Disparities in Cognition Among U.S. and Foreign-Born Minority Populations With and Without Diabetes

Adults with cognitive limitations and diabetes may be less able to adhere to treatment recommendations. Our aims were to: 1) estimate and compare the prevalence of cognitive limitations and diabetes among foreign-born non-Hispanic whites, blacks, Hispanics, Asians, and Arab Americans to US-born non-Hispanic whites; and 2) examine associations after controlling for covariates. We linked 2002-2016 National Health Interview Survey and 2003-2017 Medical Expenditure Panel Survey data (ages >=45 years, n=122,898). The prevalence of cognitive limitations was highest among foreign-born non-Hispanic whites (9.71%) and Arab Americans (9.40%) and lowest among foreign-born blacks (5.19%). Foreign-born non-Hispanic whites had higher odds (OR=1.36; 95% CI=1.05-1.49) of cognitive limitations than their US-born counterparts. Foreign-born Hispanics with diabetes had greater odds of cognitive limitations (OR=1.91; 95% CI=1.63, 2.24) compared to US-born non-Hispanic whites. Additional findings will be discussed focused on stressors that may contribute to cognition disparities using the immigrant health paradox framework.

Stress, Cognition, and Minority Health

This symposium examines the many factors influencing cognition and health among ethnically and racially diverse groups. Kindratt et al. use representative, national data to examine cognitive limitations and diabetes among foreign born Non-Hispanic Whites, Blacks, Hispanics, Asians and Arab Americans. Results indicate that prevalence of cognitive limitations was highest among non-Hispanic Whites and Arab-Americans, lowest among Blacks and Asians. Diminich et al. investigate the association of stressors and metabolic risk factors with cognitive/emotional functioning in a population of Hispanic/Latina(o) immigrants. They find a link between components of metabolic syndrome that are associated with domain specific deficits in cognition. These impairments are linked to posttraumatic stress, immigration related trauma and emotional health and wellbeing. Arevalo et al. examine cross-sectional and prospective associations of sleep duration and insomnia symptoms with measures of cognitive functioning among older Latinos from Puerto Rican ancestry with a longitudinal sample of older adults from the Boston Puerto Rican Health Study. Findings indicate that hours of sleep and insomnia symptoms are significantly associated with a number of global and specific cognitive factors. Finally, Munoz and colleagues, using a regional racially and ethnically diverse sample of people living in a large northeastern city, identified four stress profiles. These profiles (which focus on different types of stress) were differentially associated with working memory performance. In sum, these four papers document the experiences of stress and their association with cognitive functioning in diverse minority groups each of whom are disproportionately at risk for ADRD/RD. Gerald, from NIA, will serve as discussant.

567. Reasons for Deferral of COVID-19 Vaccines Among Arab American Healthcare Professionals Living in the United States

Background The WHO identified the three most common reasons for worldwide vaccine hesitancy to be safety concerns, lack of knowledge and awareness, and religion and cultural issues. There is limited information on this topic among Arab Americans, a rapidly growing demographic in the US. We sought to determine the reasons for deferral of the coronavirus disease 2019 (COVID-19) vaccine amongst Arab American health professionals living in the US. Methods This was a cross-sectional study utilizing an anonymous online survey. The survey was distributed via e-mail to National Arab American Medical Association members and Arab-American Center for Economic and Social Services healthcare employees. Respondents were considered vaccine hesitant if they selected responses other than a willingness to receive the COVID-19 vaccine. Results A total of 4,000 surveys were sent via e-mail from December 28 2020 to January 31 2021. The highest group of respondents were between the ages of 18-29 years and physicians constituted 48% of the respondents. Among 515 respondents, 41.9% (n=216) would receive the vaccine within one month of it becoming available to them, and 30.2% (n=156) had already received a vaccine. Among those who would defer the vaccine, 9.3% (n=48) would receive it within 1-3 months, 5.6% (n=29) within 3-6 months and 6.6% (n=34) after over 6 months or longer. 6.2% (n=32) would not receive the vaccine. The three most commonly reported reasons for deferral of vaccine among 75 vaccine hesitant respondents were: “I am worried about the side effects” (65.3%), “I am worried the vaccine moved through clinical trials too fast (54.7%), and “There is no information about long term side effects of the vaccine” (52%). Data indicate that about a quarter of respondents also expressed distrust of the government and the pharmaceutical industry. The results are summarized in table 1. Conclusion Reasons cited by this sample of Arab Americans for deferring the COVID-19 vaccine mirror more general concerns about vaccine side effects and need for information. Concerns about clinical trial procedures and distrust have become more prevalent with COVID-19. This data can help inform COVID-19 vaccine advocacy efforts among health care providers, and thus could have substantial impact on vaccine attitudes of the general population. Disclosures Marcus Zervos, MD, contrafect (Advisor or Review Panel member)janssen (Grant/Research Support)merck (Grant/Research Support)moderna (Grant/Research Support)pfizer (Grant/Research Support)serono (Grant/Research Support)

A Qualitative Study of Arab-American Perspectives on Intimate Partner Violence in Dearborn, Michigan

Few studies explore how intimate partner violence (IPV) affects Arab Americans. Through focus groups with stakeholders from an Arab-centered health organization and semistructured interviews with Arab-American female clients (18–65 years), we explore how IPV affects Arab-American women and factors that impede and facilitate their access to support services. We find that IPV is a critical concern among Arab Americans and that generational status, educational attainment, and support from family, friends, or religious leaders were perceived to influence access to IPV support services. This study has implications for developing culturally sensitive IPV interventions for Arab-American women.

A Journey of How The First Arab Immigrants Assimilated into American Cultures: A Sociocultural Study in Alixa Naff's Collection

Immigration from one location to another in search for a better life has been an ongoing human process. The process, as a matter of fact, began before the WWI and it continues till now. It was dramatically increased during the era of the wars. Early immigrations involved unskilled and illiterate people whose common labor was peddling. Peddling vastly enabled immigrants assimilate into American multi-cultures. It is the base on which the history of Arab American is documented. The paper is aimed to discuss the concept of immigration first, investigating the three distinctive waves of Arab immigrants to the United States, focusing on early migrations and early American cultures, the act of peddling, and how Arab immigrants assimilated to the American society. The study will answer the questions: How did Alixa Naff become American? What experience did she lead? And how did she affect the society of Arab Americans? The study originally depended on Naff's Collections which is a key insight of experiences of the first wave Arab Immigrants based on oral real history interviewed by immigrants in the new country.

Countering Post-9/11 Stereotypes: Arab American Playwrights Make Their Voices Heard

Before 9/11Arab-American drama was sporadic and inconsistent in the sense that there was a relative absence of Arab-American theater or playwrights who made their voices heard across the USA. However, after 9/11 the American theater scene witnessed a surge of Arab-American drama and theater that aimed at addressing the American audience in order to voice the concerns, fears and anxieties of Arab Americans. They wanted to dispel much of the stereotype attributes which have been wrongly associated with them because of the 9/11 terrorist attacks. This study intends to examine the dramatic endeavors of Arab-American playwrights to make their voices heard through drama, performance and theater in light of transnationalism and diaspora theory. The study argues that Arab-American dramatists and theater groups write back to the hegemonic polemics against Arabs and Muslims, which has madly become characteristic of contemporary American literature and media following 9/11. Viewed in light of the anti-Arab American literary discourse, Arab-American playwrights and performers have taken giant steps towards changing the stereotypes of Arabs, and countering the loud voices of those who try to add fuel to the blazing flames of Islamophobia. To assess the contribution of Arab-American dramatists and performers to make their voices heard loud and clear in countering the stereotypes of Arabs and Muslims, Yussef El Guindi (1960-) is going to be discussed in this paper because he has been fighting the stereotypes of Arab Americans and Islamophobia in his drama and theater. El Guindi has devoted most of his plays to fight the stereotypes that are persistently attributed to Arabs and Muslims, and his drama presents issues relating to identity formation and what it means to be Arab American. A scrutiny of his plays shows that El Guindi has dealt with an assortment of topics and issues all relating to the stereotypes of Arab Americans and the Middle East. These issues include racial profiling and surveillance; stereotypes of Arabs and Muslims in the cinema and theater; and acculturation and clash of cultures. Keywords: Arab American, Identity, Theater, Stereotypes, Diaspora, Acculturation