Neighborhood and Health Related Indicators Among Adult Latinas

Background and Purpose: Until 2014, Hispanics constitutes 17% of the US population, and is the largest ethnic minority. Although on average, their economic status has improved over time, Hispanics are still overrepresented among the populations of chronic health problems, such as HIV infections and heart diseases. Previous studies examined individual and contextual levels of social-cultural determinants of health problems among Hispanics. However, most studies on contextual determinants focused on ethnic density. Few studies simultaneously examined neighborhood socioeconomics and ethnic density. This study aimed to address this knowledge gap. We hypothesized that neighborhood concentrated disadvantages are associated with higher risk of health problems, while Hispanic density is associated with lower risk of health problems.

Methods: The study used a community sample of 274 adult Latinas in a metropolitan area in the Southeast. The data was collected in 2011, and was part of a large study focusing on substance use among Latina mother-daughter dyads. In the sample, 84% of mothers and 54% of daughters were born outside of US. Most of them immigrated from Central and South America. Depending on their language preference, we conducted surveys in either English or Spanish. In our survey, we asked them about their alcohol and drug use in the last 12 months, diagnoses of mental disorders, and health problems. We used the Interpersonal Support Evaluation List to measure their perception of available tangible and belonging support. We also documented their zip codes, which we used to link with the 2010 US census data. We extracted 10 census variables: percentage of households below the poverty line, households on public assistance, female-headed households, unemployed population, persons below18 years old, African American, Latino, foreign-born, residents living in the same house as five years earlier, and owner-occupied homes. We used factor analysis to extract their underlining factors, and identified two neighborhood factors: concentrated disadvantage and Hispanic density. We then used hierarchical nonlinear modeling (HNLM) to model substance use, physical and mental health outcomes, and a lack of money to see doctors and to buy medications. While we are primarily interested in the effects of two neighborhood factors, we controlled for individual level variables on age, generation status, US born, and interpersonal support.

Results: The results from HNLM showed that neighborhood concentrated disadvantage was positively associated with non-medical use of sedatives (OR=1.50, P<.05), alcohol abuse (OR=1.71, P<.05), a lack of money to see doctors (OR=1.40, P<.05), a lack of money to buy medications (OR=1.74, P<.01), and the number of mental diagnoses (Est. = 0.17, P<.05). Neighborhood Latino density is negatively associated with the number of mental diagnoses (Est. = -0.18, P<.05).

Conclusions and Implications: Our findings showed that neighborhood concentrated disadvantage is associated with increased risk of several health related problem, while Hispanic density is a protective factor for mental health problems. The findings suggested that preventive health services should target neighborhoods with concentrated disadvantages. Future research should examine the mechanism how Hispanic density protects Hispanics from mental health problems, which will inform the development of future interventions.