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To determine associations between spiritual well-being (faith and meaning dimensions) with emotional suffering (anxiety, depression, hopelessness, and quality of life) in Latinos with advanced cancer and examine themes of existential coping.
Design
In a mixed-methods study, participants were recruited from cancer clinics in New York and Puerto Rico. Measures included the Functional Assessment of Chronic Illness Therapy – Spiritual Well-Being Scale, the Hospital Anxiety and Depression Scale, and the Beck Hopelessness Scale. A subset of participants completed in-depth semi-structured interviews exploring the roles of existential and religious factors in adjustment to cancer. Correlations were conducted, and the interviews were analyzed with a thematic analysis approach.
Results
A sample of 142 Latinos with advanced cancer participated (67.6% stage IV and 32.4% stage III). The spiritual well-being, faith and meaning factor were associated with anxiety and depression symptoms. Meaning was associated with lower hopelessness and showed stronger associations with emotional suffering than the faith dimension. Lower acculturation was associated with higher hopelessness but not with depression/anxiety. In semi-structured interviews (n = 24), recurrent themes were: (1) receiving existential support from counselors; (2) receiving spiritual support from family and/or friends; (3) focusing on being spiritual and finding purpose rather than on a specific religion or faith; (4) religious coping; and (5) spiritual coping, focused on self-growth, finding meaning, and helping others to cope. Patients identified sources of meaning, including helping others, having a fighting spirit, a spirit of learning, enjoying work, enjoying life, family and children, confidence in providers/treatment, God/faith, and spirituality.
Significance of results
Meaning had a more significant influence than faith on emotional suffering. Participants emphasized the importance of finding meaning and purpose, self-growth, and helping others as ways to cope with an advanced diagnosis. Interventions with a meaning-making approach, emphasizing finding purpose and growth, are needed for Latinos with advanced cancer.
Volunteerism makes critical contributions to individual lives and society as a whole. However, to date, few studies have investigated volunteerism within Latino communities, a large and growing US population. The aim of this study was to understand how non-metropolitan US Latinos perceive volunteerism, as well as to determine what motivates and what deters their participation in volunteer programs. Our research team conducted six focus groups with 36 Latina women living in the State of Illinois. The focus groups covered topics such as the definition of volunteerism, participation motives and barriers, personal volunteer experience, and Latino culture, community, and organizations. We also assessed demographic information. Results from this study indicate that Latinas have a unique understanding of the concept of volunteerism. Participants associated everyday “helping” with volunteerism, establishing commonplace forms of aid as perhaps a “Latino way of volunteering.” We found time-consuming activities such as family responsibilities and work to be deterrents to Latinas participating in more formal volunteer activities.
This commentary discusses research workforce programs designed to enhance the representation and engagement of Latinos in HIV research, highlighting key challenges and proposing actionable strategies for improvement. Mentorship education and cultural inclusivity are identified as the most salient issues because the former leads to stronger health-related outcomes and is linked to cognitive-and career-related factors while the latter offers the potential to directly dismantle structures of inequity. This commentary suggests recasting of Diversity, Equity, and Inclusion (DEI) initiatives from eligibility as Latino self-identification, to all individuals’ lived experiences and/or prior experience in service/research activities. Some issues and constructs (i.e., heterogeneity, perseverance, acculturation, cultural values), typically important for certain underrepresented minoritized groups in diversity workforce programs, are reinterpreted for their relevance to all potential participants. This commentary proposes a holistic approach to trainee eligibility, creating a more inclusive environment that respects both individuality and diversity, and, importantly, contributing to DEI does not require being a member of an underrepresented minoritized population group.
When Roberto Clemente debuted with the Pittsburgh Pirates in 1955, baseball writers, Black and white, hailed him as the next great Black outfielder. When the Afro–Puerto Rican died on the last day of 1972, they remembered him as a Latin legend. Chapter 2 shows how – before the Immigration Act of 1965, before the addition of the “Spanish/Hispanic origin” question to the census form – Major League Baseball institutionalized a Black/brown color line. Management set Black and Latino teammates against one another, and Afro-Latinos found themselves, in Clemente’s words, “between the wall.”
Recruitment of diverse populations into research studies continues to be a challenge. There remains a gap in knowledge and practice on how to best engage with and recruit diverse populations, specifically among Latinos who account for 11% of research participants nationally. Our study focused on Latinas with pre-cervical and cervical cancer in the Pacific Northwest. Our research team took a multilevel approach to diversify recruitment and enrollment processes, focused on methods within healthcare, community-based, and paid media advertisements. This article shares strategies and lessons learned that helped increase participant diversity, meet enrollment goals, and expand relationships with community-based organizations.
System avoidance refers to the tendency of individuals who are concerned about formal social control (e.g., incarceration, immigration enforcement, or the removal of children from their families) to avoid surveilling institutions that engage in recordkeeping. While this research locates concerns about formal social control in an individual’s sanctionable status, the laws, policies, and practices that generate the threat of formal social control vary across space and time. Drawing on theories of legal consciousness, this article posits that spatial and temporal variation in the threat of formal social control has differential associations with whether and to what degree individuals with a sanctionable status report involvement in surveilling institutions. Our empirical case is U.S. immigration policing, which burdens Latinos across citizenship statuses. We link individual-level data on institutional involvement from the American Time Use Survey with administrative data on immigration policing across state-years. Results from double-hurdle models show that Latinos in state-years with higher rates of immigration policing (1) are less likely to report involvement in surveilling institutions but, (2) conditional on any involvement, do not vary in the time reported involved. We evaluate variations by nativity, citizenship status, institution, and the presence of sanctuary policies that circumscribe immigration policing. We conclude that the threat of formal social control across space and time implicates the situational meanings of institutional involvement for subordinated populations.
Objectives: Leveraging the non-monolithic structure of Latin America, which represents a large variability in social determinants of health (SDoH) and high levels of genetic admixture, we aim to evaluate the relative contributions of SDoH and genetic ancestry in predicting dementia risk in Latin American populations
Methods: Community-dwelling participants aged 65 and older (N = 3808) from Cuba, Dominican Republic, Mexico, and Peru completed the 10/66 protocol assessments. Dementia was diagnosed using the cross-culturally validated 10/66 algorithm. The primary outcome measured was the risk of developing dementia. Multivariate linear regression models adjusted for SDoH were used in the main analysis.
Results: We observed extensive three-way (African/European/Native American) genetic ancestry variation between countries. Individuals with higher proportions of Native American (>70%) and African American (>70%) ancestry were more likely to exhibit factors contributing to worse SDoH, such as lower educational levels (p <0.001), lower SES (p < 0.001), and higher frequency of vascular risk factors (p < 0.001). In unadjusted analysis, American individuals with predominant African ancestry exhibited a higher dementia frequency (p = 0.03) and both Native and African ancestry predominant groups showed lower cognitive performance relative to those with higher European ancestry (p < 0.001). However, after adjusting for measures of SDoH, there was no association between ancestry proportion and dementia probability, and ancestry proportions no longer significantly accounted for the variance in cognitive performance (African predominant p = 0.31 [–0.19, 0.59] and Native predominant p = 0.74 [–0.24, 0.33]).
Conclusions: The findings suggest that social and environmental factors play a more crucial role than genetic ancestry in predicting dementia risk in Latin American populations. This underscores the need for public health strategies and policies that address these social determinants to reduce dementia risk in these communities effectively.
Black and Latino individuals are underrepresented in COVID-19 treatment and vaccine clinical trials, calling for an examination of factors that may predict willingness to participate in trials.
Methods:
We administered the Common Survey 2.0 developed by the Community Engagement Alliance (CEAL) Against COVID-19 Disparities to 600 Black and Latino adults in Baltimore City, Prince George’s County, Maryland, Montgomery County, Maryland, and Washington, DC, between October and December 2021. We examined the relationship between awareness of clinical trials, social determinants of health challenges, trust in COVID-19 clinical trial information sources, and willingness to participate in COVID-19 treatment and vaccine trials using multinomial regression analysis.
Results:
Approximately half of Black and Latino respondents were unwilling to participate in COVID-19 treatment or vaccine clinical trials. Results showed that increased trust in COVID-19 clinical trial information sources and trial awareness were associated with greater willingness to participate in COVID-19 treatment and vaccine trials among Black and Latino individuals. For Latino respondents, having recently experienced more challenges related to social determinants of health was associated with a decreased likelihood of willingness to participate in COVID-19 vaccine trials.
Conclusions:
The willingness of Black and Latino adults to participate in COVID-19 treatment and vaccine clinical trials is influenced by trial awareness and trust in trial information sources. Ensuring the inclusion of these communities in clinical trials will require approaches that build greater awareness and trust.
The present study characterized heterogeneity in the cognitive profiles of monolingual and bilingual Latino older adults enrolled in the HABS-HD.
Methods:
A total of 859 cognitively unimpaired older adults completed neuropsychological testing. Raw scores for cognitive tests were converted to z-scores adjusted for age, education, sex, and language of testing. A latent profile analysis (LPA) was conducted for monolingual and bilingual speaker groups. A series of 2–5 class solutions were examined, and the optimal model was selected based on fit indices, posterior probabilities, proportion of sample sizes, and pattern of scores. Identified classes were compared on sociodemographic, psychosocial, and health characteristics.
Results:
For the monolingual group (n = 365), a 3-class solution was optimal; this consisted of a Low Average Memory group with low average verbal memory performances on the SEVLT Total Learning and Delayed Recall trials, as well as an Average Cognition group and a High Average Cognition group. For the bilingual group (n = 494), a 3-class solution was observed to be optimal; this consisted of a Low Average Memory group, with low average verbal memory performances on the learning and delayed recall trials of Logical Memory; a Low Average Executive group, where performance on Trails A and B and Digit Substitution were the lowest; and a High Average Cognition group, where performance was generally in the high average range across most cognitive measures.
Conclusions:
Cognitive class solutions differed across monolingual and bilingual groups and illustrate the need to better understand cognitive variability in linguistically diverse samples of Latino older adults.
Underrepresentation of people from racial and ethnic minoritized groups in clinical trials threatens external validity of clinical and translational science, diminishes uptake of innovations into practice, and restricts access to the potential benefits of participation. Despite efforts to increase diversity in clinical trials, children and adults from Latino backgrounds remain underrepresented. Quality improvement concepts, strategies, and tools demonstrate promise in enhancing recruitment and enrollment in clinical trials. To demonstrate this promise, we draw upon our team’s experience conducting a randomized clinical trial that tests three behavioral interventions designed to promote equity in language and social-emotional skill acquisition among Latino parent–infant dyads from under-resourced communities. The recruitment activities took place during the COVID-19 pandemic, which intensified the need for responsive strategies and procedures. We used the Model for Improvement to achieve our recruitment goals. Across study stages, we engaged strategies such as (1) intentional team formation, (2) participatory approaches to setting goals, monitoring achievement, selecting change strategies, and (3) small iterative tests that informed additional efforts. These strategies helped our team overcome several barriers. These strategies may help other researchers apply quality improvement tools to increase participation in clinical and translational research among people from minoritized groups.
A core justification for the electoral college, and its violations of political equality, is that it is necessary to protect important interests that would be overlooked or harmed under a system of direct election of the president. Yet such claims are based on faulty premises. States—including states with small populations—do not embody coherent, unified interests and communities, and they have little need for protection. Even if they did, the electoral college does not provide it. Contrary to the claims of its supporters, candidates do not pay attention to small states. The electoral college actually distorts the campaign by discouraging candidates from paying attention to small states and to much of the rest of the country as well. Instead, they devote their attention to competitive states. It is also the case that people of color do not benefit from the electoral college, because they are not well positioned to determine the outcomes in states. As a result, the electoral college system discourages attention to their interests. It does, however, provide the potential for any cohesive special interest concentrated in a large, competitive state to exercise disproportionate power.
The study examined factors associated with food and water stockpiling (FWS) during the COVID-19 pandemic.
Methods:
A secondary analysis of online survey data collected in two waves: April 2020 (wave 1) and June/July 2020 (wave 2), was conducted through REDCap web application. A total of 2,271 Non-Latino Black and Latino adults (mean age: 36.8 years (SD = 16.0); 64.3% female) living in Illinois were recruited. Participants self-reported if they stockpiled food and/or water (FWS) seven days prior to survey completion because of the pandemic. Logistic regression was used to determine if each variable was associated with the odds of reporting FWS.
Results:
Nearly a quarter (23.3%) of participants reported FWS. The adjusted model revealed that odds of FWS increase as the number of household members increased (OR: 1.21; 95% CI: 1.05-1.41). Odds of FWS were lower among participants who were not self-quarantining compared to those self-quarantining all the time (OR: 0.32; 95% CI: 0.17 – 0.62). Furthermore, individuals with lower levels of concern about COVID-19 had lower odds of FWS than those extremely concerned.
Conclusions:
Household size, self-quarantine status, and concern about COVID-19 were significantly associated with FWS. These findings highlight the need to address the concerns of marginalized individuals to promote healthy behaviors.
As the number of people of color (PoC) grows in the United States, a key question is how partisanship will develop among this important electoral group. Yet many open questions remain about PoC partisanship, due to limited availability of panel data, a lack of sensitive instrumentation, and small samples of PoC in most public opinion surveys. This brief report leverages a unique panel of African American (N = 650) and Latino (N = 650) eligible voters, before and after the 2020 Presidential Election between Democrat Joe Biden and Republican Donald Trump. Using measures that tap expressive partisan, racial, and national identity attachments, we find that Biden’s electoral victory significantly intensified partisan identity among his Democratic PoC supporters, relative to PoC who were not Democrats and supported Trump. We do not find significant changes in racial or national identities. Our results advance research on PoC’s partisanship.
The size and especially the growth of the Latino population in the United States are associated with anti-Latino and anti-immigrant attitudes. Findings from a recent line of experimental work suggest that Latino growth may also be associated with Whites’ anti-Black attitudes. Racial status threat could account for this association if Whites view Latino growth as a potential challenge to their status within a multi-group system that includes Blacks. Alternatively, or in addition, by engendering instability and uncertainty, Latino growth may promote ideological conservatism, which itself predicts racial attitudes. Building on prior work, this study examines the association between real, local Latino population growth––as opposed to manipulated or perceived growth––and Whites’ anti-Black resentment for a nationally representative sample of White Americans. Using data from the 2018 Cooperative Congressional Election Survey, the study finds that Whites in counties where the Latino population grew more report stronger anti-Black resentment. They are also more likely to perceive a threat to Whites’ racial status and to endorse ideological conservatism. Perceived threat and conservatism each partially account for the association between Latino growth and anti-Black resentment, suggesting the effect of Latino growth on anti-Black resentment is mediated through both channels.
To evaluate the effectiveness of PASOS SALUDABLES, a culturally tailored lifestyle intervention to prevent obesity and diabetes among Latino farmworkers, when implemented at large scale in the worksite.
Design:
This study was a two-arm parallel group, cluster randomised controlled trial, where participants received either a twelve-session lifestyle intervention (intervention) or six-session leadership training (control) at their worksite. The intervention was delivered by Promotoras in Spanish. All sessions were conducted at the worksites (ranches) during meal breaks. Blinded, trained research assistants collected socio-demographic and outcome data (i.e. BMI as primary outcome and waist circumference, glycated Hb (HbA1c), cholesterol and blood pressure as secondary outcomes) at baseline and follow-up assessments (i.e. 3 months, 6 months, 1 year and 1·5 years).
Setting:
Recruitment and intervention delivery occurred at twelve study ranches in Oxnard, California.
Participants:
We enrolled farmworkers hired by a large berry grower company, who were ≥18 years old, spoke Spanish and were free of diabetes at screening.
Results:
A total of 344 workers were enrolled in the intervention and 271 in the control group. The intervention resulted in attenuated increase of BMI over time; however, the difference in trend between groups was not significant (β = −0·01 for slope difference, P = 0·29). No significantly different trend by group was observed in secondary outcomes (P > 0·27).
Conclusions:
The worksite intervention, implemented during meal breaks, did not reduce BMI or other clinical indicators. Nevertheless, this study supports the feasibility of recruiting and engaging the Latino farmworker population in workplace health promotion interventions.
In the 2016 United States presidential election, candidates Trump and Clinton embraced the demands of certain social groups and in this way, politically and symbolically, chose to “own” the social identities of these groups. Trump decided to attack the Latino community, while Clinton positioned herself as an advocate for this community. This article presents the results of a social narrative analysis of the values that Clinton and her team used to reach out to Latino communities during the 2016 election. The Spanish-language messages produced by the Democratic campaign compose the sample, which includes blog posts, Facebook posts, tweets, and television ads. Clinton’s campaign produced narratives about who the “good Latinos” are and, consequently, the “good immigrants” while at the same time promoting values such as globalism, cosmopolitanism, and multiculturalism. Paradoxically, these narratives and values failed to portray Latinos’ diversity because they left out this community’s historical, social, and cultural complexity.
The book opens with a puzzle: What would compel members of one group to stand in solidarity with an outgroup in their fight for justice and equality, even when that act carries great personal risk and material sacrifice? We think a central piece of this puzzle is what we call group empathy: the ability and motivation to take another group’s perspective, feel emotionally connected to their struggles, and care about their welfare even when the individual’s interests, or those of his or her group, are at risk. We continue the discussion of this puzzle in two contemporary threat contexts: terrorism and immigration. Specifically, we ask why African Americans – who perceive a greater risk of terrorism on average – are less willing to support punitive homeland security policies that profile Arabs. Or, why are Latinos more supportive of foreign aid and more welcoming of refugees even if this means greater competition for jobs and social welfare? Once again, we think the answer lies in group empathy. We review the empirical studies used to test our theoretical expectations, followed by an outline of the book that provides a brief summary of each chapter.
Depression is strongly associated with chronic disease; yet, the direction of this relationship is poorly understood. Allostatic load (AL) provides a framework for elucidating depression-disease pathways. We aimed to investigate bidirectional, longitudinal associations of baseline depressive symptoms or AL with 5-year AL or depressive symptoms, respectively.
Methods
Data were from baseline, 2-year, and 5-year visits of 620 adults (45–75 years) enrolled in the Boston Puerto Rican Health Study. The Center for Epidemiology Studies Depression (CES-D) scale (0–60) captured depressive symptoms, which were categorized at baseline as low (<8), subthreshold (8–15), or depression-likely (⩾16) symptoms. AL was calculated from 11 parameters of biological functioning, representing five physiological systems. Baseline AL scores were categorized by the number of dysregulated parameters: low (0–2), moderate (3–5), or high (⩾6) AL. Multivariable, multilevel random intercept and slope linear regression models were used to examine associations between 3-category baseline CES-D score and 5-year continuous AL score, and between baseline 3-category AL and 5-year continuous CES-D score.
Results
Baseline subthreshold depressive symptoms [(mean (95% CI)): 4.8 (4.5–5.2)], but not depression-likely symptoms [4.5 (4.2–4.9)], was significantly associated with higher 5-year AL scores, compared to low depressive symptoms [4.3 (3.9–4.7)]. Baseline high AL [19.4 (17.6–21.2)], but not low AL [18.5 (16.5–20.6)], was significantly associated with higher 5-year CES-D score, compared to baseline moderate AL [16.9 (15.3–18.5)].
Conclusions
Depressive symptoms and AL had a bi-directional relationship over time, indicating a nuanced pathway linking depression with chronic diseases among a minority population.
Demonstrates that secularism can also lead to intraparty tension among Democrats. While many grassroots activists within the Democratic Party are highly secular (and predominantly white and upper status), the party also has a large contingent of Religionist activists (who are predominantly African American, Latino, and working class). Not only do these two groups of activists have different worldviews, they often disagree on both policy and strategy. Secularists are farther to the left, and more interested in ideological purity than compromise. In short, there is potentially a secular storm brewing within the Democratic coalition.
The relationship between religiosity and political attitudes is well established in the United States, particularly around gendered issues like abortion. However, this relationship can be complicated by the highly gendered and racialized nature of social identities. In this paper, we explore how different forms of religiosity (belonging to a denomination, specific religious beliefs, and religious behavior in church and in private) interact with gender to shape Latino abortion preferences. Using two sets of national survey data, we find that Evangelicalism and church attendance are more strongly associated with anti-abortion attitudes among Latino men, while religious beliefs are gender neutral. Our results illustrate the importance of intersectional approaches to studies of social identities and political preferences, as well as the importance of including gender in research on the role of the Evangelical church on immigrant political behavior.