Social Determinants of Health Outcomes in Older Mexican American Cancer Survivors

Abstract

This dissertation study examined the effects of economic deprivation, financial strain, linguistic acculturation, and perceived social support on functional status and depressive symptoms among older Mexican American cancer survivors. Potential mediation effects of linguistic acculturation and perceived social support were also explored. Ecosocial theory provided the framework for this analysis, and a secondary data set analysis was employed using the Hispanic Established Population for the Epidemiological Studies of the Elderly (H-EPESE). The H-EPESE was a longitudinal study with 5 waves of data currently available from 1993 to 2005. The original study interviewed 3,050 older Mexican Americans living in 5 southwestern states. Data was pooled from 5 waves of the original study spanning over 10 years from 1993 to 2005, respondents reporting a history of cancer were identified, and the synthetic cohort approach was used to center data on the event of cancer diagnosis providing pre- and post-cancer data for each respondent. Economic deprivation and financial strain were not found to be significantly related to functional status and depressive symptoms. Age was found to be significantly associated with functional status such that higher age was associated with higher mobility impairment. Age was not significantly associated with depressive symptoms; however, perceived social support was significantly associated with depressive symptoms such that a higher perceived social support was associated with lower depressive symptoms.