Assimilation to the US and diabetes risk in NYC Chinese immigrants

BACKGROUND Evidence on whether US assimilation contributes to a heightened risk of diabetes in immigrants is equivocal. We examine this question in a population of Chinese immigrants, the second largest US immigrant group.

METHODS The Chinese American Cardiovascular Health Assessment is a cross-sectional study of 2,071 Chinese immigrants living in New York City, funded by NHLBI in 2009. Diabetes was defined as self-reported treatment for diabetes or fasting glucose >=126 mg/dl. A food frequency questionnaire, adapted for Chinese populations, assessed diet and Global Physical Activity Questionnaire assessed physical activity (MET-min/week). Assimilation was operationalized as number of years in the US and age at migration. Logistic regression modeled diabetes risk; additional covariates include age, sex, occupation, educational level, insurance status, and waist circumference.

RESULTS Diabetes prevalence increased with increasing time in the US. Prevalence was 7%, 9% and 16% among adults who lived in the US <= years, 6-15 years, and >15 years, respectively. A significant and graded increase in diabetes risk with increasing time in the US remained after adjusting for age, education, and insurance status. In bivariate analysis, total calories did not vary by time in the US. Total physical activity (METs-min/week), however, decreased significantly with increasing time in the US.

CONCLUSION We add to evidence on the adverse effects of US assimilation on diabetes risk. Our findings highlight the need to examine more closely unique aspects of urban environments that might accelerate diabetes development in US immigrants, particularly factors that may discourage physical activity.