 Good morning, okay, we are ready. Welcome to UTSA and thank you all for being here. I'm Harriet Romo, I'm a professor in the Sociology Department and the director of the Mexico Center here at UTSA. And so I'm moderating this panel this morning on contextualizing elder care among Mexican origin caregivers in the 21st century Mexico and the United States. So the context and the neighborhoods of where these folks are living are very important. So we've got some really interesting presentations this morning and we'll go right through the order of our program. But I'll introduce each one and then when it's their turn, they'll go to the podium to present so that they'll be captured on the video for the people participating online. So our first speaker is Dr. Carolyn Mendis-Luck. She has a PhD in public health from the School of Public Health at UCLA and a master's in public health in community health sciences from UCLA as well. She's now an assistant professor in the College of Public Health and Human Sciences at Oregon State University. She's been an active scholar. She was a Robeless Garcia Robeless Fellow in Mexico City. She's been a researcher that has directed some big projects at UCLA. And she's also been very active in teaching about the aging frontier and taught also and lectured about race and class. So welcome Dr. Mendis-Luck. I'll try to speak. So I'm very pleased to be with all of you today to talk about my research. And I first want to say thank you to Rogelio and Jackie for the kind invitation to speak. And I'm going to be talking about informal family caregiving among women of Mexican origin. So women from Mexico City and Mexican origin women living in East Los Angeles, California. So I'm going to give a little background first. So historically, women predominate as caregivers. And this is a context of care that occurs throughout the world, not just in the Americas. And when we think about the Mexican culture and it's so closely tied to caregiving, that it's important to look at what the literature says about the Mexican culture, particularly about the family. So there's a rich description in the literature that the Mexican family is united, lives within an extended family network. And that people within the family are, are bound into one another, depend on one another, and sacrifice for each other for the greater good of the family. So what I just described can be called familismo. Maniasimo and respeto are two other cultural values that are important that have been written about in the literature. And there have been some critics about these concepts though. Particularly that they simplify and romanticize complex interpersonal relationships and processes. So it's not without its critics, although this is what the literature says about the Mexican culture. So in my prior work, I found that the tenants are actually present in the caregiving experiences of Mexican origin women. And important forms of caregiving include emotional aspects of giving care. Companionship, love, and attention, all of these are forms of caregiving that I have found in my research. And lastly, this idea of attentiveness, or in Spanish it's called estada pendiente. That's an integral part of caregiving. It's about vigilance and watching out and always being there for the person being cared for. So this study that I'm going to talk about today explored the cultural beliefs related to family care and aging among Mexican women of Mexican origin. And particularly, we were interested in examining what were the gender roles related to giving care to older adults? What were the beliefs about older adults and aging beliefs in general? And so that's what I'll be pursuing today. I'm going to focus though on two areas, gender roles and the elderly. So this analysis is actually an analysis of two different data sets that we combined. They came from two prior studies that I was a PI on. And the first data set came from Mexico City, was collected in Mexico City for my dissertation. And then the second set came from interviews with women in East Los Angeles. The East Los Angeles study replicated the study from Mexico. So both studies share the same qualitative study design methods and instruments including the topics that are covered on the interview guide. And the eligibility criteria. So the analysis for this study was first, well, a couple of things. So first we took the data that had already been transcribed. We uploaded it into Atlas TI, which is a software program to manage qualitative data. We analyzed the data in the language of the interview, whether it was in Spanish or in English. And then we followed a systematic protocol in our analysis. The first step of that was since we had these two studies, we had to combine them both into one. Each study had its own code list and coded terms. And we had to merge all of those, reconcile so that we could have one code list for the two sets of data. Which is now one big combined data set. And that was very mechanical and just took a long time to do. The next part of the analysis, which was really the analysis, is that we did three steps. Content analysis, task analysis, organization, and code mapping. And these three steps build on each other to identify, at the end, identified thematic content. And so there are specific procedures within each step on how to do that. I'm not going to go into detail on how to do that. I'd be happy to answer questions if you have any later on. But right now we're at the code mapping stage. So we are still developing thematic content. However, I do have some preliminary data that I'm able to share with you today. So first I want to give you a look at the samples. So we interviewed a total of 85 women. 41 were from Mexico City, 44 from East Los Angeles. And of those in East Los Angeles, 18 were US born and 26 were immigrant women. Mexico City caregivers tended to be younger than their East LA counterparts. And more of them worked outside the home and were married. Also not shown here, for most of the study participants for the full sample, they had lower than secondary education levels and lower incomes with respect to the average incomes in each country. So they were not well-resourced women. And lastly, they were all long-term residents in their local communities. So this table shows some caregiving characteristics of the caregiving situation and characteristics of the care receiver. And what I'd like to point out here is that in terms of the length of caregiving, that seemed to be similar across groups. And the majority of caregivers cared for a parent, followed by a husband, and then after other relatives. The majority of caregivers shared houses, shared the same house as the person they were caring for. And East LA caregivers were older, on average, than the immigrant women or the Mexican women. And another interesting fact that I want to point out is that the Mexico City caregivers were taking care of relatively healthy older adults compared to the East LA caregivers. So when you look at that, 27% of caregivers were taking care of someone who had no physical illness and had no need for ADL health. So they were relatively healthy, whereas the caregivers in East LA were taking care of really highly impaired older adults or older adults with multiple conditions. So this first series of results is on social and gender roles. So we found that women were socialized into the role throughout their lives. This wasn't something that was talked about in the family, at least not explicitly. Rather, it was something that they learned over time through observing others. So they saw caregiving being played out by other family members. And they were taught by those experiences, as well as being taught how to do some caregiving activities by those family members. But there were really no explicit discussions about the obligation to provide care. So I also want to say here that most, if not all, the women, regardless of where they lived, felt that caregiving was something that women will always do in the future, going forward. We also found that fulfilling the role was an opportunity to serve a parent or a non-spousal relative, to see the family member improve or maintain their health, or to ensure respect and good treatment of a family member. And so when we looked more at the data, look closely at the data, we saw that this fulfillment of the role was viewed a little bit differently for these two groups. Mexican caregivers saw this fulfillment as satisfaction, whereas the US-born caregivers really focused on fulfilling the role, so as to provide good treatment, good medical treatment, good physical care to their family member. And then lastly, we saw a small group of women talk about this idea that even though they know women will always be the caregiver, that a man's role should be the same in terms of caregiving. And we found that interesting that although they said, yes, a man's role should be the same, but that's not what's going to happen or what they expect is going to happen, but that it should be the same. And then when we looked at, well, who's in this small group of women, they were primarily US-born women and immigrant women. Very few Mexican caregivers expressed the same sentiment. So I'm going to give you a couple of examples here first in terms of a general in general. And this one comes from, let's see, what's her name? This one quote comes from Julia. She's 37 years old at the time of the interview, and she had been caring for her 68-year-old mother for the past 15 years. And she said, men are more about the street working and going out more. But women are about the house and the children. So here we can see the differentiation in responsibilities by men and women in general. The second one has to do with gender roles related to caregiving. And this quote comes from Susanna. She was 49 years old, and she was caring for her 80-year-old mother for the past year. She was an immigrant caregiver living in East Los Angeles. And she said, women are more understanding. Men just focus on working, and they forget about the rest. He helps economically, but he doesn't help or understand the way a woman does. So here, again, we can see that there's this differentiation in men and women's focuses, but also underlying in this quote is the idea that women are inherently better at caregiving. OK, thanks. Yeah, keep me on top. So this next set is beliefs about the elderly. And so what we found was that caregivers talked about the elderly as being a vulnerable group of people, that they were vulnerable to being viewed by others as being a burden, a hassle, or getting in the way. Some caregivers felt that elders lost status in the family or their identity or their authority in the family because of increasing dependency, role reversals because of being ill. This change of role was not necessarily because of chronological age. It had to do more with health and other extenuating circumstances. So this exemplar comes from Laura. And she was taken care of her 71-year-old husband for the past 10 years. She's also an immigrant caregiver. And she says, when a person gets older, they lose the capability to make decisions. So then they are indecisive. They don't know if they are doing good things or bad things. So then the children help the grandparents make decisions. Yes, because when they are already too sick, they can't decide anymore. OK, again, this quote, getting that the sort of changes in roles due to a diminished capacity. So this small snippet of findings that I shared with you are consistent with some of the tenets that I talked about earlier, families marionismo no respeto. But also these themes played out differently across groups. And this may speak to changes in or reflect an acculturation experience for the immigrant caregivers. But nevertheless, there's some ideals, cultural ideals, that still persisted despite living in a different environment and social context. So there were some limitations. One of them I'll point out, because I don't want to run out of too much time, is that the data, even though there were parallel studies, the data were collected at two different times. And so that fact could have affected the results that we found, because women were coming in at different historical periods of time, different lifetimes, things happening in their lives that could have affected how they answered the questions. Also the data for the first study is 18 years old. So we have to ask the question, how relevant is it to 2016? But I argue that the data still are relevant because we saw some consistencies across the groups. And so because of that consistency in some of those findings, that I tend to think, well, the data isn't so bad after all. So lastly, I'm just going to leave this as a discussion. I'm not going to talk about this too much, but I'm going to pose the questions here. So we know that the landscape of our lives are changing. And in particular, as those related to caregiving are women's increased workforce participation, delayed and reduced fertility, population aging, all of these, among other factors, are happening in the Americas today. So what implications do they have for caregiving? Will family ties weaken? Will we still see this families will play out? Will expectations change? Will caregiving remain a gendered responsibility? Will beliefs about elderly shift to accommodate changes? Will future elderly adjust their expectations? The results that I showed here, I think indicate that there is a shift underway, but that women will continue to struggle to fulfill their role obligations amidst all of this changing landscape. So what will happen, I think, is really up for a conversation. So I'll leave it at that. Thank you very much. You set the stage for the questions at the end of the panel discussions. All right, our next presenter is Kate Cagney. And she is an Associate Professor of Sociology and Health Studies and Director of the Population Research Center, Nork at the University of Chicago. She has worked with issues of social inequality and its relationship to health with a focus on neighborhoods, race and aging and the life course. She brings urban sociology theory and methods and research to health examining outcomes such as asthma prevalence, physical activity, mortality during crises and looking at the evolution of a new community in Chicago called Lakeside. She also focuses on the development of new methods to define and measure neighborhoods and social networks with smartphones related to data collection. So thank you very much, Kate, for being here. Say a special thanks to Jackie for bringing me here and also to all of you for the great day we had yesterday. And I know I've enjoyed all of our conversations, but now I feel like I have to do a little work. And so I'm gonna walk you through some research on neighborhood social context and its relationship to health. And I wanna focus, particularly given the substance of this conference, really thinking carefully about the context of community and how it might matter for the health of older Latinos.