Abstract TP182: Stroke Outcome in Mexican American Immigrants and Non-Immigrants

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Lewis B Morgenstern ◽  
Lynda Lisabeth ◽  
River Gibbs ◽  
Sehee Kim ◽  
Charles Agyemang
Keyword(s):  
Mexican Americans ◽  
Mexican American ◽  
Population Based ◽  
Cognitive Outcome ◽  
Stroke Outcome ◽  
Linear Regression Models ◽  
Corpus Christi ◽  
Project Outcomes ◽  
Stroke Study ◽  
The U.S

Background/Objective: We studied the association of being born outside of the U.S. (immigrant) or born in the U.S. (non-immigrant) with 90 day post-stroke outcomes in a population-based stroke study in Texas. Methods: Stroke cases from 2008-2016 were identified from the Brain Attack Surveillance in Corpus Christi (BASIC) project. Outcomes among survivors included ADL/IADL score (higher scores worse) for functional assessment, 3MSE (cognition, lower scores worse), and NIHSS Score (neurologic, higher scores worse). Weighted linear regression models were used to assess the effect of immigration status on the outcomes. Analysis was completed using multiple imputation and inverse probability weighting to account for differential attrition. Results: Of 935 Mexican Americans available for analysis, 83 were immigrants and 852 were non-immigrants. Immigrants had resided in the U.S. on average 47 years. Immigrants were significantly older (69 vs. 66 years), more likely male (60% vs. 49%), more likely to have atrial fibrillation and have less education than non-immigrants (all p<0.05). No differences in hypertension, diabetes, cholesterol, insurance, smoking or other comorbidities existed. The Table provides the data from the fully adjusted models. Immigrants had better functional outcome (mean difference (MD) = -0.22; p=0.02), and no difference for neurologic outcome (MD= -0.15; p=0.15). There was an association of worse cognitive outcome in immigrants (MD= -5.25; p=0.009), however, the association was explained by attenuated after the adjustment for the lower educational attainment in immigrants (MD= -0.79; p=0.64). Conclusions: In this community, there was no evidence of worse stroke outcome among Mexican American immigrants, who had lived in the U.S. for decades, compared with non-immigrants. Further studies of more recent immigrant populations are warranted.

Abstract T P132: Rapid loss of the Mexican American Survival Advantage After Stroke--The BASIC Study

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Lewis B Morgenstern ◽  
Brisa N Sánchez ◽  
Melinda Smith ◽  
Devin Brown ◽  
Nelda Garcia ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Ethnic Differences ◽  
Mexican Americans ◽  
Mexican American ◽  
Population Based ◽  
Survival Advantage ◽  
Stroke Severity ◽  
Basic Study ◽  
Entire Study ◽  
Corpus Christi

Background/Objective: As a primary, pre-specified objective of the population-based Brain Attack Surveillance in Corpus Christi (BASIC) project we studied trends in mortality following ischemic stroke among Mexican Americans (MAs) and non Hispanic whites (NHWs). MAs were previously found to have lower mortality following stroke than NHWs. Methods: We performed active and passive surveillance, and using source documentation, validated all ischemic stroke cases from January, 2000-December, 2010. Deaths were ascertained from the Texas Department of Health through December 31, 2011. Cumulative 30 day and 1 year mortality adjusted for covariates was estimated using log-binomial models with a linear term for year of stroke onset used to model time trends. Pre-specified adjustment factors were: age, sex, prior stroke or TIA, atrial fibrillation, diabetes, heart disease, hypertension, smoking, high cholesterol and stroke severity. Models used data from the entire study period to estimate adjusted mortality among stroke cases in 2000 and 2010, and to calculate projected ethnic differences. Results: There were 1,822 ischemic strokes among NHWs and 2,211 among MAs. Between 2000 and 2010, 30 day and 1 year mortality declined among NHWs, from 8.6% to 5.9% (p=0.14), and 21.7% to 17.0% (p=0.06), respectively. Among MAs, 30 day mortality remained stagnant at 5.6% (p=0.98), and a slight decline from 18.3% to 16.4% was observed for 1 year mortality (p=0.41). While, the ethnic differences in 30 day (p=0.01) and 1 year (p=0.07) mortality were robust in 2000, they were not so in 2010 (30 day, p=0.76; 1 year p=0.78). See figure. MAs are projected to have higher post-stroke mortality by 2022. Conclusions: Overall, mortality following ischemic stroke has declined in the last decade. However, the survival advantage previously documented among MAs vanished by 2010. Further, faster declines in mortality among NHWs than MAs imply a reversal of the survival advantage by approximately 2022.

Abstract WP165: Mexican Americans Receive Less Intensive Stroke Rehabilitation Than non Hispanic Whites

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Lewis B Morgenstern ◽  
Emma Sais ◽  
Michael Fuentes ◽  
Nneka Ifejika ◽  
Xiaqing Jiang ◽  
...  
Keyword(s):  
Mexican Americans ◽  
Stroke Rehabilitation ◽  
Inpatient Rehabilitation ◽  
Population Based ◽  
Cognitive Outcomes ◽  
Rehabilitation Services ◽  
Population Based Study ◽  
Corpus Christi ◽  
Home Based ◽  
Chi Squared

Background: Mexican Americans (MAs) have worse neurologic, functional and cognitive outcomes after stroke than non Hispanic whites (NHWs). Stroke rehabilitation is important for outcome. In a population-based study, we sought to determine if allocation of stroke rehabilitation services differed by ethnicity. Methods: Consecutive stroke patients were identified for a three month time period as part of the Brain Attack Surveillance in Corpus Christi (BASIC) project, Texas, USA. Cases were validated by physicians using source documentation. Patients were followed prospectively for three months following stroke to determine self-reported rehabilitation services. Descriptive statistics were used to describe the study population. Ethnic comparisons of rehabilitation services were made using chi-squared or Fisher’s exact tests. Results: Seventy-two subjects (50 MA, 22 NHW) were followed. Mean age, NHW-69 (sd-13), MA-66 (sd-11) years, sex (NHW 55% male, MA 50% male) and median presenting NIHSS (NHW-2.5, MA-3.0) did not differ significantly. There were no ethnic differences in the proportion of patients who were discharged home without rehabilitation services (p=0.9). Among those who received rehabilitation (n=48), the figure shows the distribution of the first place for services. NHWs were more likely to be discharged to inpatient rehabilitation (73%) compared with MAs (30%), p=0.016. MAs (51%) were much more likely to be receive home rehabilitation services compared with NHWs (0%) (p=0.0017). Conclusions: In this population-based study, MAs were more likely to receive home-based rehabilitation while NHWs more likely to get inpatient rehabilitation. This disparity may, in part, explain the worse stroke outcome in MAs.

Abstract 87: Eighteen-Year Trends in Ischemic Stroke Rates in a Bi-Ethnic Population

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Lynda D Lisabeth ◽  
Devin Brown ◽  
Xingyu Zhang ◽  
Sehee Kim ◽  
Erin Case ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Mexican Americans ◽  
Ethnic Disparities ◽  
Population Based ◽  
Rate Difference ◽  
Corpus Christi ◽  
Interaction Terms ◽  
Annual Population ◽  
Adjusted Rate ◽  
Using Data

Introduction: Elevated stroke rates in Mexican Americans (MA) compared with non-Hispanic whites (NHW) persisted over the first decade of the 21 st century. Our objective was to investigate recent trends in ischemic stroke (IS) rates by ethnicity and age using data from a longstanding population-based study. Methods: ISs were identified in the Brain Attack Surveillance in Corpus Christi (BASIC) Project (2000-2017) and validated by neurologists using a clinical definition. Race-ethnicity was from medical records. Annual population counts from the US Census estimated the at-risk population. Poisson regression was used to model sex-adjusted rate trends by ethnicity and age. Time was modeled using linear and quadratic terms. Ethnic differences were assessed using interaction terms between ethnicity and time. Results: 4,883 ISs were identified (median age 70 (IQR:59-80); 56% MA). Trends varied by ethnicity and age (figure). In those 45-59, rates increased substantially in NHWs (104%; p<0.001 for rate difference 2000-2017) but decreased in MAs (-21.4%; p=0.04 for rate difference 2000-2017) such that, for the first time, rates were higher in NHWs. In those 60-74, rates declined in both ethnic groups through 2010-2011 but then increased and more steeply in NHWs thereafter. In those ≥75, rates declined in MAs, declined sharply in NHWs through 2012 and then increased. Conclusions: New patterns in stroke have emerged. Ethnic disparities have declined as a result of increasing rates in NHWs most notably in midlife. Reasons for increasing rates in recent years are unclear but suggest renewed attention to prevention.

Abstract P302: Ethnic Difference of Cardiorespiratory Fitness and Related to Factors in Young Adults: The Nhanes 1999-2004

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Hong Seok LEE ◽  
Zhiwei Zhang ◽  
Karen Xu ◽  
Yong-Moon Park
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Cardiorespiratory Fitness ◽  
Mexican Americans ◽  
Mexican American ◽  
Population Based ◽  
Cardiopulmonary Fitness ◽  
Mortality And Morbidity ◽  
Fitness Level

Background: Cardiorespiratory fitness is a distinct health characteristic that relates to the ability to perform physical activity. Higher cardiorespiratory fitness was reported to have reverse relationship with overall mortality and morbidity rates due to various chronic disease. The assessment of cardiorespiratory fitness was measured by maximal oxygen uptake (VO2max; mL/kg/minute) on a submaximal treadmill test. This study was aimed to examine cardiorespiratory fitness among U.S. adults 20-49 years of age, to describe the distribution of cardiorespiratory fitness and cardiovascular risk factors depends on different ethnicity for without physical limitations or indications of cardiovascular disease. Method: Data from the 1999-2004, National Health and Nutrition Examination Survey were used to describe the distribution of cardiorespiratory fitness for adults 20-49 years of age. 8324 out of 31126 subjects have valid values of cardiopulmonary fitness in the dataset with 5391 in low category of cardiorespiratory fitness (VO 2 max < 27), 2606 in medium category (37.1 > VO 2 max ≥27) and 327 in high category (37.1 ≥ VO 2 max). The risk factors for cardiopulmonary fitness was assessed by using logistic regression after adjusting all cardiovascular risk factors. All data were analyzed using SAS Ver. 9.4. Result: Overall, there is no significant association of cardiorespiratory fitness with ethnicity ( P =0.08). 65.9% of study population was male in all races. Among, non-Hispanic whites, those with 25 m 2 /kg > BMI had better cardiorespiratory fitness (more than 37.1 mL/kg/minute) than those with BMI ≥ 35 [Odds ratio (OR): 0.496, Confidence Interval (CI): 0.258-0.957]. A similar pattern was observed for Mexican Americans. Non-Hispanic black with 25 m 2 /kg > BMI had better cardiorespiratory fitness than ones with BMI ≥ 35 m 2 /kg [OR:0.137, CI:0.059-0.318], 35 m 2 /kg > BMI≥30 m 2 /kg [OR:0.269, CI:0.124-0.583], 30 m 2 /kg > BMI≥25 m 2 /kg [OR: 0.241,0.123-0.318]. Non-Hispanic white with higher diastolic blood pressure over 90 mmHg had tendency to have lower cardiorespiratory fitness. Among metabolic panel, only Mexican American with LDL<100 mg/dl has higher cardiorespiratory fitness [OR:0.559, CI:0.319-0.981]. Discussion: Our findings on cardiorespiratory fitness level among non-Hispanic blacks, non-Hispanic whites and Mexican Americans are similar to previously reported studies, however, non-Hispanic black had different risk factors related to cardiorespiratory fitness, especially significant benefit from lower BMI less than 25 m 2 /kg since other ethnicities with BMI less than 25 m 2 /kg had benefit only compared to BMI> 35 m 2 /kg. These results can be used to improve cardiorespiratory fitness level for future population based on ethnicities. The different risk factors in fitness status can also be used to develop health policies and targeted educational campaigns.

Fostering Academic Success of Mexican Americans in a BSN Program: An Educational Imperative

2006 ◽  
Vol 3 (1) ◽  
Author(s):  
J. Carole Taxis
Keyword(s):  
Academic Success ◽  
Nursing Students ◽  
Mexican Americans ◽  
Mexican American ◽  
Minority Group ◽  
Limited Information ◽  
Mexican American Students ◽  
American Students ◽  
Faculty And Administrators ◽  
The U.S

Hispanic/Latinos are the fastest growing minority group in the U.S. and the most underrepresented in the U.S. nursing workforce. Although a body of knowledge is growing regarding factors that foster academic success of undergraduate nursing students of color, there is limited information about Hispanic students in general, and Mexican American students in particular in BSN programs. Explored in this qualitative study, were perceived influences of institutional and interpersonal factors on retention and graduation of nine Mexican American students from a predominantly White BSN program. The key findings include adequate financial assistance, maintaining bicultural relations, and experiencing authentic caring relationships from institutional agents, family, and peers as crucial factors in academic success. Recommendations for nursing faculty and administrators are offered.

English Skills, Earnings, and the Occupational Sorting of Mexican Americans along the U.S.-Mexico Border

2000 ◽  
Vol 34 (1) ◽  
pp. 133-157 ◽  
Author(s):  
Alberto Dávila ◽  
Marie T. Mora
Keyword(s):  
Mexican Americans ◽  
Mexican American ◽  
Mexican Immigrants ◽  
Labor Market Outcomes ◽  
Minority Language ◽  
Market Outcomes ◽  
Mexico Border ◽  
Language Region ◽  
Occupational Sorting ◽  
The U.S

While English proficiency enhances labor market outcomes, its role in minority-language regions remains largely unexplored. Employing the U.S.-Mexico border as a minority-language region, we analyze whether English skills differently affect the earnings and occupational sorting of Mexican Americans along the border relative to their non-border peers. We find comparable English deficiency earnings penalties for Mexican immigrants, suggesting that this group responds to English-specific regional wage gaps. U.S.-born men, however, have a larger earnings penalty along the border, possibly reflecting natives’ relative immobility owing to strong geographic preferences. Occupational sorting exercises give credence to this interpretation for native Mexican American females.

Outlaw Citizenship

2018 ◽  
pp. 29-62
Author(s):  
Alberto Varon
Keyword(s):  
Cultural Values ◽  
Mexican Americans ◽  
Mexican American ◽  
Nineteenth And Twentieth Centuries ◽  
The Relationship ◽  
The U.S

This chapter analyses perhaps the most prevalent figure associated with Mexican American manhood, the bandit. This chapter argues that, in contrast to most understandings of the bandit as an anti-U.S. criminal, Mexican American bandits developed cultural values that allowed Mexican Americans to incorporate into the U.S. nation. This chapter proposes the bandit as a figure that “cleaves” Mexican Americans to citizenship, playing on the contradictory meanings of the term cleave to both sever and adhere. Cleaving then becomes a way of conceptualizing the relationship between Mexican American manhood and citizenship throughout the nineteenth and twentieth centuries.

They Lynched Mexican-Americans Too: A Question of Anglo Colorism

2020 ◽  
Vol 42 (1) ◽  
pp. 62-76
Author(s):  
Ronald E. Hall
Keyword(s):  
Mexican Americans ◽  
Mexican American ◽  
The United States ◽  
Domestic Terrorism ◽  
Social Scientists ◽  
Border States ◽  
The Bible ◽  
Historical Archives ◽  
History Of ◽  
The U.S

The act of lynching in the United States was in fact a form of domestic terrorism perpetrated against darker-skinned Americans. Historians have been pressed to acknowledge the lynching of African-Americans particularly in the Bible-belt South in such states as Mississippi and Alabama. The history of Mexican-Americans lynched by Anglo mobs has been for the most part, ignored by Western historians. Said ignored transgressions occurred frequently in border-states including Texas. Approximately 40 years before the lynching of 14-year-old African-American Emmett Till was the lynching of 14-year-old Mexican-American Antonio Gómez. Both were boys accused of Anglo disrespect. Buried in historical archives, the lynching of Gómez was a Mexican-American manifestation of Anglo colorism. Once informed, social scientists and the U.S. society at-large must then readily admit they lynched Mexican-Americans too!

Abstract TMP44: Ethnic Differences in Informal Caregiving After Stroke: The Brain Attack Surveillance in Corpus Christi (BASIC) Project

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Cecilia N Hollenhorst ◽  
Lynda D Lisabeth ◽  
Linda C Gallo ◽  
Chia-Wei Hsu ◽  
Sehee Kim ◽  
...  
Keyword(s):  
Marital Status ◽  
Ethnic Differences ◽  
Mexican Americans ◽  
Stroke Care ◽  
Informal Caregiving ◽  
Population Based ◽  
Chi Square ◽  
Population Based Study ◽  
Corpus Christi ◽  
Occupational Goals

Background and Aims: We studied informal (non-paid) caregiving after stroke in a population-based study to determine if differences occurred between Mexican Americans (MAs) and non-Hispanic whites (NHWs). MAs are a less affluent population than NHWs. Family members who provide caregiving may need to interrupt educational and occupational goals to provide this care, which may perpetuate socioeconomic disparities between minority and majority populations. Methods: Between October, 2014 and December, 2016, stroke subjects in Texas, USA, were interviewed 90 days after stroke to determine if family or friends provided informal, unpaid caregiving, and for which activities of daily living (ADLs) they required help. Chi-square tests were used to assess the association of ethnicity and whom provided the caregiving, as well as ethnicity and the ADLs for which they required help. Ethnic differences between MAs and NHWs in receiving informal caregiving were determined using logistic regression. The odds ratio (OR, 95% CI) is reported with NHW as the referent group. Results: 473 subjects answered the caregiving questions. There were no significant differences among the two ethnic groups with respect to age, sex, NIHSS score, marital status, or insurance. MAs were more likely to require help compared with NHWs for walking (p=0.0008), bathing (p=0.0004), hygiene (p=0.0018), eating (p=0.0059), dressing (p<0.0001), moving (p=0.0015) and toileting (p=0.0007). Among all subjects, 144 (30%) received informal caregiving (35% of 300 MAs versus 22% of 173 NHWs). There were no significant ethnic differences among which family member provided the caregiving. MAs were more likely to have informal caregiving OR=1.87 (95% CI 1.11-3.13) adjusted for age, sex, NIHSS, education, insurance and marital status. Conclusions: In this population-based study, MAs required more help than NHWs for assistance with ADLs, and MAs were more likely to receive this help through informal, unpaid caregiving than NHWs. Efforts to help minority and low-resource populations provide stroke care are needed.

scholarly journals PNPLA3 Polymorphisms and Liver Aminotransferase Levels in a Mexican American Population

2012 ◽  
Vol 35 (4) ◽  
pp. 237 ◽  
Author(s):  
Quan Li ◽  
Hui-Qi Qu ◽  
Anne R. Rentfro ◽  
Megan L. Grove ◽  
Shaper Mirza ◽  
...  
Keyword(s):  
Genetic Association ◽  
Mexican Americans ◽  
Mexican American ◽  
Population Based ◽  
Nucleotide Polymorphisms ◽  
American Population ◽  
Genetic Associations ◽  
The Metabolic Syndrome ◽  
Elevated Liver Enzymes ◽  
Mexican American Population

Purpose: This study examined genetic associations of patatin-like phospholipase domain containing 3 gene (PNPLA3) polymorphisms and liver aminotransferases in an extensively documented, randomly recruited Mexican American population at high risk of liver disease. Methods: Two single nucleotide polymorphisms (SNP) in the PNPLA3 gene (i.e., rs738409 and rs2281135) were genotyped in 1532 individuals. Population stratification was corrected by the genotyping of 103 ancestry informative markers (AIMs) for Mexican Americans. Results: Both PNPLA3 SNPs showed highly significant association with alanine aminotransferase (ALT) levels, but was also, in males, associated with aspartate aminotransferase (AST) levels. Haplotypic association test of the two SNPs suggested stronger genetic association with rs738409 than rs2281135. Obvious sex effects were observed: rs738409-sex interaction in ALT levels P=8.37x10-4; rs738409-sex interaction in AST levels P=5.03x10-3. Conclusions: This population study highlights a sex-specific association of PNPLA3 polymorphisms and elevated liver enzymes in a population-based study, independent of common pathological factors of the metabolic syndrome. The strong genetic association found in women≤50 years old, but not in women > 50 years old, suggests that sex hormones may mediate the sex effect.

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