The relationship between psychosocial status, acculturation and country of origin in mid-life Hispanic women: data from the Study of Women's Health Across the Nation (SWAN)

Abstract

Method To test the hypothesis that psychosocial symptomatology differs by country of origin and acculturation among Hispanic women, we examined 419 women, aged 42–52 years at baseline, enrolled in the New Jersey site of the Study of Women's Health Across the Nation (SWAN). Women were categorized into six groups: Central (CA, n = 29) or South American (SA, n = 106), Puerto Rican (PR, n = 56), Dominican (D, n = 42), Cuban (Cu, n = 44) and non-Hispanic Caucasian (NHC, n = 142). Acculturation, depressive symptoms, hostility/cynicism, mistreatment/discrimination, sleep quality, social support, and perceived stress were assessed at baseline. Physical functioning, trait anxiety and anger were assessed at the fourth annual follow-up. Comparisons between Hispanic and non-Hispanic Caucasians used χ², t test or non-parametric alternatives; ANOVA or Kruskal–Wallis testing examined differences among the five Hispanic sub-groups. Multivariable regression models used PR women as the reference group.

Results Hispanic women were overall less educated, less acculturated (p < 0.001 for both) and reported more depressive symptoms, cynicism, perceived stress, and less mistreatment/discrimination than NHCs. Along with D women, PR women reported worse sleep than Cu women (p < 0.01) and more trait anxiety than SA and Cu women (p < 0.01). Yet, PR women were most acculturated (21.4% highly acculturated vs. CA (0.0%), D (4.8%), SA (4.8%) and Cu (2.3%) women; p < 0.001). In regression models, PR women reported depressive symptoms more frequently than D, Cu, or SA women, and reported trait anxiety more frequently than Cu or SA women. Greater acculturation was associated with more favorable psychosocial status, but PR ethnicity was negatively related to psychosocial status.

Conclusion Psychosocial symptomatology among Hispanic women differs by country of origin and the relatively adverse profile of Puerto Rican women is not explained by acculturation.

Key words:

• MENOPAUSE
• WOMEN
• HISPANIC
• ACCULTURATION
• PSYCHOLOGY

Acknowledgements

We thank the study staff at each site and all the women who participated in SWAN.

Clinical Centers  University of Michigan, Ann Arbor – MaryFran Sowers, PI; Massachusetts General Hospital, Boston, MA – Robert Neer, PI 1994–1999; Joel Finkelstein, PI 1999–present; Rush University, Rush University Medical Center, Chicago, IL – Lynda Powell, PI 1994–2009; Howard Kravitz, PI 2009; University of California, Davis/Kaiser – Ellen Gold, PI; University of California, Los Angeles – Gail Greendale, PI; University of Medicine and Dentistry, New Jersey Medical School, Newark – Gerson Weiss, PI 1994–2004; Nanette Santoro, PI 2004–present; and the University of Pittsburgh, Pittsburgh, PA – Karen Matthews, PI.

NIH Program Office  National Institute on Aging, Bethesda, MD – Marcia Ory 1994–2001; Sherry Sherman 1994–present; National Institute of Nursing Research, Bethesda, MD – Program Officers.

Central Laboratory  University of Michigan, Ann Arbor – Daniel McConnell (Central Ligand Assay Satellite Services).

Coordinating Center  New England Research Institutes, Watertown, MA – Sonja McKinlay, PI 1995–2001; University of Pittsburgh, Pittsburgh, PA – Kim Sutton-Tyrrell, PI 2001–present.

Steering Committee  Chris Gallagher, Chair; Susan Johnson, Chair.

Conflict of interest  The authors report no conflict of interest. The authors alone are responsible for the content and writing of the paper.

Source of funding  The Study of Women's Health Across the Nation (SWAN) has grant support from the National Institutes of Health (NIH), DHHS, through the National Institute on Aging (NIA), the National Institute of Nursing Research (NINR) and the NIH Office of Research on Women's Health (ORWH) (Grants NR004061; AG012505, AG012535, AG012531, AG012539, AG012546, AG012553, AG012554, AG012495). The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the NIA, NINR, ORWH or the NIH. N.S. was supported by HD041978.