Acculturation and Cardiometabolic Abnormalities Among Chinese and Korean Americans

Abstract

Background Studies generally show that higher acculturation is associated with greater cardiovascular disease (CVD) risk among immigrants in the United States (US). However, few studies have compared how proxies of acculturation are differentially associated with metabolic abnormalities measured using objective biomarkers, self-reported diagnosis, and medication use, particularly among East Asian Americans. Methods Survey data and biomarker measurements collected from random (non-fasting) blood samples of Chinese and Korean immigrants in the US (n = 328) were used to examine the associations between two proxies for acculturation (years living in the US and English speaking proficiency) with three cardiometabolic abnormalities (high triglyceride levels, diabetes, and hypercholesterolemia). Poisson regression models estimated prevalence ratios adjusted for demographic characteristics, socioeconomic factors, and body mass index. Gender, Asian subgroup, and household income were tested as potential effect modifiers. Results Living longer in the US was associated with greater likelihood of having high triglycerides. In addition, living longer in the US was associated with greater likelihood of diabetes for people with lower household income and greater likelihood of hypercholesterolemia for people with higher household income. Higher level of English proficiency was less consistently associated with higher cardiometabolic risk, although there was a significant association with greater likelihood of hypercholesterolemia. Conclusions Longer time lived in the US is associated with higher risk of cardiometabolic abnormalities among Chinese and Korean Americans. Future studies of acculturation and cardiometabolic risk should carefully consider potential mechanisms and what proxy measures of acculturation capture.

Acculturation and self-rated health among Chinese and Korean immigrants aged 49 to 75

“…Our results are consistent with previous studies on acculturation and SRH, while they contrast with the traditional knowledge about the erosion of immigrant health since migration, which suggests that acculturation is associated with unhealthy behaviors and chronic diseases ( 1 – 3 , 5 – 8 , 13 ) as immigrants adopt dietary patterns, health-related norms and behaviors in the U.S. ( 2 , 14 ). The result for SRH is different probably because SRH is a holistic and subjective indicator of perceived physical, mental, emotional health, which depends on external factors and internal responses ( 32 , 53 ).…”

“…We measured acculturation using three variables: years living in the U.S., English proficiency, and ethnic identity. Years living in the U.S. was calculated using the year difference between the date of baseline survey and the date of arriving in the U.S. We classified years living in the U.S. into two categories using 23 years (median) as a cutoff ( 13 ). As a sensitivity analysis, we repeated the same analysis using years in the US as a continuous variable and 3-categorical variable ( ≤ 10 years [11.8%], 11–20 years [28.5%], ≥21 years [59.8%]), with similar results (results not shown, but available upon request).…”

“…Acculturation is generally defined as “all changes that arise as a consequence of contact between individuals and groups of different cultural backgrounds ( 4 )”. Overall, a higher level of acculturation among immigrant groups has been associated with a higher risk of unhealthy behavior such as drinking ( 5 ) as well as chronic diseases ( 6 ) including obesity ( 7 – 9 ), breast cancer ( 10 ), and diabetes ( 11 – 13 ). This may be because immigrants converge to the health profile of the host population due to the adoption of dietary patterns, health-related norms, and other health behaviors during the acculturation process ( 2 , 14 ).…”

Cardiometabolic Health in Asian American Children

“…These results contrast with our findings of higher non-LDL (b=26.55, p<0.001), higher LDL levels (b=19.82, p=0.01), and lower HDL levels (b=-4.00, p=0.01) amongst US born Asian American adolescents. Additionally, Morey et al found that longer residencies in the US was associated with higher triglyceride levels in Chinese and Korean American adults but failed to include other Asian subgroups and children in their sample [22]. The lack of uniformity in the literature and our findings further emphasize need for more work on the health implications of Asian American acculturation.…”

“…With regard to acculturation, data is even more limited in children; however, studies in Asian American adults generally show increased acculturation correlated with poorer health [5,[20][21][22][23]. Echeverria et al studied adults using NHANES 2011-2014 and found that Asian Americans had an increased prevalence for CVD risk factors with longer durations in the US [5].…”