An Analysis of Acculturation Status and Healthcare Coverage for the Needs of Mental Health Service Utilization among Latinos in Mississippi, Louisiana, and Alabama
Abstract
:1. Introduction
2. Methods
2.1. Recruitment
- Inclusion criteria: Latino adults residing in this tri-state were included.
- Exclusion criteria: Individuals with missing information were excluded from this study.
2.2. Interview
2.3. Data Collection
2.4. Variables of Interest
2.5. Independent Variables
2.6. Sociodemographic Variables
3. Data Analysis
4. Results
5. Discussion
6. Conclusions
7. What Are the Implications for Public Health Research?
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
- United States Census Bureau. U.S. Census Bureau Projections Show a Slower Growing, Older, More Diverse Nation a Half Century from Now; United States Census Bureau: Hutland Sutherland, MD, USA, 2012. Available online: http://www.census.gov/newsroom/releasearchivepopulation/cb12-243.html (accessed on 29 August 2019).
- U.S. Census Bureau. State County QuickFacts; United States Census Bureau: Hutland Sutherland, MD, USA, 2012. Available online: http://quickfacts.census.gov (accessed on 29 August 2019).
- Sclar, D.A.; Robison, L.M.; Schmidt, J.M.; Bowen, K.A.; Castillo, L.V.; Oganov, A.M. Diagnosis of depression and use of antidepressant pharmacotherapy among adults in the United States: Does a disparity persist by ethnicity/race? Clin. Drug Investig. 2012, 32, 139–144. [Google Scholar] [CrossRef]
- Wassertheil-Smoller, S.; Arredondo, E.; Cai, J.; Castenada, S.; Choca, J.P.; Gallo, L.; Zee, P. Depression, anxiety, antidepressant use, and cardiovascular disease among men and women of different national backgrounds: Results from the Community Health Study/Study of Latinos (HCHSOL). Ann. Epidemiol. 2014, 24, 822–830. [Google Scholar] [CrossRef] [PubMed]
- Alegria, M.; Chatterji, P.; Wells, K.; Cao, Z.; Chen, C.N.; Takeuchi, D.; Jackson, J.; Meng, X.L. Disparity in depression treatment among racial and ethnic minority populations in the United States. Psychiatr. Serv. 2008, 59, 1264–1272. [Google Scholar] [CrossRef] [PubMed]
- Alegria, M.; Mulvaney-Day, N.; Torres, M.; Polo, A.; Cao, Z.; Canino, G. Prevalence of Psychiatric Disorders Across Latino Subgroups in the United States. Am. J. Public Health 2007, 97, 68–75. [Google Scholar] [CrossRef] [PubMed]
- Sorkin, D.H.; Pham, E.; Ngo-Metzger, Q. Racial and Ethnic Differences in the Mental Health Needs and Access to Care of Older Adults in California. Am. Geriatr. Soc. 2009, 57, 2311–2317. [Google Scholar] [CrossRef] [PubMed]
- Alegria, M.; Mulvaney-Day, N.; Woo, M.; Torres, M.; Gao, S.; Oddo, V. Correlates of Past-Year Mental Health Service Use Among Latinos: Results from the National Latino and American Study. Am. J. Public Health 2007, 97, 76–83. [Google Scholar] [CrossRef] [PubMed]
- Menselson, T.; Rehkopf, D.H.; Kubzansky, L.D. Depression among Latinos in the United States: A meta-analytic review. J. Consult. Clin. Psychol. 2008, 76, 355–366. [Google Scholar] [CrossRef] [PubMed]
- González, H.M.; Tarraf, W.; West, B.T.; Croghan, T.W.; Bowen, M.E.; Cao, Z.; Alegría, M. Antidepressant use in a nationally representative sample of community-dwelling US Latinos with and without depressive and anxiety disorders. Depress Anxiety 2009, 26, 674–681. [Google Scholar] [CrossRef]
- Substance Abuse and Mental Health Services Administration. Results from the 2011 National Survey on Drug Use and Health: Mental Health Findings; NSDUH Series H-45, HHS Publication No. (SMA) 12-4725; Substance Abuse and Mental Health Services Administration: Rockville, MD, USA, 2012.
- Keyes, K.M.; Martins, S.S.; Hatzenbuehler, M.L.; Blanco, C.; Bates, L.M.; Hasin, D.S. Mental health service utilization for psychiatric disorders among Latinos living in the United States: The role of ethnic subgroup, ethnic identity, and language/social preferences. Soc. Psychiatry Psychiatr. Epidemiol. 2012, 47, 383–394. [Google Scholar] [CrossRef] [PubMed]
- Leung, P.; LaChapelle, A.R.; Scinta, A.; Olvera, N. Factors Contributing to Depressive Symptoms among Mexican Americans and Latinos. Natl. Assoc. Soc. Work. 2014, 59, 42–49. [Google Scholar] [CrossRef]
- Abraído-Lanza, A.F.; Armbrister, A.N.; Flórez, K.R.; Aguirre, A.N. Toward a Theory-Driven Model of Acculturation in Public Health Research. Am. J. Public Health 2006, 96, 1342–1346. [Google Scholar] [CrossRef] [PubMed]
- Lara, M.; Gamboa, G.; Kahramanian, M.I.; Morales, L.S.; Bautista, D.E.H. Acculturation and Latino Health in the United States: A Review of the Literature and its Sociopolitical Context. Annu. Rev. Public Health 2005, 26, 367–397. [Google Scholar] [CrossRef] [PubMed]
- Improving Cultural Competence. Available online: https://www.ncbi.nlm.nih.gov/books/NBK248425/ (accessed on 29 August 2019).
- Pearson, W.S.; Zhao, G.; Ford, E.S. An Analysis of Language as a Barrier to Receiving Influenza Vaccinations among an Elderly Population in the United States. Adv. Prev. Med. 2011, 2011, 298787. [Google Scholar] [CrossRef] [PubMed]
- Eamranond, P.P.; Legedza, A.T.; Diez-Roux, A.V.; Kandula, N.R.; Palmas, W.; Siscovick, D.S.; Mukamal, K.J. Association between language and risk factor levels among adults with hypertension, hypercholesterolemia, or diabetes. Am. Heart J. 2009, 157, 53–59. [Google Scholar] [CrossRef] [PubMed]
- Isasi, C.R.; Ayala, G.X.; Sotres-Alvarez, D.; Madanat, H.; Penedo, F.; Loria, C.M.; Elder, J.P.; Daviglus, M.L.; Barnhart, J.; Siega-Riz, A.M.; et al. Is acculturation related to obesity in/Latino adults? Results from the community health study/study of Latinos. J. Obes. 2015, 2015, 186276. [Google Scholar] [CrossRef] [PubMed]
- Kandula, N.R.; Diez-Roux, A.V.; Chan, C.; Daviglus, M.L.; Jackson, S.A.; Ni, H.; Schreiner, P.J. Association of acculturation levels and prevalence of diabetes in the multi-ethnic study of atherosclerosis (MESA). Diabetes Care 2008, 31, 1621–1628. [Google Scholar] [CrossRef] [PubMed]
- Schwartz, S.J.; Unger, J.B.; Zamboanga, B.L.; Szapocznik, J. Rethinking the concept of acculturation: implications for theory and research. Am. Psychol. 2010, 65, 235–237. [Google Scholar] [CrossRef]
- Abraído-Lanza, A.F.; Echeverría, S.E.; Flórez, K.R. Latino Immigrants, Acculturation, and Health: Promising New Directions in Research. Annu. Rev. Public Health 2016, 37, 219–236. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Office of Minority Health, U.S. Deaprtment of Health and Human Service. Profile: Hispanic/Latino Americans. Available online: https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=3&lvlid=64 (accessed on 29 August 2019).
- Bhuiyan, A.R.; Leggett, S.; McCoy, P.; Cannon-Smith, G. Predictors of Dental Care Service Utilization among Latinos in Mississippi, Louisiana, and Alabama. Online J. Rural Urban Res. 2017, 7, 30–38. [Google Scholar]
- DeNavas-Walt, C.; Proctor, B.C.; Smith, J.C. U.S. Census Bureau. Income, Poverty, and Health Insurance Coverage in the United States: 2012. U.S. (PP-60-245); Government Printing Office: Washington, DC, USA, 2013.
- Kaiser Family Foundation. Health Coverage by Race and Ethnicity: The Potential Impact of the Affordable Care Act; Kaiser Commission on Medicaid and the Uninsured: Washington, DC, USA, 2013. [Google Scholar]
- De Jesus, M.; Xiao, C. Predicting Health Care Utilization among Latinos: Health Locus of Control Beliefs or Access Factors? Health Educ. Behav. 2014, 41, 423–430. [Google Scholar] [CrossRef] [PubMed]
- Office of Disease Prevention and Health Promotion. Available online: http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=1 (accessed on 29 August 2019).
- Skocpol, T. The Political Challenges That May Undermine Health Reform. Health Aff. 2010, 29, 1288–1292. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Stoltzfus, J.T.; Lazarus, S. Trump’s Executive Order on Health Care—Can It Undermine the ACA if Congress Fails to Act? N. Engl. J. Med. 2017, 376, 1201–1203. [Google Scholar] [CrossRef]
- Sherry, G.; Jackson, A. The Future of the Affordable Care Act and Insurance Coverage. Am. J. Public Health 2017, 107, 538–540. [Google Scholar]
- Abdus, S.; Mistry, K.B.; Selden, T.M. Racial and Ethnic Disparities in Services and the Patient Protection and Affordable Care Act. Am. J. Public Health 2015, 105, S668–S675. [Google Scholar] [CrossRef] [PubMed]
- Louisiana Department of Health. Available online: https://medicaid-help.org/louisiana-medicaid-insurance (accessed on 29 August 2019).
Variables | Number | Percent |
---|---|---|
States | ------ | ---- |
Mississippi | 138 | 34.4 |
Louisiana | 132 | 32.9 |
Alabama | 131 | 32.7 |
Ethnic group | ----- | ----- |
Mexican Latinos | 145 | 36 |
Other Latinos | 257 | 64 |
(Puerto Rican 4%, Cuban 4%, Honduran 20%, Guatemalan 8%, Nicaraguan 3%, Peruvian 3%, Colombian 3%, Salvadoran 3%, other 16%) | ||
Gender | ||
Female | --- | ---- |
Male | 235 | 57 |
Age category | 176 | 43 |
18–24 | --- | --- |
25–64 | 62 | 15 |
≥65 | 316 | 77 |
Education completed | 26 | 6 |
No education/Elementary | ---- | ---- |
High School/GED | 122 | 30 |
Vocational School/College/University | 152 | 38 |
Household income | 129 | 32 |
Less than 20,000 | ---- | --- |
20,000–39,999 | 195 | 52 |
Above 40,000 | 118 | 31 |
Healthcare coverage | 65 | 17 |
Healthcare coverage for the past 12 | ---- | ---- |
months | 99 | 25 |
Had healthcare coverage | 45 | 11 |
Never had healthcare coverage | 259 | 64 |
Components of acculturation | ---- | ---- |
Born in the US | ---- | ---- |
The US born | 45 | 11 |
Non-US born | 355 | 88 |
Duration of stay in the US | --- | ---- |
Staying 20 or more years | 102 | 44 |
Staying 10–19 years | 118 | 30 |
Staying less than 10 years | 117 | 26 |
Language preference | ---- | ----- |
Spanish | 309 | 79 |
English | 57 | 15 |
Both | 26 | 6 |
Acculturation status | ----- | ---- |
Low Acculturation (0–2 score) | 336 | 82 |
High Acculturation (3–5 score) | 73 | 18 |
Depression | 41 | 10.4 |
Mental health service utilization | 39 | 9.6 |
Health status | ---- | -- |
Poor/Fair | 100 | 24.6 |
Good/very good | 251 | 61.7 |
Excellent | 56 | 13.8 |
Marital status | --- | --- |
Married/Partner | 257 | 63.5 |
Divorce | 68 | 16.8 |
Never married | 80 | 19.8 |
Variables | Ethnicity Other Latinos vs. Mexican Latinos | Gender Male vs. Female | Age Category | Education | Income | Marital Status | Healthcare Coverage | Acculturation Low vs. High | Depression | Health Status |
---|---|---|---|---|---|---|---|---|---|---|
MHS p-value | −0.85 0.09 | 0.14 0.004 | 0.06 0.21 | 0.13 0.009 | 0.02 0.67 | 0.08 0.09 | 0.19 0.001 | 0.11 0.03 | 0.34 0.001 | −0.78 0.12 |
Acculturation Low vs. High p-value | −0.14 0.005 | 0.09 0.06 | −0.14 0.005 | 0.42 0.000 | 0.32 0.001 | 0.24 0.001 | 0.32 0.000 | 1 0.001 | −0.08 0.107 | 0.07 0.15 |
Variables* | β Coefficient | Standard Error | Wald Chi-Square | p-Value | Odds Ratio | 95% CI |
---|---|---|---|---|---|---|
Acculturation | --- | --- | --- | --- | --- | --- |
Low | Ref | Ref | Ref | Ref | Ref | Ref |
High | 0.42 | 0.49 | 0.74 | 0.39 | 1.53 | 0.58–4.00 |
Healthcare coverage | 1.01 | 0.41 | 6.01 | 0.01 | 2.75 | 1.23–6.19 |
Depression | 2.36 | 0.41 | 29.74 | 0.001 | 10.48 | 4.50–24.39 |
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Bhuiyan, A.R.; Cannon-Smith, G.A.; Leggett, S.S.; McCoy, P.D.; Barvié, M.; Jones, A.W. An Analysis of Acculturation Status and Healthcare Coverage for the Needs of Mental Health Service Utilization among Latinos in Mississippi, Louisiana, and Alabama. Psych 2019, 1, 460-468. https://doi.org/10.3390/psych1010035
Bhuiyan AR, Cannon-Smith GA, Leggett SS, McCoy PD, Barvié M, Jones AW. An Analysis of Acculturation Status and Healthcare Coverage for the Needs of Mental Health Service Utilization among Latinos in Mississippi, Louisiana, and Alabama. Psych. 2019; 1(1):460-468. https://doi.org/10.3390/psych1010035
Chicago/Turabian StyleBhuiyan, Azad R., Gerri A. Cannon-Smith, Sophia S. Leggett, Pamela D. McCoy, Maria Barvié, and Ashley White Jones. 2019. "An Analysis of Acculturation Status and Healthcare Coverage for the Needs of Mental Health Service Utilization among Latinos in Mississippi, Louisiana, and Alabama" Psych 1, no. 1: 460-468. https://doi.org/10.3390/psych1010035