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

描述(由申请者提供)：该项目将有助于了解移徙的社会过程及其对拉丁美洲老年移民和拉美移民健康结果的影响。具体地说，这项建议是为了研究不利因素如何在整个生命周期中积累，从而导致拉丁美洲老年人和拉美裔移民的健康结果不同。生命历程框架描述了早期生活经历如何通过对健康产生累积影响，或通过将生命机会和健康结果引导到特定的“路径”来影响后来的健康结果。第一个具体目的是显示早期生活环境(如童年社会经济状况、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导致残疾的主要原因，慢性疼痛与抑郁症状密切相关。分析将利用墨西哥健康和老龄化研究(MHAS)和健康和退休研究(HRS)，这两项纵向调查分别代表墨西哥和美国的老年人口。该项目还将探讨促使移徙的环境和移徙过程本身如何改变MHAS受访者的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迁移史显示移民对墨西哥老年人抑郁和慢性疼痛结果的影响。我将通过根据个人和家庭迁移经历对MHAS受访者的童年SES、健康状况和家庭凝聚力进行分层，来模拟抑郁和疼痛的结果，从而实现这一目标。我还将分析个人和家庭迁移史对男性和女性抑郁和痛苦的不同影响。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民有更大的其他身体残疾的可能性，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健康科学系严格博士项目的一部分进行。培训计划包括量化方法和社会人口学方面的课程，这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史蒂文·华莱士博士、加州大学洛杉矶分校的安妮·佩布利博士和德克萨斯大学医学分校的丽贝卡·王博士将在整个为期两年的培训计划中提供实质性和方法论方面的专业知识，以完成和介绍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.