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Cardiovascular Risk Factors Among Latinos : Select Behavioral and Social Determinants of Health


Background : This dissertation addressed the following aims: (1) examined the prevalence of hypertriglyceridemia and associations among carbohydrate intake and sedentary time with triglyceride concentration; (2) examined the internal consistency and construct validity of the Neighborhood Social Cohesion Scale and Neighborhood Problems Scale; and (3) examined associations of the use of four social capital indicators (Intrapersonal Support Evaluation List-12 (ISEL-12), Social Network Index (SNI), Neighborhood Social Cohesion Scale, and Neighborhood Problems Scale) within cardiovascular disease (CVD) risk factors and prevalence. Methods : For Aim 1, a secondary data analysis from the Hispanic Community Health Survey/ Study of Latinos (HCHS/SOL) was performed (N = 10,946). For Aims 2 and 3, a secondary data analysis from the HCHS/ SOL Sociocultural Ancillary Study (SCAS) was performed (N = 5,172). Results : Hypertriglyceridemia prevalence ranged from 2.04%-14.81% in men and 1.24% to 11.65% in women. Predicted carbohydrate consumption and Body Mass Index (BMI) were positively associated with triglyceride concentrations. The odds of having hypertriglyceridemia were greater for participants who were obese (odds ratio [OR; 95% confidence interval], [4.25; 3.44-5.24]) or overweight [2.79; 2.27-3.43]. The Neighborhood Social Cohesion Scale and the Neighborhood Problems Scale had acceptable internal consistency for the entire sample, language groups, and Latino heritage groups ([alpha] ≥0.60), and satisfactory fit of the one-factor model. After adjusting for sociodemographic factors and perceived and chronic stress, SNI scores were related to a lower prevalence of CHD [0.87; 0.78-0.98], ISEL-12 scores were related to a higher prevalence of CHD [1.03; 1.00-1.05], all four social capital indicators were related to diabetes (ISEL-12: [0.98;0.96-1.00]; SNI: [0.92; 0.86- 0.99]; Neighborhood Social Cohesion: [1.06; 1.02-1.10]; Neighborhood Problems: [1.04; 1.01-1.07]), SNI scores were related to a lower odds of hypertension [0.92; 0.87-0.98] and smoking [0.87; 0.80-0.93], and Neighborhood Problems was related to a higher odds of smoking [1.04; 1.01-1.07]. Conclusions : Based upon the current analyses, reduction of hypertriglyceridemia in Latinos is necessary to help decrease the risk of poor cardiovascular health, the Neighborhood Social Cohesion Scale and the Neighborhood. Problems Scale are acceptable to use within a Latino sample, and future research to confirm the effects of social capital on cardiovascular health may help reduce health disparities among Latinos

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