Puerto Rican Victimization and Crime on the Mainland: The Role of Acculturation

Abstract

This study addresses criminal victimization and contact with police among older Puerto Ricans living in Northeastern United States. Framing their experiences within the context of immigration, we assess the role that acculturation and perceived stress play on Puerto Rican crime and victimization. Data from the Boston Puerto Rican Health Study (BPRHS; N = 1,504) were analyzed using multiple logistic regressions. The experience of criminal victimization by Puerto Ricans is associated with higher educational attainment, increased perceived stress, and also with psychological acculturation. Contact with police is associated with linguistic, but not psychological, acculturation. Our findings give strength to the argument that exposure to crime and the criminal justice system increases with acculturation and that this argument is relevant to Puerto Ricans. Thus, the association between acculturation, criminal victimization, and police contact depends on the conceptualization of acculturation used. The relationship between stress, acculturation, and crime among Latinos is complex and warrants further assessment.

Introduction

Puerto Ricans living in mainland United States face substantial economic and social challenges, despite their U.S. citizenship. Previous scholarly work argues that the Puerto Rican experience can be viewed through a transnational perspective (Aranda, 2007a; Duany, 2002; Perez, 2004). Puerto Rican criminal perpetration and victimization, therefore, should be understood within the framework of Latino immigration, while simultaneously recognizing their unique experiences. In this intragroup analysis, we delineate the role of acculturation and experienced stress as related to police contact and victimization for Puerto Ricans in the greater Boston area.

Puerto Ricans in Mainland United States

Latinos in the United States differ in their experiences according to region and culture of origin, and this extends to experiences of acculturation, stress, and crime. As the second largest Hispanic group in the United States, Puerto Ricans deserve a nuanced assessment. The population of Puerto Ricans in the mainland United States now exceeds that of the Commonwealth itself, with 4.6 million in the mainland and 3.7 million residents of the island itself (U.S. Census Bureau, 2011). This represents a 36% mainland population growth between 2000 and 2010. Geographic distribution of Puerto Ricans is also unique, with 53% of mainland Puerto Ricans living in the Northeast (U.S. Census Bureau, 2011).

There is disagreement among immigrant scholars as to whether the experiences of Puerto Ricans, as legal citizens of the United States, are different from those immigrants from other nations (Ariza, 2010). However, this research argues that the Puerto Rican experience can and should be framed within an immigration framework. Puerto Ricans are best understood from a transnational perspective (Aranda, 2007a; Duany, 2002; Perez, 2004). While not officially considered as “immigrants” due to the political status of the Commonwealth of Puerto Rico, which includes U.S. citizenship for those born on the island, their experiences are similar to those of other immigrants (Perez, 2004). Puerto Rico and its residents have a history of subjugation and exploitation by the United States that differentiates it from mainland states (Ariza, 2010). The boundaries that Puerto Ricans cross are not national, but in migrating from the island to the mainland, Puerto Ricans do cross substantial geopolitical, social, and cultural boundaries (Aranda, 2007b). Duany (2002) argued that the lack of Puerto Rican sovereignty adds to a collective sense of cultural nationhood. Thus, previous research on transnational Latino immigration, acculturation, stress, and crime are as relevant and appropriate for mainland Puerto Rican populations as for other Latino groups.

Acculturation

In the early- to mid-20th-century United States, acculturation was seen as synonymous to assimilation—a unidirectional process where immigrants simultaneously unlearned their cultural behaviors while taking on the new culture (Lara, Gamboa, Kahramanian, Morales, & Hanyes Mautista, 2005). However, it was soon recognized that acculturation processes can and do vary within and between different immigrant populations. Thus arose new conceptualizations (Lara et al., 2005) and approaches toward operationalizing acculturation (Rudmin, 2009). Specifically, bidimensional models of acculturation recognize that adherence to new dominant cultures do not require the rejection of the original culture (Lara et al., 2005). In redefining acculturation as a multidimensional construct, Lopez-Class, Gonzalez Castro, and Ramirez (2011) proposed an eco-developmental framework for acculturation. Acculturation scales and measures frequently depend exclusively on language, which has a variety of limitations (Lara et al., 2005; Lopez-Class et al., 2011). Furthermore, results vary depending on the type of acculturation scale or measurement used (Lara et al., 2005). By utilizing two different acculturation scales in this study, one focusing on language and the other focusing on psychological acculturation associated with identification with a particular culture, we aim to capture a more nuanced understanding of this construct.

Acculturation, Immigration, and Crime

The past two decades have seen a resurgence of research interest in the relationship between immigration and crime. In 2000, Martinez and Lee presented and debunked a number of theoretical reasons why immigrants might perpetrate larger number of crimes by showing empirically that immigrants are actually less likely to engage in criminal behavior. This finding holds across more recent research and in a variety of areas. This negative relationship between immigration and crime can be seen on the individual/micro level as well as in the societal/macro level (Ousey & Kubrin, 2009). Not only are immigrants not more likely to be criminal perpetrators (Ousey & Kubrin, 2009), but the percentage of immigrants is not associated with more homicide in either city or national data (Martinez & Stowell, 2012). In fact, in some locations high levels of immigration in a community are associated with a decreased rate of Latino, non-Latino White, and Black homicide (Martinez & Stowell, 2012). Findings that a large foreign-born population reduces lethal violence longitudinally give strength to the revitalization thesis, which holds that immigration can have positive impacts in communities (Martinez, Stowell, & Lee, 2010). Despite this body of research, popular opinion and media representations of immigration are typically negative and continue to promote the false stereotype of criminal immigrants (Martinez & Lee, 2000), adding to migration process stress.

The relationship between acculturation, immigration, and crime has been explored in previous research, but findings remain inconclusive, as results differ according to the population studied and metrics used. Acculturation was shown to have no relationship with intimate partner violence (IPV) assaults among Mexican American college students (Ramirez, 2007) and among cohabitating or married Latino/a adults in the United States (both in terms of perpetration and victimization; Cunradi, 2009). However, in a study of Latinas in the Los Angeles, CA, area, it was found that highly or moderately acculturated Latinas were more likely to report experiencing IPV than less acculturated Latinas (Garcia, 2005). There is substantial literature on IPV and acculturation, while less exists about other types of crime. Similarly, much of the previous work has been focused on adolescents, rather than adults and older adults. Among adolescent immigrants of Chinese and Southeast Asian origins, acculturation places youth at increased risk for serious violence (Ngo & Le, 2006). Furthermore, stressful life events were predictors of violence (Ngo & Le, 2006). However, among immigrant Latino middle school students in the United States, acculturative stress (measured by discrimination stress and adaptation stress) did not predict gang involvement (Barrett, Kuperminc, & Lewis, 2013). Our focus on Puerto Rican adults is filling a gap in the acculturation and crime literature, as work has not focused on this population.

In summary, a large body of literature linking acculturation and assimilation with a variety of risk behavior exists, yet the theoretical underpinnings of these findings are underdeveloped, (Miller & Gibson, 2011), and specifics for different ethnic groups are not fully delineated. Additionally, while a substantial literature assesses the relationship between acculturation and physical and mental health outcomes, there has been less work focused on acculturation and criminological variables. The research that does exist shows mixed findings (Miller & Gibson, 2011). This study attempts to increase the understanding of the relationship between acculturation, stress, and criminological outcomes among Puerto Rican adults.

Method

Study and Participants

Data for this analysis come from the BPRHS. While the BPRHS is an ongoing longitudinal cohort study, currently conducting its third wave, only data from the first wave are included for this analysis. The BPRHS is collaboration between Tufts University, University of Massachusetts, and Northeastern University, and is funded by the National Institutes of Health (NIH) as part of the Centers for Population Health and Health Disparities (Tucker et al., 2010).

The study population consists of individuals living in the Boston, MA, metropolitan area, aged between 45 and 75 (at first interview), who identified as being of Puerto Rican descent. Multiple recruitment techniques were utilized, including random selection using tract data, door-to-door enumeration methods, and identification through participation in a local Puerto Rican community agency. The majority of the interviews were conducted in Spanish. The characteristics of the sample are presented in Table 1. Of importance to note is the disproportional percentage of females (70.4% of sample) as well as the high mean number of years participants have lived in mainland United States, 34.6 years (SD = 12.2). In order to assess and control for socioeconomic status, educational attainment was included in the analyses. Other demographic characteristics analyzed are gender and age of participant. The amount of time spent in the United States is also included, as it has relevance for the acculturation process.

Table 1.

Demographic Characteristics of Sample.

Characteristics
N	1,504
Gender
Female	1,059 (70.4%)
Male	445 (29.6%)
Education completed
Less than high school	698 (46.6%)
High school	571 (38.1%)
College or graduate school	228 (15.2%)
M age	57.07 years
SD	±7.6
M time in mainland	34.64 years
SD	±12.2

Outcome Variables

This article addresses two main variables of interest related to Puerto Rican criminology on the mainland. Both are derived from the Life Events Questionnaire (LEQ) section of the larger study, which asks participants whether or not specific events had occurred in their life in the past year (12 months). One of the outcome variables assesses criminal victimization, while the second variable assesses whether an individual has been recently in contact with the police.

The two survey questions related to experiences of criminal victimization asked whether the participant had experienced the following: “1. Being robbed or a victim of identity threat,” and “2. Being a victim of a violent act (rape, assault, etc.).” A single binary variable, hereby known as “victimized,” was created from these two questions, with a response of “0” indicating not having experienced either type of victimization and a “1” indicating victimization of either or both violent and property crime.

The two survey questions related to police contact asked whether the participant had experienced the following: “1. Involvement in a minor violation of the law (traffic ticket, disturbing the peace, etc.),” and “2. Legal trouble resulting in being arrested or held in jail” in the past 12 months. A single binary variable was created from these two questions, with a response of “0” indicating not having experienced either type of exposure to the police or criminal justice system and a “1” indicating police contact for either or both types of crime.

Stress Measure

The subjective experience of stress was assessed through the 14-item Perceived Stress Scale (PSS), which assesses the extent to which one’s life situation and events are perceived as uncontrollable and unpredictable (Cohen & Williamson, 1988). The scale showed good internal consistency, at 0.854. This stress scale utilized responses based on perceived stress from the past month only. It has been used in previous research with Latinos with good reliability (Tucker et al., 2010).

Acculturation Measures

Acculturation was assessed through two scales, one addressing language use and the other focusing on psychological attachment to either culture (Tucker et al., 2010). The linguistic acculturation scale addressed language preference in a variety of settings and was adapted from the Bidimensional Acculturation Scale for Hispanics (BAS; Marin & Gamba, 1996). Questions regarding language use in a variety of different settings allow for a nuanced understanding of acculturation, rather than a unidirectional assimilation model. The linguistic acculturation variable was utilized both in a scale format (with a range of 96) and in binary form.

The psychological acculturation scale was developed specifically for Puerto Ricans on the mainland (Tropp, Erkut, Coll, Alarcon, & Garcia, 1999) and thus addresses some of the differences in acculturation processes between Puerto Ricans and non-national Latino immigrants. The psychological acculturation scale asks questions related to preferential attachment to Puerto Rican or mainland culture. It shows good internal consistency, with Cronbach’s alpha of .898. The psychological and language acculturation scores correlated, r = .561, p < .001. Correlations between perceived stress and both the psychological and language acculturation variables were non-significant.

Analysis

This analysis was conducted using the SPSS statistical package. Descriptive statistics are presented for the variables. Bivariate analyses were conducted using chi-square tests for demographic characteristics. Independent sample t test assessed differences between victimized and non-victimized respondents, and between respondents with and without police contact. The main analysis consists of logistic regression models using three blocks and the “enter” method. A logistic regression analysis was conducted for the victimization variable as an outcome (0 = not victimized, 1 = victimized), and a second logistic regression analysis was conducted for the police contact variable as an outcome (0 = police contact, 1 = no police contact). For both regressions, the first block assessed demographic variables only, the second block added the stress measure, and the third block added the two acculturation variables. Results are presented in two sections: for victimization and then for police contact.

Results

Victimization was reported slightly more often than police contact, with 6.8% and 4.4% of the sample, respectively. There are 16 participants (1.1% of the sample) who reported both victimization and police contact in the past year.

Criminal Victimization

Bivariate analyses were conducted to assess initial differences between those victimized and not victimized. Results for the bivariate analyses are in Table 2. Pearson chi-square analyses were conducted between the victimization variable and both gender and education. While males showed a higher percentage of victimization than females in our sample, this difference was not significant. Differences in educational attainment, however, were found to be significant (p < .001) with a χ² value of 18.42. As level of education rises, a larger proportion of respondents reported criminal victimization. For example, only 4.9% of respondents with no high school education reported victimization, while a full 15.2% of those who have attended at least some college reported victimization.

Table 2.

Bivariate Results for Criminal Victimization.

	Victimized	Not victimized	χ2
n	103 (6.8%)	1,401 (93.2%)
Gender			0.62
Female	69 (6.5% of females)	990
Male	34 (7.6% of males)	441
Education***			18.42
>High school	34 (4.9%)	664
High school	39 (6.8%)	532
College+	30 (15.2%)	198

	Victimized M	Not victimized M
Age	55.82	57.16
Years in mainland	36.28	34.52
Stress score*	25.68	23.52
Psychological acculturation***	20.85	18.23
Linguistic acculturation**	30.54	23.92

^*p< .05.

^**p< .01.

^***p< .001.

Independent sample t tests were performed with the scale and continuous variables. Age and the length of time in the United States were not associated with criminal victimization. Stress and acculturation differences were found between respondents reporting criminal victimization and those respondents not reporting criminal victimization. Unsurprisingly, victimization was positively related to perceived stress, which showed significantly higher scores for those respondents who had experienced criminal victimization (p < .05). Similarly, higher acculturation scores were significantly associated with criminal victimization. This relationship between acculturation and victimization held true for both language-based acculturation (p < .01) and psychological acculturation (p < .001) in the bivariate analyses.

Multiple logistic regression was conducted with the independent variable victimization (Table 3). The first of the three models included all demographic variables: age in years, number of years the respondent has resided in mainland United States, educational attainment, and gender. The second model included all above-mentioned demographic variables and added perceived stress. The last, and third, model added both language-based and psychological acculturation measures to the variables included in the second model.

Table 3.

Logistic Regression Results for Victimization.

	Model 1			Model 2			Model 3
	B	SE	Exp(B)	B	SE	Exp(B)	B	SE	Exp(B)
Constant	3.479**	1.027	0.031	−3.479*	1.027	0.031	−4.326***	1.107	.013
Age	−0.023	0.016	0.977	−0.016	0.016	0.985	−0.010	0.017	0.990
Years in mainland	0.015	0.010	1.015	0.015	0.010	1.015	0.011	0.010	1.011
Education
<High school (reference)
High school	0.266	0.256	1.305	0.270	0.256	1.31	0.251	0.266	1.286
College +	0.960**	0.281	2.613	1.061***	0.284	2.89	1.006**	0.314	2.735
Gender
Female	0.153	0.224	1.165	0.227	0.226	1.254	0.237	0.229	1.267
Stress				0.033**	0.012	1.033	0.032**	0.012	1.033
Linguistic acculturation							−0.005	0.006	0.995
Psychological acculturation							0.043*	0.018	1.044
	Nagelkerke R2 = .035			Nagelkerke R2 = .048			Nagelkerke R2 = .058

^*p< .05.

^**p< .01.

^***p< .001.

General findings from the multiple logistic regression analyses show that Puerto Ricans with college education or higher are significantly more likely to report the experience of criminal victimization than those with less education. In the first model, respondents with some college or graduate school are 2.61 (p < .01) times more likely than respondents with no high school education to report criminal victimization. No other demographic variable showed significance within the full model. In the second model, higher perceived stress is associated significantly with victimization (p < .01), and that significance holds in the final model, upon inclusion of the acculturation variables.

The third and final model included all variables, including the two acculturation measures. Linguistic acculturation, while significant at p < .05 in the bivariate analyses, did not approach significance in the logistic regression. While our measure of linguistic acculturation did not seem to have an independent significant effect on victimization, psychological acculturation was associated significantly with victimization (p < .05). Consistent with the bivariate analysis, the odds ratio for psychological acculturation, 1.044 (p < .05), showed that more psychologically acculturated Puerto Ricans are more likely to report experiencing criminal victimization. Years in the mainland, unlike acculturation measures, were non-significant in either the bivariate or the regression analyses.

Contact With Police or With the Criminal Justice System

The second set of analyses assessed contact with the police or the criminal justice system as the dependent variable. We followed the same analytical process described in the Criminal Victimization section, above, including Pearson chi-square, t test, and multiple logistic regression. The results for police contact differed from those from the analysis on reporting criminal victimization.

Bivariate results show a significant relationship between the variables gender, higher educational status, psychological acculturation, and linguistic acculturation, with police contact. While gender was a non-significant factor in victimization, men are found to be more likely to have police contact, χ² = 28.8 (p < .001), which is in line with most criminological literature. As was the case for victimization, those with higher educational attainment report more police contact (p < .01). Perceived stress was not significantly associated with police contact. Results of the t test showed a significant difference in both psychological acculturation (p < .01) and language-oriented acculturation (p < .001) with police contact. Similarly to the relationship seen between criminal victimization and acculturation, higher acculturation scores are also related to police contact. All bivariate results are shown in Table 4.

Table 4.

Bivariate Results for Police Contact.

	Police contact	No police contact	χ2
n	66 (4.4%)	1,438 (95.6%)
Gender***			28.8
Female	27 (2.5% of females)	1,032
Male	39 (8.8% of males)	406
Education**			9.96
<High school (reference)	21	677
High school	27	544
College/graduate school	18	210

	Exposure M	No exposure M
Age	55.56	57.14
Years in mainland	37.41	34.51
Stress score	23.95	23.66
Psychological acculturation**	20.86	18.27
Linguistic acculturation***	38.60	23.72

^*p< .05.

^**p< .01.

^***p< .001.

Three logistic models were conducted for police contact following the same inclusion ordering with demographic, perceived stress, and finally the two acculturation variables. The calculated pseudo R² measure increased with each model. Full results for the multiple logistic regressions are reported in Table 5.

Table 5.

Logistic Regression Results for Police Contact.

	Model 1			Model 2			Model 3
	B	SE	Exp(B)	B	SE	Exp(B)	B	SE	Exp(B)
Constant	−3.303**	1.094	0.037	−3.772**	0.014	1.1012	−4.762***	1.322	0.009
Age	−0.025	0.019	0.976	−0.022	0.02	0.979	−0.003	0.021	0.997
Years in mainland	0.022	0.012	1.022	0.021	0.012	1.022	0.007	0.013	1.007
Education
<High School
High School	0.296	0.309	1.345	0.301	0.309	1.352	0.095	0.321	1.099
College +	0.891*	0.350	2.437	0.923**	0.352	2.516	0.516	0.382	1.675
Gender
Female	1.266***	0.260	3.548	1.296***	0.262	3.653	1.206***	0.266	3.341
Stress				0.012	1.221	.023	0.014	0.014	1.014
Psychological acculturation							0.004	0.021	1.004
Linguistic acculturation							0.018*	0.008	1.018
	Nagelkerke R2 = .084			Nagelkerke R2 = .086			Nagelkerke R2 = .102

^*p< .05.

^**p< .01.

^***p< .001.

Educational attainment does not appear to be as important a factor in these regression analyses as it was in the victimization analyses. While college education achieves significance in the first (p < .05) and second (p < .01) models, that relationship is not retained upon inclusion of acculturation indicators in the third model. This differs from both bivariate police contact analyses and the victimization analyses. Gender, however, retains its significance throughout the three models. Men are more than 3 times more likely to report police contact than are women in our sample. The inclusion of perceived stress in the second and third models does not change the results in a significant way.

While both language-oriented and psychological acculturation were associated with police contact in the bivariate analyses, only linguistic acculturation was shown to be related to police contact in the logistic regression model. Higher language-based acculturation scores increase the likelihood of police contact (p < .05).

Discussion

Findings related to those participants who have had police contact, or have allegedly offended, are in line with much previous criminological literature relevant to both the entire U.S. perpetrating population and immigrant perpetrators. In this study, we found that Puerto Rican men are 3 times more likely to have had police contact, which is consistent with the disproportionality of male offending in the United States. A study assessing offending among Puerto Rican youth revealed the same pattern as found in other populations, with males exhibiting a higher frequency of offending (Jennings et al., 2010). In the current study, the pattern of male police contact is found to remain consistent for our older population, as well.

Puerto Ricans with police contact have higher rates of acculturation, as measured through the language-based acculturation scale. As immigrants are known to perpetrate at lower rates than non-immigrants (Ousey & Kubrin, 2009), this finding gives strength to the argument that criminality increases with acculturation and that this argument is relevant to Puerto Ricans. Jennings et al. (2010) also found acculturation to be associated with offending in his work with Puerto Ricans. The Puerto Ricans in our sample generally live in neighborhoods with high density of Latino residents (Tucker et al., 2010). Thus, for those who live in such neighborhoods, acculturation to the English language might not be essential, while those who live in other neighborhoods and acquire the language might be more prone to then become involved in the criminal justice system. BAS, the language-based acculturation scale, which was found significant for those with police contact but not for victims in this study, is regarded as one of the top three most well-researched and validated acculturation measures for Latinos (Wallace, Pomery, Latimer, Martinez, & Salovey, 2010). The statistical significance with this well-tested indicator provides support to the understanding that Puerto Rican offending can be seen as similar to that of other Latino subgroups.

The findings for Puerto Rican victims are perhaps less clear and more thought provoking. Of significant interest is the finding that higher levels of educational attainment are associated with higher levels of criminal victimization. This is not a pattern that has been demonstrated or explained in previous criminological or sociological literature. Neither the Department of Justice’s bulletin on criminal victimization in 2011 (Truman & Planty, 2012) nor the more substantial publication of over 100 statistical tables on criminal victimization (U.S. Department of Justice, 2010) addresses the educational status of the victims. The relationship between high levels of educational attainment and criminal victimization could potentially be explained by differential exposures to varying populations or neighborhoods. As a variety of explanations could also be proposed for this result, further research would be required to explore this phenomenon.

Victimization shows a complex relationship with acculturation and stress. Previous work shows that victimization is more frequently followed by trauma-related symptoms among Latina women than non-Latina women (Cuevas, Sabina, & Bell, 2012). Furthermore, acculturation both serves as a predictor of psychological distress and moderates the victimization–psychological distress relationship (Cuevas et al., 2012). However, stress and acculturation are also related, such as in the concept of acculturative stress, and are difficult to disentangle (Rudmin, 2009), and create different experiences for immigrant populations. In our bivariate analyses, stress was found to be associated with victimization but not with police contact. The relationship between perceived stress and victimization remained as significant in the regression models after inclusion of the acculturation variables. Although we cannot specify the direction of this relationship, it is clear that perceived stress is a central piece of the victimization experience.

While linguistic acculturation was not found to be a significant variable in the victimization regression, psychological acculturation did remain a significant predictor. This is an interesting finding that pushes our understanding of acculturation, due to the relatively uncommon use of the psychological acculturation scale in previous literature. As a scale developed specifically for Puerto Ricans, it might be revealing dimensions specific to the Puerto Rican experience. Other studies with different behavior and health outcomes have also found varied outcomes depending on the type of acculturation measured (Arcia, Skinner, Bailey, & Correa, 2001; Henkin et al., 2011). Higher psychological acculturation to the U.S. culture could also be related to more willingness to report having been victimized and thus explain some of the reasons for higher prevalence of victimization with acculturation (Garcia, 2005). Clearly, the relationship between acculturation, stress, and criminal experience (either victimization or perpetration) is an area ripe for exploration.

Limitations

This study had a number of limitations. The disproportionate number of women in the full sample may have impacted the results, as gender is known to be an important variable in criminological research. There is always difficulty involved in obtaining both self-reported victimization and perpetration data, and it is therefore possible that rates of one or both were much higher than reported in this article. Another problem of this research addresses the issue of directionality and causality, especially concerning the perceived stress variable. Finally, acculturation is difficult to define and assess as a construct. While all efforts were made to ensure the utilization of the most appropriate measures possible, it is likely that as academic understanding of acculturation improves, so will our research instruments.

Author Biographies

Wallis E. Adams is a PhD student in sociology at Northeastern University. She is a research assistant at the Institute on Urban Health Research and Practice at Northeastern University, as well as a visiting lecturer in criminology at Framingham State University. She earned an MPH at California State University, Northridge.

Irina L. G. Todorova is adjunct associate professor in the Department of Health Sciences at Northeastern University and director of research at the Institute of Coaching, Harvard Medical School. Her PhD in psychology was earned at Sofia University and the Bulgarian Academy of Sciences. As a health psychologist, her work focuses on psychosocial aspects of health and well being, including migration and health.

Luis M. Falcón is the dean of the College of Fine Arts, Humanities and Sciences at University of Massachusetts Lowell. He holds a PhD in sociology from Cornell University. His research focuses on disparities, with an emphasis on psychosocial stress in the Hispanic population.