Joseph McCormick

The association of depression and anxiety with glycemic control among Mexican Americans with diabetes living near the U.S.-Mexico border.

BackgroundThe prevalence of diabetes is alarmingly high among Mexican American adults residing near the U.S.-Mexico border. Depression is also common among Mexican Americans with diabetes, and may have a negative influence on diabetes management. Thus, the purpose of the current study was to evaluate the associations of depression and anxiety with the behavioral management of diabetes and glycemic control among Mexican American adults living near the border.MethodsThe characteristics of Mexican Americans with diabetes living in Brownsville, TX (Nu2009=u2009492) were compared by depression/anxiety status. Linear regression models were conducted to evaluate the associations of depression and anxiety with BMI, waist circumference, physical activity, fasting glucose, and glycated hemoglobin (HbA1c).ResultsParticipants with clinically significant depression and/or anxiety were of greater age, predominantly female, less educated, more likely to have been diagnosed with diabetes, and more likely to be taking diabetes medications than those without depression or anxiety. In addition, anxious participants were more likely than those without anxiety to have been born in Mexico and to prefer study assessments in Spanish rather than English. Greater depression and anxiety were associated with poorer behavioral management of diabetes (i.e., greater BMI and waist circumference; engaging in less physical activity) and poorer glycemic control (i.e., higher fasting glucose, HbA1c).ConclusionsOverall, depression and anxiety appear to be linked with poorer behavioral management of diabetes and glycemic control. Findings highlight the need for comprehensive interventions along the border which target depression and anxiety in conjunction with diabetes management.

Using the Framingham Risk Score to Evaluate Immigrant Effect on Cardiovascular Disease Risk in Mexican Americans

Background. This study uses the Framingham Risk Score (FRS) for 10-year cardiovascular disease (CVD) to evaluate differences between Mexican American immigrants and the U.S.-born population. Methods and Results. Data from the Cameron County Hispanic Cohort (N=1,559). Average total risk scores were generated by age group for each gender. Regression analysis was conducted adjusting for covariates and interaction effects. Both women and men in the CCHC sample who were long-term immigrant residents (mean FRS scores women 4.2 with p<.001 vs. men 4.0 with p<.001) or born in the U.S. (mean FRS scores women 4.6 with p<.001 vs. men 3.3 with p<.001) had significantly higher risk scores than immigrants who had only been in this country for less than 10 years. The interaction model indicates that differences between immigrant and native-born Mexican Americans are most greatly felt at lowest levels of socioeconomic status for men in the CCHC. Conclusions. This study suggests that in terms of immigrant advantage in CVD risk, on whom, where, and how the comparisons are being made have important implications for the degree of difference observed.

Response to H1N1 in a U.S.-Mexico Border Community

Public health experts from a county health department and a school of public health collaborated to establish a simple, functional surveillance system to monitor swine-origin influenza virus as it crossed from Mexico into a Texas border community during the 2009 pandemic. The draft national and state preparedness plans were found to be cumbersome at the local level, so a simple, more practical real-time surveillance and response system was developed, in part by modifying these documents, and immediately implemented. Daily data analyses, including geographical information system mapping of cases and reports of school and daycare absences, were used for outbreak management. Aggregate reports of influenzalike illness and primary school absences were accurate in predicting influenza activity and were practical for use in local tracking, making decisions, and targeting interventions. These simple methods should be considered for local implementation and for integration into national recommendations for epidemic preparedness and response.

Trabecular Bone Score Is a Valuable Addition to Bone Mineral Density for Bone Quality Assessment in Older Mexican American Women With Type 2 Diabetes

Altered bone quality due to the underlying metabolic changes of type 2 diabetes (T2D) has been hypothesized to affect bone strength, leading to increased fracture risk in patients with T2D. Lumbar spine trabecular bone score (LS-TBS), an indirect measure of trabecular microarchitecture, provides information on bone quality and has been associated with T2D. However, trabecular bone score (TBS) is also affected by demographic patterns and body size, and is expected to be different in people from various ethnic or racial backgrounds. Therefore, it is important to understand associations between T2D and TBS for each ethnic or racial group separately. Although the relationship between TBS and age has been reported to be similar between non-Hispanic Caucasians and Mexican Americans (MAs), data on associations of LS-TBS with T2D in older MAs are lacking. Here, we report associations between TBS and T2D in 149 older MA men and women. Participants are part of a cohort known as the Cameron County Hispanic Cohort in Texas who have high prevalence of obesity and poor glycemic control. Bone mineral density was not altered for MA women with T2D, but was significantly higher in MA men with T2D compared with MA men without diabetes. Low LS-TBS was associated with T2D in women in our study. Although low TBS was associated with older age in men, TBS did not show any significant association with T2D for men. These results are similar to those found in other studies of non-Hispanic whites with diabetes. LS-TBS may add value in diagnosing poor bone quality in older MA women with T2D regardless of bone mineral density scoring.

Region of birth and cardiovascular disease in mexican americans living in the texas-Mexico border

The study aims to determine whether place of origin has an effect on Mexican American cardiovascular disease (CVD) risk on the South Texas Border. Although many studies have investigated the effect of immigration on Mexican American health, few have considered how region of origin may impact CVD risk. Subjects in the Cameron County Cohort Study were divided into 3 groups according to place of origin: Southern Mexico, Northern Mexico, and U.S. Border States. Descriptive statistics and regression analyses were conducted using CVD biomarkers and self-reported angina, stroke, and elevated blood pressure. Logistic regression revealed that subjects born in U.S. Border States and Northern Mexico states were significantly less likely to have high glucose levels (p < .05) than those born in Southern Mexico. Subjects born in Northern Mexico were less likely to have high triglycerides (p = .05). This study illustrates the importance of considering region of origin in studying the effect of immigration on Mexican American health beyond the standard: number of years in the United States.

THE PREVALENCE OF SUBCLINICAL LOWER EXTREMITY PERIPHERAL ARTERIAL DISEASE IN MEXICAN AMERICANS: RESULTS FROM THE CAMERON COUNTY HISPANIC COHORT STUDY

Background: The prevalence of lower extremity peripheral arterial disease (PAD) in Mexican Americans (MA) is poorly characterized. The purpose of this study was to determine the presence of subclinical PAD in a sample of MA adults.nnMethods: The Cameron County Hispanic Cohort is a prospective

Diabetes and Employment Productivity: The Effect of Duration and Management Among Mexican Americans*

Diabetes has been shown to affect productivity. Most of the work to this point has been based on binary indicator measures for diabetes, other than Kahn, who considered the duration of diabetes. However, diabetes is a chronic disease with increasing likelihood of complications and co-morbidities as the disease develops over time. All of these complications are potentially detrimental to work propensity and productivity. However, productivity may also depend on the degree to which a person manages his or her diabetes over the duration of the disease. This study utilizes data from a recently completed survey of households in Brownsville, Texas, a largely Mexican-American community located on the Texas-Mexico border with a high prevalence of diabetes. Diabetes management, or control, is measured by blood sugar levels, glycosylated hemoglobin levels (HbA1c), and interaction terms. Results show that the duration of diabetes is negatively associated with male productivity, but management mitigates the harmful effects only slightly. Results imply that resources should be concentrated on preventing diabetes onset rather than on managing pre-existing cases of diabetes among Mexican-Americans, so that this group does not experience the negative consequences of having to work additional years while in poor health, if recent Deficit Commission proposals to increase the retirement age to 69 are put into effect.