Catherine García wants to know how and why the fastest-growing segment of older adults in the United States—those of Hispanic/Latine origin—are at higher risk for chronic diseases, such as Type 2 diabetes, kidney disease and Alzheimer’s disease and related dementias. She’s particularly interested in discerning how social factors “get under the skin” in those populations to influence biological functions and overall health.
García is an assistant professor of human development and family science in the Falk College of Sport and Human Dynamics. She’s also a faculty affiliate at the University’s Aging Studies Institute, Center for Aging and Policy Studies and Lerner Center for Public Health Promotion and Population Health. García came to Syracuse in 2021 from the University of Nebraska-Lincoln, where she was an assistant professor of sociology and a core faculty member of the Minority Health Disparities Initiative. Her award-winning research has been supported by the National Institute on Aging and the National Institutes of Health.
You’re a gerontologist with training in sociology. What attracted you to the Falk College, and how does a social lens influence your research on health outcomes and biological functions?
I jokingly call myself the “resident gerontologist” at Falk, since I have the training and specialize in the older adult population. What attracted me to the college was the interdisciplinary focus of scholarship and service to the local community, including the many partnerships that Falk espouses. As part of the Falk community, I have been invited to join the Syracuse University/SUNY-Upstate Medical Center Aging Collaborative and Upstate’s Community Research Recruitment Accelerator, which reviews and recommends changes to studies to increase recruitment and retention rates of underserved communities.
One of my current projects, “Pathways to Cognitive Function among Older Hispanics/Latines,” emphasizes my sociological training in social stratification and how those factors translate into health risks generally within the Latine population in the United States and in Puerto Rico. I am assessing the effects that education, physiological factors and cognitive function have among a diverse sample of older Hispanics/Latines. I’m also studying how social factors have predictable and enduring biological impact and the significant consequences those social factors have for cognitive health across the life course.
What are your research goals?
I hope to better understand the pathways that social and material disadvantage present in an individual’s health and how societal disadvantages can become biologically embedded.
Social adversity and life course experience—and how that gets translated and incorporated in a person’s body at the cellular level—can translate to chronic conditions. In the Latine population, a lot of people don’t have access to health insurance (thus access to routine medical care). So, a diagnosis can come at later stage when the disease is more severe. There’s a difference there compared to someone who’s had more socioeconomic advantage in accessing regular health care and thus in their potential for healthy aging.
What are you discovering?
In a forthcoming book chapter, my colleagues and I use data from the American Community Survey, an ongoing, nationally-representative household survey conducted by the U.S. Census Bureau throughout the United States and Puerto Rico. We found that when solely considering Latine heritage, Puerto Ricans had the highest probabilities of self-reported cognitive impairment at all ages, followed by Dominicans, Cubans and Mexicans. (Cognitive impairment is a precursor to cognitive decline and dementia and one of the earliest noticeable symptoms of Alzheimer’s disease and related dementias.) When birthplace or nativity status is combined with Latine heritage, some Latine heritage groups displayed an immigrant advantage that further widened with age. (The phrase “immigrant advantage” refers to the fact that, upon arrival to the United States, most foreign-born Latines have relatively good health as they have not yet suffered the full biopsychosocial consequences of othering/marginalization, known as the Hispanic epidemiological paradox.) Additional consideration of age at migration revealed that the immigrant advantage does not extend to Latine immigrants who arrived in the United States at age 50 or older, particularly for Cuban, Dominican and Puerto Rican women. Lastly, we find that higher educational attainment is associated with lower probabilities of self-reported cognitive impairment for many Latine groups.
With data from the Health and Retirement Study (a nationally representative survey of adults over age 50 in the U.S. that has been conducted biennially since 1992), preliminary findings show that social positioning and adversity do have different influences on physiological functioning, which may help explain why certain groups of Hispanics/Latines may be more likely to experience chronic disease in middle and older adulthood.
Socially disadvantaged groups are more likely to have lower levels of education, are more likely to live in areas where they are disproportionately exposed to harm through factors such as air pollution and poor housing quality, and they tend to exhibit adverse health behaviors, such as poor nutrition, compared to their more socially advantaged counterparts. Other studies express that local economic, service, social, natural and policy environments are primary causes of health disparities. Multiple forms of social disadvantage can trigger a cascade of pathophysiological processes that may trigger disease-related processes. There’s also evidence that certain groups of Latines have worse health outcomes relative to other Latine groups, particularly older, island-born Puerto Ricans.
How can we level out health disparities among the diverse populations in the U.S.?
At minimum, we need to create protected, community-supported spaces to create healthy environments for older adults from diverse communities. Given the range of origins of Hispanics/Latines in the U.S. in ethnicity, birthplace and current residence, it is crucial to understand how these factors get “under the skin” to affect biological processes that influence chronic disease in middle and older adulthood. That’s my essential question.
A Syracuse University News Story by Diane Stirling originally published Oct. 6, 2023.