BACKGROUND AND OBJECTIVES:Family caregiving is common in U.S. Hispanic/Latino populations. Using the Sociocultural Stress and Coping Model framework, the researchers examined the prevalence, duration, and reported stress levels of caregivers from different heritage groups in the Hispanic Community Health Study/Study of Latinos (unweighted-n = 5,313). RESEARCH DESIGN AND METHODS:The researchers generated target population specific prevalence and mean estimates of study variables and compared between those who reported caregiving and those who did not. Then, for care providers, the researchers generated prevalence and mean estimates of study variables by Hispanic/Latino heritage. Lastly, they fit a series of survey generalized linear models to examine the associations between the proposed variables and the outcomes reflecting caregiving and caregiving experiences. RESULTS:Nearly two in five individuals in this study were involved in caregiving. In models adjusting for demographic covariates, participants of Mexican heritage were most likely to report caregiving for others but were less likely to report caregiving for more than 6 months. Older age and foreign-birth were linked to increased odds ratios of providing care. On average, Central Americans and Puerto Ricans reported higher levels of stress associated with caregiving. DISCUSSION AND IMPLICATIONS:Understanding the nuanced characteristics of caregivers from varying Hispanic/Latino heritage groups can facilitate the development of tailored caregiver interventions to address stress associated with being a caregiver and its impact on health.

BACKGROUND:Hispanics/Latinos in the United States experience disproportionately high psychosocial factors compared to non-Hispanic/Latino Whites. Psychosocial factors may accelerate biological aging, measured by epigenetic age acceleration (EAA), a DNA methylation biomarker predictive of morbidity and mortality. METHODS:We investigated the cumulative impact of psychosocial factors on EAA over time in 922 adults from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Psychosocial exposure profiles were derived using self-organizing maps (SOM), an unsupervised clustering method. We calculated EAA from whole blood DNA methylation at two timepoints using GrimAge and DunedinPACE. RESULTS:SOM identified four clusters: Cluster 1 (n = 196; 21.3%) had high levels of all psychosocial factors; Cluster 2 (n = 250; 27.1%) exhibited chronic, traumatic, and childhood stress; Cluster 3 (n = 250; 27.1%) showed mental health symptoms, low social support, and high perceived stress; and Cluster 4 (n = 238; 24.5%) had relatively low psychosocial stress. Adjusted weighted linear mixed models exhibited increased GrimAge in Cluster 1 (1.27 years, 95% CI: 0.57,1.97) and Cluster 2 (0.62 years, 95% CI: 0.01,1.23) compared to Cluster 4. DunedinPACE increased 3% (95% CI: 0.01,0.05) and 2% (95% CI: 0.001,0.04) in Clusters 1 and 3, respectively. CONCLUSIONS:These findings highlight the cumulative impact of psychosocial factors on EAA and how stressors can get "under the skin" and contribute to health disparities.

Across cognitive behavioral treatments for stress management, individuals' ability to effectively learn intervention components is necessary for improved outcomes. The Management of Current Stress (MOCS)-Part A, formerly known as the Measure of Current Status-Part A, captures the uptake of such "active ingredients" or perceived stress management abilities. The MOCS-A is widely used, yet its psychometric properties are not well-established. Little is known about its generalizability across populations. In the current study, we sought to test the MOCS-A reliability among cancer survivors, examine measurement invariance across sex and language (English/Spanish), and verify the measurement structure. We aggregated participants from six randomized controlled trials of stress management interventions, which ran from 1999 to 2024 and enrolled males with prostate cancer (n=649) and females with breast cancer (n=517). Five trials administered the English MOCS-A, and one administered the measure in Spanish. The MOCS-A consists of a total score and four subscales: ability to relax, awareness of bodily tension, assertiveness, and coping confidence. Depending on model assumptions, we calculated omega or alpha reliability estimates. Confirmatory factor analysis tested measurement invariance through incremental constraints added across subgroups. We compared unidimensional, four-factor, second-order, and bifactor models for best fit. The total measure (ω=.93, α=.91) and four subscales (ω=.75-.91; α=.75-.90) demonstrated acceptable reliability. Strong scalar invariance existed between males and females and Spanish and English versions. The bifactor model best fit the measure structure. The MOCS-A is internally consistent, statistically independent, appropriately scored in their current form, and may be implemented across sexes and languages.

Background: Chronic psychosocial stress and low socioeconomic status (SES) are linked to adverse health outcomes, including cardiometabolic diseases. This study investigates how these stressors impact metabolic health and body mass (MHBM) phenotypes in Hispanic/Latino adults. Objective: To assess the associations between chronic stress, SES, and MHBM phenotypes in Hispanic/Latino adults. Methods: A cross-sectional analysis was conducted using data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Sociocultural Ancillary Study (SCAS) (N=4,712, mean age 45.3±10.4 years, 52% female). Chronic stress was measured via the Chronic Burden Scale, SES was evaluated by education and income, and MHBM was assessed using BMI, waist circumference, blood pressure, lipid profiles, and glucose. Multivariable polytomous logistic regression models were used to assess associations between chronic stress, SES, and MHBM phenotypes. Results: Metabolically unhealthy phenotypes were prevalent (40% MUOB; 31% MUOW), while healthier phenotypes (MHNW, MHOW, MHOB) represented smaller proportions (4-7%). Table 1 shows that chronic stress was significantly associated with increased odds of MHOB (OR=1.19, 95% CI: 1.01–1.40) and MUOB (OR=1.19, 95% CI: 1.06–1.34); however, losing significance after adjustment. Low SES compared with high SES was significantly associated with higher odds of MUOB in both unadjusted (OR=2.37, 95% CI: 1.46–3.87) and adjusted models (aOR=2.37, 95% CI: 1.46–3.87). Low SES was also significantly associated with MUNW (OR=2.15, 95% CI: 1.33–3.50) and MHOW (OR=2.14, 95% CI: 1.38–3.32) in unadjusted models but not in adjusted models. Moderate SES compared to high SES was not significantly associated with any phenotypes in either model. Conclusion: This study highlights the lasting impact of chronic stress and low SES on metabolic health in Hispanic/Latino adults. Interventions targeting stress reduction and social risk may help prevent and manage metabolic disorders in this population.

Intro: People with obesity who are metabolically healthy (MHO) have lower CVD and HF incidence compared to those with obesity and unhealthy metabolic risk factors (MOU), but higher risk than those with normal weight and metabolic healthy profiles (MHNW). However, it is unclear whether there are differences in left ventricle (LV) cardiovascular functioning/structure associated with early-stage HF (i.e., preclinical HF) risk among various metabolic health-body mass phenotypes within the Hispanic/Latino population. Therefore, the current study assessed preclinical HF risk in persons classified as Metabolically Healthy Overweight/Obese (MH-OW/OB) compared with MUO and MHNW, who were enrolled in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) and ancillary Echocardiographic Study of Latinos (ECHO-SOL). Methods: Data were derived from the HCHS/SOL&ECHO-SOL visit 2 ( n = 2082, M age = 54.5 years old, 51.2% women). Metabolic health was defined as having none of the following: elevated fasting glucose, triglycerides, blood pressure, insulin resistance, low HDL cholesterol and or use of medication for any of the elevated criteria (e.g., hypertension medication). Body Mass was assessed via BMI categories. Preclinical HF was defined as evidence of LV diastolic/systolic dysfunction and or LV hypertrophy measured via echocardiography. Weighted logistic regression assessed preclinical HF risk between MH-OW/OB vs MUO, and MH-OW/OB vs MHNW while controlling age, sex, field center, heritage, years living in US, and time since last visit (years between visit 1 and visit 2). Study design features were incorporated in planned logistic regression analyses. Results: Of the population, 329.1 were MH-OW/OB, 1088.1 were MUO, and 154.1 were MHNW (weighted counts). Weighted logistic regression analyses indicated that MH-OW/OB had lower risk of preclinical HF compared with MUO persons [Odds Ratio (OR): 0.25, 95% CI: 0.12-0.54]. Notably, MH-OW/OB persons were not significantly different in preclinical HF risk compared with MHNW persons [OR: 1.90, 95% CI: 0.58-6.22]. Conclusion: Results suggest that the MH-OW/OB classification may not confer added risk of preclinical HF compared to MHNW. However, findings indicate that MH-OW/OB has lower preclinical HF risk compared with MUO. Additional research is needed to determine if changes in cardiac structure/function are linked with adipocyte physiology that may underlie HF pathophysiology within the Hispanic/Latino population.

Insomnia is common among veterans, particularly those with mental health conditions like depression and anxiety and can lead to significant health complications. Routine screening in healthcare settings is crucial to prevent chronic insomnia. The Insomnia Severity Index (ISI), a widely used and validated tool, has been adapted for diverse populations, but its differential item functioning (DIF) remains underexplored. This study uses moderated nonlinear factor analysis (MNLFA) to address this gap. This flexible approach allows for simultaneous modeling of multiple sources of bias based on individual characteristics, which can improve accuracy of insomnia severity ratings. Veterans (N = 620) from the Miami VA sleep center completed a baseline psychosocial assessment, HSAT (mean AHI=18), and medical/psychiatric diagnoses were extracted from medical records. MNLFA was used to model nighttime (ISI items1a,b,c) and daytime symptoms (items 2–5) separately, examining the effects of age, gender, race/ethnicity, depression, anxiety, PTSD, and chronic pain on DIF. DIF-adjusted factor scores, confirmatory factor analysis (CFA) factor scores, and sum scores were compared. The veteran sample (N=620) was middle-aged (M=52, SD=14.5), predominantly male (83.5%), and White (57.3%), with 50% diagnosed with chronic pain and 51% with clinical depression. DIF analysis showed ISI1 had intercept bias for age, Hispanic/White identity, chronic pain, and depression, as well as factor loading bias for age. ISI3 had intercept bias for depression. ISI4 exhibited intercept and factor loading bias for male gender. ISI5 and ISI6 showed intercept bias for age, and ISI7 showed both intercept and factor-loading bias for PTSD. No DIF was found for AHI. Factor scores derived from MNLFA, CFA, and sum scores were highly correlated across both factors. This study examined the DIF of ISI by investigating how an array of psychosocial factors influences insomnia severity ratings. Six of the seven ISI items demonstrated bias based on age, gender, race, depression, PTSD, and chronic pain. Differences observed between groups with these characteristics may be influenced. MNLFA demonstrated methodological advantages by allowing simultaneous modeling of DIF testing. Although difficult to implement in primary care, MNLFA-based factor scores hold promise for secondary predictive models.

Objectives: Low socioeconomic status (SES) is consistently associated with adverse cardiovascular health. Three key indicators are typically used as proxies for SES: income, education, and occupation. However, these indicators may not fully capture the unique sociodemographic features relevant to the SES of Hispanics/Latinos in the U.S. This study aims to expand the traditional SES model by identifying and incorporating additional features specific to Hispanic/Latino persons, providing a more comprehensive assessment of SES and its relationship with cardiovascular disease (CVD). Methods: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) is a community-based longitudinal cohort study of 16,415 adults self-identifying as Hispanic/Latino, enrolled from 2008-2011 from four U.S. urban communities. We utilized a multiple indicator multiple cause (MIMIC) model to identify formative and reflective indicators of a latent variable for SES. CVD was ascertained by self-report during the second in-person clinic examination from 2014-2017 (V2; N=11,623) and was defined as having had a heart attack, stroke, or angioplasty, stent, or bypass procedure. A survey logistic regression model was then used to examine the association of the latent SES with CVD at V2. Models were adjusted for age, sex, and study site. Results: Significant formative indicators of the SES latent variable included education level, whether the highest level of education was obtained in the US, employment status, and age at immigration (included in a second model with immigrants only; n=9,623). Significant reflective indicators of the SES latent variable included income, the MacArthur SES ladder, and affluence level. The measurement model demonstrated good fit to the data (RMSEA=0.016; CFI=0.984, SRMR=0.02). The SES latent variable was associated with CVD (OR=0.70, 95% CI 0.58, 0.84; for immigrants only OR=0.64, 95% CI 0.53-0.77). Conclusions: Incorporating indicators relevant to Hispanic/Latino populations provides a more comprehensive assessment of SES with potentially improved validity. The latent SES variable, including factors such as education location and age at immigration, was significantly associated with lower odds of cardiovascular disease. These findings highlight the importance of using a culturally-tailored SES framework when examining health outcomes in Hispanics/Latinos.

Background: Chronic stress and low socioeconomic status (SES) are established risk factors for poor cardiometabolic health, yet little is known about how these associations vary by sex and age, particularly among Hispanic/Latino populations. Objective: To examine associations between chronic stress, SES, and metabolic health and body mass phenotypes (MHBMPs), and whether associations differ by sex and age. Methods: Cross-sectional data from 4,712 Hispanic/Latino adults enrolled in the Visit 1 HCHS/SOL Sociocultural Ancillary Study were analyzed. Chronic stress was measured via the Chronic Burden Scale; SES was categorized based on household income and education. MHBMPs were defined using BMI, blood pressure, lipid levels, and glucose. Polytomous logistic regression models were stratified by sex (male/female) and age group (18–44, 45–65+ years) and adjusted for covariates. Results: Among women, low SES was strongly associated with metabolically unhealthy obesity (MUOB; aOR=3.31, 95% CI: 1.76–6.20), overweight (MUOW; aOR=2.19, 95% CI: 1.13–4.25), and normal weight (MUNW; aOR=1.66, 95% CI: 0.90–3.08). In men, associations were weaker, though moderate SES was inversely associated with metabolically healthy obesity (MHOB; aOR=0.32, 95% CI: 0.11–0.96). Among younger adults, low SES predicted MUOB (aOR=2.48) and MUOW (aOR=1.92); in older adults, both low and moderate SES were linked to MUOB (aORs=2.45 and 2.27, respectively). For chronic stress, women showed positive associations with MUOB and MUOW, though attenuated in adjusted models. In men, stress was inversely associated with MHOW (aOR=0.73) and MUNW (aOR=0.80). Among older adults, higher stress predicted MHOB (aOR=1.27), with no clear associations in younger adults. Conclusion: Chronic stress and SES impact cardiometabolic risk in sex- and age-specific ways. Findings suggest that cumulative stress exposure and socioeconomic disadvantage may play mechanistic roles in the development of metabolically unhealthy obesity, particularly among women and those with low SES. These patterns highlight the importance of addressing social determinants in efforts to understand and reduce cardiometabolic disparities in Hispanic/Latino populations.

Socioeconomic position (SEP) in childhood and beyond may influence the gut microbiome, with implications for disease risk. Studies evaluating the relationship between life-course SEP and the gut microbiome are sparse, particularly among Hispanic/Latino individuals, who have a high prevalence of low SEP. We use the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a population-based cohort study conducted in four field centers in the United States (U.S.), to evaluate the association between life-course SEP and gut microbiome composition. Life-course SEP indicators included parental education (proxy of childhood SEP), current SEP (n = 2174), and childhood (n = 988) and current economic hardship (n = 994). Shotgun sequencing was performed on stool samples. Analysis of Compositions of Microbiomes was used to identify associations of life-course SEP indicators with gut microbiome species and functions. Parental education and current SEP were associated with the overall gut microbiome composition; however, parental education and current education explained more the gut microbiome variance than the current SEP. A lower parental education and current SEP were associated with a lower abundance of species from genus Bacteroides. In stratified analysis by nativity, we found similar findings mainly among foreign-born participants. Early-life SEP may have long-term effects on gut microbiome composition underscoring another biological mechanism linking early childhood factors to adult disease.

OBJECTIVES:The landmark Hispanic Community Health Study/Study of Latinos (HCHS/SOL) enrolled N = 16,415 Hispanic/Latino adults (2008-2011) who have been followed for 12-16 years, through 2024. HCHS/SOL identified high rates of cardiovascular risk factors in the target population, with significant variability by Hispanic/Latino heritage (Central American, Cuban, Dominican, Mexican, Puerto Rican, and South American). In the current study, we reviewed the evidence from HCHS/SOL concerning the social, psychological, and cultural dimensions of cardiovascular health (CVH). METHOD:Through a conceptual framework blending elements of the Reserve Capacity Model and Lifespan Biopsychosocial Model, we reviewed findings from 53 studies that have examined associations of broad socioeconomic (e.g., income) and immigration (e.g., place of birth) context, cognitive-emotional factors (e.g., depression symptoms), stress/adversity (e.g., chronic stress burden, discrimination stress), interpersonal (e.g., social support) and intrapersonal (e.g., optimism) resources, and cultural beliefs and values (e.g., fatalism, religiosity) with CVH and cardiovascular disease in HCHS/SOL. RESULTS:The studies reveal a consistent pattern of associations of adverse social drivers of health, such as low income and high chronic stress, as well as U.S. birth or more years living in the United States, and of greater depression and anxiety symptoms with worse CVH. Studies concerning protective interpersonal resources have produced variable results, and few studies have examined intrapersonal resources or cultural beliefs and values. Most studies have applied a cross-sectional design. CONCLUSIONS:We conclude by discussing additional research needed to advance science regarding the social, psychological, and cultural dimensions of CVH among Hispanics/Latinos. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

We examined the sex-specific association between education and income with biological age (BA) and by race/ethnicity. The Klemera-Doubal method was used to calculate BA among 6,213 females and 5,938 males aged 30-75 years who were Hispanic, non-Hispanic (NH) White, NH Black (NHB), or NH Asian (NHA). Compared with a college education, less than a high school education was associated with greater BA by 3.06 years (95% CI: 1.58, 4.54) among females only; associations were strongest among NHB, Hispanic, and NHA females. Compared with an annual income of ≥$75,000, an income <$25,000 was associated with greater BA by 4.95 years (95% CI: 3.42, 6.48) among males and 2.76 years among females (95% CI: 1.51, 4.01); associations were strongest among NHW and NHA adults, and Hispanic males. Targeting upstream sources of structural disadvantage among racial/ethnic minority groups, in conjunction with improvements in income and education, may promote healthy aging in these populations.

OBJECTIVE:Previous research on depressive symptoms with incident hypertension has yielded mixed results, and this relationship has not been studied in a diverse group of Hispanic/Latino adults. METHODS:We studied 5927 Hispanic/Latino adults aged 18-74 years from four U.S. cities who attended baseline (2008-2011) and follow-up (2014-2017) examinations of the Hispanic Community Health Study/Study of Latinos. Baseline depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale-10; clinically relevant depressive symptoms were defined as ≥10 points. Blood pressure (BP) was measured using a standardized protocol at both examinations. Hypertension was defined as measured systolic BP ≥130 mmHg, or diastolic BP ≥80 mmHg, or self-reported antihypertension medication use. Analyses accounted for the complex survey design. RESULTS:Among 5927 persons without hypertension at baseline, the six-year age-adjusted incidence rates of hypertension were 40 and 31 per 1000 person-years among those with and without elevated depressive symptoms, respectively. Persons with elevated depressive symptoms had a 25 % (p = .003) higher 6-year incidence of hypertension than those with fewer symptoms, after adjusting for sociodemographic and clinical covariates. There was an interaction between depressive symptoms and age (pinteraction < 0.05). Among adults aged 18-34 years without hypertension at baseline (n = 1748), those with elevated depressive symptoms had 80 % higher 6-year incidence of hypertension than those with fewer symptoms (p = .001). CONCLUSIONS:These findings suggest that depressive symptoms are a risk factor for hypertension in young Hispanic/Latino adults. Early screening and treatment of depressive symptoms may aid in the prevention of hypertension.

Background Whether adverse childhood experiences (ACEs) are associated with accelerated epigenetic aging over time among the Hispanic/Latino population remains unknown. This study examined the longitudinal association between ACEs and epigenetic age acceleration (EAA), as well as potential effect modifiers, among a sample of Hispanic/Latino adults. Methods We analyzed 960 Hispanic/Latino adults with DNA methylation (DNAm) profile data from two visits (approximately six years apart) sampled from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). We used PhenoAge, GrimAge, and DunedinPace, a biomarker for the pace of biological aging, to calculate epigenetic aging deviations. Linear mixed models were fit to estimate the association between ACEs and EAA measured by each epigenetic aging measure, adjusting for sex, age, and parental highest education level. Sex and nativity were also assessed as potential effect modifiers. Results A one-unit increase in ACE score was associated with a 0.16-year (95 %CI: 0.06, 0.26, p = 0.002) higher GrimAge acceleration (AgeAccelGrim) at Visit 1. Among US-born individuals, a one-unit increase in ACE score was associated with a 0.35-year (95 %CI: 0.12, 0.58, p = 0.003) higher AgeAccelGrim and 0.01-biological year/calendar year (95 %CI: 0.01, 0.02, p = 0.0003) higher DunedinPACE at Visit 1, but statistically significantly weaker associations were found among foreign/US-territory born individuals (p for interaction=0.039 in AgeAccelGrim and 0.001 in DuendinPACE). No association was found between ACEs and the rate of change in EAA between two visits. Conclusion ACEs are associated with a higher EAA over time among Hispanic/Latino adults at a constant rate. Hispanic/Latino born in the US are more susceptible to the increased EAA related to ACEs compared with those born in a foreign country or US territory.

Background: Although the subject of numerous studies, the associations between dietary sodium, potassium, and the ratio of dietary sodium to potassium with blood pressure are not clear-cut. In addition, there is a paucity of research on these relationships in prospective cohort studies with representation from diverse Hispanic/Latino adults. Objectives: To evaluate the associations between dietary intake of sodium, potassium, and the ratio of dietary sodium to potassium and blood pressure in a diverse sample of Hispanics living in the United States. Methods: This analysis included 11,429 Hispanic/Latino participants of the prospective cohort Hispanic Community Health Study/Study of Latinos recruited between 2008 and 2011 in visit 1 who participated in a follow-up visit in 2014 - 2017. Dietary sodium and potassium intakes were averaged from 2 interviewer-administered 24-h diet recalls collected at visit 1. At both visits, blood pressure was measured 3 times in a seated position and averaged. We assessed the relationship between dietary sodium, potassium, and the sodium-to-potassium ratio with changes in systolic and diastolic blood pressure using survey-weighted multivariable-adjusted regression models. Results: At visit 1, the mean age was 41 y, and the mean sodium intake was 3203 mg/d. Each 500 mg/d sodium increment in intake was associated with an increase in systolic blood pressure ( beta : 0.35 [mmHg]; 95% con fi dence interval: 0.06, 0.63) and diastolic blood pressure ( beta : 0.45 [mmHg]; 95% con fi dence interval: 0.08, 0.82). Dietary potassium and the molar ratio of dietary sodium to potassium were not associated with changes in systolic or diastolic blood pressure. Conclusions: Among a large sample of diverse United States Hispanic/Latino adults, higher sodium intake was associated with small increases in systolic blood pressure over 6 y. This research underscores the importance of dietary sodium reduction in maintaining lower blood pressure.