A Comparison of Mental Health for Mexican and Mexican American Older Adults

描述（由申请人提供）：本项目将有助于了解移民的社会过程及其对拉丁美洲老年人和拉丁美洲移民到美国的健康结果的影响。具体来说，本研究旨在研究劣势如何在整个生命过程中积累，从而导致拉丁美洲老年人和拉丁裔移民的不同健康结果。生命历程框架描述了早期生活经历如何通过对健康的累积影响或通过将生活机会和健康结果引导到特定的“途径”来影响后来的健康结果。第一个具体目标是显示早期生活环境（如童年社会经济地位、童年健康、家庭凝聚力）对墨西哥老年人和美国墨西哥裔美国老年人晚年抑郁和慢性疼痛结果的持续影响。抑郁症目前是世界范围内致残的主要原因，慢性疼痛与抑郁症状密切相关。该分析将利用墨西哥健康与老龄化研究（MHAS）和健康与退休研究（HRS），分别对墨西哥和美国老年人口进行纵向调查。该项目还将探讨促使移徙的情况和移徙过程本身如何改变MHAS答复者整个生命过程中的健康轨迹。第二个具体目标是根据个人和家庭移民史显示移民对墨西哥老年人抑郁和慢性疼痛结果的影响。我将通过模拟MHAS受访者的童年SES，健康状况和家庭凝聚力的抑郁和疼痛结果来实现这一目标，并根据个人和家庭迁移经验进行分层。我还将分析个人和家庭迁移史对男性和女性抑郁和疼痛的不同影响。考虑到配偶移徙时独自抚养子女的经历以及返回墨西哥的女性移徙者更有可能出现其他身体残疾，移徙经历对妇女的不利影响可能比男子更大。该项目将作为加州大学洛杉矶分校公共卫生学院社区卫生科学系严格的博士课程的一部分进行。培训计划包括定量方法和社会人口学课程，这些课程将为我提供完成我的提案所需的技术和分析技能。项目导师，加州大学洛杉矶分校的Steven Wallace博士，加州大学洛杉矶分校的Anne Pebley博士和德克萨斯大学医学分部的Rebeca Wong博士，将在为期两年的培训计划中提供实质性的和方法上的专业知识，以完成和展示拟议的分析，以及博士论文。

DESCRIPTION (provided by applicant): This project will contribute to an understanding of the social processes of migration and their impact on health outcomes for older Latin Americans and Latin American migrants to the United States. Specifically, this proposal is to study how disadvantage accumulates across the life-course, resulting in divergent health outcomes for older adults in Latin America and Latino immigrants. The life-course framework describes how early-life experiences might impact later health outcomes by having a cumulative effect on health, or by channeling life chances and health outcomes down particular 'pathways'. The first specific aim is to show the continued effect of early life circumstances (e.g. childhood socio-economic status, childhood health, family cohesion) on later life depression and chronic pain outcomes among older adults in Mexico, and Mexican-American older adults in the United States. Depression is currently the leading cause of disability worldwide, and chronic pain is strongly associated with depressive symptoms. The analysis will make use of the Mexican Health and Aging Study (MHAS) and the Health and Retirement Study (HRS), longitudinal surveys representative of older adult populations in Mexico and the United States, respectively. This project will also address how the circumstances motivating migration and the process of migration itself change health trajectories across the life-course for MHAS respondents. The second specific aim is to show the effect of migration on depression and chronic pain outcomes for older Mexican adults based on personal and family migration history. I will achieve this aim by modeling depression and pain outcomes on childhood SES, health status and family cohesion among MHAS respondents, stratifying by personal and family migration experience. I will also analyze the differential effects of personal and family migration history on depression and pain for men and women. It is possible that women will be more adversely impacted by migration experience than men, given experiences of raising children alone when spouses migrate and the greater likelihood of other physical disabilities for female return migrants to Mexico. This project will be carried out as part of a rigorous doctoral program at UCLA's School of Public Health, Department of Community Health Sciences. The training program includes coursework in quantitative methods and social demography that will provide me with the technical and analytical skills necessary to complete my proposal. The program mentors, Dr. Steven Wallace of UCLA, Dr. Anne Pebley of UCLA and Dr. Rebeca Wong of Univ of Texas, Medical Branch, will provide substantive and methodological expertise throughout the two-year training program, towards the completion and presentation of the proposed analyses, as well as the doctoral dissertation.