 I'm very pleased to be here once again and now we will build on what has been said this morning partially and this environment that is growing in a context of fear and rejection and which is something that is happening also in the political arena and we will have the opportunity to discuss this. We had originally three participants unfortunately Dr. William Begab from USC wasn't able to join us because he felt sick yesterday and he was not able to travel so we will begin the first presentation by Nestor Rodriguez in the health team in which Jacqueline Hagen and David Leal participate as well from the University of Texas at Austin and the University of Texas Medical Branch talking about aging environment of fear. Nestor, the floor is yours. First I want to thank everyone who put this wonderful conference together and invited me I'm very glad to be here. My paper is going to look at two things, aging environment which is populations in the aging process and then this concept and condition of fear brought about by new relatively new immigration policies that restrict or limit immigration and let's figure out how to change this which is the one to change the slides. Okay great so let's get to the paper here's the paper's thesis here's my argument restrictive immigration policy and implemented since the mid 1990s that created fear and stress and immigrant environments but negatively affect the quality of life for older immigrants age 50 and older it negatively affect the quality of life for many immigrants much younger than that but in my paper I'm looking at older immigrants notice that I say older and not old okay I myself am over 50 way over 50 so older immigrants age 50 and older that's my argument okay so I'm particularly interested in two two let's uh statues passed by Congress in 1996 but but not solely not exclusively one is Ira Ira a sociologist call it and I put it in red because it is a a law that has done many dramatic things that impact immigrants especially the undocumented but also legal immigrants and even citizens of the U.S. were married two children of non-citizens or whatever so Ira Ira I stand for illegal immigration reform and immigrant responsibility act in just a few months apart Congress also passed pro-rock which was personal responsibility work opportunity reconciliation act and so Ira Ira made it a lot easier to deport people in 1995 before the passage of Ira Ira the government deported about 50 000 migrants back to the country just a few years ago that number had now reached from 50 000 to over 400 000 right and it primarily because of this law that makes it easier to deport people program limited access to health care medicate etc etc to immigrants to some extent this place older migrants at risk Ira Ira placed older migrants at risk for arrest detention and deportation creates instability fear and tension in households that support older migrants and restricted access to health care for migrants to older migrants Ira Ira restricted all access to health care for undocumented migrants only was the exception of emergency room and that's why you find so many undocumented migrants in emergency rooms because legally that's the only place I can go but as we know in addition to federal laws their local their state and local ordinances and laws and ordinances that have been passed in many cities here's this is the graph right outcome of local restrictive policies of proposals like water so it's not just federal law that's creating pressure on immigrants but state laws often the parallel federal laws almost the same law but at the state level to give it more power or or ordinances that say landlords cannot rent on authorized immigrants or things like that so what I'm trying to create is the image of an environment where many immigrants live with their u.s. born children or u.s. reform relative citizens where they feel a lot of stress and pressure because of the new environment of a restrictive enforcement can somebody help me one of this button is there a someone under eight years old here thank you okay so here's like ira ira this new law in 1996 and it's been like a the largest immigration law passed between now and 96 other laws but they're minor compared to ira ira right and so we think it increased and facilitated deportations because they increased the number of reasons why immigrants could be deported crimes that were committed before for which immigrants could not be committed or not even crimes offenses now became deportable okay and it made most detention arrested it made detention mandatory so we began to see detention centers which attracted for profit industry a lot of our detention centers were administered by private companies who sell stock on wall street and they're doing very well and it here's something affecting elderly it made deportations retroactive to before 96 so in 96 country changes it increases the number of reasons for which people could be deported and it said and if you committed this act even before this law like 20 years ago you're still deportable retroactive and in fact the first wave of deportations include many or a good number of elderly who back in the 60s or back in the 70s committed a crime let's say they got caught was a joint of marijuana and they were given one year suspended sentence right and they did a plea deal that you know go ahead and plead guilty and you can go back to work on monday that's what their lawyers got it sounded like a good deal at the time but then when ira ira passes that's a deportable offense even though you did it 20 years ago you're deportable and i was involved in a five city study in texas was a team looking at the impact of this new law and we found families who told us these stories about their grandfathers have been deported for something that happened in the 70s you know ICE immigration and customs enforcement coming to their houses at 4 30 in the morning they put everybody on the floor and they took the old man they said so this is the type of environment i'm talking about ira ira also had section 287 g which authorized state and local police to be deputized as immigration inspectors after receiving training in an ICE training center in south south carolina so now we have the local police acting and so and it made it difficult a lot more difficult to cancel deportations right so it you could want to have an order of deportation you're almost sure to be gone and then it created a bigger budget for more border patrol and then a budget to create a border fence or wall i don't know what it is we used to put in the u.s mr trump is the first one to call it a wall but in mexico they always called it a wall mudo right and so you know when i was doing talking to people they said well yeah the elderly can be affected but they're such a small number i mean the real problem is with the young people there that made you suffer for the within i started looking at what are the sources of older immigrants in this country that says especially undocumented so i'm looking at data from the Pew Research Center and said in the year 2000 35 percent of unauthorized migrants in the u.s had been okay only 35 percent of unauthorized migrants had been here for more than 10 or more years but but the year 2010 62 percent of unauthorized migrants had been in the u.s for 10 plus years which means that that 11.1 or .3 million undocumented immigrant population is aging it's also for the aging process and so they're contributing to the the growth or the the reproduction of older immigrant age cohorts migration policy institute tells us that there are about six percent of the 11.1 million undocumented immigrants or age 55 and over which it's about six hundred and sixty three thousand six hundred right and so that the undocumented population is aging and creating more undocumented older migrants i looked at the amoeba data set and i looked at how many were surveyed coming to the u.s age 50 and older and for 2011 that was over 87 000 and i and then for 2013 that was about 74 000 so while the net effect of Mexican migration is now zero or negative there are more people going back to Mexico than are coming in from Mexico they're still coming in from Mexico okay just not as much as they're going back to and a chunk of those coming in or migrants age 50 and older and i found that when you hit the age cohort 55 to 60 it's it's predominantly women or the older migrants who are coming over and so just real data sources for my paper i look at the amoeba which we heard about this morning i also found the 1989 legalized population survey of when the u.s government gave amnesty in 1986 irka immigration reform and control act signed by president reagan which gave amnesty to about three million migrants mainly from mexico in the courts there's the pure research center data that's also it's public data and other data sources are my own studies and projects with other researchers looking at undocumented status and stress right looking at enforced restrictive enforcement and the the fracturing of bank families and communities here and abroad so those are like my data sources and so here i'm looking there's a table here of fear and stress and immigrant environments and um i this comes from the pew they have a question how much do you worry that you a family member or a close friend will be deported and they've asked this question for four years now most recently 2013 and a lot we find that native born latinos 15 percent said they worry a lot now why would a native born latino person worry about deporting their citizens the only people you cannot deport their citizens right well they may be married to an immigrant right or they're but they have relations family relations to to immigrants or not citizens or but or you live in a household where somebody is there's an immigrant and can be deported foreign born if you look at like the year 2008 foreign born over half said they worried a lot or some that's almost 70 percent right but what this data shows is that there's a lot of worrying among immigrants right and and i just don't get the sense from statistics i've been in the communities in houston austin and even in san antonio right talking to migrants and what they do to avoid detection right by eyes or border patrol and what have we so the sphere in worry has been documented by pew and other researchers uh it's out there then i did i went back to that data and i i took out the all of respondents to the survey age 50 and older right and i foreign born and then i divided them those would become citizens and those would still not citizens right worry a lot or some that's still a large number older immigrants would become citizens 41 percent of the survey said that they worry a lot or or some right but 59 percent said worry not much or not at all right citizenship but then we you look at the non-citizens what worry a lot or some it's 53 percent of older immigrants who are non-citizens right and then worried not at all or some would be 40 percent that's still a big number and i'm wondering what who are those 40 percent who don't worry right maybe they're kind of old and they said guess that i said i don't know you know just like i come from a mexican american family who have those views about life is inevitable you take what it comes right this you feel you can't control the environment then don't resist it go go is it uh this is too small for you to see but we did a survey in austin houston and gallistan and the late 1990s and looking at what we call a cultural distress we had many variable gender legal status family status and then we had a question fear of deportation and if you could see this grab or this chart what you would see is that fear of deportation is closely correlated or explains a lot of the variants for what we call extra familial stress that means things that immigrants do outside the family going to work navigating institutions whatever right and so people express fear or stress about doing things outside the home the family that there was a there was a strong correlation with fear of deportation that affects people's behavior i'll give you an example one family i interviewed young couple with two little girls they're undocumented they said then the husband and wife never traveled outside the house together that way one of them is arrested and deported the other one stays behind so they figure out a strategy to just put a security of their children right so those are some of the stressors that we find the increased risk of deportation and i have here age distribution of deportees deported migrants and i put in red those that are 50 or older right and you can see that we're not talking of a small number we're talking of you know almost 15 000 right there and you even get deportees who are in their 70s you know almost 200 you know so that these people are just age won't save you right the only thing that will save you is us citizenship and a good lawyer or something like that right an expensive lawyer right uh you can't do this research without getting to know the immigration lawyers and they're a great group people and then there's the other risk is that if the older migrant is not deported someone in the household may be deported was the income earner and if you're an older or older migrant maybe you're more of a dependent and not an income earner right we just last year published this paper in the journal international migration that we call deporting social capital and that's based on a survey we did in El Salvador 300 deportees and we found that a big number had been in the US for a long time had been legal immigrants and owned homes had jobs whatever and they were deported for some infraction of some immigration law or because of the criminal offense right and they were like the main source of linkage to the mainstream and so when that household lost immigrants like that that family becomes vulnerable and they they become disconnected from social institutions that can help them so 20 percent of our deportee sample of 325 percent lived in multi-generational households with older members 70 percent of those who lived in five years or more in the US had older uh generational members in the household so the longer that they lived here the more likely they were to have older migrants as part of their household and these guys and women spending guys about 90 percent of deportations are guys because ICE doesn't have enough facilities yet to detain women but they're building even near San Antonio and then finally this thing turned off so I lost my timekeeper so restrictions to health care in what ways uh eight okay okay so one of the things that I needed to find out was how many older migrants actually get sick and go to hospitals so we talk about health care how much and so okay my time's up for one minute and that's all I need uh I needed a sample of undocumented migrants this age distribution and hospitalization and I found it when the US gave amnesty to 3 million migrants in 86 they also did a survey of those undocumented and they found that 8 percent of all of of every 150 and older were applied for amnesty had been in hospitals one year before amnesty right and they asked them what was your place of care and remote the largest response was doctor's office and women gave family clinics 11 percent of the women okay then my final point right here many of the migrants say they don't we didn't our survey in Texas said they didn't want to go to clinics or hospitals because they may be reported to to border patrol down in the border or to ICE and we all say well that's crazy they're not gonna come on well guess what we found Texas public hospitals offering lists to federal officials of immigration service of unauthorized immigrants who did not pay their hospital bill printouts right and this article that's there the new england journal of medicine documents or talks about 800 documented cases of hospital repatriations hospital deportations these are hospitals that they have patients may be undocumented they're poor and they have long terminal illnesses or something and they're just there and they don't know what to do because nobody's gonna pay for that so with or without their consent they take those patients they put them on a plane and send them back to Mexico or some other country where they're from right anyway I hope I did something to help describe to you the environment of fear that many migrants live in today especially older migrants thank you thank you so much Nestor indeed it's quite impressive in these last 20 years we have seen a major shift in this legal framework and without very very important social consequences and I'm certain that we will have many questions coming from the floor but maybe we will proceed there first with the with the next presentation before beginning with the question and answer session please this is Dr. Terence Hill from the University of Arizona at Tucson talking about the religious involvement and biological function in in Mexico Terence thank you before I begin I wanted to encourage the poster presenters that are coming in late you can set up your poster through those doors to the right so if you just come in late feel free to set up your poster okay so I'm gonna talk about something that we don't usually talk about at this conference and that is the association between religion and health I want to thank Veronica for talking about the institutions of religion earlier that's kind of an introduction before I begin I want to acknowledge my co-authors Sunshine Road from University of Louisville and Chris Ellison who was just down the road at UTSA in the Department of Sociology over the past 30 years numerous studies have shown that religious involvement as indicated variously indicated by observable feelings beliefs activities and experiences in relation to spiritual divine and supernatural industries tends to favor health and longevity across the life course when I say numerous studies I'm talking about thousands of studies being conducted all across the United States and pretty much any health outcome you can think of mortality risk physical health mental health health behaviors has been examined and we see a pretty consistent evidence cross-sectional data longitudinal data over the past 15 years researchers have extended the religion and health literature to biomarkers or indicators of biological functioning biological functioning typically refers to the concept of allostatic load which is code for chronic overactivity of the physiological systems that we usually think about the autonomic nervous system the hypothalam pituitary adrenal axis cardiovascular system metabolic systems and immune systems studies show that religious involvement is associated with favorable levels across a range of biological markers body mass index blood pressure C reactive protein interleukin 6 white blood cells absolute bar virus these are indicators of immune function and then cns epinephrine cortisol stress hormones and then combined overall allostatic load in this year alone we've seen two studies that have shown that religiosity in the population is correlated with longer telomeres so these associations with biomarkers extend to concepts related to molecular aging biological aging why why would um religiosity promote health in the population there are lots of conceptual models out there this is one that I produced a few years ago most of the psychosocial resources and be and health related behaviors that we care about are reliably linked and consistently linked with indicators of religious involvements um going back to Emil Durkheim religious involvement is an integrative force it um facilitates social ties and supportive social relationships and expands our networks you know that's that's what you get from the ritual being involved with religion also promotes self-esteem control believes a sense of meaning and purpose all these things kind of translate also into healthier behaviors the religion itself can prescribe things like heavy alcohol consumption but providing things like meaning and purpose and social support can actually discourage motivations for pathological health related behaviors and so when you start to tally up the social resources the psychological resources and the healthy living you start to see that dump into the body and you start to see these favorable biological profiles the end result being better mental health better physical health better mortality risk longer life expectancies so the questions that we have are do the apparent health benefits of religious involvement extend beyond the united states the research I've been talking about is coming from the united states the specific question that we're interested in does religious involvement favor healthy biological function in Mexico why should we care why should we care about religion in Mexico well Veronica gives a good sense of the importance of religious institutions and religious groups but you know we all know that the cultural significance of religion in Mexico the the institutional significance of religion in Mexico is really important when we think about religion we can think about these things the cultural practices and the institutions we can also take a global look and and appreciate that Mexico has a really high rate of Catholicism and rank high in Latin America in terms of a percent Catholic Catholic as one of the largest Catholic populations in the world behind Brazil what type of Catholics are we talking about in the U.S. Catholics are relatively moderate on social issues it seems that the Catholics in Mexico are not as moderate as indicated by these types of social attitudes Catholics in Mexico are not really supporting allowing Catholics priests to get married or allow women to become priests very small percentage of Catholics in Mexico support those types of convictions but we know very little about religious attitudes and behaviors in Mexico overall which is why we need to be thinking about the types of data that Marianna presented and the data sources that she uses because there's a large untapped resource in terms of understanding the religious context of Mexico the data set that we'll be using today is the the mhos Mexican health and aging study this is a large study of adults age 15 older and the data that we'll be showing today add to this some some information about the religious context of Mexico we in our data set nearly 40 percent of the older adults participate in activities organized by their church once or more per week nearly 40 percent and 70 nearly as nearly 75 percent 74 percent rate their religion is very important right all these things are telling us how important religion is as a cultural factor as a cultural force as an institutional force in Mexico and really again raises the question why we don't talk more about it why we don't talk more about it so to this point very few studies have considered the health consequences of religious involvement in Mexico nevertheless there are some evidence to suggest that religious involvement is associated with blood pressure and cholesterol screenings and lower rates of smoking so there's some evidence previous studies with the mhos data have documented that religious older adults in Mexico tend to you know be getting their screenings and tend to be smoking less we build on previous research by testing whether religious attendance is associated with healthier biological functioning as indicated by metabolic functioning we use a range of indicators body mass index waist to hip ratio cholesterol levels and like consolidated hemoglobin which is another indicator metabolic function cardiovascular function diastolic systolic blood pressure pulse rate and immune function as indicated by seroactive protein and then an index of all of these biomarkers here's the data most of you are familiar with this data the mhos is a national sample of older adults in Mexico we were fortunate enough in 2012 the principal investigators collected biomarkers and so we'll be using data from that that 2012 wave and those who had complete information about 1802 respondents now it's a rich data source for biomarkers but there's limited information on religious involvement we're using in this study the most common indicator in epidemiologic surveys which is frequency of participation in religious activities church attendance that type of thing and we have three levels never never participating once in a while and once or more per week and these are the way that the some of you may be wondering how these biomarkers were collected we have direct measurements of height and weight waist and hip circumference cuff measures blood draws and as well as blood spots these are the background variables that are common in the literature that will be showing all the estimates that I show you are adjusted for these background variables we're going to present different estimation procedures there's not a consistent strategy for how to code biomarkers in the in the litter in this literature some people use the continuous metrics some people dichotomize according to the high risk cutoff like the top quarter or the high risk quarter of the distribution we're going to do both and then and then we're going to use negative binomial regression to to sum the high risk dummy variables so that you have a a sense of the the count of the number of biological risks that you have within individuals this is the continuous specification ols estimates this is the part where I just told you about how important religion is in Mexico and now I'm going to tell you how it's not important at all for biological functioning okay sorry nobody got that no results across the board for a diastolic systolic pulse um there's some evidence that people who participate once or more per week have higher levels of hb1c which is not what you would expect but you do see some initial evidence of lower levels of crp like not much going on with cholesterol body mass index or waist dip ratio or the summary index of allocetic load now when we look at the dichotomous outcomes that is those distributions cut at the high risk quarter of the distribution again we see no patterns across the board with the exception of crp we had a marginal significance in the continuous estimation but in this estimation we see a lower odds of being in the high risk quarter of the distribution for crp among those who participate once a week or more and we see some non-linear relationships the cholesterol level and and then we see some evidence of people who participate having lower odds of having high cholesterol and being in the high quarter of the body mass index to summarize for 83 percent of our focal test participation in religious activities was unrelated to biological functioning in the elderly mexican population this general pattern was observed across specifications for diastolic and systolic blood pressure pulse waist dip ratio and overall allocetic load for 14 percent of our focal test participation in religious activities favored healthier biological functioning this pattern was observed across multiple specifications for C-reactor protein an indicator of immune function total cholesterol and body mass index we also saw some evidence to suggest that participation in religious activities can be associated with poorer biological functioning this pattern applied to the continuous specification of hb1a hb a1c which is an indicator of glucose metabolism and metabolic functioning for the most part our findings are inconsistent with previous research conducted in the united states the question is why we believe that our results speak to the importance of context which is you know a good thing given the theme of this conference to the extent that religious involvement is high and religious composition is relatively homogenous in mexico older adults may be heavily influenced by the general norms and expectations of their moral communities these community effects could effectively dilute the observable role of individual variations in religious involvement which is why we're not seeing the types of effects that we consistently see in the united states limitations are several limitations to this project the single item measure of religious participation is a major concern people measurement concerns about what does church attendance mean when you're trying to measure religious involvement obviously any any of the effects of religious involvement that we've observed here are conservative because you know the single item lacks reliability and content validity there are a number of other ways to to measure religious involvement that go beyond simple participation of religious activities and so we need replication with with rich data sources that not only have great biomarker measurements like the mhos but also a good religion measures there's also there is some limitations in the biomarkers assessed by the mhos in the sense that there's no indication of the autonomic nervous system like adrenaline nor adrenaline or the hb axis principally things like cortisol measures like cortisol that we would like to see so when you talk about a concept like allostatic load you you'd like to touch on all the major physiological systems that are that are implicated in the stress response but these are missing so you know for all you know there you know there could be some effects possibly in Mexico we need research to look at that and then finally cross-sectional data the best criticism of the religion health literature is health selection especially when your focal predictor variable is a is a behavior that requires health in the first place it takes a certain degree of health mental health cognitive health physical health to go to church regularly to be regularly involved in religious activities so is religion promoting health or are people who are more religious healthier in the first place you know we don't know although I would say that we are null findings are actually kind of some relief to this idea that health selection is not probably driving our results or we would see more significant effects and we only really see something for something like immune function right we're not seeing this for high blood pressure you know or cholesterol or or any of those things future directions we need to examine mechanisms leaking religious participation with immune function in this case CRP and cholesterol we need to examine cellular variations by gender urban rule etc you know other conditioning factors you know we're looking at religion and health in the aggregate perhaps there are theoretically relevant sub-communities in the Mexican population that religion may be especially beneficial for we also need to think about using more of the mhos data even though we only have biomarkers at the in 2012 we do have measures of religious involvement at earlier waves and if we're able to successfully merge earlier waves we can maybe take an index or maybe examine trajectories of religious involvement across the earlier waves to have a better sense of exposure to religious involvement over the study period and not just be looking at concurrent measures at the very minimum it would be helpful to have religion at one point in time and biomarkers at a subsequent point in time to at least highlight some or to establish some time order and then yeah that's that's pretty much it actually thank you thank you Terence it's a very interesting point of view and indeed it raises many questions that we may be able to address during the discussion but we could begin maybe beginning with the with the first presentation by Nestor are there any questions related to the to our first presenter just please in relation to what you would say concern they should all be concerned everybody should be concerned really but they should all be concerned because are the rhetoric that's used for describing these people it denigrates all of us not just the elite that some people would say i don't want to appear before this judge because he's a mexican judge it affects all of us it denigrates all of us when your daughter daughter is going for a job interview it might be in the mind of that recruiter if you're a criminal or a sex offender or a drug trafficker right i would just like to see what your reaction to that is no i completely agree that you know there's especially in some areas that for immigration immerse very rapidly like in the deep south where they were not used to having a lot of like mexican this can occur everywhere right but in some of those places they think that all latinos are undocumented or illegal whatever and so yeah i think one stereo it's like one size fits all right like one stereotype is used for everyone so i certainly agree that when people have negative views about certain groups let's say immigrants on unauthorized undocumented that it's possible and maybe probable that they extend that negative and critical view to all people of latino or mexican descent so i agree with you very much so thank you it does any other question about this the first presentation just please please the religiosity is changing over time read about it it's changing in europe now the us and perhaps mexico at some point and that may or may not be a variable as far as your findings yeah no someone else was talking about earlier about the increase in evangelicals in latin america yummy you still see really high rates of catholicism you know over 80 but but you're definitely seeing these new streams of evangelicals pentacostals being spread throughout latin america and this could actually be good for the future as mexico becomes less homogeneous in terms of its religious views and religious context you know maybe you'll start to see some clear impact of religious beliefs and behaviors you know that that's definitely a possibility at this time you're right in mexico it's difficult to to think about that too much as a variable because there's very little variation and something like religious affiliation at least because that almost everyone's a catholic almost but that's definitely something that we'll be thinking about there's another question and then bop thank you that catholicism has been embedded in in mexican culture in the fabric of mexican culture so it's often hard to distinguish what is religious versus what is cultural and so and religiosity is one way of measuring a person's affiliation and the way we think of how both religious a person is but i'd like to argue that even for those who who are not religious they may very well adhere to religious principles because they are so they are so embedded in mexican culture that's the exact point that i was trying to make at the end while we're not seeing any any differences because you have these really strong moral communities and norms for behavior and things of that nature that because they're they're so homogenous in the views that individual beliefs and behaviors become less important in that community context in america maybe it's a little different because it's more individualistic and there's there's more diversity and less the moral communities are less strong and less pronounced and less coherent so you may see more of the the effects of the of the individual differences in america than but i totally agree i totally agree i think that's the best theory for why we're not seeing much in mexico well thank you for putting that out thank you thank you bup um thanks for that i i think uh i don't actually want to quibble with your overall finance but i think that you may need to look at the individual risk factors in a different context than uh then you then at least i can tell from what you said for example cholesterol in older people predicts longer life actually and blood pressure distributions are different in in older people and in the oldest old um if you go to church you might get more infections from all the people you're sitting around and all the respiratory infections and so your measures of inflammation may go up so uh i i think these are not i i don't want to seem flip but i i think you're really not necessarily interpreting the risk factors uh correctly in terms of the implication uh anyway finally um i i may have missed it but it didn't look like you adjusted for underlying chronic illness which is going to change a lot of the risk factors and may also bring people to church so um uh i i just think it's a little more complex than you're presenting it than you might think about some of those things uh thank you for not quibbling about my results by the way um uh yeah i totally agree uh the biomarker distributions um can be unique across different life course uh segments uh that's one reason why we used a multiple specification approach and just didn't look uh didn't just look at the continuous specification we also looked at the um high risk quarter the distribution there are also other ways of looking at um uh under activity of these different biomarkers um we um are looking at these biomarkers as outcomes and um we're not uh at this point interested in their um their health consequences although i would say that our our coding schemes are consistent with um other biomarker studies not just those interested in religion but those interested in um socioeconomic status for example the macarthur studies use similar coding schemes um so we're pretty confident our our coding schemes um uh as far as your um question about um you know adjusting for uh pre-existing health issues or underlying chronic conditions things like that is your um um we don't usually predict health with health thanks you're stating about religious involvement you're really talking about judo Eurocentric you judo christian catholic slash um because there's a huge population of indigenous and the indigenous marriage review study ethno anthropology which is something that would be interesting to plug into this it's been an issue on going on the fact that Protestantism was bought a Protestant issue caused a lot of issues after colonization because it separated Mexicans while Catholicism got involved with the local religions so there's a lot more to it than that um specifically with taking it away from Eurocentric and making it Latin American centric because this is a really white perspective guilty Julia thank you just a comment there has been previous study from England in which they use locus of control the mh as also has a scale for locus of control which is the mastery one has over his destiny perhaps so if one has an internal locus of control means that one person can control his life and if it has an external locus of control it means that perhaps destiny perhaps god i think it's very interesting and i don't know perhaps it could be included in the model and could give a part of that answer that if they don't care or they don't believe that it should care because it will happen anyway because yeah that's a good question um in the u.s actually um religious involvement is consistently related with stronger control beliefs which is counterintuitive um and you see that across uh indicators of control beliefs uh the sense of control or mastery self control which is distinct and also health locus of control oftentimes those psychological dispositions are considered mechanisms or mediators or explanations for why religious people might live a healthier lifestyle because they actually believe they can control their lives they believe they can control their health and behaviors because anything is possible when you believe in a higher power and have a relationship with a higher power that's like the logic at least that's that's been employed but it's counterintuitive because usually you would think that um that our religious people would defer um and uh and would think that their lives are actually driven by forces external to them but when you actually measure the control beliefs the sense of control and or mastery uh self control and or health locus of control you see the opposite um but we don't know about mexico yeah thank you so much for your presentation so can you comment on um how you constructed the variable for total allostatic load um because you had different pathologic conditions in there and uh previous studies have uh used allostatic load and i mean actually both cdc protein and allostatic load as markers of chronic stress so did you weight all the pathologic conditions equally or did okay yes um we did um weight them equally um so we had two specifications for allostatic load one was just um a mean index of all the continuous natural biomarkers the way they exist in nature natural continuous and then um we did the high-risk cutoff or for um for each biomarker we did a dummy specification where if you were in the high-risk quarter of the distribution you received a one and if you were not in the high-risk quarter you received a zero and then we summed across those those dummies and that's when we use the count model uh to predict the count of number of high-risk biomarkers um but you're right that's another um strategy that's very sophisticated um doing like a latent variable approach maybe where you don't assume that each biomarker has an equal weight um and that is an that is another um possibility as we're developing this paper um uh that is very sophisticated um thanks thanks for nando this one thank you that's it no um so i guess what you're showing is i'm not so concerned about mexico being you know like a large majority or uh you know largely catholic as a problem for your study by in fact kind of an interesting experiment because uh if you cannot you know knowing that you there's some limitations that you acknowledge in the in the data uh that you may not be able to do anything about even with other studies in mexico i'm not sure about that but that also have health information but um i wonder if you can vary the setting though i mean because a lot of the uh the mechanisms that you showed and some of your other work with social support for instance shows how uh i mean there's a you're arguing for a social aspect of religion not about you know how the message of salvation for instance might might give you some some peace of mind and again you don't have stress with related pressures here but you know that that has good um um consequence for health it's a social issue but the way the way catholic system is organized in many parts of the country at least in especially in urban areas or at least in in many neighborhoods in urban areas it's not exactly a social organization unit for many people right again i'm over generalizing perhaps but for some there is and of course there might be ways in which you can actually look at settings in which this might be the case to try to pin down that that social support capital kind of aspect of religion but yeah it's fascinating that's exactly what we want to do because we don't want to give up on it because you're right this is a very gross analysis because we're looking at the total population but you're right uh sunshine wants wants us to be looking urban and rural and also high migration non-high migration more stable communities versus not let the stable communities we definitely recognize um for everything i said about how homogenous mexico is you're right there's still plenty of diversity to call in terms of moderation analysis and uh we are definitely going to look at that because we don't want to just settle for nothing that there's no relations we want to make sure that there's no you know relationships uh but the first thing that i listed on one of those slides was like urban versus rural and also like high migration non-high migration they did really interesting sampling job also getting these different areas of mexico also uh that uh that we could look within um these different sampling units but we totally agree totally agree hi there so my first point was just what fernando said yeah so this thing about individual versus social and probably um after some other analysis you find that there is something but probably here it's more that religion is more also a social thing social participation church organizes things tonsil and mexico at least for a catholic it's more an individual thing so probably that could be but fernando said that but um already what i was thinking in terms of variations you have this longitudinal study did you think of um sort of doing it by cohort because you know the fifth you know differences between the ones that are 50 60 70 probably there's a difference and especially because the importance of religion for someone 80 probably is or 670 probably is very different from those that are 50 so probably you could see something there in terms of you know probably for some and my third um question was did you think of looking at other um indicators like cognitive function because that has also been sort of linked and um especially in trajectory is looking at i'm thinking of you know this is a panel study longitudinal and um also because we as if i remember correctly those biomarkers are not have not been done in all waves so it could let you explore for the full sample because the biomarkers are only for a sub sample for so it could um let you explore for the full sample something that you can do parallel religious participation with another an additional additional health um indicator um yeah i think that's a great comment about the potential age variations uh in the us we we observe um consistent age variations in the benefits or effects of religious involvement you're totally right that religion can mean things different things at different stages of life course um uh and that's something we will also consider in addition to the urban rural high migration immigration gender differences also is uh is is consistent looked at um i wanted to um say something um about the this this people are acknowledging the social aspects of of religious involvement and then um i just want to emphasize that that's just um one mechanism and i don't want to overemphasize that one because people start to reduce it to us and to that's just social integration or that's just social support um but it's actually more than that and um and it's a ritual that actually drives those things it is not a proxy for those things it is actually one one ritual in our society that actually drives uh social connectedness and social support so it's conceptually distinct from um a potential mechanism of social ties social integration social support but there are also these social psych these psychological mechanisms like control beliefs or these behavioral mechanisms of healthy living um uh there's lots there's a lot going on there um and uh and uh your point's well taken that um you know our references could could be improved if we um looked at some of the health outcomes that were at all waves and not just the biological markers we're being opportunistic a little bit here we wanted to take advantage of these unique data because like it's it's really hard to find um population biomarker data with with some measure of religious involvement um uh but the cognitive functioning is there is cognitive decline is really important um and uh i actually published a paper a few years back in the journals of gerontology with the spanish epi's documenting that very thing over time uh with growth growth models um it would be interesting to um to uh to try to replicate that in um mexico i would actually like to encourage everyone that might be interested in psychosocial uh factors and population health to be um taking apart the mhos and look at every health outcome like i said i reviewed the literature i could only find a couple of studies um uh with the mhos data that looked at um health related behaviors the screen the screenings for blood pressure and things like and uh like smoking um so the cognitive functioning uh the mental health uh dietary behavior i mean there's so many things it's there's a world out there if you just want to grab it we could we could do this together well that's quite interesting and and when it's taken some time but we'll still have some minutes if there are more questions but i i wanted to just or just please go ahead and you said that context is important and you're you're finding clearly showed that context is important you find things in the u.s. and then you applied to mexico it didn't quite work out uh yet at the same time you attribute the non-finding that may be religiosity so dominant that everyone appears to it whether they are going to church or not now take another context take uh so east east germany which i've studied over the last 20 years hardly anyone there's religious it's you know it's a very has had become a very secular society now that society is very healthy i i don't have the kind of studies that you have in terms of marcus and so on but there's no difference between east and west germany now between in terms of life expectancy even though west germany is not religious so my point on my question to you then is maybe religion matters in this country but it's sort of relevant in a lot of other countries so if we don't find something perhaps we shouldn't say well religious is so important and there's a norm that uh it doesn't matter whether people go to church maybe the conclusion would be religion doesn't matter yeah uh that that's that's the first research question i had to do the health benefits of religion extend beyond the united states context i mean that is the question i would love to see data cropping up in every in every country um uh in your right um i don't know specifically about germany um i've been exposed to some exposed to some data from australia who also has uh they're not as religious as either the us or um mexico and in fact um a surprising percentage of australia identifies as jedi night when you ask them what their religious affiliation is um and uh you don't really see you don't really see an impact of religion in australia as well um so um and this raises an interesting question because maybe the religious context uh could be driving um the health benefits in in some countries and and and maybe undermining some of the data in other countries depending on um you know the context and uh and you know the first thing you said context matters yes yes it does um and uh we're just beginning to even think about this you know uh and i'm fine i came here to be honest with you that it there's not much going on in mexico i wanted there to be something going on in mexico i didn't want to show you dull patterns well what yeah possibly possibly but but i i wonder if listening to to the discussion i wonder if we are talking about the the potential benefits of religious practices or the potential benefits of spirituality which is not quite the same and and and there is a like there is a spirituality which is not necessarily linked with our specific religion this idea of mindfulness for example and these practices that can help you deal with stress and and with lots of control can be of benefit for health independently of any religious practice that has more to is more related to our culture in the case of mexico we are hundred percent guadalupe animals and all everybody but it doesn't it doesn't mean that we we leave this relation in in a in a spiritual with a spiritual meaning yeah of some kind would you oh i i i agree uh in the that's a limitation uh in the us as well in terms of uh looking at um uh people who are spiritual but not religious in the u.s most people who say they're religious are also spirit there's considerable overlap between religious and spiritual but there is a significant and growing segment of the population in the u.s who is spiritual but not religious they they connect with some kind of higher power uh but they don't identify with organized religion i'm not familiar with that with what's going on in mexico because i haven't seen those data maybe those attitude data have something about spirituality or that we could get some estimate of that but um i totally agree that we should be looking at um organizational non-organizational uh and um and uh you know uh indicators of of spirituality that are um independent um and and really test this idea you know is the are the spirituality measures related to health um that aren't necessarily uh it's so connected to the social support and the organizational aspects it's almost like a pure test when you think about it like um you know your personal beliefs uh about a connection to some you know supernatural force or something like that is that related to these mechanisms and health related factors independent of the organizational indicators i i think that would be great yeah i said a lot of things about spirituality yoga has been an increase in mexico and the indigenous things they're they're spiritual and a lot of those things seem to fall under the spirituality like you were saying much more than just the religious effects because the more you spoke about it the more i thought that's what you know the blood pressure lowering the the what did he say the ritual of it there's a lot of that going on that wasn't there when i first started traveling there yes we definitely need more research on yoga maybe one last question i want to ask something after her okay so i was wondering whether actually you don't have enough like the group is too homogeneous and so good point so if they cheer so it's almost like you have two things going on so one is that the these biomarkers maybe defined or characterized by the genetic component and you don't have so religiousness does not offer enough variation like it's not enough of a variation to to move you know in a statistically significant way the biomarkers to show the effect so that if you had a more heterogeneous group it's almost like saying the statement would be religiousness or attendance to church given you know different baselines and different characteristics of these biomarkers is protective or not but i think that you would have to have a little bit more variation on like the group on the on the biomarkers themselves so that religious shows to be protective or not are you are you saying there's no variation in our biomarker well well is there so but yeah if you were to show that is there a lot of population i mean it's a population based sample it's not a clinical sample where there might be no variation you know this is a population based sample we have people that are educated not educated rich and poor and women and men and older and younger people who are religious there's variation in the religious variables um well yeah what we're not getting at is the point that was made earlier about the culture the which is something that is an aggregate phenomenon that is above and beyond you know the individual beliefs and practices that were that were not accounting for in our analysis you know as far as the genetic thing every health outcome has a genetic component every health outcome but it's just a component and there are actually very few biomarkers or diseases that we care about as leading causes of death that are purely driven by genetics those are you know something like men dealing disease or something like that i will just say this this religion health which also includes religion as a as an aspect of the environment that interacts with genetics and so you know i never you know think about genes as being kind of you know just the sole cause of some biomarker to the exclusion of any social cultural factors i don't i don't think that way no i don't think they would be exclusive i was thinking more in terms of like whether the genetics would be so there is association like blood pressure for instance love at the levels and so if the levels are not changing that much that whether that was a reason for you not finding enough variation well like or that the very actually that's it's not that it wasn't so physically significant is just that yeah no it's definitely a possibility but i mean sunshine correct me if i'm wrong i think there's variability in our biomarkers oh okay that's what i thought yeah okay i think there was another was me oh yes Miguel okay my question is on the notion of your limitations yeah your one measurement was religious right it was religion so participation participation so how about strengthening that that that measurement by incorporating you know measurements of faith and belief yeah as you were saying your spirit spirituality is in the same notion of faith so why not include some those type of measures to strengthen that that measurement exact exactly um uh there is several people in this room maybe everyone is from has a concern of just um putting everything on this religious participation um uh dr. Gutierrez was at was asking me before i did my presentation what does it mean what does that what is a religious participation mean by itself um unfortunately we're we're limited to what's available in this data set but that's ideal what you're saying is ideal these results because we're limited to a single measure which lacks reliability all of our statistics are biased down now have lower have less power these are all conservative underestimates of the effect of religious involvement because we only have one measure if we had these other measures and we could have an index or look at multiple dimensions of religion and spirituality we may be able to see more um so um and that's always a concern when you have a bunch of null findings is that null finding real or is it a measurement artifact uh because of your exact concerns that it's overly limited to this one measure i will say this religious participation is correlated with every known measure of religious involvement it is the strongest measure in the study of religion if the empirical study of religion right so and it's the most common measure of religious involvement so it's it's it is a valid measure it's just not reliable and or content valid when you think about the broader concept of religious involvement well take an account of the discussion and then no doubt that it's this is a whole field of research open to for our interest now and then we will try to build upon this discussion to to to find more research questions and and a new way to interrogate our databases so thank you so much for participating so enthusiastically in this roundtable and now we wait for you at the poster session after 15 minutes thank you