Eva M. Durazo

A Portrait of Older Californians With Disabilities Who Rely on Public Services to Remain Independent

Low-income older adults with disabilities in California depend on a variety of public programs to help them remain in their own homes. The availability of those services has been in flux since 2009 because of cuts caused by the recession. This article reports on a qualitative study of 33 California seniors who depend on fragile arrangements of paid and unpaid assistance. Thematic analyses of in-depth interviews conducted with these older adults and their caregivers indicate that the disability needs of these individuals are often unstable, with both physical and mental health status sometimes changing day to day. Most have nowhere else to turn for help if their public services are cut. All share the common goal of staying at home and maintaining their independence. Public services serve as a crucial link in the support networks of these individuals.

Ethnic Enclaves and Type II Diabetes: a Focus on Latino/Hispanic Americans

Diabetes disproportionately impacts the Latino population and while individual traditional risk factors are key, additional external factors, such as neighborhoods, may also affect diabetes rates. This review examines the role of living in an ethnic enclave, a neighborhood with a high Latino concentration, on diabetes and its risk factors for the Latino population in the United States (U.S.). Studies fail to find an association between living in an ethnic enclave and diabetes, despite research demonstrating that enclaves have a protective effect on other health outcomes for Latinos. When considering diabetes risk factors, the associations with ethnic enclaves are mixed. For Latinos, living in an ethnic enclave is associated with healthier diets and increased physical inactivity, while data are mixed for obesity prevalence. More research is needed to determine what aspects of an ethnic enclave have a protective effect against diabetes among Latinos.

Achieving Optimal Cardiovascular Health: a Social Epidemiological Approach

Purpose of ReviewThe American Heart Association (AHA) created the cardiovascular health (CVH) index to measure and monitor population-level reduction of cardiovascular disease (CVD) risk, with a goal of 20% reduction in CVD morbidity and mortality by 2020. Few U.S. adults meet all seven ideal CVH metrics (non-smoking behavior, healthy diet and body weight, active lifestyle, good cholesterol, glucose, and blood pressure scores), with 17% of men and women only achieving five or more ideal CVH metrics. This review describes the importance of considering sociodemographic, psychosocial, and behavioral factors as key strategies to achieve the AHA 2020 goals.Recent FindingsMen, racial/ethnic minorities, and individuals of lower socioeconomic status are less likely to achieve ideal CVH—which may start in early childhood. An emerging body of literature indicates that individuals with high-quality social relationships, positive childhood experiences and psychological functioning, along with lifestyle factors, may impact attainment of optimal CVH. For example, exploring the role of food insecurity in CVH attainment demonstrates the complex interplay between contextual factors and lifestyle behaviors that may promote or deter ideal CVH. Evidence also suggests that the CVH index has convergent validity with intermediate and hard endpoints of CVD. Interventions that seek to promote multi-system resiliency may help close the gap in attainment of the AHA 2020 goals.SummaryResearch on psychosocial and behavioral factors suggests that social connections, psychological resources, and health-maintaining behaviors are important areas to target to improve CVH in minorities and other vulnerable groups.