Gianola Morgan, Llabre Maria M, Gallo Linda C, Daviglus Martha L, Sotres-Alvarez Daniela, Schneiderman Neil
University of Miami, Department of Psychology.
San Diego State University, Department of Psychology.
Med Res Arch. 2023 Oct;11(10). doi: 10.18103/mra.v11i10.4625. Epub 2023 Oct 26.
Stress and stressful events are widely accepted risk factors for cardiometabolic diseases, including coronary heart disease and diabetes. As language plays a seminal role in development and regulation of emotions and appraisals of stressful situations, it may contribute to documented differences in the stress-cardiometabolic disease association across ethnic groups. We investigated associations between language preferences (Spanish vs English) and downstream health consequences of stress. Using data from the Sociocultural Ancillary Study of the Hispanic Community Health Study/Study of Latinos, we assessed the relationship between reported stress and risk factors (alcohol use, smoking, body mass index, depressive symptoms) and prevalence of self-reported (coronary heart disease, stroke, chronic obstructive pulmonary disease [COPD]) and clinically assessed chronic conditions (diabetes, hypertension) among 5154 Hispanic/Latino adults living in the US. Factor analysis was used to calculate a composite stress variable from participants' self-reported chronic stress, perceived stress, and adverse childhood experiences. Sampling weights and survey methodology were integrated in all analyses to account for this study's complex survey design. After controlling for sociodemographic factors (Hispanic/Latino background, study site, years in the US, social acculturation, education, income, age, sex), higher composite stress scores were associated with elevated risk factors and greater prevalence of coronary heart disease, diabetes, and COPD. Furthermore, the relationship between stress and COPD was significantly stronger among Hispanic/Latino adults who preferred to be interviewed in Spanish (compared to English). Stronger connections between stress and likelihood of drinking alcohol among English-preferring persons also emerged. These results are interpreted in light of the Hispanic health paradox and the role of cultural processes in the development of health risk factors and chronic conditions. Our findings can be integrated into relevant approaches to address health disparities within and across Hispanic/Latino populations in the US.
压力和应激事件是包括冠心病和糖尿病在内的心脏代谢疾病广泛认可的危险因素。由于语言在情绪的发展和调节以及对应激情况的评估中起着至关重要的作用，它可能导致不同种族群体在压力与心脏代谢疾病关联方面已记录的差异。我们调查了语言偏好（西班牙语与英语）与压力的下游健康后果之间的关联。利用西班牙裔社区健康研究/拉丁裔研究的社会文化辅助研究数据，我们评估了5154名生活在美国的西班牙裔/拉丁裔成年人中报告的压力与风险因素（饮酒、吸烟、体重指数、抑郁症状）以及自我报告的（冠心病、中风、慢性阻塞性肺疾病[COPD]）和临床评估的慢性病（糖尿病、高血压）患病率之间的关系。因子分析用于根据参与者自我报告的慢性压力、感知压力和童年不良经历计算一个综合压力变量。所有分析都整合了抽样权重和调查方法，以考虑本研究复杂的调查设计。在控制了社会人口统计学因素（西班牙裔/拉丁裔背景、研究地点、在美国的年数、社会文化适应、教育程度、收入、年龄、性别）后，较高的综合压力得分与风险因素升高以及冠心病、糖尿病和COPD的患病率较高相关。此外，对于更喜欢用西班牙语接受访谈的西班牙裔/拉丁裔成年人，压力与COPD之间的关系显著更强（与英语相比）。在更喜欢说英语的人群中，压力与饮酒可能性之间也出现了更强的联系。这些结果根据西班牙裔健康悖论以及文化过程在健康风险因素和慢性病发展中的作用进行了解释。我们的研究结果可以纳入相关方法，以解决美国西班牙裔/拉丁裔群体内部和群体之间的健康差异问题。
