Trauma, Psychological Distress, and Pre-Clinical Markers of Cardiometabolic Disease Among US Latinos
Trauma exposure and psychological distress are associated with poor cardiometabolic health. US Latinos suffer from cardiometabolic health disparities and may be at increased risk for trauma exposure and distress. The extent to which psychological distress contributes to the association between trauma exposure and cardiometabolic disease remains unclear, and there is scant research examining this topic among Latinos. The purpose of this dissertation was to evaluate the prevalence and correlates of trauma exposure among Latinos, and the cross-sectional associations between trauma exposure, psychological distress, and C-Reactive Protein (CRP) and Metabolic Syndrome (MetS). The study used cross-sectional data from the Hispanic Community Health Study/Study of Latinos and from the Sociocultural Ancillary Study, a large sample of US Latinos (N = 5,313) who completed medical examinations and psychosocial questionnaires. Prevalence and correlates of trauma exposure were calculated using weighted frequencies and Chi-square tests. The prevalence of lifetime trauma exposure was 85% for men and 77% for women, and 37% of the sample reported experiencing three or more traumatic events. Several risk factors for trauma exposure emerged: being born outside of the US 50 states, preferring English, identifying as Puerto Rican, South American or more than one background, and immigrating to the US prior to age 18. Structural equation models (SEM) examined the associations among trauma exposure, psychological distress (latent variable), CRP and MetS (latent variable), while accounting for demographic and immigration/acculturation covariates. Model fit was evaluated using common descriptive fit indices: CFI, RMSEA, SRMR. Results from SEM models indicated that lifetime trauma count was not directly associated with CRP (β = -.01, p = .90) or MetS (β = -.01, p = .97).; psychological distress was a significant indirect pathway between lifetime trauma count and CRP (95% CI = .001, .005) but not MetS (95% CI = -.013, .024), and several health behaviors were indirect factors in the association between trauma exposure, psychological distress, and CRP/MetS. Most SEM paths were invariant by sex, except for the association between alcohol use and CRP/MetS. US Latino adults report high prevalence of trauma exposure, which appears to be indirectly associated with pre-clinical markers of cardiometabolic disease.