Abstract MP16: Status of Cardiovascular Health in US Immigrants Using the AHA’s Life’s Essential 8 Metrics: Prevalence Estimates and Social Determinants From the 2013-2018 National Health and Nutrition Examination Survey

Abstract

Introduction: The US has the largest immigrant population globally, with a record high ~47 million foreign-born residents in 2022. Immigrants endure social and structural factors that may adversely influence their cardiovascular health (CVH). Hypothesis: Overall and individual metrics of CVH will vary by immigration status (US-born vs. foreign-born) and among foreign-born sub-populations. Methods: The analytic sample included 13,471 adults (19% foreign-born), ages 20-79 y (not pregnant or institutionalized) and free of CVD, from the 2013-2018 NHANES. We calculated the CVH score (range 0-100, low CVH: <50) and component scores, consistent with AHA’s Life’s Essential 8 guidelines. T-tests were used to compare CVH scores by nativity and, among foreign-born individuals, by sex, ethnicity, years in the US, and citizenship. Survey weighted logistic models evaluated social determinants of health (SDOH) in relation to odds of having low CVH. Results: Compared to US-born adults, foreign-born adults had higher overall CVH, diet, nicotine exposure, BMI, and blood pressure scores, but lower physical activity, glucose, and cholesterol scores (p<0.01); there were no differences in sleep health scores (Figure A). Among immigrants, those who were men, Hispanic, and living in the US ≥15y had lower CVH scores (p<0.001); CVH scores did not differ by citizenship (Figure B-E). Scores for individual CVH metrics also varied across immigrant sub-populations. In logistic models, being male, 45+ y, Hispanic, food insecure, or having < college education, depression, or ≥15y in the US was related to 57%-150% higher odds of having low CVH. Marital status, income, health insurance, citizenship, and home ownership were not related to CVH. Conclusions: While US immigrants have higher overall CVH compared to US-born persons, CVH status is complex and varies across immigrant sub-populations. Understanding immigration as a SDOH is essential for effective public health initiatives aimed at improving CVH in the heterogeneous US immigrant population.