Two Research Examples: Marriage and Health Among

Older Mexican Americansand the

Texas City Study

M. Kristen Peek, PhD Department of Preventive Medicine and Community

Health

Sealy Center on Aging

Marriage and Health

• General finding that marriage is beneficial to health

• Why?– Selection

• Positive selection• Adverse selection

– Protection• Social support• Financial • Healthy lifestyles/behaviors

Marriage and Health

• Studies using general samples – Find more evidence

for protection– Find gender

differences

• Studies using married couples– Concordance of

mental health– Concordance of blood

pressure, self-rated health, cholesterol, certain chronic conditions

– Health behavior similarities

Marriage, Health, and Mexican Americans

• R01 builds on previous research by:– Examining associations of health between couples, especially

looking at effects of spouses’ health on their partners’ health (mental, physical, and mortality)

– Specific Aim 1– Examine connection between health events in one spouse and

physical and mental health of the other spouse – Specific Aim 2

– Assess association of physical functioning in one spouse and physical and mental health of the other spouse

– Specific Aim 3– Investigate relationship between mortality of one spouse and

physical and mental health of the other spouse

Marriage, Health, and Mexican Americans

• Data source: H-EPESE (Dr. Kyriakos Markides, PI)– 3,050 Mexican Americans aged 65+ in the Southwest – Currently in 5th wave– Measures predominantly social epidemiological

• Identify couples• 553 couples at baseline, 407 at Wave 2, 288 at

Wave 3• Predominantly focused on baseline

Results So Far

• Blood pressure concordance– strong association for spouses’ blood

pressures, even when accounting for health behaviors and risk factors

• Connection of well-being measures – Association of husbands’ self rated health,

psychological distress, and life satisfaction with wives’ measures and vice versa

Results So Far

• Chronic conditions and psychological distress among couples– Prevalence of chronic conditions in one spouse

was associated with an increase in psychological distress over a two-year period

• Concordance of chronic conditions between spouses– Hypertension, arthritis, and cancer of each spouse

was associated with an increased odds of the other spouse having the same condition

Results So Far

• Shared lifestyle – health behaviors – Husbands’ BMI predicts wives’ BMI, vice

versa– Wives’ risk of ever smoking higher if husband

ever smoked (RR 2.15)– Husbands’ risk of ever smoking higher if

husband ever smoked (RR 1.42)– Wives’ risk of ever drinking higher if husband

ever drank (RR 7.25)– Husbands’ risk of ever drinking higher if wife

ever drank (RR 1.32)

Summary

• Evidence consistent with other couples studies that spouses’ health statuses are strongly linked

• Beginnings of findings of gender differences

• Implications for older Hispanics that spouses could be at increased risk for poor health outcomes

Environmental Risk, Stress, and Health among Hispanics in Texas

City, Texas

• Project funded by NIH grant P50 CA10563-02, James Goodwin, MD, PI (UTMB Center for Population Health and Health Disparities)

• Examine relationships among following multi-level factors:– Stressors (including a technological hazard)– Socio-cultural contexts– Psychosocial processes– Stress (psychological and physiological)– Health outcomes

• To develop predictive models of health for various populations under stress, with a particular focus on Mexican Americans

• Technological hazards are an increasingly important type of stressor

• Processes linking risk perception, coping, stress, and health are under-researched

• Role of culture in processes probably important but not well understood

• Hispanics and Hispanic culture largely ignored in these research areas

Background

• Expand research in risk perception, coping, and stress with the inclusion of new measures

• Focus on Mexican Americans to address important gaps in the risk and stress literatures

• Very little longitudinal data exist on exposure to technological hazards

Significance of Study

Conceptual Framework

Design Overview

• Place and population of Texas City provides a “natural experiment” to investigate the processes of interest

• Overweighted Hispanic sample

• Longitudinal component for key measures

Quantitative Data Collection

• Years 1 and 2– Collect cross-sectional data using a dual-language

community based survey instrument with Hispanics, non-Hispanic Blacks, and non-Hispanic whites

• Years 2 through 5– Phone follow-up interviews every 6 months for 3 years

using SF-36, Perceived Stress Scale, Perceived Risk of Hazard Scale, and other outcome measures

– Blood collection 2-3 weeks after survey interview to measures 8 physiological stress indicators including cortisol, plasma cytokines, and viral antibody titers

Plant Explosion, March 23, 2005

• Expected to change perceptions of risk and stress

• Research shift to address understanding effects of disaster

Chad Green : Galveston County Daily News

Current Post-explosion Plan

• Called each of 548 pre-explosion with another survey (old and new items)

• 315 surveys pre and post explosion

• 120 blood samples as well

• Consider intensive longitudinal follow-up (e.g., every 3 months) on 548

Preliminary Findings on the Explosion Cohort

• Primarily descriptive – N = 315– 64% Hispanic, 10% non-Hispanic Black, 25%

non-Hispanic White– Age ranges 25-88, mean = 50.3– 64% female, 55% married– 25% more than high school degree– 42% have no chronic conditions – Mean CES-D=8

Preliminary Findings on the Explosion Cohort

• Description on impact of explosion– Very few were injured or knew anyone who

was injured– But, almost all said they saw, heard, and felt

explosion (73%)– 28% said there was property damage in their

neighborhood from the explosion

Preliminary Findings on the Explosion Cohort

• SF-36 and PTSD-C comparisons:– Mean Physical Component Scale (PCS) T1=49.3– Mean PCS T2=45.7– Mean Mental Component Scale (MCS) T1=50.4– Mean MCS T2=47.7– Mean PCS, T2

• NHB=45.2, NHW=43.0, H=46.7– Mean MCS, T2

• NHB=43.3, NHW=49.4, H=47.6– PTSD-C

• NHB=20.8, NHW=6.5, H=13.5

Preliminary Findings on the Explosion Cohort

• SF-36 and PTSD-C comparisons (cont):– Mean PCS, T2

• High impact=44.7, Low impact=48.5• Damage=46.3, No damage=45.8

– Mean MCS, T2• High impact=47.3, Low impact=48.4• Damage=43.6, No damage=49.7

– PTSD-C• High impact=13.9, Low impact=8.3• Damage=17.1, No damage=10.3

What Next?

• Add blood data

• Keep collecting follow-up data for larger project

• More analyses on pre- and post-explosion data