William A. Vega

A Family Approach to Cardiovascular Risk Reduction: Results from The San Diego Family Health Project:

The effectiveness of a family-based cardiovascular disease risk reduction intervention was evaluated in two ethnic groups. Participants were 206 healthy, volunteer low-to-middle-income Mexican-American and non-Hispanic white (Anglo-American) families (623 individuals), each with a fifth or a sixth-grade child. Families were recruited through elementary schools. Half of the families were randomized to a year-long educational intervention designed to decrease the whole familys intake of high salt, high fat foods, and to increase their regular physical activity. Eighty-nine percent of the enrolled families were measured at the 24-month follow-up. Both Mexican- and Anglo-American families in the experimental groups gained significantly more knowledge of the skills required to change dietary and exercise habits than did those in the control groups. Experimental families in both ethnic groups reported improved eating habits on a food frequency index. Anglo families reported lower total fat and sodium intake. There were no significant group differences in reported physical activity or in tested cardiovascular fitness levels. Significant differences for Anglo-American experimental vs. control adult subjects were found for LDL cholesterol. Significant intervention-control differences ranging from 2.2 to 3.4 mmHg systolic and/or diastolic blood pressure were found in all subgroups. Direct observation of diet and physical activity behaviors in a structured environment suggested generalization of behavior changes. There was evidence that behavior change persisted one year beyond the completion of the intervention program. It is concluded that involvement of families utilizing school based resources is feasible and effective. Future studies should focus on the most cost-effective methods of family involvement, and the potential for additive effects when family strategies are combined with other school health education programs.

Depressive symptoms and their correlates among immigrant Mexican women in the United States

Correlates of depressive symptomatology and caseness are examined for a survey sample of N = 1825 poor Mexican immigrant women in San Diego County, California. The Center for Epidemiologic Studies--Depression (CES--D) checklist is tested against a variety of demographic variables as well as health status and service utilization rates. Statistically significant associations were found between CES--D and education, years in the United States, income, marital status and number of adults in household. Also significant were associations with health status, confidant support and recent, traumatic life event. Utilization rates point to medical doctors as the major source of formal treatment and a heavy reliance on family and friends. The implications of the high disorder rates for diagnosis and treatment among immigrants are discussed.

Psychiatric symptomatology among Mexican American farmworkers

The paper presents findings from an epidemiologic field survey of 500 Mexican American farmworkers conducted in central California. The survey was intended as a health needs assessment of this population and the Health Opinion Survey was used to establish normative psychiatric symptom distributions. Analyses of the data by gender, age and income revealed that these socio-demographic variables were not important predictors of symptom levels, although the highest mean scores were reported in the 40-59 age group. Income levels were modest and fairly uniform, which contributed to the lack of mean score variation. Symptom distributions were analyzed for the variables age and sex using the HOS criteria of caseness and it was found that approx. 20% of the sample reached the criteria of caseness. A comparison of HOS mean scores with a national sample of surveys indicated that Mexican American farmworkers had symptom levels which resemble those of other low income socio-economic groups, such as southern blacks. Another analysis was conducted which reported a striking correspondence between self perception of health with psychiatric symptoms. A conclusion reached from the survey is that the Mexican American farmworkers in this sample appear to be experiencing psychiatric symptom levels which place them at extraordinary risk. Stresses associated with this group, i.e., limited social mobility, transience, poverty, discrimination and a high rate of traumatic life events were identified as possible contributors to this risk proneness.