How Ethnic Enclaves Affect Diabetes and Depression Risk Among Older Mexican-origin Latinos in the Southwest

This dissertation examines the role of ethnic enclaves on diabetes and depression risk for older Latinos of Mexican-origin living in the Southwestern United States. I use the 2004-2005 Hispanic Established Populations for the Epidemiological Studies of the Elderly (Hispanic EPESE) survey, in addition to United States (U.S.) Census data and business data from Infogroup. Using multilevel logistic regression, I examine if ethnic enclaves are associated with diabetes, and explore the possible underlying mechanisms by testing for mediation or moderation by social networks and ethnic ownership of businesses. I follow the same analysis for ethnic enclaves and depression risk. My findings suggest that ethnic enclaves provide a protective effect for diabetes, even when controlling for neighborhood- and individual-level characteristics. I do not observe mediation or moderation by social networks as measured by a social ties scale and the social cohesion and trust scale. There is also no moderation by the concentration of Latino-owned businesses in a neighborhood. For depression risk, my findings show a protective effect by ethnic enclaves, however the protective effect is only present once I adjust for neighborhood- and individual-level characteristics including having recently moved. Further examining the ethnic enclave and depression risk relationship, I observe some mediation by social ties and social cohesion and trust. However I do not find any impact on the ethnic enclave and depression risk association by concentration of Latino-owned businesses. Furthermore, results indicate a different health effect by immigrant enclaves on depression risk. Living in a neighborhood with a high immigrant concentration is a risk factor for depression, however this effect appears to be mediated by social networks, measured by social ties and social cohesion and trust. Thus, while ethnic enclaves seem to be protective of health for older Mexican-origin adults, the mechanisms explaining the protective effect may be different for diabetes and depression risk. Also there appears to be differences in the impact of neighborhood characteristics on health, such that an ethnic enclave may be protective while an immigrant neighborhood is a risk factor to health