Although evidence suggests that the morbidity and mortality of Latino elders (of any Hispanic ancestry) are similar to those of non-Latino whites, Latinos have higher rates of disability. Little is known about influences on the use of in-home health services designed to assist disabled Latino elders. We examine the effects of various cultural and structural factors on the use of visiting nurse, home health aide, and homemaker services. Data are from the Commonwealth Fund Commission's 1988 national survey of 2,299 Latinos aged 65 and older. Mexican-American elders are less likely than the average Latino to use in-home health services despite similar levels of need. Structural factors including insurance status are important reasons, but acculturation is not pertinent. Physicians should not assume that Latino families are taking care of their disabled elders simply because of a cultural preference. They should provide information and advice on the use of in-home health services when an older Latino patient is physically disabled.
Research on caregiving of elders in Mexican American families is urgently needed. We know little about family caregivers, family transitions in relation to the caregiving role, reciprocal impact of caregivers and care recipients on one another, adaptive strategies, positive benefits of caregiving (caregiver gain), specific caregiving burdens, or supportive interventions for family caregiving. Theory derivation using the concepts and structure of life course perspective provides a way to fill the knowledge gaps concerning Mexican American caregiving families, taking into account their ethnic status as an important Hispanic subgroup and the unique cultural and contextual factors that mark their caregiving experiences.
Mexican American; life course perspective; elder caregiving
Despite evidence of ethnic differences in family caregivers’ experiences, the extent to which caregiver interventions are culturally tailored to address these differences is unknown. A systematic review of literature published from 1980–2009 identified: differences in caregiving experiences of African American, Latino and Chinese American caregivers; psychosocial support interventions in these groups; and cultural tailoring of interventions. Ethnic differences in caregiving occurred at multiple levels (intrapersonal, interpersonal, environmental) and in multiple domains (psychosocial health, life satisfaction, caregiving appraisals, spirituality, coping, self-efficacy, physical functioning, social support, filial responsibility, familism, views toward elders, use of formal services and health care). Only 18 of 47 intervention articles reported outcomes by caregiver ethnicity. Only 11 reported cultural tailoring; 8 were from the REACH initiative. Cultural tailoring addressed: familism, language, literacy, protecting elders, and logistical barriers. Results suggest that more caregiver intervention studies evaluating systematically the benefits of cultural tailoring are needed.
cultural sensitivity; cultural competence; dementia caregivers; Latinos; African Americans; Chinese Americans; support interventions
Hospice care is promoted as a model for improving end of life care and decreasing burden on caregivers. However, hospice use is low in Latinos and little is known about how Latinos make hospice decisions and experience hospice once enrolled. We used qualitative methods to conduct in-depth interviews and focus groups with 15 Latino bereaved hospice family caregivers and 15 White Non-Latino bereaved hospice family caregivers to describe hospice experiences and evaluate whether cultural factors affected the experience. We identified differences in decision-making and caregiving experience that were influenced by culture. For example, cultural values of denial, secrecy about prognosis and a collective, family-centered system influenced hospice decisions and experience in Latinos but not Non-Latinos. This study identifies a significant dilemma; that is, how to discuss hospice with a patient and family who prefer not to discuss a terminal prognosis. Future research is needed to extend these preliminary results; such results may be useful for designing interventions to improve end of life care and caregiving in Latinos.
Hospice; Latino; End of Life; Cancer; Caregiving; Communication
The objective of this study was to examine associations between specific dimensions of the multidimensional cumulative risk index (CRI) and asthma morbidity in urban, school-aged children from African American, Latino and Non-Latino White backgrounds. An additional goal of the study was to identify the proportion of families that qualify for high-risk status on each dimension of the CRI by ethnic group. A total of 264 children with asthma, ages 7–15 (40% female; 76% ethnic minority) and their primary caregivers completed interview-based questionnaires assessing cultural, contextual, and asthma-specific risks that can impact asthma morbidity. Higher levels of asthma-related risks were associated with more functional morbidity for all groups of children, despite ethnic group background. Contextual and cultural risk dimensions contributed to more morbidity for African-American and Latino children. Analyses by Latino ethnic subgroup revealed that contextual and cultural risks are significantly related to more functional morbidity for Puerto Rican children compared to Dominican children. Findings suggest which type of risks may more meaningfully contribute to variations in asthma morbidity for children from specific ethnic groups. These results can inform culturally sensitive clinical interventions for urban children with asthma whose health outcomes lag far behind their non-Latino White counterparts.
Pediatric asthma; Cumulative risks; Ethnic minority; Urban
Objective The goal of this study is to identify individual, family/cultural, and illness-related protective factors that may minimize asthma morbidity in the context of multiple urban risks in a sample of inner-city children and families. Methods Participating families are from African-American (33), Latino (51) and non-Latino white (47) backgrounds. A total of 131 children with asthma (56% male), ages 6–13 years and their primary caregivers were included. Results Analyses supported the relationship between cumulative risks and asthma morbidity across children of the sample. Protective processes functioned differently by ethnic group. For example, Latino families exhibited higher levels of family connectedness, and this was associated with lower levels of functional limitation due to asthma, in the context of risks. Conclusions This study demonstrates the utility of examining multilevel protective processes that may guard against urban risks factors to decrease morbidity. Intervention programs for families from specific ethnic groups can be tailored to consider individual, family-based/cultural and illness-related supports that decrease stress and enhance aspects of asthma treatment.
asthma outcomes; cultural factors; inner city; pediatric asthma; protective factors
Striking decreases in colorectal cancer (CRC) incidence have been seen recently in non-Latino Whites but not in Latinos. The purpose of our study was to examine the influence of limited English proficiency (LEP) on differences in CRC test use rates between Mexican American and non-Latino White adults in California and reported reasons for not getting a CRC exam.
Cross-sectional analysis of the 2005 California Health Interview Survey (CHIS).
Representative sample of non-institutionalized adults living in California.
Mexican American (n=1,529) and non-Latino White men and women aged 50 and older (n=16,775) who had not been diagnosed with CRC.
Logistic regression analyzed the effect of ethnicity and limited English proficiency (LEP) on CRC test use after adjusting for sociodemographics, healthcare access, health status, and other health behaviors.
Main Outcome Measures
Respondents' likelihood of not receiving the CRC exam was examined as a function of ethnicity and LEP status; differences in reasons for not receiving CRC testing between ethnic groups were also examined.
More than 40% of Californian Mexican American adults aged 50 and older have never had either fecal occult blood test or lower endoscopy CRC tests. Mexican Americans were more likely to have difficulty understanding their doctor due to language barriers (P<.01). Mexican Americans more often reported provider barriers in getting an endoscopy (ie, test was not recommended by their medical provider) than non-Latino Whites (P=.01). After adjustment for covariates, Mexican Americans were 1.32 times and those with LEP were 1.68 times more likely to have never had either CRC test.
Limited English proficiency significantly decreased the likelihood of getting tested for CRC (P<.01). Eliminating language barriers should result in improvements in CRC test use among limited English proficiency Mexican Americans.
Mexican Americans; Colonoscopy; Colorectal Cancer; Screening
Little research has focused on the mental health of Latino caregivers with a relative with schizophrenia, despite data showing that up to three-quarters of Latino persons with schizophrenia live with their families. This study examined the relation between caregivers’ mental health and perceived burden and stigma and characteristics of the patient and caregiver.
Interviews were conducted in the language of preference (Spanish or English) in Wisconsin, California, and Texas with 85 Latinos caring for an adult with schizophrenia. Measures included the Center for Epidemiologic Studies–Depression Scale, the Zarit Burden Scale, and the Greenley Stigma Scale.
General population studies of Mexican Americans have found that between 12% and 18% meet the cutoff for being at risk of depression; however, 40% of the sample met this criterion. Younger caregiver age, lower levels of caregivers’ education, and higher levels of the patients’ mental illness symptoms were predictive of higher levels of caregivers’ depressive symptoms. Caregivers’ perceived burden mediated the relation between patients’ psychiatric symptoms and caregivers’ depression. Caregivers’ perceived stigma was significantly related to caregivers’ depressive symptoms, even when the analyses statistically adjusted for psychiatric symptoms and demographic variables.
The high rates of depressive symptoms among Latino families caring for a relative with schizophrenia suggest that interventions should include attention to the mental health and recovery of family caregivers in addition to the patient’s recovery. Younger Latino caregivers and those with lower levels of education are particularly at risk of depression.
La familia drives elder care in Mexican–American (MA) families, but nursing home placement can result from day-to-day caregiving demands that increase caregiver difficulty with activities of daily living (ADLs). Using life course perspective, this article describes the initial data wave of 31 MA caregivers from a descriptive, longitudinal, mixed-methods study of 110 MA caregivers and care recipients over 15 months in their caregiving trajectories. Fifteen of 31 caregivers consistently indicated “no help needed” on the Katz ADL, whereas all but one reported “help needed” during semistructured interviews with cultural brokers. In addition to the discrepancy between results on the Katz ADL and interviews, findings include consideration of nursing home placement by moderately acculturated caregivers and minimization of their illnesses by caregivers. Additional methods of MA caregiver assessment may be needed due to the questionable accuracy of the Katz ADL; additional research should explore minimization and acculturation in MA caregivers.
family caregivers; Mexican-American; activities of daily living; minimization
Latino and African American children with asthma are at increased risk for asthma morbidity compared with non–Latino White children. Environmental control (ie, environmental exposures and family strategies to control them) may contribute to greater asthma morbidity for ethnic minority children living in urban environments. This study examined ethnic differences in a semi-structured assessment of environmental control, associations between environmental control and asthma outcomes (asthma control, functional limitation, and emergency department [ED] use), and ethnic differences in environmental triggers in a sample of urban Latino, African American, and non–Latino White families. One hundred thirty-three children (6–13 years of age) and their caregivers completed demographic questionnaires, measures of asthma control and morbidity, and a semi-structured interview assessing environmental control. Reported environmental control differed significantly by ethnicity (P<0.05), with Latino families reporting higher levels of environmental control. Reported environmental control was significantly associated with asthma control (P<0.017) and functional limitation (P<0.017). Reported environmental control and ED use were significantly associated in Latino families (P<0.05). Non–Latino White and African American families reported more secondhand smoke exposure than Latino families (P<0.001). Latino families reported more optimal home environmental control than other ethnic groups. Substantial ethnic differences in asthma triggers suggest that observed ethnic disparities in asthma may be due, at least in part, to differences in the home environment.
There is limited information on whether recent improvements in the control of cardiovascular disease (CVD) risk factors among individuals with diabetes have been concentrated in particular sociodemographic groups. This article estimates racial/ethnic- and education-related disparities and examines trends in uncontrolled CVD risk factors among adults with diabetes. The main racial/ethnic comparisons made are with African Americans versus non-Latino whites and Mexican Americans versus non-Latino whites.
RESEARCH DESIGN AND METHODS
The analysis samples include adults aged ≥20 years from the National Health and Nutrition Examination Survey (NHANES) 1988–1994 and the NHANES 1999–2008 who self-reported having diabetes (n = 1,065, NHANES 1988–1994; n = 1,872, NHANES 1999–2008). By use of logistic regression models, we examined the correlates of binary indicators measuring 1) high blood glucose, 2) high blood pressure, 3) high cholesterol, and 4) smoking.
Control of blood glucose, blood pressure, and cholesterol improved among individuals with diabetes between the NHANES 1988–1994 and the NHANES 1999–2008, but there was no change in smoking prevalence. In the NHANES 1999–2008, racial/ethnic minorities and individuals without some college education were more likely to have poorly controlled blood glucose compared with non-Latino whites and those with some college education. In addition, individuals with diabetes who had at least some college education were less likely to smoke and had better blood pressure control compared with individuals with diabetes without at least some college education.
Trends in CVD risk factors among individuals with diabetes improved over the past 2 decades, but racial/ethnic- and education-related disparities have emerged in some areas.
Research suggests that, among Latinos, there are health benefits associated with living in a neighborhood populated with coethnics. While social networks and social cohesion are the proposed explanation for the salubrious effect and are assumed to be characteristics of Latino immigrant enclaves, evidence for this is limited. We used multilevel regression to test the relative contribution of individual race/ethnicity and neighborhood concentration of Mexican Americans as predictors of social networks and social cohesion. After accounting for personal characteristics, we found a negative association between neighborhood concentration of Mexican Americans and social cohesion. Among Latinos, living in a neighborhood with increased coethnics was associated with increased social ties. Compared to non-Latino whites, Mexican Americans reported more social ties but lower social cohesion. Contrary to the assumption that Mexican immigrant enclaves beget social cohesion, we did not find this to be true in Chicago neighborhoods.
Ethnic enclaves; Social ties; Social cohesion; Latino immigrants; Neighborhoods
To investigate rates of psychotropic medication use by youths served in public service sectors as a function of race/ethnicity.
Logistic regression models were used to examine racial/ethnic differences in caregiver report of psychotropic medication use for a random stratified sample of 1,342 children who were served in public service sectors during the second half of fiscal year 1996–97.
Race/ethnicity predicted caregiver report of past-year and lifetime psychotropic medication use when all other factors were held constant. Specifically, caregivers of African-American and Latino children were less likely to report past-year use compared to white children; caregivers of Latino children and “others” were less likely to report lifetime use. Additional factors predictive of medication use in regression models included younger age, male gender, higher household income, insurance type, active to mental health sector at time of enumeration into the study, impairment and diagnosis of mood, and anxiety or attentional disorder.
Racial/ethnic differences in use of psychotropic medication occur in children served in public service sectors and need to be considered in clinical diagnosis and treatment.
psychotropics; pediatrics; race; ethnicity
Acceptance of functional decline accompanying chronic illness is challenging for all elders, and even more so for African-American elders. This study examined functional status and the number, types, and acceptance of chronic conditions in 16 African-American and 46 White elders. African-American elders reported better functioning but resembled Whites in number of chronic conditions and acceptance. All African-Americans reported hypertension; 76% of Whites reported arthritis. Greater acceptance was correlated with fewer chronic conditions (r = −.23, p < .05) and better functioning (r = −.59, p < .01). Poorer functioning (i.e., functional disability) was correlated with more chronic conditions (r = .27, p < .05). Culturally sensitive interventions are needed to enhance elders’ acceptance of chronic conditions and to improve their functioning.
acceptance; chronic conditions; functional status; health disparities
Employing a United States sample of 5,810 Yahoo heterosexual internet dating profiles, this study finds race–ethnicity and gender influence body type preferences for dates, with men and whites significantly more likely than women and non-whites to have such preferences. White males are more likely than non-white men to prefer to date thin and toned women, while African-American and Latino men are significantly more likely than white men to prefer female dates with thick or large bodies. Compatible with previous research showing non-whites have greater body satisfaction and are less influenced by mainstream media than whites, our findings suggest Latinos and African Americans negotiate dominant white idealizations of thin female bodies with their own cultures’ greater acceptance of larger body types.
Beauty; Body; Date selection; Ethnicity; Gender; Race; Internet dating
Abstract In recent years, a vast literature has accumulated on the negative effects on family caregivers of providing care to elders, while relatively little research has explored caregiving as a positive experience. Only a handful of studies have examined any aspect of informal caregiving among American Indians. This mixed methods study explores the negative and positive aspects of providing elder care among 19 northern plains American Indian family members. These caregivers described low levels of burden and high levels of reward, attributable to cultural attitudes toward elders and caregiving, collective care provision, strong reciprocal relationships with elders, enjoyment of elders, and relatively low levels of care provision. Caregiving manifested as part of a complex exchange of assistance rather than a unidirectional provision of assistance from the family member to the elder. That caregiving emerged as such an overwhelmingly positive experience in a community faced with poverty, alcohol disorders, trauma, and cultural traumatization is testimony to the important roles that elders often continue to play in these communities.
American Indian; Caregiving; Elders; Family; Positive valuation of elders; Caregiving reward
Identify factors that explain why some Mexican immigrants in California use health services in Mexico.
California Health Interview Survey 2001 data were analyzed for medical care, dental care, and/or prescription drug purchases in Mexico in the previous year. Logistic regressions estimated the effect on use of need, availability, accessibility, and acceptability among immigrants from Mexico.
An estimated 952,000 California adults used medical, dental, or prescription services in Mexico during the past year, 488,000 of whom were Mexican immigrants. Long-stay Mexican immigrants had the highest rate (15%), followed by short-stay Mexican immigrants (11.5%), U.S.-born Mexican Americans (5.4%) and U.S.-born non-Latino whites (2.1%). Predictors of use by immigrants included need, no insurance, delay seeking care, more recent immigration, limited English, and nonphysician provider use. Living closer to the border increased use, although half of immigrants seeking services lived more than 120 miles from the border. Mexican immigrants with long stays in the U.S. have a somewhat different pattern of predictors from those with short stays.
Mexican immigrants are the most likely to seek medical, dental, and prescription services in Mexico. A large number, but small percentage, of U.S.-born non-Latino whites purchase prescription drugs there. While proximity facilitates use, access and acceptability barriers in the U.S. medical care system encourage immigrants to seek care in Mexico who would be helped by expanded binational health insurance.
Cross-border Health Care; Access to care; Mexican-origin population; Prescription Drugs; Dental care; Language Access; Uninsured; Immigrants
Latinos in the United States are an ethnically diverse group disproportionately affected by HIV/AIDS. We describe HIV seroprevalence, HIV risk behaviors and utilization of health services among Mexican American injection drug users (IDUs) in California (n = 286) and compare them to White (n = 830) and African American (n = 314) IDUs. Study participants were recruited from syringe exchange programs (n = 24) in California. HIV seroprevalence among Mexican Americans (0.5%) was dramatically lower than Whites (5%) and African Americans (8%). Mexican Americans reported fewer sex-related risks than Whites and African Americans though injection-related risks remained high. Compared to Whites, Mexican Americans were more likely to participate in drug treatment during a 6 month period (AOR 1.5, 95% CI 1.1, 2.0) but less likely to receive any health care (AOR 0.6, 95% CI 0.5, 0.8). Exploring cultural and structural factors among Mexican American IDUs may offer new insights into how to maintain low rates of HIV seroprevalence and reduce barriers to health care utilization.
Injection drug use; HIV/AIDS; Mexican American; Syringe coverage; Drug treatment; Health care utilization
Since the early 1980s, epidemiological studies using state-of-the-art methodologies have documented the unmet mental health needs of Latinos adults in the U.S. and Puerto Rico. This paper reviews 16 articles based on seven epidemiological studies, examines studies methodologies, and summarizes findings about how Latino adults access mental health services. Studies consistently report that, compared to non-Latino Whites, Latinos underutilize mental health services, are less likely to receive guideline congruent care, and rely more often on primary care for services. Structural, economic, psychiatric, and cultural factors influence Latinos’ service access. In spite of the valuable information these studies provide, methodological limitations (e.g., reliance on cross-sectional designs, scarcity of mixed Latino group samples) constrict knowledge about Latinos access to mental health services. Areas for future research and development needed to improve Latinos’ access and quality of mental health care are discussed.
Latino; Hispanic; mental health services; service access; literature review
Antidepressant drugs are among the most widely prescribed drugs in the United States; however, little is known about their use among major ethnic minority groups.
Collaborative Psychiatric Epidemiology Surveys (CPES) data were analyzed to calculate nationally representative estimates of Latino and non-Latino White adults antidepressant use.
The 48 coterminous United States was the setting.
Household residents aged 18 years and older (N=9,250).
Past year antidepressant use.
Compared to non-Latino Whites, few Latinos, primarily Mexican Americans, with 12-month depressive and/or anxiety disorders reported past year antidepressant use. Mexican Americans (OR=0.48; 95%CI=0.30–0.77) had significantly lower odds of use compared to non-Latino Whites, which were largely unaffected by factors associated with access to care. Over half of antidepressant use was by respondents not meeting 12-month criteria for depressive or anxiety disorders. Lifetime depressive and anxiety disorders explained another 21% of past year antidepressant use, leaving another 31% of drug use unexplained.
We found a disparity in antidepressant use for Mexican Americans compared to non-Latino Whites that was not accounted for by differences in need and factors associated with access to care. About one third of antidepressant use was by respondents not meeting criteria for depressive or anxiety disorders. Our findings underscore the importance of disaggregating Latino ethnic groups. Additional work is needed to understand the medical and economic value of antidepressant use beyond their primary clinical targets.
Latinos; Hispanics; Cubans; Mexicans; Puerto Ricans; major depressive disorder; depression; anxiety disorders; antidepressive agents
The Wisconsin Smoking Withdrawal Scale (WSWS) is a valid and reliable scale among non-Latino Whites but has not been validated for use among other racial/ethnic groups despite increasing use with these populations. The current study examined the structural invariance and predictive equivalency of the WSWS across three racial/ethnic groups.
The WSWS scores of 424 African American, Latino, and White smokers receiving smoking cessation treatment were analyzed in a series of factor analyses and multiple-group analyses. Additionally, hierarchical logistic regression analyses were conducted to determine whether WSWS scores differentially predicted smoking relapse across racial/ethnic groups. These analyses were consistent with a step-down hierarchical regression procedure for examination of test bias.
The 7-factor structure of the WSWS was largely confirmed in the current study, with the exception of the removal of two offending items. Evidence of full invariance across race/ethnicity was found in multiple-group analyses. The WSWS total score and subscales measuring anger, anxiety, concentration, and sadness predicted relapse, whereas the hunger, craving, and sleep subscales did not. None of these scales displayed differential predictive ability across race/ethnicity. The WSWS sleep subscale showed a significant interaction with race/ethnicity such that it was a significant predictor of relapse among Whites but not African Americans or Latinos.
Overall, the WSWS is similar in structure and predictive of relapse across racial/ethnic groups. Caution should be exercised when using the WSWS sleep subscale with African Americans and Latinos.
This study examined family and cultural influences on adjustment among ninety low-income Latino middle school children (46% girls; Average age = 11.38, SD = .66) and their primary caregivers (93% Female; Average age = 36.12, SD = 6.13). All participants identified as Hispanic/Latino, with 75% of families identifying as Mexican-origin Latino, and 77% of parents and 32% of children identifying as immigrants. Hierarchical linear modeling analyses revealed that family reframing interacted with familism, with high levels of both associated with fewer psychological symptoms, while passive appraisal is linked to worse functioning. Results are discussed with regard to the implications of this research for preventive interventions with families in poverty.
This study identifies the risk and protective factors associated with informal caregiving by older (≥70 years) Mexican Americans and profiles caregiving arrangements. Overall, a greater number of informal caregivers (n = 92) were married and female. They also had higher physical functioning and better cognition than non-caregivers (n = 1,888) but fewer visited a physician regularly. Informal caregivers also showed an increased risk of depressive symptoms. A third of caregivers spent more than 20 h/day caregiving and the majority (84%) of care recipients were family members. In order to support the efforts of this disproportionately burdened caregiver group, increased social support and healthcare services are needed.
Informal caregiving; Depression; Cognition; Mexican Americans
Latino children experience a higher prevalence of caries than do children in any other racial/ethnic group in the US. This paper examines the intersections among four societal sectors or contexts of care which contribute to oral health disparities for low-income, preschool Latino1 children in rural California.
Findings are reported from an ethnographic investigation, conducted in 2005–2006, of family, community, professional/dental and policy/regulatory sectors or contexts of care that play central roles in creating or sustaining low income, rural children's poor oral health status. The study community of around 9,000 people, predominantly of Mexican-American origin, was located in California's agricultural Central Valley. Observations in homes, community facilities, and dental offices within the region were supplemented by in-depth interviews with 30 key informants (such as dental professionals, health educators, child welfare agents, clinic administrators and regulatory agents) and 47 primary caregivers (mothers) of children at least one of whom was under 6 years of age.
Caregivers did not always recognize visible signs of caries among their children, nor respond quickly unless children also complained of pain. Fluctuating seasonal eligibility for public health insurance intersected with limited community infrastructure and civic amenities, including lack of public transportation, to create difficulties in access to care. The non-fluoridated municipal water supply is not widely consumed because of fears about pesticide pollution. If the dentist brought children into the clinic for multiple visits, this caused the accompanying parent hardship and occasionally resulted in the loss of his or her job. Few general dentists had received specific training in how to handle young patients. Children's dental fear and poor provider-parent communication were exacerbated by a scarcity of dentists willing to serve rural low-income populations. Stringent state fiscal reimbursement policies further complicated the situation.
Several societal sectors or contexts of care significantly intersected to produce or sustain poor oral health care for children. Parental beliefs and practices, leading for example to delay in seeking care, were compounded by lack of key community or economic resources, and the organization and delivery of professional dental services. In the context of state-mandated policies and procedures, these all worked to militate against children receiving timely care that would considerably reduce oral health disparities among this highly disadvantaged population.
The aim of this study was to determine ethnic and site differences in quality of life (QOL) in a sample of Latino (Puerto Rican and Dominican) and non-Latino White (NLW) caregivers of children with asthma in mainland US and Island PR. We also investigated ethnic and site differences in associations between caregiver QOL and indicators of asthma morbidity.
Seven-hundred and eighty-seven children with asthma (7–16 years of age) and their primary caregivers participated. Primary caregivers completed a measure of QOL, child asthma control, and emergency department utilization, among other measures.
Ethnic and site differences were found on total QOL scores (ΔF(1, 783) = 29.46, p < .001). Island PR caregivers reported worse QOL scores than RI Latino and NLW caregivers; RI Latino caregivers reported significantly worse QOL scores than NLW caregivers. In RI Latino and Island PR children, worse caregiver QOL was associated with asthma that was not in control and with 1 or more ED visits.
Latino caregivers may be experiencing a greater level of burden related to their child’s asthma than NLW caregivers. Caregiver QOL in pediatric asthma may be a reflection of broader, contextual stress that some Latino caregivers experience on a daily basis (e.g., cultural beliefs, acculturation). Future research should continue to investigate mechanisms that explain the burden associated with pediatric asthma in Latino families, as well as whether QOL assessments should consider the impact of everyday stressors on caregiver QOL in pediatric asthma.
pediatric asthma; quality of life; caregivers; disparities; ethnicity