Stress Measured by Allostatic Load Varies by Reason for Immigration, Age at Immigration, and Number of Children: The Africans in America Study

Abstract

Stress leads to physiologic dysfunction and cardiometabolic disease. Allostatic load score (ALS) measures stress-induced cardiovascular, metabolic, and inflammatory biomarkers. We estimated the odds of high ALS by reason for and age at immigration, duration of American residence, number of children, and socioeconomic status in 193 African immigrants (male: 65%, age 41 ± 10 y (mean ± Standard Deviation (SD)), range 22–65 y). ALS was calculated with High-ALS defined as ALS ≥ 3.0 and Low-ALS defined as ALS < 3.0. Oral glucose tolerance tests (OGTT) were performed, the cardiovascular disease (CVD) risk estimated, and TNF-α, an inflammatory cytokine, measured. Logistic regression was used to estimate odds of High-ALS. In the High- and Low-ALS groups, ALS were 4.0 ± 1.2 vs. 1.3 ± 0.7, diabetes prevalence: 14% vs. 4%, CVD risk: 23% vs. 8%, TNF-α levels: 15 ± 9 vs. 11 ± 6 pg/mL, respectively (all p ≤ 0.01). Immigrants were more likely to be in the High-ALS group if their reason for immigration was work or asylum/refugee (OR 2.18, p = 0.013), their age at immigration was ≥30 y (OR 3.28, p < 0.001), their duration of residence in United States was ≥10 y (OR 3.16, p = 0.001), or their number of children was ≥3 (OR 2.67, p = 0.019). Education, income, health insurance, marital status, and gender did not affect High-ALS odds. Factors adversely influencing allostatic load and cardiometabolic health in African immigrants were age at and reason for immigration, duration of residence in America, and number of children.

Africans Who Arrive in the United States before 20 Years of Age Maintain Both Cardiometabolic Health and Cultural Identity: Insight from the Africans in America Study

“…Evidence linking cultural continuity in childhood to lower levels of stress, resilient behavior, and less cardiometabolic disease in adulthood was powerfully presented in a study by Currie et al of indigenous adults living in Western Canada [24]. The value of family support on mitigating adverse cardiometabolic health was also evident in our earlier investigations in which we reported that immigrants who came to the United States for family reunification had lower allostatic loads than immigrants who were refugees or seeking asylum [3].…”

“…2 Chi-square or unpaired t-test. 3 Variables used to calculate CVD-Risk. 4 Married or living with partner (category includes: never married, separated, divorced, widowed).…”

“…In adapting to life in the United States, African immigrants have to face many challenges, including the transition from a majority to a minority population and racial discrimination [ 1 , 3 , 4 ]. In short, international migration has both physiologic and psychological consequences and the potential to adversely affect cardiometabolic health [ 3 , 4 , 5 , 6 , 7 , 8 ]. Cardiometabolic health encompasses obesity, diabetes, dyslipidemia, and cardiovascular disease (CVD).…”

“…Data presented as mean ± SE or percentages 2. For continuous variables, multiple regression were done to adjust for age, for categorical variables chi-square analyses were performed 3. Variables used to calculate CVD-Risk 4.…”

Support and Emotional Well-Being of Asylum Seekers and Refugees in Spain

“…In this line, the most vulnerable group among immigrants is that of refugees, who, due to the circumstances surrounding the abandonment of the country of origin, are more vulnerable to mental health problems [ 22 ] and have to face many difficulties to integrate into the host country [ 2 , 23 ]. As described by Tribe [ 24 ], the circumstances in which they leave their countries are very different between the two groups:…”