Written by Karen D’Alonzo, PhD, RN, APNC
An important area of health-related research for Hispanic immigrant women is cardiovascular risk reduction. Consistent with the Hispanic Paradox, the risk for cardiovascular disease among immigrant Latinos is relatively low at the time of arrival but increases greatly with length of residence in the US. Mexican-American women in particular have one of the world’s highest rates of metabolic syndrome (MS), a disorder characterized by central (abdominal) obesity, insulin resistance/hyperinsulinemia, hypertension, and dyslipidemia, all of which increase the risk for cardiovascular disease. This type of inquiry is ideally carried out using a lens of community based participatory research (CBPR), where researchers and community are partners in the research process.
My research is guided by two specific, but complementary frameworks: allostatic load (AL) and syndemics. Using a framework of allostatic load (AL), one factor that may contribute to MS among Mexican immigrant women is perceived stress. Acculturation-related factors such as family separation, cultural conflicts, low socioeconomic status, language barriers, racism and discrimination and low perceived control over employment may contribute to chronic stress and may predispose Mexican immigrant women to the development of MS. Recently, the threat of deportation is a major stressor for many families where one or more members are among los sin papeles (the undocumented). Syndemic theory is likewise a useful framework to study complex public health problems such as obesity. A syndemic is a set of two or more linked health problems that interact and worsen the burden of disease in a population. My recent work has focused on verifying the impact of AL on obesity and other related (syndemic) issues in this community.
In a case-control study we conducted among Mexican women living here in NJ and a group who remained behind in the same community in Oaxaca, MX, we discovered that both systolic and diastolic blood pressure were significantly higher in the NJ group and the differences in blood pressure increased with time in the US. In addition, among women in NJ, greater acculturation stress was significantly related to abdominal obesity (waist-to-hip ratio). These findings suggest some measures of AL increased with time in the US, and acculturation stress may be a significant factor.
We also completed a concept mapping study among 1st and 2nd generation Mexican immigrants in New Brunswick to identify factors felt to contribute to obesity. Participants identified a number of issues addressing their fears of fears of deportation, and the prioritization of financial resources away from healthy eating, resulting in food insecurity and weight gain. We have tentatively identified a syndemic of obesity among Mexican immigrants to guide future research. We propose that Mexican immigrants who encounter social exclusion based on anti-immigrant discrimination are more likely to report co-occurring problems of obesity, food insecurity, depression, and type 2 diabetes mellitus (SOFIDD). The research team plans to use this information to inform future community-level multiple-component interventions to address obesity in this population.
This work is collectively referred to community based participatory research (CBPR), which involves partnerships between academics and communities. Much of this work has been carried out in partnership with Lazos America Unida (LAU), a Mexican American community-based organization in New Brunswick. Special thanks go out to Teresa Viva, President of LAU and Maria Vivar, Promotora Coordinator, both of whom have been have been partners throughout the research process.
Please click here to learn more about Karen and her work with the community.
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