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The Association of Duration of Residence in the United States with Cardiovascular Disease Risk Factors Among South Asian Immigrants

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Abstract

South Asians are disproportionately impacted by cardiovascular disease (CVD). Our objective was to examine the association between duration of residence in the US and CVD risk factors among South Asian adult immigrants. Multivariate logistic regression analyses using pooled data from the 2005, 2007, 2009 California Health Interview Surveys. Duration of residence in the US <15 years was significantly associated with overweight/obese BMI (OR 0.59; 95 % CI 0.35, 0.98 for 5 to <10 years), daily consumption of 5+  servings of fruits/vegetables (OR 0.37; 95 % CI 0.15, 0.94 for 10 to <15 years), and sedentary lifestyle (OR 2.11; 95 % CI 1.17, 3.81 for 10 to <15 years) compared with duration of residence ≥15 years after adjusting for illness burden, healthcare access, and socio-demographic characteristics. Duration of residence was not significantly associated with other CVD risk factors. Duration of residence is an important correlate of overweight/obesity and other risk factors among South Asian immigrants.

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References

  1. Barnes PM, Adams PF, Powell-Griner E. Health characteristics of the Asian adult population: United States, 2004–2006. Advance data from vital and health statistics; no 394. Hyattsville: National Center for Health Statistics. 2008.

  2. US Census Bureau and India Abroad Center for Political Awareness. Indian–American Population by State. [Cited 2009 July 9]; Available from: http://www.indianembassy.org/ind_us/census_2000/ia_population_map_2001.pdf.

  3. Palaniappan L, Mukherjea A, Holland A, Ivey SL. Leading causes of mortality of Asian Indians in California. Ethn Dis Winter. 2010;20(1):53–7.

    Google Scholar 

  4. Palaniappan L, Wang Y, Fortmann SP. Coronary heart disease mortality for six ethnic groups in California, 1990–2000. Ann Epidemiol. 2004;14(7):499–506.

    Article  PubMed  Google Scholar 

  5. Joshi P, Islam S, Pais P, Reddy S, Dorairaj P, Kazmi K, et al. Risk factors for early myocardial infarction in South Asians compared with individuals in other countries. JAMA. 2007;297(3):286–94.

    Article  CAS  PubMed  Google Scholar 

  6. Chiu M, Austin PC, Manuel DG, Tu JV. Comparison of cardiovascular risk profiles among ethnic groups using population health surveys between 1996 and 2007. Can Med Assoc J. 2010;182(8):E301–10.

    Article  Google Scholar 

  7. Tillin T, Forouhi NG, Davey-Smith G, McKeigue PM, Chaturvedi N. Cardiovascular disease mortality in relation to childhood and adulthood socio-economic markers in British south Asian men. Heart. 2008;94:476–81.

    Article  CAS  PubMed  Google Scholar 

  8. Forouhi NG, Sattar N, Tillin T, McKeigue PM, Chaturvedi N. Do known risk factors explain the higher coronary heart disease mortality in South Asian compared with European men? Prospective follow-up of the south all and Brent studies UK. Diabetologia. 2006;49(11):2580–8.

    Article  CAS  PubMed  Google Scholar 

  9. Barnett AH, Dixon AN, Bellary S, Hanif MW, O’Hare JP, Raymond NT, et al. Type 2 diabetes and cardiovascular risk in the UK south Asian community. Diabetologia. 2006;49(10):2234–46.

    Article  CAS  PubMed  Google Scholar 

  10. Sheth T, Nair C, Nargundkar M, Anand S, Yusuf S. Cardiovascular and cancer mortality among Canadians of European, south Asian and Chinese origin from 1979 to 1993: an analysis of 1.2 million deaths. Can Med Assoc J. 1999;161(2):132–8.

    CAS  Google Scholar 

  11. Anand SS, Yusuf S, Vuksan V, Devanesen S, Teo KK, Montague PA, et al. Differences in risk factors, atherosclerosis, and cardiovascular disease between ethnic groups in Canada: the study of health assessment and risk in ethnic groups (SHARE). Lancet. 2000;356(9226):279–84.

    Article  CAS  PubMed  Google Scholar 

  12. Harding S, Rosato M, Teyhan A. Trends for coronary heart disease and stroke mortality among migrants in England and Wales, 1979–2003: slow declines notable for some groups. Heart. 2008;94(4):463–70.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  13. Gholap N, Davies M, Patel K, Sattar N, Khunti K. Type 2 diabetes and cardiovascular disease in south Asians. Prim Care Diabetes. 2011;5(1):45–56.

    Article  PubMed  Google Scholar 

  14. Balarajan R. Ethnicity and variations in the nation’s health. Health Trends. 1995;27(4):114–9.

    PubMed  Google Scholar 

  15. Gill P, Kai J, Bhopal R, Wild S. Health care needs assessment: black and minority ethnic groups. Health care needs assessment the epidemiologically based needs assessment reviews. Third Series Abingdon: Radcliffe Publishing Ltd. 2007.

  16. Gunarathne A, Patel JV, Gammon B, Gill PS, Hughes EA, Lip GYH. Ischemic stroke in south Asians. Stroke. 2009;40(6):e415–23.

    Article  PubMed  Google Scholar 

  17. Gunarathne A, Patel JV, Potluri R, Gammon B, Jessani S, Hughes EA, et al. Increased 5-year mortality in the migrant south Asian stroke patients with diabetes mellitus in the United Kingdom: the West Birmingham stroke project. Int J Clin Pract. 2008;62(2):197–201.

    Article  CAS  PubMed  Google Scholar 

  18. OECD. Mortality from cardiovascular disease. OECD/World Health Organization, Health at a Glance: Asia/Pacific 2012: OECD Publishing: http://dx.doi.org/10.1787/9789264183902-8-en. 2012.

  19. Yan S, Li J, Li S, Zhang B, Du S, Gordon-Larsen P, et al. The expanding burden of cardiometabolic risk in China: the China Health and Nutrition Survey. Obes Rev. 2012;13(9):810–21.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  20. Popkin BM. Global nutrition dynamics: the world is shifting rapidly toward a diet linked with noncommunicable diseases. Am J Clin Nutr. 2006;84(2):289–98.

    CAS  PubMed  Google Scholar 

  21. Lieberman LS. Dietary, evolutionary, and modernizing influences on the prevalence of type 2 diabetes. Annu Rev Nutr. 2003;23(1):345–77.

    Article  CAS  PubMed  Google Scholar 

  22. Misra R, Patel T, Kotha P, Raji A, Ganda O, Banerji M, et al. Prevalence of diabetes, metabolic syndrome, and cardiovascular risk factors in US Asian Indians: results from a national study. J Diabetes Complicat. 2010;24(3):145–53.

    Article  PubMed  Google Scholar 

  23. Mohanty SA, Woolhandler S, Himmelstein DU, Bor DH. Diabetes and cardiovascular disease among Asian Indians in the United States. J Gen Intern Med. 2005;20(5):474–8.

    Article  PubMed Central  PubMed  Google Scholar 

  24. Ye J, Rust G, Baltrus P, Daniels E. Cardiovascular risk factors among Asian Americans: results from a National Health Survey. Ann Epidemiol. 2009;19(10):718–23.

    Article  PubMed  Google Scholar 

  25. Jonnalagadda SS, Diwan S. Health behaviors, chronic disease prevalence and self-rated health of older Asian Indian immigrants in the US. J Immigr Health. 2005;7(2):75–83.

    Article  PubMed  Google Scholar 

  26. Thorpe L, Upadhyay U, Chamany S, Garg R, Mandel-Ricci J, Kellerman S, et al. Prevalence and control of diabetes and impaired fasting glucose in New York City. Diabetes Care. 2009;32(1):57–62.

    Article  PubMed Central  PubMed  Google Scholar 

  27. Venkataraman R, Nanda NC, Baweja G, Parikh N, Bhatia V. Prevalence of diabetes mellitus and related conditions in Asian Indians living in the United States. Am J Cardiol. 2004;94(7):977–80.

    Article  PubMed  Google Scholar 

  28. Ivey SL, Mehta KM, Fyr CL, Kanaya AM. Prevalence and correlates of cardiovascular risk factors in south Asians: population-based data from two California surveys. Ethn Dis Autumn. 2006;16(4):886–93.

    Google Scholar 

  29. Flowers E, Molina C, Mathur A, Prasad M, Abrams L, Sathe A, et al. Prevalence of metabolic syndrome in south Asians residing in the United States. Metab Syndr Relat Disord. 2010;8(5):417–23.

    Article  CAS  PubMed  Google Scholar 

  30. Yates T, Davies MJ, Gray LJ, Webb D, Henson J, Gill JM, et al. Levels of physical activity and relationship with markers of diabetes and cardiovascular disease risk in 5474 white European and south Asian adults screened for type 2 diabetes. Prev Med. 2010;51(3–4):290–4.

    Article  CAS  PubMed  Google Scholar 

  31. Misra KB, Endemann SW, Ayer M. Leisure time physical activity and metabolic syndrome in Asian Indian immigrants residing in Northern California. Ethn Dis Fall. 2005;15(4):627–34.

    Google Scholar 

  32. Mooteri SN, Petersen F, Dagubati R, Pai RG. Duration of residence in the United States as a new risk factor for coronary artery disease (the Konkani heart study). Am J Cardiol. 2004;93(3):359–61.

    Article  PubMed  Google Scholar 

  33. Salant T, Lauderdale DS. Measuring culture: a critical review of acculturation and health in Asian immigrant populations. Soc Sci Med. 2003;57(1):71–90.

    Article  PubMed  Google Scholar 

  34. Cunningham SA, Ruben JD, Narayan KMV. Health of foreign-born people in the United States: a review. Health Place. 2008;14(4):623–35.

    Article  Google Scholar 

  35. Singh GK, Siahpush M. Ethnic-immigrant differentials in health behaviors, morbidity, and cause-specific mortality in the United States: an analysis of two national data bases. Hum Biol. 2002;74(1):83–109.

    Article  PubMed  Google Scholar 

  36. Koya DL, Egede LE. Association between length of residence and cardiovascular disease risk factors among an ethnically diverse group of United States immigrants. J Gen Intern Med. 2007;22(6):841–6.

    Article  PubMed Central  PubMed  Google Scholar 

  37. Dodani S, Dong L. Acculturation, coronary artery disease and carotid intima media thickness in south Asian immigrants–unique population with increased risk. Ethn Dis Summer. 2011;21(3):314–21.

    Google Scholar 

  38. Oza-Frank R, Stephenson R, Venkat Narayan K. Diabetes prevalence by length of residence among US immigrants. J Immigr Minor Health. 2009;2009:1–8.

    Google Scholar 

  39. Lauderdale DS, Rathouz PJ. Body mass index in a US national sample of Asian Americans: effects of nativity, years since immigration and socioeconomic status. Int J Obes Relat Metab Disord. 2000;24(9):1188–94.

    Article  CAS  PubMed  Google Scholar 

  40. Sanchez-Vaznaugh EV, Kawachi I, Subramanian SV, Sanchez BN, Acevedo-Garcia D. Differential effect of birthplace and length of residence on body mass index (BMI) by education, gender and race/ethnicity. Soc Sci Med. 2008;67(8):1300–10.

    Article  PubMed  Google Scholar 

  41. Goel MS, McCarthy EP, Phillips RS, Wee CC. Obesity among US immigrant subgroups by duration of residence. JAMA. 2004;292(23):2860–7.

    Article  CAS  PubMed  Google Scholar 

  42. Roshania R, Narayan KM, Oza-Frank R. Age at arrival and risk of obesity among US immigrants. Obesity Silver Spring. 2008;16(12):2669–75.

    Article  PubMed  Google Scholar 

  43. Palaniappan LP, Araneta MRG, Assimes TL, Barrett-Connor EL, Carnethon MR, Criqui MH, et al. Call to action: cardiovascular disease in Asian Americans: a science advisory from the American heart association. Circulation. 2010;122:1242–52.

    Article  PubMed  Google Scholar 

  44. Lear SA, Humphries KH, Hage-Moussa S, Chockalingam A, Mancini GBJ. Immigration presents a potential increased risk for atherosclerosis. Atherosclerosis. 2009;205(2):584–9.

    Article  CAS  PubMed  Google Scholar 

  45. Chiu M, Austin PC, Manuel DG, Tu JV. Cardiovascular risk factor profiles of recent immigrant’s vs long-term residents of Ontario: a multi-ethnic study. Can J Cardiol. 2012;28(1):20–6.

    Article  PubMed  Google Scholar 

  46. Mukhopadhyay B, Sattar N, Fisher M. Diabetes and cardiac disease in south Asians. Br J Diabetes Vasc Dis. 2005;5(5):253–9.

    Article  Google Scholar 

  47. Patel DJ, Winterbotham M, Britt RP, Sutton GC, Bhatnagar D, Mackness MI, et al. Coronary risk factors in people from the Indian subcontinent living in West London and their siblings in India. Lancet. 1995;345(8947):405–9.

    Article  PubMed  Google Scholar 

  48. California Health Interview Survey. CHIS methodology series. Los Angeles: Center for Health Policy Research, University of California; 2009.

    Google Scholar 

  49. California Health Interview Survey. CHIS 2007 methodology series: report 4—response rates. Los Angeles: UCLA Center for Health Policy Research; 2009.

    Google Scholar 

  50. California Health Interview Survey. CHIS 2009 methodology series: report 4—response rates. Los Angeles: UCLA Center for Health Policy Research; 2011.

    Google Scholar 

  51. California Health Interview Survey. CHIS 2005 methodology series: report 4—response rates. Los Angeles: UCLA Center for Health Policy Research; 2007.

    Google Scholar 

  52. Lloyd-Jones DM, Hong Y, Labarthe D, Mozaffarian D, Appel LJ, Van Horn L, et al. Defining and setting national goals for cardiovascular health promotion and disease reduction: the American Heart Association’s strategic impact goal through 2020 and beyond. Circulation. 2010;121(4):586–613.

    Article  PubMed  Google Scholar 

  53. US Department of Health and Human Services. 2008 Physical Activity Guidelines for Americans. 2008; http://www.health.gov/paguidelines/.

  54. World Health Organization. Global Database on Body Mass Index, BMI Classification. 2004 [cited 2009 July 9]; http://apps.who.int/bmi/index.jsp?introPage=intro_3.html.

  55. August K, Sorkin D. Racial/ethnic disparities in exercise and dietary behaviors of middle-aged and older adults. J Gen Intern Med. 2011;26(3):245–50.

    Article  PubMed Central  PubMed  Google Scholar 

  56. Centers for Disease Control and Prevention. Nutrition for everyone: Fruits and vegetables. [cited 2011 April 2]; http://www.cdc.gov/nutrition/everyone/fruitsvegetables/index.html.

  57. McGee DL, Liao Y, Cao G, Cooper RS. Self-reported health status and mortality in a multiethnic US cohort. Am J Epidemiol. 1999;149(1):41–6.

    Article  CAS  PubMed  Google Scholar 

  58. US Census Bureau. S0201: Selected population profile in the United States, 2010 American Community Survey 1-Year Estimates. [cited 2012 November 26]; http://factfinder2.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=ACS_10_1YR_S0201&prodType=table.

  59. Klein RJ, Schoenborn CA. Age adjustment using the 2000 projected US population: Department of Health and Human Services. USA: Centers for Disease Control and Prevention, National Center for Health Statistics; 2001.

    Google Scholar 

  60. Shiwaku K, Anuurad E, Enkhmaa B, Kitajima K, Yamane Y (2004) Appropriate BMI for Asian populations. The Lancet 363(9414):1077(letter).

    Google Scholar 

  61. World Health Organization expert consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363(9403):157–63.

    Article  Google Scholar 

  62. Zheng W, McLerran DF, Rolland B, Zhang X, Inoue M, Matsuo K, et al. Association between Body-Mass Index and risk of death in more than 1 Million Asians. N Engl J Med. 2011;364(8):719–29.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  63. Razak F, Anand SS, Shannon H, Vuksan V, Davis B, Jacobs R, et al. Defining obesity cut points in a multiethnic population. Circulation. 2007;115(16):2111–8 Comparative Study Research Support, Non-US Gov’t.

    Article  PubMed  Google Scholar 

  64. Misra A, Chowbey P, Makkar B, Vikram N, Wasir J, Chadha D. Consensus statement for diagnosis of obesity, abdominal obesity and the metabolic syndrome for Asian Indians and recommendations for physical activity, medical and surgical management. JAPI. 2009;57:163–70.

    CAS  PubMed  Google Scholar 

  65. Raj S, Ganganna P, Bowering J. Dietary habits of Asian Indians in relation to length of residence in the United States. J Am Diet Assoc. 1999;99(9):1106–8.

    Article  CAS  PubMed  Google Scholar 

  66. Krosnick JA. Survey research. Annu Rev Psychol Rev. 1999;50:537–67.

    Article  CAS  Google Scholar 

  67. CHIS 2003 study benchmarking key estimates for CHIS with those from major federal health surveys. [Cited 2012 April 16]; http://www.chis.ucla.edu/dataquality5.html.

  68. Groves RM. Nonresponse rates and nonresponse bias in household surveys. Public Opin Q. 2006;70(5):646–75.

    Article  Google Scholar 

  69. CHIS 2005 Using neighborhood characteristics to assess nonresponse bias. [cited 2012 April 16]; http://www.chis.ucla.edu/dataquality4.html.

  70. CHIS 2007 Nonresponse analysis. [cited 2012 April 16]; http://www.chis.ucla.edu/dataquality3.html.

  71. Newell SA, Girgis A, Sanson-Fisher RW, Savolainen NJ. The accuracy of self-reported health behaviors and risk factors relating to cancer and cardiovascular disease in the general population: a critical review. Am J Prev Med. 1999;17(3):211–29.

    Article  CAS  PubMed  Google Scholar 

  72. Del Boca FK, Darkes J. The validity of self-reports of alcohol consumption: state of the science and challenges for research. Addiction. 2003;98:1–12.

    Article  PubMed  Google Scholar 

  73. Okura Y, Urban LH, Mahoney DW, Jacobsen SJ, Rodeheffer RJ. Agreement between self-report questionnaires and medical record data was substantial for diabetes, hypertension, myocardial infarction and stroke but not for heart failure. J Clin Epidemiol. 2004;57(10):1096–103.

    Article  PubMed  Google Scholar 

  74. Patrick DL, Cheadle A, Thompson DC, Diehr P, Koepsell T, Kinne S. The validity of self-reported smoking: a review and meta-analysis. Am J Public Health. 1994;84(7):1086–93.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  75. Yeager DS, Krosnick JA. The validity of self-reported nicotine product use in the 2001–2008 National Health and Nutrition Examination Survey. Med Care. 2010;48(12):1128–32.

    Article  PubMed  Google Scholar 

  76. Natarajan S, Lipsitz SR, Nietert PJ. Self-report of high cholesterol: determinants of validity in US adults. Am J Prev Med. 2002;23(1):13–21.

    Article  PubMed  Google Scholar 

  77. Gorber SC, Tremblay M, Moher D, Gorber B. A comparison of direct versus self-report measures for assessing height, weight and body mass index: a systematic review. Obes Rev. 2007;8(4):307–26.

    Article  PubMed  Google Scholar 

  78. Prince SA, Adamo KB, Hamel ME, Hardt J, Gorber SC, Tremblay M. A comparison of direct versus self-report measures for assessing physical activity in adults: a systematic review. Int J Behav Nutr Phys Act. 2008;5(1):56–79.

    Article  PubMed Central  PubMed  Google Scholar 

  79. New York City Health and Nutrition Examination Survey. [cited 2013 May]; http://www.nyc.gov/html/doh/html/data/nyc-hanes.shtml.

  80. Mediators of Atherosclerosis in South Asians Living in America Study. [cited 2013 May]; http://www.masalastudy.org/.

  81. Hunt LM, Schneider S, Comer B. Should, “acculturation” be a variable in health research? A critical review of research on US Hispanics. Soc Sci Med. 2004;59(5):973–86.

    Article  PubMed  Google Scholar 

  82. Pourat N, Kagawa-Singer M, Breen N, Sripipatana A. Access versus acculturation: identifying modifiable factors to promote cancer screening among Asian American women. Med Care. 2010;48(12):1088–96.

    PubMed  Google Scholar 

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Acknowledgments

The authors thank Gerardo Moreno, MD, MSHS and Keith C. Norris, MD, FACP for their review of manuscript drafts. NB was supported by the Division of General Internal Medicine and Health Services Research and the American Heart Association-Pharmaceutical Roundtable Spina Outcomes Center (0875133 N) fellowship at the University of California, Los Angeles. WJM was supported by the NHLBI - 1P50HL105188-6094. No funding source had any role in the study design, analysis, interpretation of data, writing of the manuscript, or decision to submit the article for publication.

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Authors and Affiliations

  1. Division of General Internal Medicine and Health Services Research, Department of Medicine, University of California, 911 Broxton Avenue, Room 203, Los Angeles, CA, 90095-1769, USA

    Nazleen Bharmal, Martin F. Shapiro, Carol M. Mangione & Mitchell D. Wong

  2. National Institutes of Health, Office of Behavioral and Social Sciences Research, Bethesda, MD, USA

    Robert M. Kaplan

  3. Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, CA, USA

    Marjorie Kagawa-Singer

  4. Department of Health Policy and Management, Department of Psychology, Fielding School of Public Health, University of California, Los Angeles, CA, USA

    William J. McCarthy

  5. Division of Cancer Prevention and Control Research, Jonsson Comprehensive Cancer Center, University of Los Angeles, Los Angeles, CA, USA

    William J. McCarthy

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  1. Nazleen Bharmal
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Bharmal, N., Kaplan, R.M., Shapiro, M.F. et al. The Association of Duration of Residence in the United States with Cardiovascular Disease Risk Factors Among South Asian Immigrants. J Immigrant Minority Health 17, 781–790 (2015). https://doi.org/10.1007/s10903-013-9973-7

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