Ethnic and Social Class Differences in Selected Anthropometric Characteristics of Mexican American and Anglo Adults: The San Antonio Heart Study

Selected anthropometric dimensions and indices were examined in 1328 randomly selected Mexican American and Anglo adults, 25 through 64 years of age, from San Antonio, Texas. The Mexican Americans were resident in three socioeconomically distinct areas in the city: (1) low income barrio, (2) middle income transitional area, and (3) high income suburban area. The Anglos were resident in only the latter two areas. Among the Mexican Americans, stature increases with socioeconomic status in both sexes. Mexican American men from the three social strata do not differ significantly in weight, relative weight, Quetelet’s index and subcutaneous fatness. Mexican American women from the lowest social stratum are absolutely and relatively heavier with thicker skinfolds and a larger arm circumference than women from the transitional and suburban areas. Suburban women are smaller in all dimensions except stature. Social class differences in Anglos from the transitional and suburban areas parallel those for Mexican Americans in the same areas. Ethnic comparisons within the same socioeconomic level show Mexican Americans as shorter, relatively but not absolutely heavier, and fatter at the subscapular but not the triceps skinfold site than Anglos. The thicker subscapular skinfolds of Mexican Americans, coupled with the lack of an ethnic difference at the triceps skinfold site, suggests an ethnic difference in fat patterning. These findings have implications for the definition of obesity in epidemiologic surveys using anthropometric techniques, since the sites chosen for skinfold measurements may not be equally diagnostic of obesity in different ethnic groups

Primary care-public health linkages: Older primary care patients with prediabetes & type 2 diabetes encouraged to attend community-based senior centers

The Institute of Medicine (IOM) suggests that primary care-public health integration can improve health outcomes for vulnerable patients, but the extent to which formal linkages may enhance patients' use of community resources, or the factors that may influence providers to encourage their patients to use these resources, remain unclear. We conducted baseline assessments in 2014–2015 with 149 older adults with prediabetes or diabetes who had recently joined three senior centers linked to a network of primary care clinics in San Antonio, Texas. In addition to collecting sociodemographic and clinical characteristics, we asked members to identify their source of primary care and whether a health care provider had encouraged them to go to the senior center. We also asked members why they had joined the senior centers and which programs interested them the most. Members' source of primary care was not associated with being encouraged to attend the senior centers by a health care professional. Multivariable analysis indicated that participants with total annual household incomes of $20,000 or less [OR = 2.78; 95% CI = (1.05, 7.14)] and those reporting 12 years of education or less [OR = 3.57; 95% CI = (1.11, 11.11)] were significantly more likely to report being encouraged to attend the senior center by a health care provider. Providers who are aware of community-based resources to support patient self-management may be just as likely to encourage their socioeconomically vulnerable patients with prediabetes or diabetes to use them as providers who have a more formal partnership with the senior centers. Keywords: Older adults, Primary health care, Public health, Senior centers, Socioeconomic status, Health promotion, Diabete