archives@tulane.edu / Hispanic older adults are burdened by obesity, and Body Mass Index (BMI) - a common measure of obesity, has limitations with aging. Further, Food Insecurity (FI) is linked to adverse health outcomes, including obesity. Yet, there is limited knowledge on obesity-related health risk disparities on account of place of birth among Hispanic older adults and the effect of FI. This study examines: 1) the prevalence of obesity {BMI/Waist Circumference (WC) classification} by place of birth and their associations to health risks- cardiometabolic risk factors (CRF) and physical performance (PP), and 2) the impact of FI. First, a cross-sectional analysis of National Health and Nutrition Examination Survey (NHANES) III with sample population of n= 4,584 participants aged 50 years and older {Non-Hispanic whites (NHW), n=3059; United States born Hispanics (USB-H), n=1170; Foreign-born Hispanics (FB-H), n=355} was done. Measurements include body types created from BMI/WC cut off values; CRFs as defined by the American heart association; PP-time tandem stand, time to complete five-stand and time to complete 8ft walk; sociodemographic (SDF) and behavioral factors (BF). Weighted multivariable logistic regression analyzed associations between body types and health risks controlling for SDF and BF. Second, NHANES 2005-2014 with sample population of (n=5,772; NHW, n=3869; USB, n=613; FBH, n=1,290) was analyzed. Food security status was defined as suggested by the United States Department of Agriculture (food secure-FS, food insecure-FI). Multivariable logistic regressions examined relationships between FI, obesity, and having at least one CRF. The proportion of body types varied across ethnicity-place of birth. NHW and FBH were more likely to have normal BMI/WC, while USB-H were more likely to have high BMI/WC. Body types with high BMI/WC were more likely to have CRFs and poorer PP when compared to those with normal BMI/WC. Stratifying by ethnicity-place of birth, FI persons had 1.60-1.80 odds of having at least one CRF when compared to persons who are FS. This study suggests that regardless of place of birth, Hispanic older adults are at obesity-related health risks. The concurrent use of BMI and WC measures in clinic settings and population-based research may encourage healthy aging. / 1 / Queendaleen Chukwurah

The purpose is to promote culturally competent care among healthcare providers by identifying and describing how Hispanics in East Tennessee view health and what they do to prevent illness. A focus group of six to ten Hispanics of mixed genders over age eighteen moderated by a native Spanish-speaking interpreter. Questions explored how Hispanics define health and sickness, health maintenance practices, and alternative medicines and practices. Results were interpreted from Spanish to English to be analyzed. The Circle in Which You Live was described by members as consisting of relationships, physical health, and peace of the mind and soul. In Shutting Themselves in Their Stress, group members described Hispanic women specifically as experiencing stress most often. Members explored how the mind attracts illness, types of pain, and nonpharmacological remedies in The Problems Do Not End. Stress is a major concern for health. Hispanics have a very holistic view of health. Pain relief methods mentioned by participants include distraction, bags of ice, and relaxation. Healthcare providers need to take time to ask about specific stressors in patient’s lives, collaborate with the patient, and explore ways to decrease and manage stress in a culturally sensitive manner.

Social support plays a crucial role in both the physical and mental adjustment to the diagnosis of breast cancer and its treatment. However, the mediating effects of social support are embedded within the larger, social and cultural contexts in which support given and received. Due to language, culture and economic issues, immigrants may find themselves without the social support and networks that had previously enabled them to cope with illness and disease. This research grounds our understanding of social support and breast cancer within that larger context that includes the social environment and the experience of health disparities. Ethnographic methods were used to explore the cultural domains of social support and to examine cultural and structural factors that influence this multifaceted construct. Participant observation, key informant interviews and 28 in-depth interviews with Latina immigrants diagnosed with breast cancer were conducted in Phase I. The qualitative data gathered in Phase 1 informed the development of the structured questionnaire that was administered in Phase II to 60 Latina immigrants in West Central Florida who had been diagnosed with breast cancer. Breast cancer not only affects individuals, it impacts their social relationships, finances, work, and social roles. The analysis provides a rich and in-depth understanding of social support and contextualizes the breast cancer experience of Latina immigrants. Results suggest that cultural expectations about gender roles shape what kinds of support and assistance is provided by men and women. Spirituality and prayer were identified as non verbal sources of support. Beliefs about not burdening the family with personal concerns and beliefs that family needs should come before one's own were negatively associated with social support. English proficiency and length of time in the United States were not associated with social support. Regardless of length of time in the US there appears to be strong ties with family in their native country. While family both in the US and in their native country were identified as sources of support, they were also identified as a source of stress. Recommendations for clinicians, practitioners and community-based organizations that provide supportive services and programs to Latinos are included.

Negative experiences of stigmatization, discrimination, and rejection are common among people living with HIV in the United States, and particularly when they are also members of a minority group. Some three decades after the first cases of AIDS were identified, people infected with HIV continue to be perceived and characterized negatively. While an HIV/AIDS diagnosis is typically associated with negativity, this study investigates the extent to which collective experiences among HIV-positive people result in healthy responses and positive social adjustment. This study is focused on the ways in which HIV-positive Puerto Rican men in Boston live positive despite being diagnosed with HIV. Rather than wrapping themselves in the social stigma of HIV and the isolation that entails, they participate in processes that affirm themselves and their peers. In so doing, they help generate both healthy and meaningful lives for themselves and others. The study examines the process in which Puerto Rican men living with HIV in Boston participate, promote, and reaffirm an HIV community, la comunidad, as a social entity with a unique culture and identity. This study also investigates how this community influences, supports, and encourages the adoption of positive transformations for living long term with HIV. On the basis of nine months of field research, this qualitative study employed both focus groups and interviews with fifty HIV-positive Puerto Rican men in Boston. These men were recruited, using convenience sampling, from different community-based organizations (CBOs) that provide HIV/AIDS services in Boston. The study finds that HIV-positive Puerto Rican men in Boston build community, not in response to social exclusion, but built on shared positive practices and strategies for living healthy with HIV. These men come together to negotiate and form a unique cultural community expressed in norms, beliefs, and practices that, although centered on HIV, are designed for living healthy. These expressions reaffirm a sense of community in everyday settings and transform the lives of these men with positive behaviors and healthy lifestyles. The findings reveal that this transformation takes place in the context of a community, with the support, encouragement, and at times, policing of others. La comunidad is where the lives of these men are transformed as they learn, adopt, and experience living positive with HIV.

Considering all the developments and dynamics spanning the Andean cultural history, contact between Andeans and Europeans in the sixteenth century was unprecedented in terms of scope, impact and violence. Paradoxically, it is a time period that has received little archaeological attention. Historic Peru has almost always been studied through the ethnohistorical sources, revealing incomplete and often distorted by layers of European ethnocentrism and behavioral misperception of Andean cultures. Often, the very lives of people and the nuanced experiences of native cultures have remained unknown, obscured by a lack of data and wide range of assumptions about the colonial society that emerged in the wake of the conquest. This article applies bioarchaeological perspectives in the study of colonial Central Andes. The excavations in the village of Mórrope, Lambayeque Valley (northern Peru) allows us to integrate multiple independent lines of ethnohistoric, archaeological, and biological data to examine two central issues: (1) How did conquest impact patterns of pre-Hispanic health, diet, and physical activity? (2) What do burial patterns reveal about parallel processes of native cultural change and identity in colonial Peru? / Considerando la totalidad de los desarrollos y dinamicas culturales que abarca la historia andina, el contacto entre los andinos y los europeos a partir del siglo XVI no tiene precedentes en terminos de su alcance, impacto y violencia. Paradojicamente, es la epoca que ha recibido poca atencion arqueologica. El Peru historico, casi siempre, ha sido estudiado a traves de las fuentes etnohistoricas que son reveladoras e incompletas, a menudo distorsionadas por capas de etnocentrismo europeo y percepcion erronea del comportamiento de las culturas andinas. A menudo, la vida misma y los matices de las experiencias vividas por las culturas nativas son desconocidos, y estan cubiertos de misterio y de una amplia gama de supuestos acerca de la sociedad colonial que surgio de la estela de la conquista. En este articulo, se aplican las perspectivas bioarqueologicas en el estudio de los Andes Centrales coloniales. Las excavaciones en el pueblo de Morrope, valle de Lambayeque (Costa Norte del Peru), nos permiten integrar multiples lineas de datos independientes etnohistoricos, arqueologicos y biologicos para examinar dos cuestiones centrales: 1) .Como impacto la conquista en los patrones de salud, actividad fisica y dieta prehispanicos? 2) .Que revelan los patrones de enterramiento como experiencias paralelas de cambio cultural e identidad nativa en el Peru colonial?