In 2022, around 17 percent of Hispanics or Latinos in the U.S. received mental health treatment or counseling in the past year. This statistic represents the percentage of U.S. Hispanic or Latino adults who received mental health treatment in the past year from 2002 to 2023.

In 2023, around 59.2 million adults in the United States received treatment or counseling for their mental health within the past year. Such treatment included inpatient or outpatient treatment or counseling, or the use of prescription medication. Anxiety and depression are two common reasons for seeking mental health treatment. Who most often receives mental health treatment? In the United States, women are almost twice as likely than men to have received mental health treatment in the past year, with around 21 percent of adult women receiving some form of mental health treatment in the past year, as of 2021. Considering age, those between 18 and 44 years are more likely to receive counseling or therapy than older adults, however older adults are more likely to take medication to treat their mental health issues. Furthermore, mental health treatment in general is far more common among white adults in the U.S. than among other races or ethnicities. In 2020, around 24.4 percent of white adults received some form of mental health treatment in the past year compared to 15.3 percent of black adults and 12.6 percent of Hispanics. Reasons for not receiving mental health treatment Although stigma surrounding mental health treatment has declined over the last few decades and access to such services has greatly improved, many people in the United States who want or need treatment for mental health issues still do not get it. For example, it is estimated that almost half of women with some form of mental illness did not receive any treatment in the past year, as of 2022. Sadly, the most common reason for U.S. adults to not receive mental health treatment is that they thought they could handle the problem without treatment. Other common reasons for not receiving mental health treatment include not knowing where to go for services or could not afford the costs.

Phase I: Summary statistics of the MAS and T2D variables (N = 15).

AimTacrolimus, an immunosuppressant used to prevent organ rejection in renal transplant patients, exhibits high inter-patient variability, necessitating therapeutic drug monitoring. Early post-transplant tacrolimus exposure in Hispanics is understudied. Although genotypic information is linked to pharmacokinetic differences, its clinical application remains limited. This study aimed to use a real-world data-driven, pharmacokinetic model-based approach for tacrolimus in Hispanics to determine a suitable initial dose and design an optimal dose titration strategy by simulations to achieve plasma trough concentration target levels of 10–12 ng/mL at the earliest.MethodsSparse concentration-time data of tacrolimus were obtained from electronic medical records for self-identified Hispanic subjects following renal transplant. Rich pharmacokinetic literature data was leveraged to estimate structural pharmacokinetic model parameters, which were then fixed in the current analysis. Only apparent clearance was estimated with the sparse tacrolimus data and potential covariates were identified. Simulations of various starting doses and different dose titration strategies were then evaluated.ResultsThe analysis included 121 renal transplant patients with 2,215 trough tacrolimus concentrations. A two-compartment transit absorption model with allometrically scaled body weight and time-varying hematocrit on apparent clearance adequately described the data. The estimated apparent clearance was 13.7 L/h for a typical patient weighing 70 kg and at 30% hematocrit, demonstrating a 40% decrease in clearance compared to other patient populations. Model based simulations indicated the best initial dose for the Hispanic population is 0.1 mg/kg/day. The proposed titration strategy, with three dose adjustments based on trough levels of tacrolimus, increased the proportion of patients within the target range (10–12 ng/mL) more than 2.5-fold and decreased the proportion of patients outside the therapeutic window by 50% after the first week of treatment.ConclusionHispanic renal transplant population showed an estimated 40% decrease of apparent clearance in the typical patient compared to other populations with similar characteristics. The proposed dose adjustment attained the target range rapidly and safely. This study advocates for tailored tacrolimus dosing regimens based on population pharmacokinetics to optimize therapy in Hispanic renal transplant recipients.

The Rio Grande Valley (RGV) in South Texas has one of the highest prevalence of obesity and type 2 diabetes (T2D) in the United States (US). We report for the first time the T2D prevalence in persons with HIV (PWH) in the RGV and the interrelationship between T2D, cardiometabolic risk factors, HIV-related indices, and antiretroviral therapies (ART). The PWH in this study received medical care at Valley AIDS Council (VAC) clinic sites located in Harlingen and McAllen, Texas. Henceforth, this cohort will be referred to as Valley AIDS Council Cohort (VACC). Cross-sectional analyses were conducted using retrospective data obtained from 1,827 registries. It included demographic and anthropometric variables, cardiometabolic traits, and HIV-related virological and immunological indices. For descriptive statistics, we used mean values of the quantitative variables from unbalanced visits across 20 months. Robust regression methods were used to determine the associations. For comparisons, we used cardiometabolic trait data obtained from HIV-uninfected San Antonio Mexican American Family Studies (SAMAFS; N = 2,498), and the Mexican American population in the National Health and Nutrition Examination Survey (HHANES; N = 5,989). The prevalence of T2D in VACC was 51% compared to 27% in SAMAFS and 19% in HHANES, respectively. The PWH with T2D in VACC were younger (4.7 years) and had lower BMI (BMI 2.43 units less) when compared to SAMAFS individuals. In contrast, VACC individuals had increased blood pressure and dyslipidemia. The increased T2D prevalence in VACC was independent of BMI. Within the VACC, ART was associated with viral load and CD4+ T cell counts but not with metabolic dysfunction. Notably, we found that individuals with any INSTI combination had higher T2D risk: OR 2.08 (95%CI 1.67, 2.6; p < 0.001). In summary, our results suggest that VACC individuals may develop T2D at younger ages independent of obesity. The high burden of T2D in these individuals necessitates rigorously designed longitudinal studies to draw potential causal inferences and develop better treatment regimens.

More than 50 million people were found to lack access to health services and were therefore regarded as socially vulnerable in Mexico in 2022, the highest number in the period analyzed. This represented around 39.1 percent of the country's population. The number of inhabitants in Mexico lacking access to health services had been decreasing from 2008 to 2016, but started increasing again in 2018.