Addressing Syndemic Health Disparities Among Latin Immigrants Using Peer Support

Abstract

The purpose of this project was to develop a multidimensional understanding of synergistic connections between food-related and emotional health in the lives of Latina immigrants using a community-engaged approach with women who participate in a social isolation support group. The domains of interest included the intersection of social isolation, depression, diabetes, and food insecurity. We tested an innovative “structured dialogue” (SD) approach to integrating the domains of interest into the group dynamic. We documented key positive impacts of participation in the group on women’s everyday experiences and emotional wellbeing. We demonstrated the extent to which this approach increases women’s knowledge of food and food resources, and their self-efficacy for dealing with diabetes and food insecurity.

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Fig. 1

Notes

  1. 1.

    At the time of the creation of the SISG and at the time of the study, the HC was called The St. Joseph Center for Children and Families. In 2017, the name of the Center and its organizational affiliation changed.

References

  1. 1.

    Pedersen PV, Andersen PT, Curtis T. Social relations and experiences of social isolation among socially marginalized people. J Soc Pers Rel. 2012;29(6):839–58.

    Article  Google Scholar 

  2. 2.

    Miller DK, Malmstrom TK, Joshi S, Andresen EM, Morley JE, Wolinsky FD. Clinically relevant levels of depressive symptoms in community-dwelling middle-aged African Americans. J Am Ger Soc. 2004;52(5):741–8.

    Article  Google Scholar 

  3. 3.

    Cullen SW, Solomon PL. Family and community integration and maternal mental health. Admin Pol Ment Health & Ment Health Serv Res. 2013;40(2):133–44.

    Article  Google Scholar 

  4. 4.

    Valtorta NK, Kanaan M, Gilbody S, Ronzi S, Hanratty B. Loneliness and social isolation as risk factors for coronary heart disease and stroke: systematic review and meta-analysis of longitudinal observational studies. Heart. 2016;102(13):1009–16.

    CAS  Article  Google Scholar 

  5. 5.

    Burdette HL, Wadden TA, Whitaker RC. Neighborhood safety, collective efficacy, and obesity in women with young children. Obes. 2006;14(3):518–25.

    Article  Google Scholar 

  6. 6.

    Ross CE, Mirowsky J. Neighborhood disadvantage, disorder, and health. J Health Soc Behav. 2001;42(3):258–76.

    CAS  Article  Google Scholar 

  7. 7.

    Rizo CF, Macy RJ. Help seeking and barriers of Hispanic partner violence survivors: a systematic review of the literature. Aggression Violent Behav. 2011;16(3):250–64.

    Article  Google Scholar 

  8. 8.

    Kyriakakis S, Dawson BA, Edmond T. Mexican immigrant survivors of intimate partner violence: conceptualization and descriptions of abuse. Violence Vict. 2012;27(4):548–62.

    Article  Google Scholar 

  9. 9.

    Izzo C, Weiss L, Shanahan T, Rodriguez-Brown F. Parental self-efficacy and social support as predictors of parenting practices and children’s socio-emotional adjustment in Mexican immigrant families. J Prev Interv Comm. 2000;20(1–2):197–213.

    Article  Google Scholar 

  10. 10.

    Taylor HO, Taylor RJ, Nguyen AW, Chatters L. Social isolation, depression, and psychological distress among older adults. J Aging Health. 2018;30(2):229–46.

    Article  Google Scholar 

  11. 11.

    Marcus AF, Illescas AH, Hohl BC, et al. Relationships between social isolation, neighborhood poverty, and cancer mortality in a population-based study of U.S. adults. PloS One. 2017;12(3):e0173370. https://doi.org/10.1371/journal.pone.0173370.

    CAS  Article  Google Scholar 

  12. 12.

    Kana'Iaupuni SM, Donato KM, Thompson-Colon T, et al. Counting on kin: social networks, social support, and child health status. Soc For. 2005;83(3):1137–64.

    Google Scholar 

  13. 13.

    Belliveau M. Gendered matters: undocumented Mexican mothers in the current policy context. Affilia. 2012;26:32–46.

    Article  Google Scholar 

  14. 14.

    Sanchez-Birkhead AC, Kennedy HP, Callister LC, Miyamoto TP. Navigating a new health culture: experiences of immigrant Hispanic women. J Immig Minor Health. 2011;13(6):1168–74.

    Article  Google Scholar 

  15. 15.

    Dreby J, Schmalzbauer L. The relational contexts of migration: Mexican women in new destination sites. Soc Forum. 2013;28:1–26.

    Article  Google Scholar 

  16. 16.

    Mendenhall E, Jacobs EA. Interpersonal abuse and depression among Mexican immigrant women with type 2 diabetes. Cult Med Psych. 2012;36(1):136–53.

    Article  Google Scholar 

  17. 17.

    Bawadi HA, Ammari F, Abu-Jamous D, Khader YS, Bataineh S’, Tayyem RF. Food insecurity is related to glycemic control deterioration in patients with type 2 diabetes. Clin Nutr. 2012;31(2):250–4.

    Article  Google Scholar 

  18. 18.

    Laraia BA. Food insecurity and chronic disease. Adv Nutr: Int Rev J. 2013;4(2):203–12.

    Article  Google Scholar 

  19. 19.

    Seligman HK, Jacobs EA, López A, et al. Food insecurity and glycemic control among low-income patients with type 2 diabetes. Dia Care. 2012;35(2):233–8.

    Article  Google Scholar 

  20. 20.

    Waitzkin H, Getrich C, Heying S, Rodríguez L, Parmar A, Willging C, et al. Promotoras as mental health practitioners in primary care: a multi-method study of an intervention to address contextual sources of depression. J Com Health. 2011;36(2):316–31.

    Article  Google Scholar 

  21. 21.

    Bruening M, MacLehose R, Loth K, Story M, Neumark-Sztainer D. Feeding a family in a recession: food insecurity among Minnesota parents. Am J Pub Health. 2012;102(3):520–6.

    Article  Google Scholar 

  22. 22.

    AUTHOR, Colleagues. “It is always that sense of wanting…never really being satisfied”: women’s quotidian struggles with food insecurity in a Hispanic Community in NM. J Hung Env Nutr. 2014;92:183–209. https://doi.org/10.1080/19320248.2014.898176.

    Article  Google Scholar 

  23. 23.

    Singer M. Introduction to syndemics: a critical systems approach to public and community health. Hoboken: John Wiley & Sons; 2009.

    Google Scholar 

  24. 24.

    Singer M, Clair S. Syndemics and public health: reconceptualizing disease in bio-social context. Med Anthro. 2003;17(4):423–41.

    Article  Google Scholar 

  25. 25.

    Singer M, Bulled N, Ostrach B. Syndemics and human health: implications for prevention and intervention. Ann Anthro Prac. 2012;36(2):205–11.

    Google Scholar 

  26. 26.

    Singer M, Bulled N, Ostrach B, Mendenhall E. Syndemics and the biosocial conception of health. Lancet. 2017;389:10072,941–50.

    Article  Google Scholar 

  27. 27.

    Ostrach B, Singer M. At special risk: biopolitical vulnerability and HIV/STI syndemics among women. Health Soc Rev. 2012;21(3):258–71.

    Article  Google Scholar 

  28. 28.

    Lerman S, Ostrach B, Singer M, editors. Foundations of biosocial health: stigma and illness interactions. Lanham: Lexington Books of Rowan and Littlefield; 2017.

    Google Scholar 

  29. 29.

    Sharma A. Syndemics: health in context. Lancet. 2017;389:10072.

    Google Scholar 

  30. 30.

    Gonzalez-Guarda RM, McCabe BE, Mathurin E, DeBastiani SD, Montano NP. The influence of relationship power and partner communication on the syndemic factor among Hispanic women. Wom Health Iss. 2017;27(4):478–84.

    Article  Google Scholar 

  31. 31.

    Himmelgreen DA, Romero-Daza N, Amador E, Pace C. Tourism, economic insecurity, and nutritional health in rural Costa Rica: using syndemics theory to understand the impact of the globalizing economy at the local level. Ann Anthro Prac. 2012;36(2):346–64.

    Google Scholar 

  32. 32.

    Mendenhall E. Syndemic suffering: social distress, depression, and diabetes among Mexican immigrant women. New York NY: Left Coast Press; 2012.

    Google Scholar 

  33. 33.

    Potochnick S, Arteaga I. A decade of analysis: household food insecurity among low-income immigrant children. J Fam Issues. 2018;39(2):527–51.

    Article  Google Scholar 

  34. 34.

    Carney MA. The biopolitics of ‘food insecurity’: towards a critical political ecology of the body in studies of women’s transnational migration. J Pol Ecol. 2014;21(1):1–18.

    Google Scholar 

  35. 35.

    Carney MA. The unending hunger: tracing women and food insecurity across borders. Berkeley: Univ of California Press; 2015.

    Google Scholar 

  36. 36.

    Gonzalez-Guarda RM, McCabe BE, Vermeesch AL, Cianelli R, Florom-Smith AL, Peragallo N. Cultural phenomena and the syndemic factor: substance abuse, violence, HIV, and depression among Hispanic women. Ann Anthro Prac. 2012;36(2):212–31.

    Google Scholar 

  37. 37.

    Martinez I, Kershaw TS, Keene D, Perez-Escamilla R, Lewis JB, Tobin JN, et al. Acculturation and syndemic risk: longitudinal evaluation of risk factors among pregnant Latina adolescents in New York City. Ann Behav Med. 2017;52(1):42–52.

    Article  Google Scholar 

  38. 38.

    Vermeesch AL, Gonzalez-Guarda RM, Hall R, McCabe BE, Cianelli R, Peragallo NP. Predictors of depressive symptoms among Hispanic women in south Florida. W J Nurs Res. 2013;35(10):1325–38.

    Article  Google Scholar 

  39. 39.

    Delormier T, Frohlich KL, Potvin L. Food and eating as social practice: understanding eating patterns as social phenomena and implications for public health. J Soc Health Ill. 2009;31(2):215–28.

    Article  Google Scholar 

  40. 40.

    AUTHOR, Colleagues. “I took the lemons and I made lemonade”: women’s quotidian strategies and the re-contouring of food insecurity in a Hispanic community in NM. In: AUTHOR ed. Off the edge of the table: women redefining the limits of the food system and the experience of food insecurity. Lanham, MD: Lexington Press; 2014.

    Google Scholar 

  41. 41.

    Madden R. Being ethnographic: a guide to the theory and practice of ethnography. Thousand Oaks, CA: Sage Press; 2011.

    Google Scholar 

  42. 42.

    U.S. Census Bureau. American community survey 2016. Available at: https://www.census.gov/data.html

    Google Scholar 

  43. 43.

    NM Department of Health. Strategic Plan 2017–19. 2017. https://nmhealth.org/publication/view/plan/2229/.

  44. 44.

    NM Department of Health. NM's Indicator-Based Information System (IBIS). 2016. Available at: https://ibis.health.state.nm.us/indicator/view/DiabDeath.RacEth.Sex.html

  45. 45.

    Bernalillo County Health Council. Bernalillo County Health Assessment. 2012. Available at: http://www.bchealthcouncil.org/Resources/Documents/CINCH%20Health%20Assessment%2012-18-12.pdf

  46. 46.

    Mishra S, Page-Reeves J, Regino L, et al. Community summary report: results from a CTSC-funded planning project to develop a diabetes prevention initiative with East Central Ministries. Albuquerque: University of New Mexico Prevention Research Center; 2012.

    Google Scholar 

  47. 47.

    New Mexico Department of Health. Bureau of Vital Records and Health Statistics. 2012. Available at: http://www.vitalrecordsnm.org/.

  48. 48.

    New Mexico Health Policy Commission. 2008 Hospital Inpatient Discharge Data 2009. Available at: http://nmhealth.org/documents/2010ComprehensiveStrategicHealthPlanUpdate.pdf.

  49. 49.

    Center for American Progress. Poverty Talk: New Mexico. 2018. Available at: https://talkpoverty.org/indicator/listing/hunger/2017

  50. 50.

    Federal Interagency Forum on Aging-Related Statistics. Older Americans 2016: key indicators of well-being. Washington, DC: U.S. Government Printing Office; 2016.

    Google Scholar 

  51. 51.

    Rodriguez JC. Squeezed tighter: public assistance benefits face reductions as state battles budget woes, leaving struggling families to do without necessities. The Albuquerque Journal December. 2010;27.

  52. 52.

    Sawyer RL. Depression: Center for Epidemiologic Studies Depression Scale (CES-D): a self-report depression scale for research in the general population. 1977. Available at: http://apm.sagepub.com/content/1/3/385.abstract

  53. 53.

    Tuomilehto J, Lindström J Diabetes: type II diabetes risk assessment form. Finnish Diabetes Association Available at: http://www.diabetes.fi/files/502/eRiskitestilomake.pdf

  54. 54.

    Dahlem NW, Zimet GD, Walker RR. The multidimensional scale of perceived social support: a confirmation study. J Clin Psych. 1991 47(6), 756–761. Multidimensional scale of perceived social support. Available at: http://www.yorku.ca/rokada/psyctest/socsupp.pdf

  55. 55.

    Economic Research Service United States Department of Agriculture (USDA). U.S. Adult Food Security Survey Module: Three-Stage Design, with Screeners. United States Department of Agriculture (USDA). September 2012. Available at: http://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-us/survey-tools.aspx#household

  56. 56.

    Williams P. “I would have never ”: a critical examination of women’s agency for food security through participatory action research. In: AUTHOR, ed. Women Redefining the Experience of Food Insecurity: Life Off the Edge of the Table. Lanham, MD: Lexington Books; 2014. p. 275–314.

    Google Scholar 

  57. 57.

    Hammersley M. Questioning qualitative inquiry: critical essays. London: Sage Publications; 2008.

    Book  Google Scholar 

  58. 58.

    Creswell JW. Research design: qualitative, quantitative, and mixed methods approaches. Thousand Oaks, CA: Sage Publications; 2013.

    Google Scholar 

  59. 59.

    Gläser J, Laudel G. Life with and without coding: two methods for early-stage data analysis in qualitative research aiming at causal explanations. Qual Forum. 2013;14:2. https://doi.org/10.17169/fqs-14.2.1886.

    Article  Google Scholar 

  60. 60.

    Hill CS, Knox B, Thompson E, et al. Consensual qualitative research: an update. J Couns Psych. 2005;52(2):196–205.

    Article  Google Scholar 

  61. 61.

    Parry K. Constant comparison. From Michael Lewis-Beck. In: Bryman A, Liao TF, editors. The SAGE encyclopedia of social science research methods. Thousand Oaks, CA: Sage Publications; 2003.

    Google Scholar 

  62. 62.

    AUTHOR. Conceptualizing food insecurity and women’s agency: a synthetic introduction. In AUTHOR (ed.), Off the edge of the table: women redefining the limits of the food system and the experience of food insecurity. Lanham, MD: Lexington Press, 2014.

    Google Scholar 

  63. 63.

    Andrews C. Culture’s role in immigrant health: how cultural consonance shapes diabetes and depression among Mexican women in Alabama. Doctoral dissertation: The University of Alabama; 2018.

    Google Scholar 

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Acknowledgements

We would like to thank women who are members of the social isolation support group who participated in this research in multidimensional ways. Their stories are inspiring and their insights were extremely valuable as we developed our interpretations. We would also like to thank Betty Skipper, PhD, for her wise advice as we prepared the statistical analysis for this article, and Helene Silverblatt, MD, for her support for this research as a senior research mentor.

Funding

The project discussed here, Understanding and Reducing Health Disparities Among Latina Immigrant Women in Relation to Synergistic Dynamics Associated with Social Isolation, Depression, Diabetes and Food Insecurity, was funded by a Community Engagement Pilot Award #CTSC0010-5 from the University of New Mexico (UNM) Clinical & Translational Science Center (CTSC) from April 1, 2014 to March 31, 2015.

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Correspondence to Janet Page-Reeves.

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Human Subjects

This project was reviewed and approved by the Human Research Protections Office (HRPO) as project #14-006 on February 4, 2014. The HRPO is the Institutional Review Board (IRB) ethics committee for research with human subjects at UNM. All participants provided signed informed consent.

Conflict of Interest

We note that Jackie Perez works for the Hopkins Center, and previously worked for the Center under its previous name, St. Joseph Center for Children and Families. Tamara Thiedeman previously worked for the St. Joseph Center for Children and Families. Perez is currently the Director of the Center and Thiedeman was its previous Director. Both are licensed mental health professionals and they provide/provided services to clients, including some of the women who participated in this study. Both were involved in establishing the Women’s Social Isolation Support Group discussed here and both participated in the research. However, we believe that this relationship did not interfere with their ability to carry out the research, as they were interested in an objective analysis of the dynamics of the group process as part of an assessment of the services they provide.

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Page-Reeves, J., Shrum, S., Rohan-Minjares, F. et al. Addressing Syndemic Health Disparities Among Latin Immigrants Using Peer Support. J. Racial and Ethnic Health Disparities 6, 380–392 (2019). https://doi.org/10.1007/s40615-018-00535-y

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Keywords

  • Women
  • Hispanics/Latinos
  • Immigrants
  • Peer support
  • Social isolation
  • Depression
  • Food insecurity
  • Diabetes