TY - JOUR
T1 - The Association Between Acculturation and Cardiovascular Disease Risk in Ghanaian and Nigerian-born African Immigrants in the United States
T2 - The Afro-Cardiac Study
AU - Commodore-Mensah, Yvonne
AU - Ukonu, Nwakaego
AU - Cooper, Lisa A.
AU - Agyemang, Charles
AU - Himmelfarb, Cheryl Dennison
N1 - Funding Information:
Funding This study was funded by was supported by a pilot fund award to the Center of Excellence for Cardiovascular Health in Vulnerable Populations (P30NR011409) at Johns Hopkins University School of Nursing. L.A.C was supported by a grant from the National Heart, Lung, and Blood Institute (K24 HLHL083113). The funders played no role in the study design, data collection and analysis, the decision to publish, or preparation of the manuscript.
Publisher Copyright:
© 2017, Springer Science+Business Media, LLC.
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2018/10/1
Y1 - 2018/10/1
N2 - The burden of cardiovascular disease (CVD) risk in ethnic minorities in the United States (US) is high. Acculturation may worsen or improve cardiovascular health in immigrants. We sought to examine the association between acculturation and elevated cardiovascular disease risk in African immigrants, a growing immigrant population in the US. We conducted a cross-sectional study of Ghanaian and Nigerian born-African immigrants in the US. To determine whether acculturation was associated with having elevated CVD risk (defined as ≥3 CVD risk factors or Pooled Cohort Equations score ≥7.5%), we performed unadjusted and adjusted logistic regression analyses. For both outcomes, sex-specific models were fitted. Participants (N = 253) were aged 35–74 years and resided in Baltimore–Washington-D.C. The mean age (SD) was 49.5 (9.2) years and 58% were female. Residing in the US for ≥10 years was associated with an almost fourfold (95% CI 1.05–14.35) and eightfold (95% CI 2.09–30.80) greater odds of overweight/obesity and elevated CVD risk respectively in males. Females residing in the US for ≥10 years had 2.60 times (95% CI 1.04–6.551) greater odds of hypertension than newer residents. Participants were classified according to acculturation strategies: Integrationists, 166 (66%); Traditionalists, 80 (32%); Marginalists, 5 (2%); and Assimilationists, 2 (1%). Integrationists had a 0.46 (95% CI 0.24–0.87) lower odds of having ≥3 CVD risk factors and 0.38 (95% CI 0.18–0.78) lower odds of having elevated CVD risk (Pooled Cohort Equations score ≥7.5%) than Traditionalists. Although longer length of stay was associated with CVD risk, Integrationists had lower CVD risk than Traditionalists. Our results suggest that coordinated public health responses to the epidemic of CVD risk factors in the US should target this understudied population. Acculturation should be considered as a meaningful contributor of increased CVD risk and acculturation strategies may be used to tailor interventions in African immigrants. Promoting successful integration may reduce immigrants’ CVD risk.
AB - The burden of cardiovascular disease (CVD) risk in ethnic minorities in the United States (US) is high. Acculturation may worsen or improve cardiovascular health in immigrants. We sought to examine the association between acculturation and elevated cardiovascular disease risk in African immigrants, a growing immigrant population in the US. We conducted a cross-sectional study of Ghanaian and Nigerian born-African immigrants in the US. To determine whether acculturation was associated with having elevated CVD risk (defined as ≥3 CVD risk factors or Pooled Cohort Equations score ≥7.5%), we performed unadjusted and adjusted logistic regression analyses. For both outcomes, sex-specific models were fitted. Participants (N = 253) were aged 35–74 years and resided in Baltimore–Washington-D.C. The mean age (SD) was 49.5 (9.2) years and 58% were female. Residing in the US for ≥10 years was associated with an almost fourfold (95% CI 1.05–14.35) and eightfold (95% CI 2.09–30.80) greater odds of overweight/obesity and elevated CVD risk respectively in males. Females residing in the US for ≥10 years had 2.60 times (95% CI 1.04–6.551) greater odds of hypertension than newer residents. Participants were classified according to acculturation strategies: Integrationists, 166 (66%); Traditionalists, 80 (32%); Marginalists, 5 (2%); and Assimilationists, 2 (1%). Integrationists had a 0.46 (95% CI 0.24–0.87) lower odds of having ≥3 CVD risk factors and 0.38 (95% CI 0.18–0.78) lower odds of having elevated CVD risk (Pooled Cohort Equations score ≥7.5%) than Traditionalists. Although longer length of stay was associated with CVD risk, Integrationists had lower CVD risk than Traditionalists. Our results suggest that coordinated public health responses to the epidemic of CVD risk factors in the US should target this understudied population. Acculturation should be considered as a meaningful contributor of increased CVD risk and acculturation strategies may be used to tailor interventions in African immigrants. Promoting successful integration may reduce immigrants’ CVD risk.
KW - Acculturation
KW - African
KW - Cardiovascular disease
KW - Culture
KW - Health disparities
KW - Hypertension
KW - Immigrants
KW - Obesity
UR - http://www.scopus.com/inward/record.url?scp=85028778447&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85028778447&partnerID=8YFLogxK
U2 - 10.1007/s10903-017-0644-y
DO - 10.1007/s10903-017-0644-y
M3 - Article
C2 - 28852948
AN - SCOPUS:85028778447
VL - 20
SP - 1137
EP - 1146
JO - Journal of Immigrant and Minority Health
JF - Journal of Immigrant and Minority Health
SN - 1557-1912
IS - 5
ER -