This article reports the development of a short (12-item) acculturation scale for Hispanics. Separate factor analyses of the responses of 363 Hispanics and 228 non-Hispanic whites produced three fa...

Development of a Short Acculturation Scale for Hispanics

http://repository.ui.ac.id/dokumen/lihat/3528.pdf

Assessment of cardiovascular risk by use of multiple-risk-factor assessment equations: A statement for healthcare professionals from the American Heart Association and the American College of Cardiology

Results Age-standardized prevalence of CVD risk factors varied by Hispanic/Latino background; obesity and current smoking rates were highest among Puerto Rican participants (for men, 40.9% and 34.7%; for women, 51.4% and 31.7%, respectively); hypercholesterolemia prevalence was highest among Central American men (54.9%) and Puerto Rican women (41.0%). Large proportions of participants (80% of men, 71% of women) had at least 1 risk factor. Age- and sex-adjusted prevalence of 3 or more risk factors was highest in Puerto Rican participants (25.0%) and significantly higher (P.001) among participants with less education (16.1%), those who were US-born (18.5%), those who had lived in the United States 10 years or longer (15.7%), and those who preferred English (17.9%). Overall, self-reported CHD and stroke prevalence were low (4.2% and 2.0% in men; 2.4% and 1.2% in women, respectively). In multivariate-adjusted models, hypertension and smoking were directly associated with CHD in both sexes as were hypercholesterolemia and obesity in women and diabetes in men (odds ratios [ORs], 1.5-2.2). For stroke, associations were positive with hypertension in both sexes, diabetes in men, and smoking in women (ORs, 1.7-2.6). Conclusion Among US Hispanic/Latino adults of diverse backgrounds, a sizeable proportion of men and women had adverse major risk factors; prevalence of adverse CVD risk profiles was higher among participants with Puerto Rican background, lower SES, and higher levels of acculturation.

/pdf/prevalence-of-major-cardiovascular-risk-factors-and-qbju8qq0kn.pdf

Prevalence of major cardiovascular risk factors and cardiovascular diseases among Hispanic/Latino individuals of diverse backgrounds in the United States.

Objective: This article reviews information on the rapid changes in diet, activity and body composition that lower- and middle-income countries are undergoing and then examines some of the potential health implications of this transition. Design and Setting: Data came from numerous countries and also from national food balance (FAOSTAT) and World Bank sources. Nationally representative and nationwide surveys are used. The nationally representative Russian Longitudinal Monitoring Surveys from 1992–96 and the nationwide China Health and Nutrition Survey from 1989–93 are examined in detail. Results: Rapid changes in the structure of diet, in particular associated with urbanization, are documented. In addition, large changes in occupation types are documented. These are linked with rapid increases in adult obesity in Latin America and Asia. Some of the potential implications for adult health are noted. Conclusions: The rapid changes in diet, activity and obesity that are facing billions of residents of lower- and middle-income countries are cause for great concern. Linked with these changes will be a rapid increase in chronic diseases. Little to date has been done at the national level to address these problems.

/pdf/the-nutrition-transition-and-its-health-implications-in-44tgtb0zvd.pdf

The nutrition transition and its health implications in lower-income countries.

It was a great privilege to be asked to give the 1995 Ancel Keys lecture, following five very distinguished colleagues [Geoffrey Rose, Henry Blackburn, Jeremiah Stamler, Fred Epstein, and William Kannel] and honoring Ancel Keys. It is difficult to imagine how little we would know about CHD without their contributions.

The subject of my lecture, “Why are women so superior with regard to coronary heart disease?,” is surely one of the most interesting of all epidemiological questions. My intention is to illustrate methodological problems and review old and new provocative results, making inferences from a variety of disciplines. My focus is on the origin of the gender gap, not postmenopausal estrogen therapy. There will be no conclusions, only reconstruction. My lecture is outlined in Fig 1⇓.



 Figure 1. 
Lecture outline.



### Unhealthy Behaviors

For years it was thought that the excess male mortality was explained by unhealthy behaviors that were more socially acceptable for men than women. These behaviors might include cigarette smoking, heavy alcohol use, eating more red meat and fewer fruits and vegetables, and exposure to physical hazards. The usual view was that differences in behavior were more important determinants of the higher male mortality than inherent sex differences in physiology.1 More recently, studies adjusting for unhealthy behaviors show that they contribute to but do not fully explain the increased risk of CHD in men.2 

### Work Outside the Home

It was also a popular premise that men were harmed by the stresses of the workplace; women were apparently protected by being at home relaxing with the children and the washing up. As Bernard notes, “. . . the husband went forth each day to grapple with the cruel cold world and the wife remained in the ‘heart’ of the home, generating sweetness and light to bind the wounds inflicted on the husband and …

Sex Differences in Coronary Heart Disease Why Are Women So Superior? The 1995 Ancel Keys Lecture

A study of coronary heart disease (CHD) among Japanese migrants compared with Japanese living in Japan provided the opportunity to study factors possibly responsible for the high rates of CHD in America as compared with Japan. Comparable methods were employed in examining 11,900 men of Japanese ancestry aged 45--69 living in Japan, Hawaii and California. The age-adjusted prevalence rates for definite CHD as determined by ECG were: Japan 5.3, Hawaii 5.2 and California 10.8/1000. For definite plus possible CHD the rates were 25.4, 34.7 and 44.6. The prevalence of angina pectoris and pain of possible myocardial infarction, determined by questionnaire, showed a similar gradient. Elevated serum cholesterol showed a Japan-Hawaii-California gradient, but the prevalence of hypertension in Japan was intermediate between the prevalence in Hawaii and the higher prevalence in California. The three geographic locations were compared as to prevalence of CHD at comparable levels of blood pressure and cholesterol. At each blood pressure level and at each cholesterol level, the greater prevalence of CHD in California persisted. These facts, plus the near universality of smoking in Japan, suggest that conventional risk factors only partly explain the observed gradient in CHD.

https://www.jayskaufman.com/uploads/3/0/8/9/30891283/marmot_cvd_and_stroke_in_japanese_living_in_japan,_hawaii_and_california_aje_1975.pdf

Epidemiologic studies of coronary heart disease and stroke in japanese men living in japan, hawaii and california: prevalence of coronary and hypertensive heart disease and associated risk factors

A cohort of 4653 men of Japanese ancestry living in Hawaii, with traditional Japanese social and cultural lifestyles, were studied for the association of the prevalence and incidence of coronary heart disease (Honolulu Heart Program, 1971-1979). Two of four scales of acculturation were significantly associated with coronary heart disease prevalence independently of 11 other risk factors, but none of the acculturation scales were associated with incidence appeared to be mostly due to the inclusion of fatal cases in the incidence data, although other explanations are possible. Measures of acculturation were also significantly associated wih many of the other coronary heart disease risk factors in such a way that the more traditional Japanese men had lower serum cholesterol and uric acid, were less obese, more physically active, and smoked fewer cigarettes than the more westernized men. A comparison of bivariate and multivariate analyses indicated that some of acculturation scales were indirectly associated with coronary heart disease because of the confounding association with the other risk factors.

Acculturation and coronary heart disease among japanese men in hawaii

This is a study of the association of Type A behavior with the prevalence and 8-year incidence of coronary heart disease (CHD) among 2187 Japanese men in the Honolulu Heart Program cohort. Type A behavior was determined by the Jenkins Activity Survey questionnaire in 1970. The prevalence rate of total CHD was significantly associated with Type A behavior, and this association was independent of other major risk factors in multivariate analyses. With the incidence data, however, there was no significant association of any clinical type of CHD with Type A behavior. Examination of the relationship of Type A behavior to other risk factors showed significant associations with serum cholesterol, obesity, physical inactivity, and alcohol consumption. Pathologic findings among 48 men who died showed no association of Type A behavior with microscopic evidence of myocardial infarction or with grades of atherosclerosis in the coronary arteries and aortas.

The type A behavior pattern and coronary heart disease among Japanese men in Hawaii.

Possible effects of cultural variables on the risk of coronary heart disease (CHD) were examined in 7705 men of Japanese ancestry living in Hawaii. The six-year incidence of CHD was related to birthplace (Japan or elsewhere), number of years spent in Japan, ability to read and write Japanese, ability to speak Japanese, and to an index of preference for a traditional Japanese diet. Statistically significant inverse relationships were found between CHD incidence and all of these variables which reflect the degree of exposure to Japanese culture during childhood. In multivariate analyses where the major CHD risk factors were taken into account, years spent in Japan and ability to read and write Japanese remained significant. Hence, exposure to Japanese culture during childhood appears to protect against CHD in adulthood. This may explain, in part, the gradient of CHD frequency among Japanese in Japan, Japanese-Americans, and Caucasians that could not be entirely attributed to the established risk factors.

Judith Blackfield Cohen

Papers

Epidemiologic studies of coronary heart disease and stroke in japanese men living in japan, hawaii and california: prevalence of coronary and hypertensive heart disease and associated risk factors

Acculturation and coronary heart disease among japanese men in hawaii

The type A behavior pattern and coronary heart disease among Japanese men in Hawaii.

Childhood cultural experience and the incidence of coronary heart disease in hawaii japanese men

The effects of policies and programs on reduction of mental hospitalization