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The prevalence of type-2 diabetes (T2DM) among Mexican-American older adults along the U.S.-Mexico border region is at epidemic proportions. Healthcare reform is trending toward long-term home-based management of chronic conditions. Under the Mexican cultural norm of familism, daily care for elders is also often provided by family caregivers whose competence levels may vary. Adherence to the prescribed medication regimen is critical to attainment of optimal glucose control. However, there is a startling lack of literature that addresses the link between family medication administration and care recipients’ health outcome. This paper explores the role of culture in medication administration by family caregivers of elders with T2DM from the perspective of caregiver capabilities and caregiving demands. A critical review of the literature offers suggestions to guide future studies.
Objective Studies assessing the risk of developing CVD between different racial groups in the United States have reached varying conclusions. The purpose of this study was to identify risk for CVD using the Framingham Risk Score (FRS) between racial/ethnic groups. A secondary aim of this study was to compare risk for CVD based on SES status/poverty ratio. Methods A cross-sectional data analysis was conducted using the 2015-2020 NHANES datasets using individuals aged 18 to 79 years. Sample weights were assigned by NHANES researchers to each participant allowing researchers to generalize results to all non-institutionalized US civilians. Results Mexican Americans (MA) had the lowest average FRS and significantly lower CVD risk than all other racial groups, except NH Asian. NH Asians had the second lowest FRS and significantly lower risk than NH Blacks and NH Whites, but their risk was similar to other Hispanic or the other/multi-racial groups. NH Blacks showed no significant difference in FRS compared to NH Whites, other Hispanic, and other/multi-racial groups. NH Whites were not statistically different from other Hispanic or other/multi-racial groups. Other Hispanic and multi-racial groups did not exhibit statistically significant differences. Overall, Mexican Americans had the lowest FRS whereas NH Whites had the highest. Conclusions NH whites demonstrated the highest CVD risk according to FRS, as the oldest racial/ethnic group in the cohort. SES did not consistently predict FRS differences between racial/ethnic groups. These findings suggest a need to further explore FRS as a means of identifying individuals who are at high risk of developing CVD.
The objective of this study was to examine differences between Latino and White older adults in attitudes toward suicide and physician-assisted suicide in chronic pain scenarios. We used a cross sectional study design at four outpatient care sites in San Antonio, Texas. The study sample included 204 subjects (106 Whites and 98 Latinos), 60 years of age and older, with Mini Mental State Examination scores of 24 or higher. No statistically significant between ethnic group differences in attitudes toward suicide or physician-assisted suicide in chronic pain scenarios were found. However, separate analyses by ethnic group showed that the factors associated with these attitudes differed between ethnic groups, with attitudes among Whites significantly and negatively associated with religiosity and those among Latinos significantly and positively associated with depression, while acculturation was significantly and negatively associated with attitudes toward physician-assisted suicide in chronic pain scenarios. This study’s findings suggest that depression and acculturation among Latino elders and religion among White elders are determinant factors of these attitudes in chronic pain, end-of-life scenarios. Further research is needed with more heterogeneous study samples, including Latino subgroups (e.g. Mexican Americans, Puerto Ricans, Cubans) and more diverse ethnic groups in terms of socioeconomic status and educational level characteristics.