Abstract P152: Linguistic Acculturation is Associated With Better Cardiometabolic Health Among Bhutanese Refugees Living in the United States

Abstract

Background: United States (US) South Asians are a fast-growing immigrant group that on average, while having a higher socioeconomic status, present with an increased prevalence and faster development of cardiometabolic health (CMH) conditions. Acculturation—the process of adapting norms of a host culture—can give rise to a unique set of stressful challenges and is associated with poor CMH outcomes among immigrant groups. However, the impact of acculturation on South Asian CMH is relatively unknown due to limited studies, especially when considering the Bhutanese community; the third largest US refugee group. Hypothesis: We hypothesize that increased English linguistic acculturation among US Bhutanese adults would be associated with poorer CMH. Methods: Using 2021-2022 Bhutanese Community of Central Ohio Health Study data, we examined associations of linguistic acculturation and sociodemographic characteristics in relation to CMH conditions among Bhutanese adults living in Central Ohio (N=495). A summed score for responses of very limited (1 point); limited (2 points); fair (3 points); good (4 points); and excellent (5 points) English language proficiency in speaking, listening and understanding, reading, and writing was used to capture limited (≤8), intermediate (9-19), and excellent (20) linguistic acculturation. CMH was assessed from participant self-report of clinical diagnosed or treated hypertension, type 2 diabetes, and dyslipidemia, as well as weight and height to calculate body mass index (BMI). Adjusting for sex, age, and BMI, we used Poisson regression to estimate prevalence ratios (PR) and 95% confidence intervals (CI) of associations of linguistic acculturation and sociodemographic characteristics in relation to CMH conditions. Results: Most participants were aged 18 to 44 years (69.8%) and migrated to the US ≥11 years ago (60.2%). Linguistic acculturation prevalence was 34.1% for very limited/limited and 65.9% for fair to excellent. Most participants reported no CMH condition (70%), while 12.9% reported one, 10.8% reported two, and 6.3% reported three. Fair to excellent vs. very limited/limited linguistic acculturation were associated with a lower prevalence of having three CMH conditions (PR=0.17 [95% CI: 0.03-0.97]). Migrating to the US ≥11 years vs. <11 years was associated with a higher prevalence of having two CMH conditions (PR=1.67 [95% CI: 0.95-2.95]). Conclusions: In conclusion, more linguistic acculturation was associated with better CMH among Bhutanese adults living in the US. Given the burden of CMH disparities among minoritized racial/ethnic groups in the US, future studies should consider acculturation to further explore the role of language in shaping immigrant and refugee health across the lifecourse.