TY - JOUR
T1 - Diabetes and acculturation in African immigrants to the United States
T2 - analysis of the 2010–2017 National Health Interview Survey (NHIS)
AU - Mukaz, Debora Kamin
AU - Melby, Melissa K.
AU - Papas, Mia A.
AU - Setiloane, Kelebogile
AU - Nmezie, Nwakaego Ada
AU - Commodore-Mensah, Yvonne
N1 - Publisher Copyright:
© 2020 Informa UK Limited, trading as Taylor & Francis Group.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020
Y1 - 2020
N2 - Objective: This study sought to assess the association between unidimensional acculturation and diabetes, and analyze mediating pathways of the association in African immigrants to the United States (U.S.). Hypothesis: Acculturation would be positively associated with diabetes and that BMI (Body mass index), physical activity, and psychological distress would mediate this association. Methods: An analysis of cross-sectional data from the 2010–2017 National Health Interview Surveys was performed. Adults aged ≥ 18 years who were born in Africa (African immigrants) and residing in the U.S. were considered. The outcome was self-reported diabetes, and acculturation was defined by percent of life spent in the U.S. and citizenship. Multivariable logistic regression analysis was used to assess the association between acculturation and diabetes, and mediation analysis was used to examine the mediating effects of BMI, physical activity, and psychological distress on this association. Results: The analytic sample included 1648 African immigrants with mean (SD) age of 41.3 ± 0.45 years; 56.4% male. Additionally, 46% had ≥ college education, and 21.4% lived below the poverty threshold. About two-thirds were overweight/obese. Less than 50% exercised at adequate levels of physical activity levels. A small percentage (1.8%) reported psychological distress. The prevalence of self-reported diabetes was 6.1%, and 76.5% reported being acculturated. In the multivariate logistic regression analysis, higher levels of acculturation were associated with higher odds of diabetes diagnosis (Odds Ratio (OR) = 2.2; 95% CI = 1.1–4.4). Although BMI mediated the association between acculturation and diabetes ((Formula presented.) = 2.11, p = 0.036), only 18.9% of the total effect of acculturation on diabetes was explained by BMI. Conclusions: Acculturation increased the odds of diabetes diagnosis, and BMI mediated the association. Thus, tailoring culturally-appropriate interventions to control BMI may contribute to preventing diabetes within African immigrant communities to the U.S.
AB - Objective: This study sought to assess the association between unidimensional acculturation and diabetes, and analyze mediating pathways of the association in African immigrants to the United States (U.S.). Hypothesis: Acculturation would be positively associated with diabetes and that BMI (Body mass index), physical activity, and psychological distress would mediate this association. Methods: An analysis of cross-sectional data from the 2010–2017 National Health Interview Surveys was performed. Adults aged ≥ 18 years who were born in Africa (African immigrants) and residing in the U.S. were considered. The outcome was self-reported diabetes, and acculturation was defined by percent of life spent in the U.S. and citizenship. Multivariable logistic regression analysis was used to assess the association between acculturation and diabetes, and mediation analysis was used to examine the mediating effects of BMI, physical activity, and psychological distress on this association. Results: The analytic sample included 1648 African immigrants with mean (SD) age of 41.3 ± 0.45 years; 56.4% male. Additionally, 46% had ≥ college education, and 21.4% lived below the poverty threshold. About two-thirds were overweight/obese. Less than 50% exercised at adequate levels of physical activity levels. A small percentage (1.8%) reported psychological distress. The prevalence of self-reported diabetes was 6.1%, and 76.5% reported being acculturated. In the multivariate logistic regression analysis, higher levels of acculturation were associated with higher odds of diabetes diagnosis (Odds Ratio (OR) = 2.2; 95% CI = 1.1–4.4). Although BMI mediated the association between acculturation and diabetes ((Formula presented.) = 2.11, p = 0.036), only 18.9% of the total effect of acculturation on diabetes was explained by BMI. Conclusions: Acculturation increased the odds of diabetes diagnosis, and BMI mediated the association. Thus, tailoring culturally-appropriate interventions to control BMI may contribute to preventing diabetes within African immigrant communities to the U.S.
KW - acculturation
KW - African immigrants
KW - diabetes
KW - immigrant health
KW - Immigration
KW - mediation analysis
UR - http://www.scopus.com/inward/record.url?scp=85091606382&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85091606382&partnerID=8YFLogxK
U2 - 10.1080/13557858.2020.1820958
DO - 10.1080/13557858.2020.1820958
M3 - Article
C2 - 32977725
AN - SCOPUS:85091606382
JO - Ethnicity and Health
JF - Ethnicity and Health
SN - 1355-7858
ER -