221280 Heterogeneity in the association of acculturation with body mass index and waist circumference among Hispanic and Chinese participants in the Multi-ethnic Study of Atherosclerosis (MESA)

Tuesday, November 9, 2010

Sandra S. Albrecht, MPH , Center for Social Epidemiology and Population Health, Department of Epidemiology, Ann Arbor, MI
Ana V. Diez Roux, MD, PhD , Department of Epidemiology, Center for Integrative Approaches to Health Disparities, University of Michigan, Ann Arbor, MI
Namratha R. Kandula, MD, MPH , Division of General Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
Theresa L. Osypuk, SD, SM , Northeastern University, Bouve College of Health Sciences, Boston, MA
Hanyu Ni, PhD, MPH , National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
Sandi Shrager , Collaborative Health Studies Coordinating Center, University of Washington, Seattle, WA
Nativity and years living in the U.S. have been linked to body mass index (BMI) and waist circumference (WC) among immigrants. Few have examined heterogeneity in this relationship. Doing so may inform how social processes that relate to different immigrant integration patterns impact obesity. Using baseline data from 802 Mexican-Americans, 694 Non-Mexican-American Hispanics, and 803 Chinese-Americans aged 45-84 in the Multi-ethnic Study of Atherosclerosis (2000-2002), we investigated whether the association of nativity (U.S. vs. foreign-birth) and years of U.S. residence (<10, ≥ 10 years) with clinically-measured BMI (kg/m2) and WC (cm) varied first by race/ethnicity, then by gender or education within race/ethnic groups. Controlling for age, gender, education, and income, U.S. birth was significantly associated with a higher mean BMI and WC among non-Mexican-American Hispanics (mean differences (95% confidence intervals) (BMI: 2.57 (1.27-3.87); WC: 7.76 (4.35-11.16)), Chinese-Americans (BMI: 1.67 (0.44-2.89); WC: 4.75 (1.10-8.40)), and Mexican-Americans only for BMI (0.95 (0.05-1.84)) (p-interaction=0.01 (WC)). Among the foreign-born, greater time in the U.S. was only significantly associated with higher mean BMI and WC among Mexican-Americans (BMI: 1.80 (0.45-3.14); WC: 3.95 (0.70-7.21)). The association of nativity with BMI/WC varied significantly by education and gender only among non-Mexican-Americans. Specifically, foreign birth was no longer protective against higher BMI/WC among males (p-interaction=0.06) and the less educated (p-interaction=0.02). These results confirm that greater acculturation is related to higher BMI and WC but the strength and presence of this relationship differs by ethnicity, gender, and education. This heterogeneity should be considered in research on health consequences of immigration.

Learning Areas:
Diversity and culture

Learning Objectives:
1. Describe the relationship between acculturation measures and body mass index and waist circumference for different ethnic groups. 2. Evaluate whether the impact of greater acculturation on body mass index and waist circumference differs for men and women, and for populations with different levels of education.

Keywords: Immigrants, Obesity

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I designed the study, analyzed all the data, and wrote the abstract.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.