Mariaelena Gonzalez

Online health information-seeking behavior and confidence in filling out online forms among Latinos: A cross-sectional analysis of the California Health Interview Survey, 2011-2012

Background Health information is increasingly being disseminated online, but there is a knowledge gap between Latinos and non-Hispanic whites, particularly those whose English language proficiency is poor, in terms both of online health information-seeking behavior and computer literacy skills. This knowledge gap may also exist between US- and foreign-born Latinos. Objective The specific aim of this study was to examine Internet use, online health information-seeking behavior, and confidence in filling out online forms among Latinos, particularly as it relates to health-risk behaviors. We then stratified our sample by nativity. Methods We used the adult population file of the 2011-2012 California Health Interview Survey, analyzing Internet use, online health information-seeking behavior, and confidence in filling out online forms using binary logistic regression among Latinos and whites (N=27,289), Latinos (n=9506), and Latinos who use the Internet (n=6037). Results Foreign-born Latinos (OR 0.71, 95% CI 0.58-0.88, P=.002) have lower odds of engaging in online health information-seeking behavior, and higher odds (OR 2.90, 95% CI 2.07-4.06, P<.001) of reporting a lack of confidence in filling out online forms compared to US-born Latinos. Correlates of online health information-seeking behavior and form confidence varied by nativity. Conclusions Latinos, particularly foreign-born individuals, are at an increased risk of being left behind as the move to increase online content delivery and care expands. As online health information dissemination and online health portals become more popular, the impact of these sites on Latino gaps in coverage and care should be considered.

Generation status as a determinant of influenza vaccination among Mexican-identified adults in California, 2011-12.

First generation Latinos often have better health behaviors and outcomes than second and third generation Latinos. This study examined the correlates of seasonal influenza vaccinations among Mexican-identified (Mexican) adults, who make up the largest Latino subgroup in California. A sample of Mexican adults (N = 7493) from the 2011–12 California Interview Health Survey was used to compare the odds of first, second, and third generation Mexicans receiving influenza vaccinations in the past year. We performed a logistic regression taking into account socio-demographic characteristics, health status, and access to care. We repeated the analysis after stratifying for nativity, and then age. Being a second (odds ratio (OR) = 0.74, confidence interval (CI): 0.59, 0.92) and third generation or higher (OR = 0.66, CI: 0.51, 0.86) Mexican was associated with lower odds of getting an influenza vaccination compared to first generation Mexicans. Having a chronic disease, and access to care was associated with higher odds of vaccination, while lower age was associated with lower odds of vaccination among both US-, and foreign-born Mexicans. Given that the majority of Mexicans in California are US-born, the fact that being second- and third-generation Mexicans was associated with lower influenza vaccination rates is of significant concern.

Ozone pollution and asthma emergency department visits in the Central Valley, California, USA, during June to September of 2015: a time-stratified case-crossover analysis

Abstract Objective: The San Joaquin Valley (SJV) exceeds the state and national standards for ozone (O3). This study investigates whether short-term exposure to O3 is associated with asthma emergency department (ED) visits. Methods: We identified 1,101 ED visits in June–September of 2015 in SJV, California, who lived within 15 km of active air monitors. Conditional logistic regression models were used to obtain the odds ratio (OR) and 95% confidence interval (CI) associated with an interquartile (IQR) increase in ozone. We explored the potential effect modification by sex (female and male), race (White, Black and Hispanic), age (2–5, 6–18, 19–40, 41–64 and > = 65) and county (Merced, Madera, Kings, Fresno and Kern). Results: An IQR range (18.1 ppb) increase in O3 exposure three days before an asthma attack (lag 3) was associated with a 6.6% [OR: 1.066 (95% CI: 1.032, 1.082)] increase in the odds of having an asthma ED visit. The overall ORs differed across age groups and races/ethnicities, with strongest for children aged 6–18 years [OR: 1.219 (95% CI: 1.159, 1.280)], adults 19–40 years [OR: 1.102 (95% CI: 1.053, 1.154)] and Blacks [OR: 1.159 (95% CI: 1.088, 1.236)], respectively. O3 exposure was not positively associated with asthma ED visits for Whites, while it was for other underrepresented groups. Fresno had the highest number of asthma ED visits and positive association among all five counties. Conclusion: We found that O3 exposure is associated with asthma ED visits in the SJV.

Soda consumption and hospital admissions among Californian adults with asthma

ABSTRACT Introduction: Asthma prevalence has been increasing consistently since 1995 in California. Recent studies have found that consuming soda and sugar-containing drinks may pose a risk for asthma. Research that examines the relationship between soda intake and asthma among adult asthmatics is limited. Objective: This study investigated the relationship between sugar-sweetened soda consumption and asthma hospitalization among adult asthmatics in California. Methods: This cross-sectional study was based on the 2011–2012 California Health Interview Survey (CHIS) data and included 3,784 adults who were diagnosed with asthma by a doctor and who currently reported either that they still had asthma, or that they had suffered from an asthma attack in the last 12 months. The analysis was survey weighted. The exposure variable was soda intake measured as the number of times soda was consumed in the last week. The health outcome measure was overnight hospital admission due to asthma. Logistic regression was used to examine the association between soda consumption and overnight hospital admission after adjusting for age, education, sex, race/ethnicity, weight status, smoking status, and self-rated health. Results: Adults with asthma who drank soda three or more times per week reported higher odds of overnight hospitalization (adjusted odds ratio = 2.77, 95% CI: 1.51–5.10, p = 0.001). Conclusions: Our findings suggest that efforts designed to limit soda consumption would benefit asthma suffers by reducing hospital admissions. This, however, needs further research to confirm a direct causal association.