1. Two Research Examples: Marriage and Health Among Older Mexican Americans and the Texas City Study M. Kristen Peek, PhD Department of Preventive Medicine and Community Health Sealy Center on Aging

2. Marriage and Health General finding that marriage is beneficial to health Why? –Selection Positive selection Adverse selection –Protection Social support Financial Healthy lifestyles/behaviors

3. 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

4. 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

5. Marriage, Health, and Mexican Americans Data source: H-EPESE (Dr. Kyriakos Markides, PI) –3,050 Mexican Americans aged 65+ in the Southwest –Currently in 5 th wave –Measures predominantly social epidemiological Identify couples 553 couples at baseline, 407 at Wave 2, 288 at Wave 3 Predominantly focused on baseline

6. 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

7. 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

8. 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)

9. 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

10. 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

11. 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

12. 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

13. Conceptual Framework

14. 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

15. 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

16. 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

17. 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

18. 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

19. 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

20. 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

21. 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

22. What Next? Add blood data Keep collecting follow-up data for larger project More analyses on pre- and post-explosion data