V. Nelly Salgado de Snyder

Factors Associated with Acculturative Stress and Depressive Symptomatology Among Married Mexican Immigrant Women

The purpose of the present study was to describe levels of acculturative stress and individual stressors and their relationship to levels of depressive symptomatology among young Mexican immigrant women. The mean age of the respondents was 25.7 years with a mean of 9.4 years of education. Their age at migration was 18.5 years and their average length of stay in the United States was 7.5 years. Women who in the last three months experienced discrimination, sex-role conflicts, and concern about starting a family in this country had significantly higher (over 16) CES-D scores than women who did not report experiencing those situations. The overall findings suggest that this sample of Mexican women immigrants as a group are at risk for the development of psychological problems.

The Prevalence of Nervios and Associated Symptomatology Among Inhabitants of Mexican Rural Communities

The purpose of the present contribution is to describe the prevalence ofnervios through self-report, to identify psychological andsomatic symptoms associated with nervios, and to report thecomorbidity of nervios with mood and anxiety disorders amongMexican rural-origin adults. The data reported here were collected aspart of a larger project, whose aims were to determine the prevalence ofselected mental health problems, their sociocultural manifestation andinterpretation, and the utilization of mental health services among theinhabitants of rural communities in Mexico. A multi-stage, stratified,random sample of two regions in Mexico was obtained. The total number ofparticipants used in the analyses was 942 adults: 441 men and 501women. We found a prevalence of nervios of 15.5% in thegeneral population. When analyzed by sex, women had a significantlyhigher prevalence (20.8%) of this condition than men(9.5%). Also, all the somatic and psychological symptomsassociated with nervios had a higher prevalence among womenthan men.

The Role of Ethnic Loyalty among Mexican Immigrant Women.

The purpose of this study was to examine the role of Ethnic Loyalty in a sample of 140 Mexican women who immigrated to the United States at age 14 or older and who have lived in this country for an average of 7.5 years. Using the median of the ethnic loyalty scale as the cut-off point respondents were divided into two groups: High Loyalty and Low Loyalty. Women who remained highly loyal to Mexican culture (High Loyalty) had significantly lower levels of self-esteem and satisfaction and higher levels of acculturative stress than their counterparts who scored lower on the loyalty scale (Low Loyalty). Furthermore, most of the women in the High Loyalty group had plans of returning to Mexico and planned on obtaining only legal residency status rather than U.S. citizenship. Findings of the study suggest that because of the lack of appropriate coping skills to deal with their new environment, immigrant women from Mexico who remain strongly attached to their traditional Mexican culture (High Loyalty) are at higher risk of manifesting psychological conflicts than those women who are more flexible in their cultural orientation as shown by their lower ethnic loyalty scores.The purpose of this study was to examine the role of Ethnic Loyalty in a sample of 140 Mexican women who immigrated to the United States at age 14 or older and who have lived in this country for an average of 7.5 years. Using the median of the ethnic loyalty scale as the cut-off point respondents were divided into two groups: High Loyalty and Low Loyalty. Women who remained highly loyal to Mexican culture (High Loyalty) had significantly lower levels of self-esteem and satisfaction and higher levels of acculturative stress than their counterparts who scored lower on the loyalty scale (Low Loyalty). Furthermore, most of the women in the High Loyalty group had plans of returning to Mexico and planned on obtaining only legal residency status rather than U.S. citizenship. Findings of the study suggest that because of the lack of appropriate coping skills to deal with their new environment, immigrant women from Mexico who remain strongly attached to their traditional Mexican culture (High Loyalty) are at highe...

Escala de violencia e índice de severidad: una propuesta metodológica para medir la violencia de pareja en mujeres mexicanas

OBJECTIVE To construct and validate a scale to assess violence by the male partner against women. An index of severity of the emotional and physical damage was also designed to assess the intensity of the violent actions against women. MATERIAL AND METHODS The sample consisted of a total of 26 042 women who participated as respondents in the National Survey on Violence against Women (ENVIM per its abbreviation in Spanish) conducted in Mexico during 2003. Respondents were all users of health services provided by the Mexican government. The questionnaire was organized into 17 sections, one of which was a 27-item scale to assess partner violence. The purpose of this scale was to measure the type (physical, emotional, sexual and financial) and degree of violence based on severity. A severity index was constructed based on two procedures: 1) the validity, reliability, and factor analyses of the scale and 2) the assessment of severity by expert judges who assigned a value to each item of the scale. RESULTS The validity and reliability results indicated this scale has adequate internal validity (Cronbachs Alpha = 0.99). The factor analysis with Varimax rotation yielded a four-factor solution. The factors were: 1) Psychological violence; 2) Physical violence; 3) Severe physical violence; and 4) Sexual violence. The combination of the four factors accounted for 62.2% of the variance in the scale. Using the ratings from the judges a table of values for each of the violent actions described was obtained. The scores assigned by the judges ranged from 0 to 354. Results revealed a prevalence of 21% partner violence in the last twelve months. The prevalence of psychological violence was 18.5%; of physical violence 10.1%; severe physical violence 6.7% and sexual violence 7.0%. CONCLUSION The scale of violence described in this article is a very useful and reliable instrument to assess marital violence against women. It is suggested that this instrument be used in other settings to compare results with different samples.Objective. To construct and validate a scale to assess violence by the male partner against women. An index of severity of the emotional and physical damage was also designed to assess the intensity of the violent actions against women. Material and Methods. The sample consisted of a total of 26 042 women who participated as respondents in the National Survey on Violence against Women (ENVIM per its abbreviation in Spanish) conducted in Mexico during 2003. Respondents were all users of health services provided by the Mexican government. The questionnaire was organized into 17 sections, one of which was a 27-item scale to assess partner violence. The purpose of this scale was to measure the type (physical, emotional, sexual and financial) and degree of violence based on severity. A severity index was constructed based on two procedures: 1) the validity, reliability, and factor analyses of the scale and 2) the assessment of severity by expert judges who assigned a value to each item of the scale. Results. The validity and reliability results indicated this scale has adequate internal validity (Cronbach’s Alpha=0.99). The factor analysis with Varimax rotation yielded a four-factor solution. The factors were: 1) Psychological violence; 2) Physical violence; 3) Severe physical violence; and 4) Sexual violence. The combination of the four factors accounted for 62.2% of the variance in the scale. Using the ratings from the judges a table of values for each of the violent actions described was obtained. The scores assigned by the judges ranged from 0 to 354. Results reValdez-Santiago R, Hijar-Medina MC, Salgado de Snyder VN, Rivera-Rivera L, Avila-Burgos L, Rojas R. Escala de violencia e indice de severidad: una propuesta metodologica para medir la violencia de pareja en mujeres mexicanas. Salud Publica Mex 2006;48 supl 2:S221-S231.

Women as primary caregivers in Mexico: challenges to well-being

The purpose of this contribution is to review the peer reviewed literature from the last 20 years regarding the role of Mexican women in the family, and to describe the psychosocial and health challenges they face. We analyze the current problems and recent improvements in three areas: reproductive health, nutrition, and mental health, and we discuss how the role of caregiver may influence or be influenced by these health issues. We emphasize the cultural context, womens role as caregivers, the challenges they face, and the strength and resilience these women exhibit. We conclude that it is imperative that we modify the way in which Mexican womens needs are assessed, interpreted, and confronted, along with a definite need for concrete proposals that take into account both womens challenges and strengths, and the cultural context and national reality.

UNDERSTANDING THE SEXUALITY OF MEXICAN‐BORN WOMEN AND THEIR RISK FOR HIV/AIDS

Participants in this study were 300 Mexican women of rural origin who were born and raised in villages of that country and who belong to one of three groups: married and living with their husbands in Los Angeles, California (n = 100), married to migrant workers but living in Mexico (n = 100), and living in Mexico with their spouses (n = 100). Trained female professionals conducted face-to-face interviews in Spanish, in Mexico and in the United States. The purpose of this study was to identify specific sexual practices, coping strategies in sex-related situations, and fears and concerns regarding sexual intercourse. This article analyzes how these elements place Mexican rural-origin women at risk for HIV/AIDS. It discusses the need to design intervention strategies to prevent HIV/AIDS that take into consideration the limited power of women in traditional societies and the cultural precepts that promote gender roles characterized by male dominance and female submissiveness in the sexual arena.

Género y pobreza: determinantes de la salud en la vejez

L vejez es un constructo social que involucra la asignación de roles de acuerdo con la edad, por ejemplo, en cuanto a la participación en actividades económicas y sociales, según el género y las normas socioculturales. La vejez debe entenderse como un proceso que involucra una serie de experiencias, muchas de ellas subjetivas, que se encuentran íntimamente relacionadas con las experiencias de vida, la edad biológica y la acumulación de riesgos a lo largo de los años vividos.1,2 Las mujeres conforman la mayoría entre los adultos mayores en casi todos los países del mundo. Este fenómeno, conocido como la ‘feminización’ del envejecimiento, se observa universalmente porque las mujeres llegan a vivir más que los hombres. A pesar de que en el ámbito mundial nacen aproximadamente 105 niños por cada 100 niñas, las mujeres rebasan a los hombres numéricamente alrededor de las edades 30 a 40 años, y dicha ventaja numérica se hace mayor conforme avanza la edad.3 Datos de la Organización de las Naciones Unidas (ONU) revelan que globalmente, alrededor del año 2000, había 190 mujeres por cada 100 hombres entre ancianos de mayor edad. Por ejemplo, entre los octogenarios se estiman 181 mujeres por cada 100 hombres, aunque esta proporción aumenta de manera importante para los nonagenarios, con aproximadamente 287 mujeres por cada 100 hombres; y entre los adultos mayores de 100 años en los que se concentran nuevamente las mujeres: 386 mujeres por cada 100 hombres.4,5 La Organización Mundial de la Salud (OMS)6 ha reportado que, actualmente, más de la mitad de las mujeres en el mundo que tienen 60 años y más viven en países en desarrollo (198 millones comparados con 135 millones de mujeres de los países desarrollados). Las proyecciones demográficas sugieren que el grupo de las mujeres añosas continuará creciendo de forma dramática. En México, la esperanza de vida al nacimiento para la población general es de 75.4 años; 77.9 años para las mujeres y 73.0 años para los hombres. Las diferencias entre hombres y mujeres se acentúan en los estados de la República con menor esperanza de vida, es decir, los más rezagados.7 A la fecha, la población de adultos mayores, principalmente los que viven en la pobreza, han recibido muy poca atención por parte de investigadores, prestadores de servicios y diseñadores de políticas públicas. Existe un limitado número de estudios que se han enfocado en la relación entre envejecimiento, género y pobreza. Sobre todo la inequidad persistente a nivel mundial en el acceso a oportunidades para una mejor calidad de vida entre las mujeres ancianas que viven en pobreza.

No hacen viejos los años, sino los daños: envejecimiento y salud en varones rurales

Objective. To analyze the social factors associated with the health status of elderly men, 60 years and older, who live in poverty in the rural areas of Mexico. Material and Methods. A cross-sectional, descriptive study was conducted between February and October 2002, in a convenience sample of 392 elderly men residing in rural areas of the states of Guerrero, Morelos and Jalisco states. A validated questionnaire was applied to collect data on sociodemographic characteristics, general wellbeing, health problems, food consumption, and some indicators of mental health, personal strength and social support. Data analysis was performed with the SPSS v. II.1 software, to obtain chi-squared tests; food intake measures were analized with one-way ANOVA. Results. Study subjects were married or were widowers and had six children on average. A higher proportion of the elderly men of Morelos state reported to have suffered more illnesses and a higher consumption of alcohol when compared to the other two state groups. Sixty percent of the men in the study used both home remedies and medication for their health problems. More than one half of them did not receive adequate social support from their families. Conclusions. The results of this study suggest that the process of ageing among rural elderly men is perceived as a burden, mainly because of the context of poverty in which they live. The lack of appropriate income and access to health services through adequate pension and retirement plans for the elderly poor is a problem that requires immediate attention.

Modelo de integración de recursos para la atención de la salud mental en la población rural de México

OBJETIVO: Identificar conductas de utilizacion de servicios para resolver problemas de salud mental en los pobladores de localidades rurales de Mexico; construir un modelo sobre los caminos de la atencion para la salud mental que siguen los pobladores rurales, y proponer un modelo de integracion para mejorar la calidad y el acceso a estos servicios. MATERIAL Y METODOS: En 1997 se realizaron entrevistas a profundidad con 21 pobladores adultos (nueve hombres y 12 mujeres), y siete prestadores de servicios de una comunidad rural del estado de Jalisco, Mexico. El rango de edad de las mujeres fue de 23 a 44 anos, 10 casadas y dos solteras. Los hombres tenian entre los 30 y 74 anos de edad, ocho casados y un viudo. Los prestadores de servicios fueron un sacerdote, un medico general, un encargado de farmacia, dos enfermeras y dos sanadores tradicionales (un sobador y un curandero). RESULTADOS: El primer intento que hace una persona para remediar un sintoma es acudir a los autocuidados. Cuando estos no son suficientes para aliviarlo, las personas avanzan al segundo ambito del camino: buscar ayuda de la red social, cuyos miembros, ademas de brindar informacion referente a remedios y cuidados, ofrecen su apoyo emocional e instrumental. Si despues de consultar a la red el sintoma no ha desaparecido, el individuo busca la ayuda de otras fuentes externas, concretamente la de los miembros del sistema etnomedico local. La gente en esas localidades busca ayuda del medico unicamente cuando el sintoma persiste o cuando ha sido referido en repetidas ocasiones por algun miembro del sistema etnomedico local o de su red social. La busqueda de un especialista de la salud mental (psiquiatra o psicologo) es muy improbable entre los pobladores rurales debido a la dificultad de acceso geografico a estos servicios por el costo que implica hacer uso de estos y por la distancia cultural existente entre el prestador de servicios y el paciente. CONCLUSIONES: Para llevar a cabo con exito programas de intervencion culturalmente sensibles en el medio rural se requiere contar con informacion detallada, derivada de la investigacion y de la participacion activa de todos los recursos humanos e institucionales disponibles, desde profesionales e investigadores autenticamente multidisciplinarios, hasta educadores, lideres sociales, religiosos, politicos, miembros de la comunidad e instituciones de esas localidades. El modelo propuesto de integracion de recursos personales y comunitarios para la atencion de la salud contempla la creacion de programas de sensibilizacion, informacion y capacitacion para los pobladores de la comunidad y los prestadores de servicios; el sistema etnomedico y el sistema formal de salud se proponen como indispensables.

Servicios de salud en la Mixteca: utilización y condición de afiliación en hogares de migrantes y no-migrantes a EU

Objective. To describe the socioeconomic and demographic characteristics of households in the Mixteca Baja and analyze differences in affiliation with health care programs and utilization, among members of households with migrants (HogMig) and without migrants (HogNoMig) to the United States. Material and Methods. A cross-sectional, descriptive survey was used with heads of households in a representative sample from the Mixteca Baja of 702 homes with and without migrants to the US. Results. Members of HogMig had more personal and economic resources than those of HogNoMig; they also regularly received remittances. The majority of members of both HogMig and HogNoMig did not receive benefits from the Oportunidades program or health coverage through Seguro Popular, IMSS or ISSSTE. In general, while they used the local health clinic, they often preferred to pay for private practitioners. A small proportion of those covered by IMSS or ISSSTE reported very low utilization of the health services offered by those institutions.