The impact of immigration, assimilation and social context with weight status and coronary risk of Mexican Americans, Puerto Ricans and Cubans in the United States.

Abstract

This dissertation answered five questions using the Hispanic Health and Nutrition Examination Survey (HHANES, 1982--1984)---the largest and most comprehensive Latino health survey conducted in the United States. The analytical sample consisted of individuals ages 20--74. HHANES surveyed a total of 3,326 Mexican Americans in the southwest, 1,220 Puerto Ricans in the New York area, and 865 Cubans in Dade County, Florida. The first question addressed the association between socioeconomic status (SES) and weight status and coronary risk for Latinos. The data showed that SES operates differently for men and women, and by ethnicity. For Latino men, there was an inverse relationship between SES and weight status. For women, there was a positive association between SES and weight status for Mexican Americans, but not for Puerto Ricans and Cubans. SES was unrelated to coronary risk, irrespective of gender. The second question examined the relationship among acculturation, generation status, and health outcomes risk for Latinos? The data indicated that lower levels of acculturation and generation status were associated with better health outcomes---lower Body Mass Index (BMI), lower weight gain and lower coronary risk. The third question examined the joint contribution of SES and cultural factors with weight status and coronary risk. Cultural factors were stronger predictors of the health outcomes considered and the association between cultural factors and health status persisted when adjusted for SES. Another question examined if social and psychological factors and health-related behaviors mediated the relationship among SES, cultural factors and health outcomes. The data showed that martial status, body image, and smoking mediated the association between SES and the outcomes for Latino men, and for Cuban women. Body image and alcohol consumption mediated the association between the cultural factors and BMI only for Mexican American women. The last question examined if Mexican Americans were unique compared to Puerto Ricans and Cubans. The analyses revealed that SES was less salient to the outcomes for Mexican Americans than for other Latino groups. Conversely, the cultural factors were more salient to the outcomes for Mexican Americans than for Puerto Ricans and Cubans.