Cardiovascular disease behavioral risk factors among Latinos by citizenship and documentation status

Abstract

Background: Studies have observed that recent Latino immigrants tend to have a physical health advantage compared to immigrants who have been in the US for many years or Latinos who are born in the United States. An explanation of this phenomenon is that recent immigrants have positive health behaviors that protect them from chronic disease risk. This study aims to determine if trends in positive cardiovascular disease (CVD) risk behaviors extend to Latino immigrants in California according to citizenship and documentation status. Methods: We examined CVD behavioral risk factors by citizenship/documentation statuses among Latinos and non-Latino US-born whites in the 2011-2015 waves of the California Health Interview Survey. Adjusted multivariable logistic regressions estimated the odds for CVD behavioral risk factors, and analyses were stratified by sex. Results: In adjusted analyses, using US-born Latinos as the reference group, undocumented Latino immigrants had the lowest odds of current smoking, binge drinking, and frequency of fast food consumption. There were no differences across the groups for fruit/vegetable intake and walking for leisure. Among those with high blood pressure, undocumented immigrants were least likely to be on medication. Undocumented immigrant women had better patterns of CVD behavioral risk factors on some measures compared with other Latino citizenship and documentation groups. Conclusions: This study observes that the healthy Latino immigrant advantage seems to apply to undocumented female immigrants, but it does not necessarily extend to undocumented male immigrants who had similar behavioral risk profiles to US-born Latinos.

Is use of a smuggler to cross the US-Mexico border associated with mental health problems among undocumented immigrants from Mexico?

“…More research is needed to better understand the mechanisms linking the use of a smuggler and later health risks. Based on other studies of undocumented immigrants in the US, barriers to accessing healthcare and changes in health behaviors may be plausible mechanisms [5][6][7][8][9][23][24][25][26].…”

“…Much of what is known about immigrant health has focused on nativity, citizenship, and length of residence based on available data in state and national databases. The best source of data about undocumented immigrants in the US comes from the California Health Interview Survey, which has provided valuable insights into the health outcomes of Latine immigrants living in California [5,6]. National estimates of the impact of social and policy barriers to public benefits, especially healthcare, on immigrant health have used imputation methods [7][8][9].…”

A Longitudinal Study of Acculturation in Context and Cardiovascular Health and Their Effects on Cognition Among Older Latino Adults

“…First, our results continue to support the acculturation in context framework as a multifaceted concept that differentially contributes to cognitive health in the older Latino population 26 and extends this work to include cardiovascular health. Second, although aspects of our acculturation in context framework have been examined in isolation, 11 , 12 , 13 , 19 we are among the first to employ composite scores of acculturation and extend this work to include broader socioenvironmental determinants as related to cardiovascular health in Latino adults. Third, our work also demonstrates that Latino‐centric constructs, for example, familism, may differentially contribute to general and domain‐specific cardiovascular health, extending previous cross‐sectional studies into a longitudinal framework, and answering calls in the literature for such investigations.…”

“…Acculturation, that is, the process of adapting to a new environment and potentially adopting its values and practices, is a culturally relevant construct that has been associated with many cardiovascular health factors in the Latino population in both positive and negative ways; however, this acculturation‐related work has primarily been cross‐sectional and more consistently focused on AHA‐defined biological factors than AHA‐defined health behaviors. For example, some studies report that Latino adults with lower levels of acculturation to the United States—quantified by non‐US‐based nativity, shorter length of residence in the United States, later age at immigration, and/or Spanish language‐based preferences—have lower levels of cardiovascular risk when considering the presence/absence of hypertension, diabetes, hypercholesterolemia, obesity, and smoking 11 , 12 , 13 ; other studies report associations in the opposite direction, 14 , 15 and still others report no relationship. 16 , 17 Mixed results have also been reported for the associations of acculturation with dietary patterns, 13 , 18 with less work focused on acculturation and older Latino adults' physical activity levels.…”

“…For example, some studies report that Latino adults with lower levels of acculturation to the United States—quantified by non‐US‐based nativity, shorter length of residence in the United States, later age at immigration, and/or Spanish language‐based preferences—have lower levels of cardiovascular risk when considering the presence/absence of hypertension, diabetes, hypercholesterolemia, obesity, and smoking 11 , 12 , 13 ; other studies report associations in the opposite direction, 14 , 15 and still others report no relationship. 16 , 17 Mixed results have also been reported for the associations of acculturation with dietary patterns, 13 , 18 with less work focused on acculturation and older Latino adults' physical activity levels. 19 Only 1 study directly assessed the relationship between acculturation and cardiovascular health using the AHA's LS7, reporting that, for a multiethnic cohort (22% Latino), higher levels of acculturation to the United States (ie, US nativity, longer length of residence in the United States, and speaking English in the home) were associated with lower odds of having average to ideal cardiovascular health.…”