The Boston Puerto Rican Health Study, a longitudinal cohort study on health disparities in Puerto Rican adults: Challenges and opportunities

USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts, USA.
BMC Public Health (Impact Factor: 2.26). 03/2010; 10(1):107. DOI: 10.1186/1471-2458-10-107
Source: PubMed


The Boston Puerto Rican Health Study is an ongoing longitudinal cohort study designed to examine the role of psychosocial stress on presence and development of allostatic load and health outcomes in Puerto Ricans, and potential modification by nutritional status, genetic variation, and social support.
Self-identified Puerto Ricans, aged 45-75 years and residing in the Boston, MA metro area, were recruited through door-to-door enumeration and community approaches. Participants completed a comprehensive set of questionnaires and tests. Blood, urine and salivary samples were extracted for biomarker and genetic analysis. Measurements are repeated at a two-year follow-up.
A total of 1500 eligible participants completed baseline measurements, with nearly 80% two-year follow-up retention. The majority of the cohort is female (70%), and many have less than 8th grade education (48%), and fall below the poverty level (59%). Baseline prevalence of health conditions is high for this age range: considerable physical (26%) and cognitive (7%) impairment, obesity (57%), type 2 diabetes (40%), hypertension (69%), arthritis (50%) and depressive symptomatology (60%).
The enrollment of minority groups presents unique challenges. This report highlights approaches to working with difficult to reach populations, and describes some of the health issues and needs of Puerto Rican older adults. These results may inform future studies and interventions aiming to improve the health of this and similar communities.

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    • "Inclusion criteria/eligibility included selfidentified Puerto Rican ethnicity, aged 45–75 years, and being able to answer questions in English or Spanish. Individuals who were unable to answer questions due to serious health conditions or who had a low Mini Mental State Examination (MMSE) score (r10) were excluded (Tucker et al., 2010). Participants completed a comprehensive set of survey questionnaires and a neuropsychological test, via in person interviewing. "
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    ABSTRACT: Neighborhood context may influence health and health disparities. However, most studies have been constrained by cross-sectional designs that limit causal inference due to failing to establish temporal order of exposure and disease. We tested the impact of baseline neighborhood context (neighborhood socioeconomic status factor at the block-group level, and relative income of individuals compared to their neighbors) on allostatic load two years later. We leveraged data from the Boston Puerto Rican Health Study, a prospective cohort of aging Puerto Rican adults (aged 45-75 at baseline), with change in AL modeled between baseline and the 2nd wave of follow-up using two-level hierarchical linear regression models. Puerto Rican adults with higher income, relative to their neighbors, exhibited lower AL after two years, after adjusting for NSES, age, gender, individual-level SES, length of residence, and city. After additional control for baseline AL, this association was attenuated to marginal significance. We found no significant association of NSES with AL. Longitudinal designs are an important tool to understand how neighborhood contexts influence health and health disparities. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Health & Place 05/2015; 33. DOI:10.1016/j.healthplace.2015.02.001 · 2.81 Impact Factor
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    • "Baseline recruitment occurred between 2004 and 2009. Specifics of the study and recruitment are described in detail elsewhere (Tucker et al., 2010). The initial data collection yielded a baseline cohort of 1504 participants. "
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    ABSTRACT: Pre-migration and post-migration factors may influence the health of immigrants. Using a cross-national framework that considers the effects of the sending and receiving social contexts, we examined the extent to which pre-migration and post-migration factors, including individual and neighborhood level factors, influence depressive symptoms at a 2-year follow-up time point. Data come from the Boston Puerto Rican Health Study, a population-based prospective cohort of Puerto Ricans between the ages of 45 and 75 y. The association of neighborhood ethnic density with depressive symptomatology at follow-up was significantly modified by sex and level of language acculturation. Men, but not women, experienced protective effects of ethnic density. The interaction of neighborhood ethnic density with language acculturation had a non-linear effect on depressive symptomatology, with lowest depressive symptomatology in the second highest quartile of language acculturation, relative to the lowest and top two quartiles among residents of high ethnic density neighborhoods. Results from this study highlight the complexity, and interplay, of a number of factors that influence the health of immigrants, and emphasize the significance of moving beyond cultural variables to better understand why the health of some immigrant groups deteriorates at faster rates overtime. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Social Science & Medicine 05/2015; 138. DOI:10.1016/j.socscimed.2015.05.040 · 2.89 Impact Factor
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    • "The Internal Review Boards of Tufts Medical Center and Northeastern University have approved the study's protocol. The original 1500 participants were recruited using door-to-door enumeration and community approaches within randomly selected census blocks that were located in census tracks with at least 25 Puerto Rican adults between the ages of 45 and 75 years (Tucker et al. 2010). Eligibility included living within the Boston metropolitan area, Spanish or English language proficiency, 45–75 years of age, and self-identification as of Puerto Rican descent. "
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