Correlates of Acculturation Among Hispanic Women

1
Correlates of Acculturation Among Hispanic Women

• Carrie J. Wales, Oregon Health Sciences
  University
• Kenneth D. Rosenberg, MD, MPH, Oregon Department
  of Human Services, Office of Family Health
• Alfredo P. Sandoval, MS, MBA, Oregon Department
  of Human Services, Office of Family Health

2
Background

• Health status may change as immigrants
  acculturate
• Oregon PRAMS data was used to explore perinatal
  health outcomes among Hispanic women in Oregon by
  acculturation status

3
Oregon PRAMS

• PRAMS (Pregnancy Risk Assessment Monitoring
  System)
• A postpartum population-based survey asking
  Oregon women about attitudes and behaviors
  before, during and after pregnancy
• Administered by the Office of Family Health,
  Oregon Department of Human Services
• Over-samples racial and ethnic minorities

4
Goals

• To identify domains in which perinatal outcomes
  vary according to acculturation status
• To find significant differences between women
  with higher levels of acculturation and lower
  levels of acculturation

5
Methods

• Combined Oregon PRAMS data from 2000-2001
• Included only Hispanic women (n1120)
• 62 women did not have information on language in
  which survey was completed and were excluded from
  analysis

6
Methods

• Divided women into three categories of
  acculturation status
• Low acculturation foreign-born and completed
  survey in Spanish (n716, 64)
• Intermediate foreign-born and completed survey
  in Spanish or native-born and completed survey in
  English (n111, 9.9)
• High acculturation native-born and completed
  survey in English (n231, 20.6)

7
Methods

• Used SPSS to tabulate unweighted counts and
  weighted percentages of womens responses to 138
  questions or birth certificate variables
• Used SUDAAN to perform chi-square tests for trend
• A p-value of less than 0.05 was used to determine
  significance

8
Results
Higher levels of acculturation were associated
with adverse outcomes and risk factors including

• having firearms, stored loaded and unlocked, in
  the home
• feeling as though they were discriminated against
  by health care workers
• experiencing stressful life events

• not receiving important prenatal care advice
• not breastfeeding their babies
• alcohol and tobacco consumption
• having an unintended pregnancy
• etc.

9
Results
Lower levels of acculturation were associated
with adverse outcomes and risk factors such as

• putting their baby to sleep on its side or
  stomach
• receiving inadequate dental care
• having less health insurance
• receiving late prenatal care

• not using birth control before pregnancy
• having lower income levels (lt 20,000/yr)
• having lower education levels (lt 12 years)
• etc.

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Results - Examples
Question 6 Just before you got pregnant, did you
have health insurance that covered prenatal care?
Chi-Square 139.32, p lt 0.001
Question 70 Are any firearms now kept in or
around your home? Include those kept in your
home, in a garage, outdoor storage area, car,
truck or other motor vehicle. Chi-Square
28.58, p , 0.001
11
Discussion Conclusions

• Although Hispanic women with the highest level of
  acculturation have positive demographic
  characteristics such as more education, higher
  levels of income, smaller family sizes, and
  better health insurance coverage, they tend to
  experience a wider variety of risk factors and
  adverse health outcomes than do Hispanic women in
  the lower levels of acculturation.

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Discussion Conclusions

• It has been hypothesized that as immigrants
  acculturate, their health status declines
  possibly due to exposure to US mainstream culture
  and to the decline in protective native cultural
  behaviors.
• We need to know more about the health disparities
  related to acculturation among Hispanic women in
  order to improve public health practice in
  Oregon.

13
Acknowledgments

• Tina Kent
• Centers for Disease Control and Prevention (CDC)
• Maternal and Child Health Bureau, DHHS
• For more information, please contact
• Carrie Wales Kenneth Rosenberg, MD, MPH
• Graduate Student Intern
  Maternal Child Health Epidemiologist
• Oregon Health Science University
  Oregon Department of Human Services
• walesca_at_ohsu.edu ken.d.rosenberg_at_sta
  te.or.us
• 971-673-0237