Abstract MP56: Length of Stay and Allostatic Load in Immigrants to the United States-Evidence From the 2011 - 2016 National Health and Nutrition Examination Surveys

Abstract

Introduction: Stress alters the cardiometabolic and inflammatory systems. Allostatic load, a measure of chronic and cumulative stress is associated with cardiovascular events and mortality. Immigration is known to be a stressful experience; however, it is unclear how length of stay, a proxy for acculturation, is associated with allostatic load in US immigrants. Hypothesis: We hypothesized that greater length of stay will be associated with higher allostatic load among US immigrants. Methods: We used a cross-sectional design to examine the 2011-2016 National Health and Nutrition Examination Surveys. Allostatic load was defined by a count of the number of high-risk classifications for 10 cardiovascular, metabolic, and immune system biomarkers: systolic blood pressure, diastolic blood pressure, total cholesterol, triglycerides, glycated hemoglobin, albumin, creatinine clearance, body mass index, waist circumference, and white blood cells. Logistic regression was used to examine the odds of a high allostatic load score (≥ 4) as in previous literature, adjusting for survey weights. Results: We included 7318 immigrants with mean age (±se) 44(±0.52); 49% were male. Half of the sample was of Mexican/Hispanic origin, 26% were Asian and 7% were Black. The median allostatic load score was 2.2. The odds of high allostatic load decreased with longer stay in the US. After adjusting for age, race, education, income, insurance status, and routine place for healthcare, those who had resided in the US for 10 to 20 years were 45% (95% CI: 1.1-1.9) more likely to have a high allostatic load than those who had been in the US <10 years. The unadjusted and adjusted results are presented in the Table. Conclusion: Length of stay in immigrants is associated with having a high allostatic load. The odds of increased allostatic load declines with longer length of US residence. Additional research is needed to further understand the process and impact of cumulative stress among immigrants to reduce racial/ethnic health disparities.