Three essays on the social and temporal dimensions of cardiovascular health among the Mexican-origin population in the United States

Date

2014-08

Authors

Dondero, Molly

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Abstract

The size of the Mexican-origin population in the United States means that its health patterns have important implications for the country’s overall population health. Understanding how this population is woven into the country’s complex social patterning of health is critical to understanding current social disparities in health. Drawing on a health disparities perspective and nationally representative datasets, this dissertation addresses key gaps in the social demographic literature on the health of the Mexican-origin population through three empirical chapters that examine how multiple measures of cardiovascular health are distributed across diverse social status and temporal configurations. I first examine how the obesity epidemic has unfolded across multiple temporal (age, period, and cohort) and social dimensions (gender, nativity, and race) for the Mexican-origin population. I find that period rather than cohort forces have shaped the rise in obesity among the Mexican-origin population. Furthermore, the pronounced group differences in obesity prevalence have remained stable across periods and cohorts, with the exception of a growing nativity gap among Mexican-origin women, among whom obesity has increased faster for U.S.-born individuals compared with foreign-born individuals. I next address the intersection of two additional temporal and social determinants of health: duration of residence in the United States and educational attainment. Building on research documenting a weak relationship between education and health for Mexican immigrants, I assess whether duration of U.S. residence strengthens this association. The patterns vary by outcome, but generally indicate that negative education gradients in health are more pronounced for long-term Mexican immigrants than for recent Mexican immigrants and that the education gradients of long-term Mexican immigrants resemble those of U.S.-born Whites. I then engage the literature linking acculturation to poor health among Mexican immigrants. Acculturation models of immigrant health have come under critique for ignoring the structural determinants of health. I engage in this debate by using segmented assimilation theory—which emphasizes the role of structural factors—to examine whether education conditions the association between acculturation and health. I find support for the idea that the detrimental influence of acculturation on cardiovascular health is concentrated among Mexican immigrant adults with low levels of education.

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