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APHA Scientific Session and Event Listing

Jane M. Brotanek, MD, MPH¹, Hong Ji, MS¹, Emmanuel Ngui, DrPH, MSc², and Glenn Flores, MD¹. (1) Center for the Advancement of Underserved Children, Department of Pediatrics, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, (414) 456-5778, jbrotane@mcw.edu, (2) Center for the Advancement of Underserved Children, Department of Pediatrics, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226

Background: Multiple studies of immigrant and pediatric populations in the US have consistently documented that less acculturation is associated with better health and health outcomes, even though immigrant populations often have a higher prevalence of risk factors associated with worse health outcomes, such as poverty, lack of health insurance, and fewer visits to health care professionals. A greater understanding of “the healthy immigrant effect” may provide key insights on how to improve the health and well-being of all children. Along with the overweight epidemic in US adolescents, there is a dramatic surge in the immigrant population. Little is known about whether acculturation, generational status, birthplace, or primary language spoken at home are associated with overweight in US adolescents.

Objective: To examine whether acculturation, generational status, place of birth, or primary language spoken at home are associated with overweight in US adolescents.

Methods: Analyses were performed of the National Health and Nutrition Examination Survey (NHANES IV: 1999-2002) for a nationally representative sample of US adolescents 12-18 years old. Measures included acculturation (using the Short Acculturation Scale), generational status, birthplace, primary language spoken at home, and overweight/at risk of overweight (OWARO: BMI greater than or equal to the 85th percentile). Multivariate analyses were done to adjust for gender, poverty, and race/ethnicity.

Results: 92% of the 4,339 adolescents were US-born and 8% were foreign-born; 90% had English as their primary language (EPL) and 10%, a non-English primary language (NEPL). Among Latino adolescents, 73% had high acculturation and 27%, low acculturation. 21% of foreign-born adolescents and 33% of US-born adolescents were OWARO (p=.001). 32% of EPL adolescents and 29% of NEPL adolescents were OWARO (p=0.5). 30% of 1st-generation Latino adolescents, 41% of 2nd-generation Latino adolescents, and 38% of 3rd-generation Latino adolescents were OWARO (p=.4). 35% of Latino adolescents with low acculturation and 39% of those with high acculturation were OWARO (p=.2). In multivariate analyses, US-born (OR, 1.8; 95% CI, 1.1-3.0) and EPL (OR, 1.6; 95% CI, 1.1-2.2) adolescents had higher odds of OWARO; among Latino adolescents, being 2nd-generation was associated with OWARO (OR, 2.0; 95% CI, 1.2-3.2).

Conclusions: US-born and EPL adolescents are at significantly higher risk of overweight. Among Latino adolescents, generational status, but not acculturation, is associated with OWARO. Further research is needed to identify how generational status, place of birth, and primary language spoken at home might be protective against adolescent overweight.

Learning Objectives:

• Indicate whether acculturation, generational status, place of birth, or primary language are associated with overweight in US adolescents
• Recognize that US-born and EPL (having English as their primary language) adolescents are at significantly higher risk of overweight

Keywords: Culture, Obesity

Presenting author's disclosure statement:

Any relevant financial relationships? No