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 - Nmezi, Nwakaego Ada
AU - Commodore-Mensah, Yvonne
N1 - Funding Information:
This work was supported by the University of Delaware. This study is based on Debora Kamin Mukaz’s dissertation. Many thanks to Dr. Thomas Ilvento for providing much-needed feedback on the analysis.
Publisher Copyright:
© 2020 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2022
Y1 - 2022
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 - African immigrants
KW - Immigration
KW - acculturation
KW - diabetes
KW - immigrant health
KW - mediation analysis
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U2 - 10.1080/13557858.2020.1820958
DO - 10.1080/13557858.2020.1820958
M3 - Article
C2 - 32977725
AN - SCOPUS:85091606382
SN - 1355-7858
VL - 27
SP - 770
EP - 780
JO - Ethnicity and Health
JF - Ethnicity and Health
IS - 4
ER -