Cecilia B Rosales
- Associate Dean, Phoenix Programs
- Professor, Public Health
- Interim Associate Dean, Community Engagement and Outreach
Dr. Cecilia Rosales is Associate Dean, Phoenix Campus. She is also Professor & Chair, Division of Public Health Practice & Translational Research for the Mel & Enid Zuckerman College of Public Health at the University of Arizona.
Dr. Rosales and team of colleagues is currently collaborating with El Colegio de Sonora and the Secretaria de Salud de Sonora on a National Institutes of Health R01 grant, Tools and practices to decrease cardiovascular disease and complications in the diabetic population of Mexico. The research project aims to test the effectiveness of certain tools and practices to decrease cardiovascular disease and complications from diabetes.
- M.D. MS Epidemiology
- University of Arizona, Tucson, Arizona
- Mel & Enid Zuckerman College of Public Health (2016 - Ongoing)
- Mel & Enid Zuckerman College of Public Health (2016 - Ongoing)
- Mel and Enid Zuckerman College of Public Health, University of Arizona (2014 - 2016)
- Mel and Enid Zuckerman College of Public Health, University of Arizona (2011 - 2015)
- Division of Community, Environment and Policy, Policy and Management Section, Mel and Enid Zuckerman College of Public Health, University of Arizona (2005 - 2016)
- OHTLI Award
- Mexican government for, Fall 2018
- Chicanos Por La Causa-Cause for Change Honoree
- Chicanos Por La Causa, Summer 2016
- Most Influential Women in Arizona Business
- Arizona Business Magazine, Summer 2016
- Pueblo High School Hall of Fame Recipient
- Pueblo High Alumni Foundation, Fall 2015 (Award Finalist)
- Dr. Cesar E Chavez Community Service Award
- Arizona State University Chicano/Latino Faculty & Staff Association, Spring 2015 (Award Finalist)
- Change Champion Award
- Public Health Institute, Fall 2014
- Profiles of Success, Latino Excellence in Health & Sciences
- Valle del Sol, Fall 2013
- UA Alumni Association Club President Award
- UA Alumni Association, Fall 2013
US Mexico Border Policy and Binational Collaboration, Policy and Management, Service Learning
Border and binational health, farmworker health, social corporate responsibility, health disparities,
Master's ReportPHP 909 (Spring 2021)
Public Hlth Policy+MgmntPHPM 574 (Spring 2021)
Independent StudyPHP 599 (Fall 2020)
Master's ReportPHP 909 (Fall 2020)
Public Hlth Policy+MgmntPHPM 574 (Fall 2020)
DissertationHPS 920 (Spring 2020)
Honors ThesisPHP 498H (Spring 2020)
Master's ReportPHP 909 (Spring 2020)
Public Hlth Policy+MgmntPHPM 574 (Spring 2020)
DissertationHPS 920 (Fall 2019)
Honors ThesisPHP 498H (Fall 2019)
Master's ReportPHP 909 (Fall 2019)
Master's ReportPHP 909 (Summer I 2019)
DissertationPHPM 920 (Spring 2019)
Honors ThesisPHP 498H (Spring 2019)
Master's ReportPHP 909 (Spring 2019)
Public Hlth Policy+MgmntPHPM 574 (Spring 2019)
DissertationHPS 920 (Fall 2018)
DissertationPHPM 920 (Fall 2018)
Honors ThesisPHP 498H (Fall 2018)
Master's ReportPHP 909 (Fall 2018)
Master's ReportPHP 909 (Summer I 2018)
DissertationPHPM 920 (Spring 2018)
Master's ReportPHP 909 (Spring 2018)
Public Hlth Policy+MgmntPHPM 574 (Spring 2018)
DissertationPHPM 920 (Fall 2017)
Master's ReportPHP 909 (Fall 2017)
Public Hlth Policy+MgmntPHPM 574 (Fall 2017)
DissertationCPH 920 (Summer I 2017)
Master's ReportCPH 909 (Summer I 2017)
DissertationCPH 920 (Spring 2017)
Independent StudyCPH 699 (Spring 2017)
Master's ReportCPH 909 (Spring 2017)
Public Hlth Policy+MgmntCPH 574 (Spring 2017)
DissertationCPH 920 (Fall 2016)
Independent StudyCPH 499 (Fall 2016)
Master's ReportCPH 909 (Fall 2016)
Public Hlth Policy+MgmntCPH 574 (Fall 2016)
Master's ReportCPH 909 (Summer I 2016)
DissertationCPH 920 (Spring 2016)
Master's ReportCPH 909 (Spring 2016)
Public Hlth Policy+MgmntCPH 574 (Spring 2016)
- Sabo, S. J., Nicolette, T., Jill, d. Z., & Rosales, C. B. (2014). Entre Fronteras (Between Borders): The Power of Service-Learning in Cultural Exchange and Social Action in the United States -Mexico Borderlands. eBook ISBN: 978-989-98013-7: Heritage 2014 Proceedings of the 4th International Conference on Heritage and Sustainable Development.
- Arranda, P., Ortega, I., Rosales, C. B., Sabo, S. J., De Zapien, J. G., & Zapien, A. (2013). Migracion y atenciion a la salud de los Jornalero agricolas. In Alternativas en la crisis para la transformacion de las politicas sociales en Mexico. Hermosillo, Mexico: Fundación Konrad Adenauer.More infoArranda P, Ortega I, Rosales C, de Zapien J, Sabo S, Zapien A. (2013) Migracion y atención a la salud de los Jornalero agricolas. In Alternativas en la crisis para la transformación de las políticas sociales en México, México/Hermosillo, El Colegio de Sonora, CIAD, Fundación Konrad Adenauer
- Carr, T. F., Beamer, P. I., Rothers, J., Stern, D. A., Gerald, L. B., Rosales, C. B., Van Horne, Y. O., Pivniouk, O. N., Vercelli, D., Halonen, M., Gameros, M., Martinez, F. D., & Wright, A. L. (2019). Prevalence of Asthma in School Children on the Arizona-Sonora Border. The journal of allergy and clinical immunology. In practice, 5(1), 114-120.e2.More infoMexican-born children living in the United States have a lower prevalence of asthma than other US children. Although children of Mexican descent near the Arizona (AZ)-Sonora border are genetically similar, differences in environmental exposures might result in differences in asthma prevalence across this region.
- Bojorquez, I., Rosales, C., Angulo, A., de Zapien, J., Denman, C., & Madanat, H. (2018). International migration and dietary change in Mexican women from a social practice framework. Appetite, 125, 72-80.More infoMigration from lower- and middle-income to high-income countries is associated with dietary change, and especially with the adoption of a modern, less healthy diet. In this article we analyze the dietary changes experienced by Mexican migrants, employing as a theoretical framework the concept of social practice. According to this framework, practices integrate material elements, meanings and competences that provide their conditions of possibility. Practices are shared by members of social groups, and interact with other competing or reinforcing practices. Between 2014 and 2015, we conducted semi-structured interviews with 27 women, international return migrants living in Tijuana, Mexico. The interview guide asked about history of migration and dietary change. We found three main areas of dietary change: from subsistence farming to ready meals, abundance vs. restriction, and adoption of new food items. The first one was associated with changes in food procurement and female work: when moving from rural to urban areas, participants substituted self-produced for purchased food; and as migrant women joined the labor force, consumption of ready meals increased. The second was the result of changes in income: participants of lower socioeconomic position modified the logic of food acquisition from restriction to abundance and back, depending on the available resources. The third change was relatively minor, with occasional consumption of new dishes or food items, and was associated with exposure to different cuisines and with learning how to cook them. Public health efforts to improve the migrants' diets should take into account the constitutive elements of dietary practices, instead of isolating individuals from their social contexts.
- López-Gálvez, N., Wagoner, R., Beamer, P., de Zapien, J., & Rosales, C. (2018). Migrant Farmworkers' Exposure to Pesticides in Sonora, Mexico. International journal of environmental research and public health, 15(12).More infoExpanding agribusiness in Sonora, a state in Northern Mexico, has increased the demand for temporary migrant agricultural workers. Sonora is one of the top states in Mexico for pesticide utilization. We conducted an exploratory study to evaluate exposure to organophosphate (OP) and pyrethroid pesticides among migrant farmworkers. A sample of 20 migrant farmworkers was recruited from a large commercial grape farm during the harvest season. We administered a questionnaire on work activities, exposure characteristics, and socio-demographics. We collected urine samples to quantify pesticide metabolite concentrations. Most participants were originally from the state of Chiapas, Mexico, none had completed high school, and about half spoke an indigenous language as well as Spanish. The majority of participants had detectable concentrations of pyrethroid and organophosphate biomarkers. Geometric mean creatinine-adjusted concentrations for 3-phenoxybenzoic acid (1.83 µg/g), trans-3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane carboxylic acid (0.88 µg/g), 4-fluoro-3-phenoxybenzoic acid (0.94 µg/g), 3,5,6-trichloro-2-pyridinol (3.56 µg/g), and para-nitrophenol (0.63 µg/g) were significantly higher than in the general United States' population and Mexican Americans. Our results also suggest that migrant farmworkers in this region are exposed to pesticides at higher levels than other farmworkers' studies. Farmworkers' age, language, training on personal protective equipment, time at the farm, and season, were significant exposure determinants.
- Sabo, S., Denman Champion, C., Bell, M. L., Cornejo Vucovich, E., Ingram, M., Valencia, C. I., Castro Vasquez, M. d., Gonzalez Fagoaga, J. E., Guernsey De Zapien, J. E., & Rosales, C. B. (2018). Meta Salud Diabetes study protocol: a cluster-randomised trial to reduce cardiovascular risk among a diabetic population of Mexico. BMJ Open, 3(8), 1-10. doi:10.1136/bmjopen-2017-020762
- Sabo, S., Denman Champion, C., Bell, M. L., Cornejo Vucovich, E., Ingram, M., Valenica, C., Castro Vasquez, M. D., Gonzalez-Fagoaga, E., Geurnsey de Zapien, J., & Rosales, C. B. (2018). Meta Salud Diabetes study protocol: a cluster-randomised trial to reduce cardiovascular risk among a diabetic population of Mexico. BMJ open, 8(3), e020762.More infoNorthern Mexico has among the highest rates of cardiovascular disease (CVD) and diabetes in the world. This research addresses core gaps in implementation science to develop, test and scale-up CVD risk-reduction interventions in diabetics through a national primary care health system.
- Contreras, O. A., Rosales, C. B., Gonzalez-Fagoaga, E., Valencia, C. I., & Rangel, M. G. (2017). Impacting Binational Health through Leadership Development: A Program Evaluation of the Leaders across Borders Program, 2010-2014. Frontiers in public health, 5, 215.More infoWorkforce and leadership development is imperative for the advancement of public health along the U.S./Mexico border. The Leaders across borders (LaB) program aims to train the public health and health-care workforce of the border region. The LaB is a 6-month intensive leadership development program, which offers training in various areas of public health. Program curriculum topics include: leadership, border health epidemiology, health diplomacy, border public policies, and conflict resolution.
- Rangel Gomez, M. G., Tonda, J., Zapata, G. R., Flynn, M., Gany, F., Lara, J., Shapiro, I., & Rosales, C. B. (2017). Ventanillas de Salud: A Collaborative and Binational Health Access and Preventive Care Program. Frontiers in public health, 5, 151.More infoWhile individuals of Mexican origin are the largest immigrant group living in the U.S., this population is also the highest uninsured. Health disparities related to access to health care, among other social determinants, continue to be a challenge for this population. The government of Mexico, in an effort to address these disparities and improve the quality of life of citizens living abroad, has partnered with governmental and non-governmental health-care organizations in the U.S. by developing and implementing an initiative known as -Health Windows-(VDS). The VDS is located throughout the Mexican Consular network and aim to increase access to health care and health literacy, provide health screenings, and promote healthy lifestyle choices among low-income and immigrant Mexican populations in the U.S.
- Rosales, C. B., de Zapien, J. E., Chang, J., Ingram, M., Fernandez, M. L., Carvajal, S. C., & Staten, L. K. (2017). Perspectives on a US-Mexico Border Community's Diabetes and "Health-Care" Access Mobilization Efforts and Comparative Analysis of Community Health Needs over 12 Years. Frontiers in public health, 5, 152.More infoThis paper describes a community coalition-university partnership to address health needs in an underserved US-Mexico border, community. For approximately 15 years, this coalition engaged in community-based participatory research with community organizations, state/local health departments, and the state's only accredited college of public health. Notable efforts include the systematic collection of health-relevant data 12 years apart and data that spawned numerous health promotion activities. The latter includes specific evidence-based chronic disease-preventive interventions, including one that is now disseminated and replicated in Latino communities in the US and Mexico, and policy-level changes. Survey data to evaluate changes in a range of health problems and needs, with a specific focus on those related to diabetes and access to health-care issues-identified early on in the coalition as critical health problems affecting the community-are presented. Next steps for this community and lessons learned that may be applicable to other communities are discussed.
- Valencia, C. I., Asaolu, I. O., Ehiri, J. E., & Rosales, C. (2017). Structural barriers in access to medical marijuana in the USA-a systematic review protocol. Systematic reviews, 6(1), 154.More infoThere are 43 state medical marijuana programs in the USA, yet limited evidence is available on the demographic characteristics of the patient population accessing these programs. Moreover, insights into the social and structural barriers that inform patients' success in accessing medical marijuana are limited. A current gap in the scientific literature exists regarding generalizable data on the social, cultural, and structural mechanisms that hinder access to medical marijuana among qualifying patients. The goal of this systematic review, therefore, is to identify the aforementioned mechanisms that inform disparities in access to medical marijuana in the USA.
- Valencia, C. I., Ernst, K., & Rosales, C. B. (2017). Tuberculosis Treatment Completion in a United States/Mexico Binational Context. Frontiers in public health, 5, 118.More infoTuberculosis (TB) remains a salient public health issue along the U.S./Mexico border. This study seeks to identify the social and structural factors, which are associated with TB disease burden in the binational geographic region. Identification of barriers of treatment completion provides the necessary framework for developing evidence-based interventions that are culturally relevant and context specific for the U.S./Mexico border region.
- Ortega, M. I., Sabo, S., Aranda Gallegos, P., De Zapien, J. E., Zapien, A., Portillo Abril, G. E., & Rosales, C. (2016). Agribusiness, Corporate Social Responsibility, and Health of Agricultural Migrant Workers. Frontiers in public health, 4, 54.More infoLiving conditions and health of migrant farmworkers could benefit from a health promotion model based on corporate social responsibility (CSR).
- Rosales, C. B. (2016). Agribusiness, Corporate Social Responsibility and Health of Agricultural Migrant Workers. Frontiers in Public Health, 4(54), 10. doi:10.3389/fpubh.2016.00054
- Rosales, C. B. (2016). Developing a Network of Community Health Workers: Improving the Lives of Migrant Farmworkers. Open Journal of Social Sciences, 4, 14. doi:http://dx.doi.org/10.4236/jss.2016.410011
- Rosales, C. B. (2016). Editorial: Emergent Public Health Issues in the US–Mexico Border Region. Frontiers in Public Health, 4(93), 10. doi:https://doi.org/10.3389/fpubh.2016.00093
- Rosales, C. B. (2016). Prevalence of Asthma in School Children on the Arizona-Sonora Border. The Journal of Allergy and Clinical Immunology: In Practice, 5(1), 6. doi:http://dx.doi.org/10.1016/j.jaip.2016.07.001
- Rosales, C. B. (2016). The effects of prenatal cannabis exposure on fetal development and pregnancy outcomes: a protocol. BMJ, 5(3), 10.
- Rosales, C. B., Carvajal, S., & de Zapien, J. E. (2016). Editorial: Emergent Public Health Issues in the US-Mexico Border Region. Frontiers in public health, 4, 93.
- Denman, C. A., Bell, M. L., Cornejo, E., de Zapien, J. G., Carvajal, S., & Rosales, C. (2015). Changes in health behaviors and self-rated health of participants in Meta Salud: a primary prevention intervention of NCD in Mexico. Global heart, 10(1), 55-61.More infoMeta Salud was a community health worker-facilitated intervention for the prevention of noncommunicable diseases in Northern Mexico.
- Gunn, J. K., Rosales, C. B., Center, K. E., Nuñez, A. V., Gibson, S. J., & Ehiri, J. E. (2015). The effects of prenatal cannabis exposure on fetal development and pregnancy outcomes: a protocol. BMJ open, 5(3), e007227.More infoThe effects of exposure to marijuana in utero on fetal development are not clear. Given that the recent legislation on cannabis in the US is likely to result in increased use, there is a need to assess the effects of prenatal cannabis exposure on fetal development and pregnancy outcomes. The objective of this review is to assess the effects of prenatal exposure to cannabis on pregnancy outcomes (including maternal and child outcomes).
- Sabo, S., de Zapien, J., Teufel-Shone, N., Rosales, C., Bergsma, L., & Taren, D. (2015). Service learning: a vehicle for building health equity and eliminating health disparities. American journal of public health, 105 Suppl 1, S38-43.More infoService learning (SL) is a form of community-centered experiential education that places emerging health professionals in community-generated service projects and provides structured opportunities for reflection on the broader social, economic, and political contexts of health. We describe the elements and impact of five distinct week-long intensive SL courses focused on the context of urban, rural, border, and indigenous health contexts. Students involved in these SL courses demonstrated a commitment to community-engaged scholarship and practice in both their student and professional lives. SL is directly in line with the core public health value of social justice and serves as a venue to strengthen community-campus partnerships in addressing health disparities through sustained collaboration and action in vulnerable communities.
- Denman, C. A., Rosales, C., Cornejo, E., Bell, M. L., Munguía, D., Zepeda, T., Carvajal, S., & Guernsey de Zapien, J. (2014). Evaluation of the community-based chronic disease prevention program Meta Salud in Northern Mexico, 2011-2012. Preventing chronic disease, 11, E154.More infoMeta Salud is a community health worker-facilitated intervention in Hermosillo, Sonora, Mexico, and was adapted from Pasos Adelante, a similar evidence-based intervention developed for a Latino population in the United States-Mexico border region. The objective of this study was to examine outcomes for Meta Salud and compare them with outcomes for Pasos Adelante.
- Langellier, B. A., Guernsey de Zapien, J., Rosales, C., Ingram, M., & Carvajal, S. C. (2014). State Medicaid expansion, community interventions, and health care disparities in a United States-Mexico border community. American journal of public health, 104(8), e94-e100.More infoWe investigated whether access to and use of health care services increased among residents of a low-income, predominantly Mexican American border community affected by the expansion of Arizona's Medicaid program in 2001 and multiple community-level programs and policies.
- Rosales, C. B., Coe, K., Ortiz, S., Gámez, G., & Stroupe, N. (2014). Social justice, health, and human rights education: challenges and opportunities in schools of public health. Public health reports (Washington, D.C. : 1974), 127(1).
- Sabo, S. J., Shaw, S. J., Ingram, M. -., Teufel-Shone, N. I., Carvajal, S., De Zapien, J. G., Rosales, C. B., Redondo, F., Garcia, G., & Rubio-Goldsmith, R. (2014). Everyday Violence , Structural Racism and Mistreatment at the US-Mexico Border. Social Science and Medicine, 109, 66-74.More infoSabo S, Shaw S, Ingram M, , Teufel Shone N, Carvajal S, de Zapien J, Rosales C, Redondo F**, Garcia G**, . Rubio-Goldsmith R. Everyday Violence , Structural Racism and Mistreatment at the US-Mexico Border. Social Science and Medicine.
- Sabo, S., Shaw, S., Ingram, M., Teufel-Shone, N., Carvajal, S., de Zapien, J. G., Rosales, C., Redondo, F., Garcia, G., & Rubio-Goldsmith, R. (2014). Everyday violence, structural racism and mistreatment at the US-Mexico border. Social science & medicine (1982), 109, 66-74.More infoImmigration laws that militarize communities may exacerbate ethno-racial health disparities. We aimed to document the prevalence of and ways in which immigration enforcement policy and militarization of the US-Mexico border is experienced as everyday violence. Militarization is defined as the saturation of and pervasive encounters with immigration officials including local police enacting immigration and border enforcement policy with military style tactics and weapons. Data were drawn from a random household sample of US citizen and permanent residents of Mexican descent in the Arizona border region (2006-2008). Qualitative and quantitative data documented the frequency and nature of immigration related profiling, mistreatment and resistance to institutionalized victimization. Participants described living and working in a highly militarized environment, wherein immigration-related profiling and mistreatment were common immigration law enforcement practices. Approximately 25% of respondents described an immigration-related mistreatment episode, of which 62% were personally victimized. Nearly 75% of episodes occurred in a community location rather than at a US port of entry. Participant mistreatment narratives suggest the normalization of immigration-related mistreatment among the population. Given border security remains at the core of immigration reform debates, it is imperative that scholars advance the understanding of the public health impact of such enforcement policies on the daily lives of Mexican-origin US permanent residents, and their non-immigrant US citizen co-ethnics. Immigration policy that sanctions institutional practices of discrimination, such as ethno-racial profiling and mistreatment, are forms of structural racism and everyday violence. Metrics and systems for monitoring immigration and border enforcement policies and institutional practices deleterious to the health of US citizens and residents should be established.
- Carvajal, S. C., Miesfeld, N., Chang, J., Reinschmidt, K. M., de Zapien, J. G., Fernandez, M. L., Rosales, C., & Staten, L. K. (2013). Evidence for long-term impact of Pasos Adelante: using a community-wide survey to evaluate chronic disease risk modification in prior program participants. International journal of environmental research and public health, 10(10).More infoEffective community-level chronic disease prevention is critical to population health within developed and developing nations. Pasos Adelante is a preventive intervention that aims to reduce chronic disease risk with evidence of effectiveness in US-Mexico residing, Mexican origin, participants. This intervention and related ones also implemented with community health workers have been shown to improve clinical, behavioral and quality of life indicators; though most evidence is from shorter-term evaluations and/or lack comparison groups. The current study examines the impact of this program using secondary data collected in the community 3-6 years after all participants completed the program. A proportional household survey (N = 708) was used that included 48 respondents who indicated they had participated in Pasos. Using propensity score matching to account for differences in program participants versus other community residents (the program targeted those with diabetes and associated risk factors), 148 natural controls were identified for 37 matched Pasos participants. Testing a range of behavioral and clinical indicators of chronic disease risk, logistic regression models accounting for selection bias showed two significant findings; Pasos participants were more physically active and drank less whole milk. These findings add to the evidence of the effectiveness of Pasos Adalente and related interventions in reducing chronic disease risk in Mexican-origin populations, and illustrate the use of innovative techniques for using secondary, community-level data to complement prior evaluation research.
- Carvajal, S. C., Rosales, C., Rubio-Goldsmith, R., Sabo, S., Ingram, M., McClelland, D. J., Redondo, F., Torres, E., Romero, A. J., O'Leary, A. O., Sanchez, Z., & de Zapien, J. G. (2013). The border community and immigration stress scale: a preliminary examination of a community responsive measure in two Southwest samples. Journal of immigrant and minority health / Center for Minority Public Health, 15(2).More infoUnderstanding contemporary socio-cultural stressors may assist educational, clinical and policy-level health promotion efforts. This study presents descriptive findings on a new measure, the border community and immigration stress scale. The data were from two community surveys as part of community based participatory projects conducted in the Southwestern US border region. This scale includes stressful experiences reflected in extant measures, with new items reflecting heightened local migration pressures and health care barriers. Stressors representing each main domain, including novel ones, were reported with frequency and at high intensity in the predominantly Mexican-descent samples. Total stress was also significantly associated with mental and physical health indicators. The study suggests particularly high health burdens tied to the experience of stressors in the US border region. Further, many of the stressors are also likely relevant for other communities within developed nations also experiencing high levels of migration.
- Carvajal, S., Carvajal, S., Rosales, C. B., Rosales, C. B., Raquel, G. R., Raquel, G. R., Sabo, S., Sabo, S., Ingram, M. -., Ingram, M. -., McClelland, D., McClelland, D., Redondo, F., Redondo, F., Torres, E., Torres, E., Romero, A. J., Romero, A. J., O'Leary, A. O., , O'Leary, A. O., et al. (2013). The Border Community and Immigration Stress Scale: A Preliminary Examination of a Community Responsive Measure in Two Southwest Samples. Journal of Immigrant & Minority Health, 2(15), 427-436.More infoThis article is based on earlier research on Migrant Farmworker health in Yuma, Arizona. The article was first published on-line in 2012, then in print in 2013.
- Chang, J., Guy, M. C., Rosales, C., de Zapien, J. G., Staten, L. K., Fernandez, M. L., & Carvajal, S. C. (2013). Investigating social ecological contributors to diabetes within Hispanics in an underserved U.S.-Mexico border community. International journal of environmental research and public health, 10(8).More infoHispanics bear a disproportionate burden of diabetes in the United States, yet relations of structural, socio-cultural and behavioral factors linked to diabetes are not fully understood across all of their communities. The current study examines disparities and factors associated with diabetes in adult Hispanics of Mexican-descent (N = 648) participating in a population survey of an underserved rural U.S.-Mexico border community. The overall rate of diabetes prevalence rate in the sample, based on self-report and a glucose testing, was 21%; much higher than rates reported for U.S. adults overall, for all Hispanic adults, or for Mexican American adults specifically. Acculturation markers and social determinants of health indicators were only significantly related to diabetes in models not accounting for age. Older age, greater BMI (>30), greater waist-to-hip ratio as well as lower fruit and vegetable consumption were significantly related to increased likelihood of diabetes when all structural, cultural, behavioral, and biological factors were considered. Models with sets of behavioral factors and biological factors each significantly improved explanation of diabetes relative to prior social ecological theory-guided models. The findings show a critical need for diabetes prevention efforts in this community and suggest that health promotion efforts should particularly focus on increasing fruit and vegetable consumption.
- Rosales, C. (2013). The Enigma of the Stigma of Hair Loss: Why is Cancer-Treatment Related Alopecia so Traumatic for Women?. Open Cancer Journal, 6, 1-8.More infoCoe, K., Staten, L., Rosales, C., & Swanson, M. (2013). The Enigma of the Stigma of Hair Loss: Why is Cancer-Treatment Related Alopecia so Traumatic for Women?. Open Cancer Journal, 6, 1-8.
- Rosales, C., Carvajal, S. C., Kibor, C., McClelland, D. J., Ingram, M., de Zapien, J. G., Torres, E., Redondo, F., Rodriguez, K., Rubio-Goldsmith, R., Meister, J., & Rosales, C. B. (2013). Stress and Sociocultural Factors Related to Health Status Among US-Mexico Border Farmworkers. Journal of immigrant and minority health / Center for Minority Public Health.More infoThis study examines factors relating to farmworkers' health status from sociocultural factors, including stress embedded within their work and community contexts. A cross-sectional household survey of farmworkers (N = 299) included social-demographics, immigration status descriptors, and a social-ecologically grounded, community-responsive, stress assessment. Outcomes included three standard US national surveillance measures of poor mental, physical, and self-rated health (SRH). Logistic regression models showed that higher levels of stress were significantly associated (Ps
- Rosales, C., Sugeng, A. J., Beamer, P. I., Lutz, E. A., & Rosales, C. B. (2013). Hazard-ranking of agricultural pesticides for chronic health effects in Yuma County, Arizona. The Science of the total environment, 463-464.More infoWith thousands of pesticides registered by the United States Environmental Protection Agency, it not feasible to sample for all pesticides applied in agricultural communities. Hazard-ranking pesticides based on use, toxicity, and exposure potential can help prioritize community-specific pesticide hazards. This study applied hazard-ranking schemes for cancer, endocrine disruption, and reproductive/developmental toxicity in Yuma County, Arizona. An existing cancer hazard-ranking scheme was modified, and novel schemes for endocrine disruption and reproductive/developmental toxicity were developed to rank pesticide hazards. The hazard-ranking schemes accounted for pesticide use, toxicity, and exposure potential based on chemical properties of each pesticide. Pesticides were ranked as hazards with respect to each health effect, as well as overall chronic health effects. The highest hazard-ranked pesticides for overall chronic health effects were maneb, metam-sodium, trifluralin, pronamide, and bifenthrin. The relative pesticide rankings were unique for each health effect. The highest hazard-ranked pesticides differed from those most heavily applied, as well as from those previously detected in Yuma homes over a decade ago. The most hazardous pesticides for cancer in Yuma County, Arizona were also different from a previous hazard-ranking applied in California. Hazard-ranking schemes that take into account pesticide use, toxicity, and exposure potential can help prioritize pesticides of greatest health risk in agricultural communities. This study is the first to provide pesticide hazard-rankings for endocrine disruption and reproductive/developmental toxicity based on use, toxicity, and exposure potential. These hazard-ranking schemes can be applied to other agricultural communities for prioritizing community-specific pesticide hazards to target decreasing health risk.
- Ortega, M., Rosales, C., de Zapien, J. G., Aranda, P., Castañeda, A., Saucedo, S., Montaño, C., & Contreras, A. (2012). Migration, agribusiness and nutritional status of children under five in Northwest Mexico. International journal of environmental research and public health, 9(1).More infoThe aim of this study was to examine the nutritional status of children of Mexican migrant worker families under five years of age within the context of global food markets. The sample included 404 children less than five years old from farms and agricultural communities in northwest Mexico. Prevalence of stunting and underweight of children appeared very similar to that of indigenous children from the national sample survey (difference 0.9 and 1.6 percentage points, respectively). Compared to the national sample of Mexican children, stunting and underweight seemed higher in migrant children (difference 17.7 and 4.5 percentage points, respectively), but wasting, an indicator of both chronic and acute undernutrition, appeared to indicate a process of nutritional recuperation. Migrant children living in poverty and suffering from chronic undernutrition, poor performance and scarce education opportunities, can be expected to eventually become agricultural workers with low productivity and poor general health. Consumer's demands on social and environmental standards of fresh food production in developed countries could be an opportunity to impact the lives of migrant agricultural workers, their families and communities.
- Rosales, C., Ortega, M. I., De Zapien, J. G., Paniagua, A. D., Zapien, A., Ingram, M., & Aranda, P. (2012). The US/Mexico border: a binational approach to framing challenges and constructing solutions for improving farmworkers' lives. International journal of environmental research and public health, 9(6).More infoMexican migrant and seasonal farmworkers in the US-Mexico border region face health hazards and occupational risks and are becoming commonly known in the public health literature. According to several studies, farmworkers have high levels of chronic diseases such as diabetes and respiratory problems, are at risk for infectious diseases, and experience among the highest incidences of work-related injuries of any profession. The findings from two studies are considered and presented with the objective of contributing to an overall understanding of migrant farmworkers as a workforce moving across national boundaries and affected by the work environments and health stressors both shared and unique to each context. We propose a binational approach to comprehensively address the health problems and socioeconomic challenges faced by migrant and seasonal farmworkers. In this paper we present the results of two distinct but complementary studies of farmworker health on the Arizona-Sonora border.
- Rosales, C. B., Nuno, T., Dieke, A., Galvez, F. N., Dutton, R. J., Guerrero, R., Dulin, P., Jiménez, E. A., Granillo, B., & de Zapien, J. G. (2011). U.S.-Mexico cross-border workforce training needs: survey implementation. Journal of injury & violence research, 3(1).More infoSince the tragic events experienced on September 11, 2001, and other recent events such as the hurricane devastation in the southeastern parts of the country and the emergent H1N1 season, the need for a competent public health workforce has become vitally important for securing and protecting the greater population. Objective: The primary objective of the study was to assess the training needs of the U.S. Mexico border states public health workforce.
- Hayden, M. H., Uejio, C. K., Walker, K., Ramberg, F., Moreno, R., Rosales, C., Gameros, M., Mearns, L. O., Zielinski-Gutierrez, E., & Janes, C. R. (2010). Microclimate and human factors in the divergent ecology of Aedes aegypti along the Arizona, U.S./Sonora, MX border. EcoHealth, 7(1).More infoThis study examined the association of human and environmental factors with the presence of Aedes aegypti, the vector for dengue fever and yellow fever viruses, in a desert region in the southwest United States and northwest Mexico. Sixty-eight sites were longitudinally surveyed along the United States-Mexico border in Tucson, AZ, Nogales, AZ, and Nogales, Sonora during a 3-year period. Aedes aegypti presence or absence at each site was measured three times per year using standard oviposition traps. Maximum and minimum temperature and relative humidity were measured hourly at each site. Field inventories were conducted to measure human housing factors potentially affecting mosquito presence, such as the use of air-conditioning and evaporative coolers, outdoor vegetation cover, and access to piped water. The results showed that Ae. aegypti presence was highly variable across space and time. Aedes aegypti presence was positively associated with highly vegetated areas. Other significant variables included microclimatic differences and access to piped water. This study demonstrates the importance of microclimate and human factors in predicting Ae. aegypti distribution in an arid environment.
- Rosales, C. B., Coe, M. K., Stroupe, N. R., Hackman, A., & de Zapien, J. G. (2010). The Culture of Health Survey: a qualitative assessment of a diabetes prevention coalition. Journal of community health, 35(1).More infoIn the past two decades, the fields of public health and social services have increasingly turned toward collaborative and community-based approaches to address complex health and social issues. One aspect of these approaches has been the development and implementation of community coalitions. Coalitions have been used to successfully address a wide range of issues, including cancer prevention, tobacco use, HIV/AIDS, youth violence, heart disease, diabetes, and sexual exploitation of youth runaways. In south Tucson, Arizona the SEAH coalition was developed to address diabetes and substance abuse prevention. Using a qualitative interview guide, the Culture of Health Survey, this study was aimed at identifying community perceptions of the coalition and its effectiveness in the areas of community leadership, partnerships, trust, and movement towards positive change. We also sought to document the dissemination, throughout a community, of information on the activities and functioning of a community based coalition and whether or not it was seen as one that held fast to the community values and not to individual agendas. Results highlight the importance of outreach, education, trust, and partnerships in promoting diabetes prevention through a community coalition.
- Rosales, C., Robinson, K. L., Ernst, K. C., Johnson, B. L., & Rosales, C. B. (2010). Health status of southern Arizona border counties: a Healthy Border 2010 midterm review. Revista panamericana de salud pública = Pan American journal of public health, 28(5).More infoThe region on the United States (US) side of the US-Mexico border consists of 44 counties in four states; populations on both sides of the border have similar health problems. Healthy Border 2010: An Agenda for Improving Health on the US-Mexico Border (HB 2010) is a binational agenda of health promotion and disease prevention for individuals in the region. This study reports on the health status of the four southern Arizona border counties.
- Fenn, J., Rosales, C., & Logue, C. (2007). "Sir insulin monk versus the evil Diana betes": a program addressing type 2 diabetes education and prevention in youth. The Diabetes educator, 33(3), 455-459.More infoThe purpose of this article is to share an innovative method of integrating community resources into a program designed to deliver age-appropriate and culturally appropriate diabetes education to youth. The educational program involves an interactive dialogue that engages school-aged children in an active process of learning about diabetes. School or community-based settings provide the best venue for presenting information to youth on diabetes. In addition, peer education is an excellent method of creating interest among youth. Many adults have received diabetes education simply by observing the program. This program has become an appealing and interactive method of delivering type 2 diabetes prevention information to children of all ages.
- Cowan, L., Esteban, E., McElroy-Hart, R., Kieszak, S., Meyer, P. A., Rosales, C., Applegate, M., Mada Vélez, G., Arias-Ortiz, J., & Rubin, C. (2006). Binational study of pediatric blood lead levels along the United States/Mexico border. International journal of hygiene and environmental health, 209(3).More infoTo evaluate lead exposure among children living in border communities, the states of Arizona and New Mexico in the United States (US), and the states of Sonora and Chihuahua in Mexico collaboratively requested that the Centers for Disease Control and Prevention (CDC) provide technical assistance to document pediatric blood lead levels (BLLs) in children living along this part of the US/Mexico border. Two studies were conducted to evaluate BLLs of children aged 1-6 years. In 1998, 1210 children were tested in the Arizona/Sonora study; in 1999, 874 children were tested in New Mexico/Chihuahua. Overall geometric mean BLL was 32.5 microg/l (95% Confidence Interval 31.5-33.5) with BLLs ranging from below limit of detection to 320.0 microg/l. Mean BLLs were higher among children living on the Mexican side of the border (43.2 microg/l) compared to those on the US side (22.3 microg/l). Mean BLLs ranged from 14.9 to 31.2 microg/l at the US sites and from 26.9 to 55.2 microg/l at the Mexican sites. This study used a convenience sample and cannot be considered representative of the general population. Nonetheless, the range of mean BLLs among the sites and especially the higher mean BLLs among children living in the border communities in Mexico suggests different exposures to lead and warrants further attention.
- Aranda, P., Ortega, I., Rosales, C. B., de Zapien, J., Beamer, P., Lopez-Galvez, N., & Wagoner, R. (2017, Fall). Heat and Hydration Assessment of Migrant Grape-Workers in Sonora, Mexico. International Society of Exposure Science Conference. Research Triangle Park, NC.
- Aranda, P., Ortega, I., Rosales, C. B., de Zapien, J., Beamer, P., Wagoner, R., & Lopez-Galvez, N. (2017, Fall). A Pilot Study on Migrant Grape Workers Exposure to Pesticides in Sonora, Mexico. International Society of Exposure Science Conference. Research Triangle Park, NC.
- Rosales, C. B., De Zapien, J. G., Sabo, S., Ingram, M., Cornejo, E., & Denman, C. (2017, Fall). Importance of implementation science in translation of evidence based health promotion programming in Mexico. American Public Health Association Annual Meeting. Atlanta, Georgia: American Public Health Association.
- Sugeng, A. J., Canales, R. A., Lutz, E. A., Rosales, C. B., & Beamer, P. (2015, October). Modeling the Transport of Agricultural Pesticides into Farmworkers’ Homes. International Society of Exposure Science. Henderson, NV.
- Sabo, S., Teufel-Shone, N. I., Rosales, C. B., & De Zapien, J. G. (2014, July). Entre Fronteras (Between Borders): the power of service learning in cultural exchange and social action in the US-Mexico borderlands. 4th International Conference of Heritage and Sustainable Development. Guimares, Portugal: UNESCO.
- De Zapien, J. G., Denman, C., Cornejo, E., Staten, L., Carvajal, S. C., & Rosales, C. B. (2013, November). Meta salud: Building binational collaboration with community health workers for prevention of chronic disease. APHA.
- Gomez, S., Celaya, M., Silk, M., England, B., De Zapien, J. G., Rosales, C. B., Dawley, D., Andrade, R., Tobar, M. -., Healy, E., & Taren, D. L. (2013, November). Parent ambassador program: A model for expanding the public health workforce to effect school wellness plans. American Public Health Association Annual Meeting. Boston MA: American Public Health Association.
- Hanna, J. J., Gonzalez Fagoaga, J. E., Rangel, G., & Rosales, C. B. (2018, November). Health Awareness for Underserved Hispanic/Latino Populations through a Primary Prevention Mobile Health Unit. American Public Health Association Annual Meeting. San Diego, California: American Public Health Association.
- Ingram, M., Denman, C., Aceves, B., Ocejo, A., Cornejo, E., de Zapien, J. G., & Rosales, C. B. (2018, November). Role of implementation science in addressing chronic disease on a global scale. APHA Annual Meeting. San Diego, CA: American Public Health Association.
- Carvajal, S. C., Jean, C., Sam, S., De Zapien, J. G., & Rosales, C. B. (2013, November). Diabetes disparities in Latino adults in US-Mexico border: Are social context-related stressors contributing?. APHA.
- Carvajal, S. C., Jean, C., Sam, S., De Zapien, J. G., & Rosales, C. B. (2014, November). AZCHW Coalition: History, Process, and Outcomes. APHA.
- Sugeng, A. J., Canales, R. A., Lutz, E. A., Rosales, C. B., & Beamer, P. I. (2014, October). Using Chemical Characteristics to Explain Agricultural Pesticide Transport Pathways from the Field into Homes. International Society of Exposure Science. Cincinnati, OH: International Society of Exposure Science.
- Sugeng, A., Canales, R. A., Lutz, E. A., Rosales, C. B., & Beamer, P. I. (2014, October). Using chemical characteristics to explain transport pathways of agricultural pesticides from the field into homes. International Society of Exposure Science. Cincinnati, OH.
- Sugeng, A., Sugeng, A. J., Canales, R. A., Canales, R. A., Lutz, E. A., Lutz, E. A., Rosales, C. B., Rosales, C. B., Beamer, P. I., & Beamer, P. I. (2014, October). Exploring the Influence of Household and Housing Characteristics on Transport of Agricultural Pesticides into Farmworkers' Homes. International Society of Exposure Science. Cincinnati, OH.
- Bravo-Clouzet, R., Heckert, K. A., Ehiri, J. E., Rosales, C. B., Attakai, A. -., Guerrero, R., Andrade, R., & Taren, D. L. (2013, November). New frontiers in global health leadership: Building strong health systems to respond to non-communicable diseases – a versatile training toolkit for professionals and graduate students. American Public Health Association Annual Meeting. Boston MA: American Public Health Association.
- Sabo, S. J., De Zapien, J. G., Ingram, M. -., Rosales, C. B., & Carvajal, S. (2013, November). Everyday violence of immigration related ethno-racial profiling and mistreatment: A mixed methods approach to understanding immigration policy as a structural determinants of health. American Public Health Association Annual Meeting. Boston, MA: American Public Health Association.More infoPublic health scholars have called for research into the impact of state level immigration policies on the public's health and have recognized these policies may exacerbate existing racial and ethnic disparities among immigrant populations and their co-ethnics. Objective: The purpose of this study was to apply the theory of everyday violence to explore immigration policy and militarization of the US-Mexico border as a structural determinant of health. Methods: Through qualitative and quantitative data, the prevalence and type of direct and indirect experiences of immigration related ethno- racial profiling, mistreatment and resistance to institutionalized victimization were explored among 499 Mexican border farmworkers during the years 2005-2007. Results: Farmworkers were predominately US citizens and permanent residents with more than two decades working in US agriculture. Approximately 25% described a personally experienced and/ or witnessed immigration related mistreatment encounter, categorized as verbal, physical and or psychological mistreatment by an immigration official. Approximately 75% of all mistreatment encounters occurred in a non US-port of entry community location, and more than half were experienced personally and or reported by female farmworkers who were 30% of the total sample. Conclusion: Farmworkers described living and working in a highly militarized environment, whereby immigration related ethno-racial profiling and mistreatment were common immigration law enforcement practices. This paper argues for the inclusion of immigration policy that sanctions the institutional practices of discrimination, such as ethno-racial profiling and mistreatment by immigration officials, as a structural determinant of health and a form of everyday violence.
- Sabo, S. J., Rosales, C. B., De Zapien, J. G., Change, J., & Carvajal, S. (2013, November). Diabetes disparities in Latino adults in US-Mexico border: Are social context-related stressors contributing?. American Public Health Association Annual Meeting. Boston, MA: American Public Health Association.More infoMexican-descent persons living at the border have high rates of diabetes. Health consequences are further exacerbated by SES and health care access disparities, and within Arizona, an intense socio-political environment associated with immigration enforcement. This work examines context-relevant stressors as well as a more general stress and mental health problems, in relating to diabetes. The participants are from proportional household samples of adult Latino farmworkers (Southwest Arizona; N=299) and of Latino adults (Southeast Arizona; N = 648). The data were part of community-based participatory research involving diverse partnerships of academics, promotoras and other community advocates, and other public health professionals requesting surveillance, programmatic and policy-related data. Response rates were over 85%, a testament to the community partnerships and strong community rapport. Except for social-ecologic stress (1st sample only; from the Border Community and Immigration Stress Scale) and glucose (2nd sample only), measures were derived from standard behavior/health surveillance instruments. In the farmworker sample 16% reported physician diabetes diagnosis, while in the other sample the rate was 21% (including 1% detected from the glucose test alone). These rates are about 2-3 times that for non-Hispanic whites in the US, and 25-50% higher than the national rates for Latino or Mexican American adults. Models tested in both samples showed among stress and mental health indicators, only the BCISS related to significantly excess (AOR=1.7) risk for diabetes. Efforts to reduce diabetes should consider a broad range of culturally and context-relevant stressors, and consider ways to intervene on the individual, group and policy level.
- Sabo, S., Ingram, M., De Zapien, J. G., Rosales, C. B., & Carvajal, S. C. (2013, November). Everyday violence of immigration related ethno-racial profiling and mistreatment: A mixed methods approach to understanding immigration policy as a structural determinants of health.. APHA.
- Taren, D. L., Taren, D. L., De Zapien, J. G., De Zapien, J. G., Teufel-Shone, N. I., Teufel-Shone, N. I., Rosales, C. B., Rosales, C. B., Sabo, S., Sabo, S., Foote, J. A., Foote, J. A., Bergsma, L. J., Bergsma, L. J., Heckert, K. A., Heckert, K. A., Raine, S., Raine, S., Lutz, E. A., & Lutz, E. A. (2013, June). Creating an Environment that has Service Learning Integrated into the Curricula. Innovations for Public Health Education, Columbia University.