Length of Residence in the United States is Associated With a Higher Prevalence of Cardiometabolic Risk Factors in Immigrants: A Contemporary Analysis of the National Health Interview Survey

Abstract

BackgroundCardiometabolic risk (CMR) factors including hypertension, overweight/obesity, diabetes mellitus, and hyperlipidemia are high among United States ethnic minorities, and the immigrant population continues to burgeon.Methods and ResultsHypothesizing that acculturation (length of residence) would be associated with a higher prevalence of CMR factors, the authors analyzed data on 54, 984 US immigrants in the 2010–2014 National Health Interview Surveys. The main predictor was length of residence. The outcomes were hypertension, overweight/obesity, diabetes mellitus, and hyperlipidemia. The authors used multivariable logistic regression to examine the association between length of US residence and these CMR factors.The mean (SE) age of the patients was 43 (0.12) years and half were women. Participants residing in the United States for ≥10 years were more likely to have health insurance than those with <10 years of residence (70% versus 54%, P<0.001). After adjusting for region of birth, poverty income ratio, age, and sex, immigrants residing in the United States for ≥10 years were more likely to be overweight/obese (odds ratio [OR], 1.19; 95% CI, 1.10–1.29), diabetic (OR, 1.43; 95% CI, 1.17–1.73), and hypertensive (OR, 1.18; 95% CI, 1.05–1.32) than those residing in the United States for <10 years.ConclusionsIn an ethnically diverse sample of US immigrants, acculturation was associated with CMR factors. Culturally tailored public health strategies should be developed in US immigrant populations to reduce CMR.

Singapore Indian Eye Study‐2: methodology and impact of migration on systemic and eye outcomes

“…First‐generation immigrants had lower prevalence of current smoking, and second‐generation immigrants had higher prevalence of obesity compared with the Singaporean general population. In the current study, first‐generation immigrants had higher prevalence of hypertension and CKD at both visits and diabetes and CVD at baseline contrary to earlier reports . The reason for this higher prevalence in first generation could be speculated because of the older age, lower socio‐economic status as well as psychological stress associated with migration.…”

“…For example, a systematic review showed a positive relationship between western acculturation in the host country and obesity in populations migrating from low‐income or middle‐income to high‐income countries . In another US study, immigrants residing in the USA for ≥10 years had higher prevalence of cardiovascular risk factors including diabetes, hypertension and obesity than those with <10 years of residence . On the other hand, lens opacities were found to be lower in Bangladeshi immigrants in UK compared with Bangladeshis of similar age and gender living in urban and rural Bangladesh, and uncorrected refractive error was found to be associated with low acculturation in the Mexican–American immigrants in the USA .…”

“…It has been reported that the number of India‐born people living outside of India has doubled between 1990 and 2013 from 7 million to 14 million . Migrant studies have shown that the health risks and health behaviour of migrants tend to be different from the host population influenced by the change in living conditions, environment, lifestyle and physiological and psychological stress associated with migration . For example, a systematic review showed a positive relationship between western acculturation in the host country and obesity in populations migrating from low‐income or middle‐income to high‐income countries .…”

“…3 Migrant studies have shown that the health risks and health behaviour of migrants tend to be different from the host population influenced by the change in living conditions, environment, lifestyle and physiological and psychological stress associated with migration. [4][5][6][7] For example, a systematic review showed a positive relationship between western acculturation in the host country and obesity in populations migrating from lowincome or middle-income to high-income countries. 5 In another US study, immigrants residing in the USA for ≥10 years had higher prevalence of cardiovascular risk factors including diabetes, hypertension and obesity than those with <10 years of residence.…”

Diabetes risk scores for Hispanics living in the United States: A systematic review

“…Limited data for Hispanic populations present multiple challenges. Electronic databases may not include detailed information on factors that increase risk of diabetes for Hispanics such as country of origin [16], length of residency in the U.S. [25, 26], stress [27] and depression [28, 29]. Questionnaire assessments may provide some of these variables but data on biomedical tests and clinical factors such as family history of diabetes, gestational diabetes or polycystic ovary syndrome depend on individual access to care.…”