Are long-term changes in neighborhood ethnic composition related to BMI and waist circumference among Chinese immigrants? Evidence from the Multi-Ethnic Study of Atherosclerosis

Background: Obesity is rising in the US, including among immigrants. Although explanations for immigrant health patterns often focus on individual-level acculturation, broader factors—including immigrants’ residential neighborhoods—may be important. 

Objective: Using detailed epidemiological prospective cohort data combined with residential histories, we analyzed associations of patterns of long-term neighborhood coethnic concentration (census tract % Chinese residents) with waist circumference (WC) and body mass index (BMI) among older Chinese immigrants in the US. Based on social theory, we hypothesized that compared to stable neighborhood coethnic concentration, a pattern of residential segregation (increasing neighborhood % Chinese over time) would be associated with lower WC and BMI, while a pattern of residential assimilation (decreasing neighborhood % Chinese) would be associated with higher WC and BMI. 

Methods: We used pooled repeated-measures outcome and covariate data from 2000–2012 (2687 observations) about 640 Chinese immigrant participants in the Multi-Ethnic Study of Atherosclerosis aged 44−93 living in Los Angeles and Chicago. We used residential history information from 1980−2012 to measure longitudinal patterns of residential segregation and assimilation exposures. 

 Results: In adjusted multilevel linear regression models, recent (previous 0−10 years) residential segregation was associated with lower WC compared to stable neighborhood % Chinese (difference = -1.25 cm [-1.84, -0.66]), as hypothesized, while residential segregation farther in the past (previous 10−20 years) was not associated with WC. Recent residential assimilation was weakly associated with lower WC (unexpected direction), while residential assimilation farther in the past was associated with higher WC, as hypothesized. BMI results were similar. 

Conclusions: Longitudinal patterns of neighborhood coethnic concentration were related to WC and BMI among older Chinese immigrants, but associations varied by time period and sometimes deviated from hypothesized directions. Future research incorporating both larger-scale epidemiological data and focused qualitative data may help elucidate the complex processes relating neighborhood conditions to immigrant health.