaAssuntos
População Negra/etnologia , COVID-19/psicologia , Infecções por HIV/psicologia , Disparidades nos Níveis de Saúde , Justiça Social , Mulheres/psicologia , Adulto , Feminino , Humanos , Jamaica/etnologia , Racismo , Saúde Reprodutiva , Apoio Social , Estados Unidos/etnologia , Populações VulneráveisRESUMO
OBJECTIVES: Ageism has increased over 200 years and costs the U.S. health care system $63 billion a year. While scholars agree on the consequences of ageism, there are disagreements on whether it is related to the demographics of aging, or society's cultural values. We test both hypotheses across 20 countries. METHOD: To circumvent the sampling limitations of survey studies, we used an 8-billion-word corpus, identified 3 synonyms with the highest prevalence-aged, elderly, old people-and compiled the top 300 words (collocates) that were used most frequently with these synonyms for each of the 20 countries. The resulting 6,000 collocates were rated on an ageism scale by 2 raters to create an ageism score per country. Cultural dimension scores-Power Distance, Individualism, Masculinity, Uncertainty Avoidance, and Long-term Orientation-were taken from Hofstede, and demographics-size and speed of population aging-came from the World Development Indicators. RESULTS: Of the 20 countries, UK topped the ageism table, while Sri Lanka had the lowest ageism score. Multiple regression models showed that higher levels of masculinity and long-term orientation are associated with ageism, controlling for other cultural dimensions, demographics (size and speed of aging), and economics (GDP-per-capita). DISCUSSION: Our findings blunt the deterministic nature of ageism at the societal level. Demographics is only one side of the ageism coin, and the cultural side is equally, if not more important. This study lays the groundwork to tackle societal ageism-one of our generation's most pernicious threats.
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Etarismo/etnologia , Envelhecimento/etnologia , Atitude , Cultura , Masculinidade , Adulto , África/etnologia , Ásia/etnologia , Australásia/etnologia , Conjuntos de Dados como Assunto , Europa (Continente)/etnologia , Humanos , Jamaica/etnologia , América do Norte/etnologiaRESUMO
Background: Obesity prevention and its associated co-morbidities such as diabetes require a multi-tiered, culturally sensitive, population-based approach. South Florida's tri-county area is home to approximately 75% of Florida's total Caribbean immigrant population. This project is the first Caribbean-focused intervention using the Go-Slow-Whoa or GSW format which designates whether a food or beverage should be chosen frequently (Go - green), less often (Slow - yellow), or rarely (Whoa - red) based on the content of nutrients, sodium, fat, and sugar. Specific Aims: 1. To create and evaluate culturally appropriate nutrition materials for the Caribbean diaspora population in Broward County (i.e. tailor existing GSW evidence-based materials for this population). 2. To quantify which social determinants of health are most relevant to this population. Methods: Mixed methods were utilized in this study. The qualitative, exploratory arm consisted of semi-structured focus groups that included 38 subjects from five Caribbean countries most represented in South Florida: Jamaica, Haiti, Trinidad and Tobago, Cuba and Dominican Republic. The quantitative arm employed descriptive and inferential statistics to analyze social determinants of health (SDOH) obtained from a modified National Association of Community Health Centers' PRAPARE survey. Intercept survey data was also collected from a convenience sample of 24 Caribbean immigrants in Broward County. Findings: Analysis revealed a lack of culturally appropriate foods and exercise examples in the current GSW materials. At 92% and 82% respectively, an overwhelming majority of our intercept surveys indicated that our revised, culturally appropriate materials were helpful in making positive food and beverage choices. Further study is required to determine which SDOH variables are relevant to this population. Conclusions: Health disparities and inequity in the healthy living education of our Caribbean subpopulation are best addressed using an inclusive research frame that captures the cultural essence and preferences of this understudied community.
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Assistência à Saúde Culturalmente Competente , Dieta Saudável , Emigrantes e Imigrantes , Exercício Físico , Promoção da Saúde , Obesidade/prevenção & controle , Determinantes Sociais da Saúde , Adulto , Região do Caribe/etnologia , Cuba/etnologia , República Dominicana/etnologia , Feminino , Florida , Grupos Focais , Haiti/etnologia , Migração Humana , Humanos , Jamaica/etnologia , Masculino , Pessoa de Meia-Idade , Política Nutricional , Obesidade/terapia , Pesquisa Qualitativa , Trinidad e Tobago/etnologiaRESUMO
INTRODUCTION: The intersecting vulnerabilities of migrant agricultural workers (MAWs) impact both their health and their access to health care in rural areas, yet rural clinicians' voices are rarely documented. The purpose of this study was to explore health professionals' perspectives on health care for MAWs in sending countries and rural Ontario, Canada. METHODS: Qualitative research design occurred over three distinct projects, using a multi-methodological approach including semi-structured interviews in Mexico, Jamaica and rural Ontario (n=43), and session field notes and questionnaires administered to healthcare providers (n=65) during knowledge exchange sessions in rural Ontario. A systematic analysis of these data was done to identify common themes, using NVivo software initially and then Microsoft Excel for application of a framework approach. RESULTS: Structural challenges posed by migrant workers' context included difficulties preventing and managing work-related conditions, employers or supervisors compromising confidentiality, and MAWs' fears of loss of employment and return to countries of origin prior to completing treatments. Structural challenges related to health services included lack of adequate translation/interpretation services and information about insurance coverage and MAWs' work and living situations; scheduling conflicts between clinic hours and MAWs' availability; and difficulties in arranging follow-up tests, treatments and examinations. Intercultural challenges included language/communication barriers; cultural barriers /perceptions; and limited professional knowledge of MAWs' migration and work contexts and MAWs' knowledge of the healthcare system. Transnational challenges arose around continuity of care, MAWs leaving Canada during/prior to receiving care, and dealing with health problems acquired in Canada. A range of responses were suggested, some in place and others requiring additional organization, testing and funding. CONCLUSION: Funding to strengthen responses to structural and intercultural challenges, including research assessing improved supports to rural health professionals serving MAWs, are needed in rural Canada and rural Mexico and Jamaica, in order to better address the structural and intersecting vulnerabilities and the care needs of this specific population.
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Atitude do Pessoal de Saúde , Acessibilidade aos Serviços de Saúde/organização & administração , Atenção Primária à Saúde/organização & administração , Migrantes , Barreiras de Comunicação , Confidencialidade/normas , Continuidade da Assistência ao Paciente , Características Culturais , Feminino , Humanos , Entrevistas como Assunto , Jamaica/etnologia , Masculino , México/etnologia , Saúde Ocupacional/normas , Ontário/epidemiologia , Atenção Primária à Saúde/normas , Pesquisa Qualitativa , População Rural , Estações do Ano , Local de Trabalho/organização & administraçãoRESUMO
African American/Black women's rate of HIV infection has been explored along several variables. Understanding how the epidemic affects different ethnic groups of women is crucial in developing effective prevention strategies. There remains a gap in knowledge around the effects of ethnicity on the rate of infection among the culturally diverse groups of women living in the U.S. subsumed under the label African American/Black. The purpose of the study is to explore whether cultural differences exist among African Jamaican and African American women that may affect their empowerment and condom-use intentions, placing them at a more heightened risk of contracting HIV. The results indicate that women's sense of power, either in their relationships or within themselves, was not related to their condom-use self-efficacy or condom-use intentions. Although none of the five hypotheses was fully supported, related significant findings suggest that women's level of acculturation was negatively related to their intentions to negotiate condom use. The longer women were in the United States, the lower their condom-use intentions.
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Negro ou Afro-Americano/psicologia , Preservativos/estatística & dados numéricos , Empoderamento , Infecções por HIV/prevenção & controle , Negociação , Mulheres/psicologia , Adulto , Feminino , Humanos , Jamaica/etnologia , Masculino , Parceiros Sexuais , Estados UnidosRESUMO
Remote acculturation (RA) is a modern form of non-migrant acculturation toward distant cultures prompted by indirect/intermittent globalization-related cultural exposure. RA theory holds that not only are global cultures now pouring into local neighborhoods, but many youth are also internalizing these remote cultures. How well do they fare? Prior studies in Jamaica and elsewhere have reported that U.S./Western-oriented adolescents exhibit poorer health habits. However, no studies have yet investigated adolescents' behavioral or academic adjustment in the context of RA, whether in Jamaica or elsewhere. Therefore, 245 adolescents and their mothers from high schools in Kingston, Jamaica (Madolescent_age = 13.3; Mmother_age = 40.2) completed questionnaires assessing their RA in terms of behaviors and values, as well as the adolescents' behavioral resilience and grades. SEM analyses revealed that RA was, indeed, linked to adolescent behavioral and academic adjustment in Jamaica. Overall, Jamaican orientation was associated with better adaptation whereas European American orientation was associated with worse.
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Sucesso Acadêmico , Aculturação , Adaptação Psicológica , Comportamento do Adolescente/etnologia , Internacionalidade , Ajustamento Social , Adolescente , Adulto , Criança , Feminino , Humanos , Jamaica/etnologia , Masculino , População UrbanaRESUMO
This study assessed dietary intakes, nutritional composition, and identified commonly eaten foods among Jamaicans in Florida. Dietary intake was assessed among 44 study participants to determine commonly eaten foods and nutrient composition. Weighed recipes were collected and analyzed to determine nutrient composition for traditional foods. Top foods that contributed to macronutrient and micronutrient intake were identified and adherence to dietary recommendations was evaluated. Mean daily energy intake was 2879 (SD 1179) kcal and 2242 (SD 1236) kcal for men and women respectively. Mean macronutrient intakes were above dietary recommendations for men and women. Top foods contributing to energy included rice and peas, sweetened juices, chicken, red peas soup, and hot chocolate drink. Results showed sodium intake was more than double the adequate intake estimate (1300-1500 mg). Findings highlight the need to include commonly eaten traditional foods in dietary questionnaires to accurately assess diet-related chronic disease risk. Findings have implications for risk factor intervention and prevention efforts among Jamaicans.
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Dieta/etnologia , Emigrantes e Imigrantes/estatística & dados numéricos , Ingestão de Energia/etnologia , Adulto , Índice de Massa Corporal , Comportamento do Consumidor , Feminino , Florida/epidemiologia , Humanos , Jamaica/etnologia , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Fatores SocioeconômicosRESUMO
The study aimed to establish a relationship of ethnicity to diastolic dysfunction in subjects of African-Caribbean and South Asian origins and the impact of diastolic dysfunction and ethnicity on all-cause and cardiovascular mortality. Hypertensive subjects with ejection fraction ≥55% and no history of ischaemic heart disease/valve pathology (n = 1546, 830 South Asians and 716 African-Caribbeans) were identified from the Ethnic-Echocardiographic Heart of England Screening Study (E-ECHOES). Diastolic function and cardiac remodelling were measured by echocardiography. African-Caribbean ethnicity was associated with lower prevalence of having diastolic dysfunction (odds ratio 0.67, 95% confidence interval 0.51-0.87, p = 0.003) and increased left ventricular filling pressure (odds ratio 0.48, 95% confidence interval 0.34-0.69, p < 0.001) as well as lower left atrial index (p < 0.001). This was the case despite the fact that African-Caribbean ethnicity was independently associated with higher left ventricular mass index (p < 0.001). Ninety-two deaths (6%) occurred during 68 ± 21 months follow-up. On Cox regression analysis, South Asian ethnicity (p = 0.024) was predictive of all-cause death before adjustment for parameters of diastolic dysfunction, but it was no longer predictive of death after accounting for these variables. South Asian ethnicity is independently associated with worse parameters of diastolic function in hypertension, despite African-Caribbeans having more prominent hypertrophy.
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Insuficiência Cardíaca Diastólica/etnologia , Hipertensão/complicações , Adulto , Idoso , Ásia Ocidental/etnologia , População Negra/estatística & dados numéricos , Estudos Transversais , Ecocardiografia , Feminino , Insuficiência Cardíaca Diastólica/diagnóstico por imagem , Insuficiência Cardíaca Diastólica/etiologia , Insuficiência Cardíaca Diastólica/mortalidade , Humanos , Jamaica/etnologia , Masculino , Pessoa de Meia-Idade , Prevalência , Reino Unido/epidemiologiaRESUMO
Background The epidemiology of ESRD requiring maintenance dialysis (ESRD-D) in large, diverse immigrant populations is unclear.Methods We estimated ESRD-D prevalence and incidence among immigrants in Ontario, Canada. Adults residing in Ontario in 2014 were categorized as long-term Canadian residents or immigrants according to administrative health and immigration datasets. We determined ESRD-D prevalence among these adults and calculated age-adjusted prevalence ratios (PRs) comparing immigrants to long-term residents. Among those who immigrated to Ontario between 1991 and 2012, age-adjusted ESRD-D incidence was calculated by world region and country of birth, with immigrants from Western nations as the referent group.Results Among 1,902,394 immigrants and 8,860,283 long-term residents, 1700 (0.09%) and 8909 (0.10%), respectively, presented with ESRD-D. Age-adjusted ESRD-D prevalence was higher among immigrants from sub-Saharan Africa (PR, 2.17; 95% confidence interval [95% CI], 1.84 to 2.57), Latin America and the Caribbean (PR, 2.11; 95% CI, 1.90 to 2.34), South Asia (PR, 1.45; 95% CI, 1.32 to 1.59), and East Asia and the Pacific (PR, 1.34; 95% CI, 1.22 to 1.46). Immigrants from Somalia (PR, 4.18; 95% CI, 3.11 to 5.61), Trinidad and Tobago (PR, 2.88; 95% CI, 2.23 to 3.73), Jamaica (PR, 2.88; 95% CI, 2.40 to 3.44), Sudan (PR, 2.84; 95% CI, 1.53 to 5.27), and Guyana (PR, 2.69; 95% CI, 2.19 to 3.29) had the highest age-adjusted ESRD-D PRs relative to long-term residents. Immigrants from these countries also exhibited higher age-adjusted ESKD-D incidence relative to Western Nations immigrants.Conclusions Among immigrants in Canada, those from sub-Saharan Africa and the Caribbean have the highest ESRD-D risk. Tailored kidney-protective interventions should be developed for these susceptible populations.