Hispanic Journal of Behavioral Sciences recent issues

"The Price of Being Mexican": Sentencing Disparities Between Noncitizen Mexican and Non-Mexican Latinos in the Federal Courts

Logue, M. A. — Tue, 03 Nov 2009 03:23:37 PST

With the increasing discourse about a crime-immigration nexus and Latinos, it is critical to ascertain how the criminal justice system responds to noncitizen Latino defendants. Using federal sentencing data to investigate the role of national origin and immigration status on noncitizen Latinos’ sentencing outcomes, several findings emerge. First, national origin conditions the sentences received for Mexicans and non-Mexican Latinos. Second, immigration status perpetuates disparities among defendants within each Latino subgroup. Third, examining the aggravating factors within each immigration status category shows that national origin poses greater sentencing penalties for Mexican defendants.

The Role of Quality of Life in the Rural Resettlement of Mexican Immigrants

Garcia, C. — Tue, 03 Nov 2009 03:23:37 PST

The past 10 years have seen the continued growth of the Mexican-origin population in the United States. This growth has been accompanied by the movement of immigrants away from traditional settlement locations in the Southwest. Using data collected from 45 interviews with immigrant workers in Northeastern Oklahoma, this study explores factors that motivate the movement of Mexican immigrants to nontraditional locations. The study finds that along with economic and political variables, a search for a higher quality of life than is available in urban locations also plays a key role in relocation decisions. The availability of employment opportunities, housing, and low crime rates make rural America an attractive alternative to urban settlement.

Mexican Immigrant Fathers' and Mothers' Engagement With School-Age Children

Hossain, Z., Shipman, V. — Tue, 03 Nov 2009 03:23:37 PST

This study examined mothers’ and fathers’ reports of their time spent in their school-age children’s care and academic work and the relationships between socioeconomic status and social support variables with fathers’ time spent in children’s care and academic work within two-parent Mexican immigrant families. Mother and father dyads from 79 two-parent Mexican immigrant families with a second- or third-grade child residing in rural towns in southwestern United States participated in the study. Multivariate analyses of variance indicated that mothers spent significantly more time in children’s basic care, care on demand, and both academic interaction at home and at school than did fathers. Hierarchical regression analyses revealed that fathers’ time spent in children’s care was positively related to their educational level and extrafamilial support and that their time spent in children’s academic work, although positively influenced by their education, was negatively influenced by family size. Findings are discussed with regard to gender role differences in parental engagement with children within Mexican immigrant families and their implications for informing policy makers, educators, and parents of the importance of parental time spent in enriching children’s development and culturally sensitive strategies for doing so.

Friendship, Educational Engagement, and School Belonging: Comparing Hispanic and White Adolescents

Vaquera, E. — Tue, 03 Nov 2009 03:23:37 PST

The current study explores the relationship between friendship formation, school engagement, and belonging among White and Hispanic students. It employed the National Longitudinal Study of Adolescent Health, a nationally representative sample of adolescents in high school. The sample consisted of 6,366 Mexican, 1,132 Cuban, 1,330 Puerto Rican, 4,446 Central/South Hispanic origin youth, and 46,592 non-Hispanic Whites. Hispanic students are less likely to report having friends and to having their best friend at school. Both Hispanic and White students who have a best friend report fewer engagement problems and a higher school belonging. However, only students whose best friend attends their same school report higher levels of school belonging. Findings suggest that ethnic origin is an important stratifier among Hispanics for the studied school outcomes. Signs for optimism are discussed as some Hispanic ethnic groups report higher levels of school belonging compared with their White counterparts.

Peer Victimization and Depressive Symptoms in Mexican American Middle School Students: Including Acculturation as a Variable of Interest

Bauman, S., Summers, J. J. — Tue, 03 Nov 2009 03:23:37 PST

This study examined direct and indirect victimization and depressive symptoms in a sample of 229 Mexican American middle school students. The effects of gender, grade, and acculturation on both victimization and depressive symptoms were investigated. The moderating effect of receiving prosocial actions from peers was also explored. Approximately 23% of students in the sample were victimized. Females were recipients of more prosocial behavior, but receiving prosocial behavior did not moderate the influence of victimization on depressive symptoms. Significantly more depressive symptoms were reported by victims than by nonvictims. Anglo-oriented participants reported significantly more depressive symptoms than did their bicultural classmates. Indirect victimization made the largest contribution to a regression equation predicting depressive symptoms. Implications of the findings are discussed.

Protective Effects of Ethnic Identity on Mexican American College Students' Psychological Well-Being

Iturbide, M. I., Raffaelli, M., Carlo, G. — Tue, 03 Nov 2009 03:23:37 PST

The current study investigated whether different ethnic identity components moderate the associations between acculturative stress and psychological adjustment among Mexican American college students (N = 148; 67% female) who completed self-report surveys. For women, ethnic affirmation/ belonging and ethnic identity achievement moderated the relation between acculturative stress and depression at low but not high levels of acculturative stress. Among men with low levels of other group orientation, levels of self-esteem were similar regardless of levels of acculturative stress. Discussion focuses on the role of ethnic identity in Latino students’ psychological adjustment and of protective factors that buffer students from acculturative stress. Future research should identify other protective factors that serve as buffers for students experiencing high levels of acculturative stress.

The Use of Female Commercial Sex Workers' Services by Latino Day Laborers

Galvan, F. H., Ortiz, D. J., Martinez, V., Bing, E. G. — Tue, 03 Nov 2009 03:23:37 PST

This article reports the characteristics of Latino day laborers who have sex with female commercial sex workers (CSWs). A sample of 450 day laborers in Los Angeles was used. Multivariate logistic regression was used to determine the association of independent variables with the likelihood of having sex with a CSW. Overall, 26% of the 450 day laborers reported having had sex with a CSW in the previous 12 months. A lower likelihood of having sex with a CSW was found for those with more than 6 years of education and for those who were married and living with their spouses. A higher likelihood of having sex with a CSW was found for those who met the criteria for harmful drinking or drug dependence. Commercial sex work has been associated with sexually transmitted infections and other problems among clients of CSWs and warrants further attention by providers working with day laborers.

Latino Definitions of Success: A Cultural Model of Intercultural Competence

Torres, L. — Tue, 03 Nov 2009 03:23:37 PST

The present study sought to examine Latino intercultural competence via two separate methodologies. Phase 1 entailed discovering and generating themes regarding the features of intercultural competence based on semistructured interviews of 15 Latino adults. Phase 2 included conducting a cultural consensus analysis from the quantitative responses of 46 Latino adults to determine the cultural model of intercultural competence. The major results indicated that the participants, despite variations in socioeconomic and generational statuses, shared a common knowledge base regarding the competencies needed for Latinos to successfully navigate different cultures. Overall, the cultural model of Latino intercultural competence includes a set of skills that integrates traditional cultural values along with attributes of self-efficacy. The findings are discussed within a competence-based conceptualization of cultural adaptation and potential advancements in acculturation research.

Parenting and Neighborhood Predictors of Youth Problem Behaviors Within Hispanic Families: The Moderating Role of Family Structure

Gayles, J. G., Coatsworth, J. D., Pantin, H. M., Szapocznik, J. — Tue, 25 Aug 2009 03:44:17 PDT

This study examined the influence of family and neighborhood contexts on Hispanic youth problem behavior. The effects of parents' perceptions of neighborhood context and parenting practices on problem behavior were examined in 167 one-parent (n = 75) and two-parent (n = 92) families. Results from multigroup path analyses showed significant main effects of perceived neighborhood context on parenting practices and on youth problem behavior and significant main effects of parenting practices on problem behavior in one- and two-parent families. Neighborhood context was indirectly related to problem behavior through positive parenting in one-parent families. The results demonstrate that parenting is embedded within greater ecological contexts and show that their relations with youth can vary across family structure. Implications for further longitudinal investigation and prevention research are discussed.

Mexican American High School Students' Perceived Levels of Challenge in School

Martinez, S. — Tue, 25 Aug 2009 03:44:17 PDT

This study examines the self-reported average level of challenge of 793 students while in school and doing various school-related activities. Using multivariate regression models, the study examines whether Mexican American students report lower levels of challenge in school and during school-related activities as compared with students of other racial/ethnic groups. The findings suggest that in the general context of school, Mexican American students report the highest levels of challenge. In more specific contexts such as when in science class, Mexican American students report the lowest levels of challenge. Additional findings, implications for educators, and directions for future research are discussed.

Psychological Coping and Well-Being of Male Latino Undergraduates: Sobreviviendo la universidad

Gloria, A. M., Castellanos, J., Scull, N. C., Villegas, F. J. — Tue, 25 Aug 2009 03:44:17 PDT

This study examined 100 male Latino undergraduates' cultural self-esteem, perceived educational barriers, cultural fit, coping responses (CRs), and subsequent well-being within higher education. The most commonly reported CR for Latino males was to actively find out more about the situation and take a positive planned action. Assessing group mean differences, a class standing by generation interaction revealed that first-generation lower division and first-generation upper division students reported higher perceptions of barriers to staying in school than second-generation lower division and second-generation upper division students, respectively. Similarly, examining differences of coefficients, the strength of the relationship of perceptions of barriers to staying in school and psychological well-being was significantly stronger for the first-generation than second-generation male students Cultural congruity and emotion-focused coping were most predictive of psychological well-being; however, perception of barriers to staying in school was consistently evident in understanding male Latino undergraduates' educational experiences.

Psychometric Properties of the Acculturation Rating Scale for Mexican Americans--II: Exploring Dimensions of Marginality Among a Diverse Latino Population

Tue, 25 Aug 2009 03:44:17 PDT

The Acculturation Rating Scale for Mexican Americans—II is one of the most frequently used measures of acculturation, despite lack of validation. This study analyzed the structure of the Marginality Scale of the Acculturation Rating Scale for Mexican Americans—II using data from a diverse Latino sample of residents. Confirmatory factor analysis of the Marginality Scale yielded poor model-to-data fit for the hypothesized scales. Exploratory analysis and tests of construct validity were performed to further analyze the Marginality Scale. Results indicate that the revised version needs further work and should be validated with the original intended population for the scale. The utility of the marginality concept is questioned overall considering its history of lack of clear conceptualization and validity.

Skin Color and Self-Perceptions of Immigrant and U.S.-Born Latinas: The Moderating Role of Racial Socialization and Ethnic Identity

Telzer, E. H., Vazquez Garcia, H. A. — Tue, 25 Aug 2009 03:44:17 PDT

Research has increasingly identified race as a salient characteristic that affects one's life experiences and psychological well-being. However, little is known about how skin color affects the emotional health of Latinos. The present study examined how skin color relates to the self-perceptions of immigrant (N = 26) and U.S.-born (N = 55) Latina college women. Results indicate that immigrant Latina participants with darker skin tend to have poorer self-perceptions than their U.S.-born peers, including lower self-esteem, lower feelings of attractiveness, and a desire to change their skin color to be lighter. Both racial socialization and ethnic identity served to buffer Latinas from the negative self-perceptions associated with darker skin. These findings suggest that skin color may be a particularly central risk factor for immigrant Latinas' well-being, and racial socialization and ethnic identity may serve as important protective factors.

Hurricane Chasers in New Orleans: Latino Immigrants as a Source of a Rapid Response Labor Force

Fussell, E. — Tue, 25 Aug 2009 03:44:17 PDT

Little is known about the Latino workers who came to New Orleans after Hurricane Katrina to clean up and repair the city. The author uses data from surveys collected at the visits of the Brazilian, Mexican, and Nicaraguan consulates (N = 253) to study the internally mobile immigrants who arrived after Katrina and who anticipate leaving New Orleans within 2 years of the survey, or what the author calls a rapid response labor force. Four hypotheses are examined: (1) that there is no difference between national origin groups in their propensity to be a member of the rapid response labor force; (2) that members are newer immigrants who have few ties to immigrants already in the United States; (3) that members are pioneers (unaccompanied working age men with weak residential ties); and (4) that members use a mobility strategy to obtain higher wages. I find that Brazilians and Mexicans are more likely than Nicaraguans to be rapid responders. Rapid responders have low levels of U.S. migratory experience, little or no English language ability, and few social network ties compared to those who are not internally mobile. These rapid responders use an internal mobility strategy to obtain higher wages and overcome their labor market disadvantages.

Illness Beliefs Regarding the Causes of Diabetes Among Latino College Students: An Exploratory Factor Analysis

Santos, S. J., Hurtado-Ortiz, M. T., Sneed, C. D. — Tue, 25 Aug 2009 03:44:17 PDT

This study examined the validity of the Klonoff and Landrine Illness-Belief Scale when applied to Latino college students (n = 156; 34% male, 66% female) at high risk for future diabetes onset. Principal factor analysis yielded four significant factors—emotional, folk beliefs, punitive, gene/hereditary— which accounted for 64.5% of variance and provided a culturally relevant Latino perspective of the causes of diabetes. Additional analyses by age, gender, immigrant status, and psychological acculturation revealed significant differences by age on the emotional and folk illness factors and a negative correlation between assimilation and endorsement of the emotional factor. The implication of these four illness factors for predicting health-related behaviors and health outcomes among young Latinos was discussed as were recommendations for future research.

Dr. Israel Cuellar (1946-2008)

Zamarripa, M. X. — Tue, 25 Aug 2009 03:44:17 PDT

On September 7th, 2008, the mental health field lost a trailblazing researcher and clinician as he lost his battle with amyotrophic lateral sclerosis (ALS), commonly referred to as Lou Gehrig's disease. Dr. Israel Cuéllar made significant contributions to the study of acculturation including its importance in delivering appropriate mental health services to diverse populations. In particular, the construction of the Acculturation Scale for Mexican Americans-II (Cuéllar, Arnold, & Maldonado, 1995) has been and continues to be one of the most important instruments in the measurement of the acculturation process. It remains the most utilized instrument for measuring acculturation for Mexican Americans. For many of us in the mental health field, particularly those of us with an interest and passion to find ways to best serve the Latina/o population, he will remain an inspiration.

Academic Resilience Among Undocumented Latino Students

Perez, W., Espinoza, R., Ramos, K., Coronado, H. M., Cortes, R. — Fri, 10 Apr 2009 14:32:23 PDT

This study examined the academic resilience of undocumented immigrant Latino students. It was hypothesized that due to their legal and social marginalization, students who experienced high risk accompanied by high levels of both personal and environmental protective factors would have higher academic outcomes than students with lower levels of these protective resources. The results from regression and cluster analyses (N = 104) indicated that despite specific risk factors (e.g., elevated feelings of societal rejection, low parental education, and high employment hours during school) undocumented students who have high levels of personal and environmental protective factors (e.g., supportive parents, friends, and participation in school activities) report higher levels of academic success than students with similar risk factors and lower levels of personal and environmental resources. The results also suggested variability in risk exposure among undocumented students with some students reporting low levels of risk accompanied by high levels of personal and environmental protective factors.

Elvira Arellano: No Rosa Parks: Creation of "Us" Versus "Them" in an Opinion Column

McElmurry, S. E. — Fri, 10 Apr 2009 14:32:23 PDT

From August 2006 through August 2007, Elvira Arellano, an undocumented Mexican immigrant, lived in a church on Chicago's West Side with her U.S.-born 7-year-old son, Saul, to avoid a deportation order. Her plight played out in Chicago-area and national media, piggybacking on a nationwide debate on immigration. This study focuses on one piece of media coverage of the Arellano controversy: a column written by the Chicago Sun-Times journalist Mary Mitchell, titled "Blacks Know Rosa Parks and You, Arellano, Are No Rosa Parks," published in August 2006. The controversial column spurred reaction from journalists and readers from other Chicago-area newspapers, mostly notably, Hoy, a Spanish-language daily. This study will illustrate how Arellano is simultaneously positioned as a member of an in-group of "Us" or an out-group of "Them" in the Sun-Times and Hoy and will correlate this Us-Them positioning with differences in the perceived and/or actual audience of each newspaper.

Psychological Health and Meaning in Life: Stress, Social Support, and Religious Coping in Latina/Latino Immigrants

Dunn, M. G., O'Brien, K. M. — Fri, 10 Apr 2009 14:32:23 PDT

This study examined the relative contributions of (a) gender, (b) perceived stress, (c) social support from family and significant other, and (d) positive and negative dimensions of religious coping to the prediction of the psychological health and meaning in life among 179 Central American immigrants from El Salvador and Guatemala. Findings reveal that greater perceived stress by Latinas/Latinos was predictive of psychological health and meaning in life, while social support from a significant other also explained variance in meaning in one's life. Negative religious coping, specifically reappraisal of God's powers, was predictive of search for meaning in one's life.

Stress Resilience Among Border Mexican American Women

Guinn, B., Vincent, V., Dugas, D. — Fri, 10 Apr 2009 14:32:23 PDT

The purpose of this study was to identify factors distinguishing Mexican American women living near the U.S.-Mexican border who are resilient to the experience of stress from those who are not. The study sample consisted of 418 participants ranging in age from 20 to 61 years. Data were gathered through a self-report survey instrument composed of items assessing stress vulnerability, acculturation, health, physical activity, education, and marital status. Descriptive discriminant analysis was used to determine which variables made the greatest contribution in discerning between stress-resistant and stress-susceptible women. The results indicated that higher educational attainment, greater acculturation, better health status, and marriage differentiated between those women reporting themselves resilient to the effects of stress and those reporting being vulnerable. These results have implications for stress resilience promotion among this population group.

Partnering With Community-Based Organizations to Reduce Intimate Partner Violence

Fri, 10 Apr 2009 14:32:23 PDT

Latinas experiencing intimate partner violence (IPV) often avoid formal resources due to fear, distrust, and cultural and language barriers, yet little research addresses culturally appropriate interventions for abused Latinas. To develop effective interventions, we must include abused Latinas' voices in research and collaborate with the community-based organizations (CBOs) that serve them. This article's team of academics and CBOs used a community-based participatory research (CBPR) approach to inform development of a culturally and linguistically appropriate IPV intervention for Latinas. The authors were able to reach abused Latinas (n = 114) with a relatively low mean acculturation level in a state that is only 8% Latino. The authors share six recommendations from their successful experience to engage, enhance, and sustain research partnerships with CBOs, including strategies to share power and knowledge, and demonstrate accountability to the partnership and the community.

Pesticide Risk Communication, Risk Perception, and Self-Protective Behaviors Among Farmworkers in California's Salinas Valley

Cabrera, N. L., Leckie, J. O. — Fri, 10 Apr 2009 14:32:23 PDT

Agricultural pesticide use is the highest of any industry, yet there is little research evaluating farmworkers' understandings of the health risks chemical exposure poses. This study examines pesticide education, risk perception, and self-protective behaviors among farmworkers in California's Salinas Valley. Fifty current and former farmworkers were interviewed for this research. Despite several potential barriers to risk communication (e.g., language differences and nonuniform methods of pesticide safety training), the respondents understood many of the potential health consequences of exposure while holding elevated levels of risk perception relative to the general public. They received information on the health effects of pesticide exposure from both grower-based training and personal social networks; however, the respondents continued to participate in unnecessarily risky behaviors.

Beyond Affirmation: How the School Context Facilitates Racial/Ethnic Identity Among Mexican American Adolescents

Gonzalez, R. — Tue, 30 Dec 2008 18:41:13 PST

Identity development is a dynamic process which involves reconciling multiple messages. While ethnic minority adolescents' development is affected profoundly by discrimination, positive racial/ethnic encounters can also transform one's identity. Questionnaire data were gathered from 122 tenth-grade Mexican Americans in a low-performing school that had over 60% "Hispanic" students. Based on the data, 12 second-generation youth were selected for interviews based on their level of academic engagement and experiences with negative racial/ethnic encounters in school. Interviewees' descriptions of positive encounter experiences revealed ways in which schools can reinforce equal status and integrate Mexican American youth. Youth felt a renewed commitment to their ethnic selves when they participated in events that they perceived as dispelling stereotypes and when they had concrete experiences in which their bilingual competence was perceived as an asset. This qualitative study identifies avenues for future research on positive racial/ethnic encounters and academic engagement.

Hispanic Acculturation in a Predominately Black High School: Application of an Adapted Model

Hughes, C., Hollander, M. J., Martinez, A. W. — Tue, 30 Dec 2008 18:41:13 PST

The authors applied an adaptation of prior models of acculturation to all 16 Hispanic students attending a predominately Black, high-poverty, urban high school (n = 1,267 students) identified by No Child Left Behind standards as failing. No published study to date has investigated Hispanic acculturation within such a setting. Findings reveal that students were identified across all four acculturation modes of the model and that only half (n = 8) of students demonstrated substantial affiliation with a dominant U.S. culture. Of these, five students identified more strongly with the dominant Black culture of the school versus the prevailing White U.S. culture. Findings are discussed with respect to future research and practice designed to improve educational experiences for Hispanic youth.

Developmental Considerations and Acculturation of Children: Measures and Issues

Lopez, F. A. — Tue, 30 Dec 2008 18:41:13 PST

This article presents the secondary validation of the Brief Acculturation Rating Scale for Mexican Americans-II (Brief ARSMA-II) for use with children— carried out using two samples of Mexican-descent children (ages = 9-11) from two states ( N = 295). The Brief ARSMA-II was originally normed on adolescents and adults but has been validated and used with children. Ethnic identity development perspectives suggest that the interpretation of scores derived from acculturation measures normed on adolescents and adults may not extend accurately to children. Convergent validity and differential discrimination between groups were examined using scores on the Brief ARSMA-II; scores on an acculturation measure designed for the present study, the Things About Me (TAM); and traditional proxy measures of acculturation. Results from this study do not support the use of the Brief ARSMA-II with children. The importance of considering contextual effects in the interpretation of scores of children's acculturation experience is discussed.

Cost of Being a Mexican Immigrant and Being a Mexican Non-Citizen in California and Texas

Takei, I., Saenz, R., Jing Li, — Tue, 30 Dec 2008 18:41:13 PST

This study examines the labor market costs associated with being foreign-born and not having U.S. citizenship among Mexicans in California and Texas, the two largest states. Data from the 2000 5% Public Use Microdata Sample are used to conduct the multivariate regression analysis. The results show that being an immigrant, particularly a non-citizen immigrant, is associated with lower hourly wages in California as compared with Texas. The results also indicate that these costs are greater for those who arrived after 1990, especially in California. Findings suggest that Mexican immigrants faced harsher social context in California in the post-IRCA (Immigration Reform and Control Act) period, as represented in anti-immigrant policies and sentiments. Partly, larger population concentration of immigrants, especially non-citizens, could be a source of intensive within-group labor market competition among the foreign-born workers.

Discrimination, Stress, and Acculturation Among Dominican Immigrant Women

Araujo Dawson, B. — Tue, 30 Dec 2008 18:41:13 PST

Researchers have well established the association between discriminatory experiences, life chances, and mental health outcomes among Latino/as, especially among Mexican Americans. However, few studies have focused on the impact of stress or the moderating effects of low acculturation levels among recent immigrants, such as Dominicans. Using the transactional stress model, the present community-based study examines the relationship between discrimination and stress, and whether this association varies by low acculturation levels in a sample of 246 Dominican women. Results indicate a positive relationship between major racist events (e.g., job-related discrimination), everyday discrimination (e.g., not receiving services in a store), and stress levels. Furthermore, low acculturation moderated the impact that discriminatory experiences had on the stress level of Dominican women. Implications for further research on discrimination and stress among Dominican immigrants are discussed.

Participatory Action Research With Colombian Immigrants

Balcazar, F. E., Garcia-Iriarte, E., Suarez-Balcazar, Y. — Tue, 30 Dec 2008 18:41:14 PST

This article describes a participatory needs assessment process in which Colombian immigrants in Chicago collaborated with university researchers to identify their common concerns and implement self-help efforts to address some of their most pressing needs. A total of 261 Colombians completed a needs assessment survey, and 46 attended a public forum in which the issues were discussed and groups of volunteers were organized to coordinate and plan actions to address identified needs. Groups of volunteers conducted the research and developed a guide to health care and a guide to social services in the state of Illinois, which were widely distributed in the community. The participatory methodology appears to have effectively mobilized individuals who volunteered their time to help others—particularly newcomers who often find themselves at a loss to maneuver and understand a complex array of systems and services that are completely unfamiliar. Implications for future research are discussed.

South Texas Mexican American Use of Traditional Folk and Mainstream Alternative Therapies

Martinez, L. N. — Tue, 30 Dec 2008 18:41:14 PST

A telephone survey was conducted with a large sample of Mexican Americans from border (n = 1,001) and nonborder (n = 1,030) regions in Texas. Patterns of traditional folk and mainstream complementary and alternative medicine (CAM) use were analyzed with two binary logistic regressions, using gender, self-rated health, confidence in medical doctors, income, education, and acculturation as predictors. Approximately 45% of respondents were CAM users within the last 12 months. Users of both types of CAM were likely to be women and to have a high education level. Compared to nonusers, traditional folk CAM users were found to have lower self-rated health, less confidence in medical doctors, and lower acculturation. Mainstream CAM users had higher income and self-rated health than nonusers.