Abstract
BackgroundEthnic minority populations in the United States (US) are disproportionately affected by cardiovascular disease (CVD) risk factors, including hypertension, overweight/obesity, and diabetes. The size and diversity of ethnic minority immigrant populations in the US have increased substantially over the past three decades. However, most studies on immigrants in the US are limited to Asians and Hispanics; only a few have examined the prevalence of CVD risk factors across diverse immigrant populations. The prevalence of diagnosed hypertension, overweight/obesity, and diagnosed diabetes was examined and contrasted among a socioeconomically diverse sample of immigrants. It was hypothesized that considerable variability would exist in the prevalence of hypertension, overweight and diabetes.MethodsA cross-sectional analysis of the 2010–2016 National Health Interview Survey (NHIS) was conducted among 41,717 immigrants born in Europe, South America, Mexico/Central America/Caribbean, Russia, Africa, Middle East, Indian subcontinent, Asia and Southeast Asia. The outcomes were the prevalence of diagnosed hypertension, overweight/obesity, and diagnosed diabetes.ResultsThe highest multivariable adjusted prevalence of diagnosed hypertension was observed in Russian (24.2%) and Southeast Asian immigrants (23.5%). Immigrants from Mexico/Central America/Caribbean and the Indian subcontinent had the highest prevalence of overweight/obesity (71.5 and 73.4%, respectively) and diagnosed diabetes (9.6 and 10.1%, respectively). Compared to European immigrants, immigrants from Mexico/Central America/Caribbean and the Indian subcontinent respectively had higher prevalence of overweight/obesity (Prevalence Ratio (PR): 1.19[95% CI, 1.13–1.24]) and (PR: 1.22[95% CI, 1.14–1.29]), and diabetes (PR: 1.70[95% CI, 1.42–2.03]) and (PR: 1.78[95% CI, 1.36–2.32]). African immigrants and Middle Eastern immigrants had a higher prevalence of diabetes (PR: 1.41[95% CI, 1.01–1.96]) and PR: 1.57(95% CI: 1.09–2.25), respectively, than European immigrants —without a corresponding higher prevalence of overweight/obesity.ConclusionsImmigrants from Mexico/Central America/Caribbean and the Indian subcontinent bore the highest burden of overweight/obesity and diabetes while those from Southeast Asia and Russia bore the highest burden of hypertension.
Highlights
Ethnic minority populations in the United States (US) are disproportionately affected by cardiovascular disease (CVD) risk factors, including hypertension, overweight/obesity, and diabetes
The purpose of this study was to examine and contrast the prevalence of diagnosed hypertension, overweight/obesity, and diagnosed diabetes among a diverse sample of US immigrants and establish whether there is a high burden of CVD risk factors among US immigrants
The sample consisted of immigrants from Europe (12.5%), South America (6.6%), Mexico/Central America/Caribbean (47%), Russia (2.7%), Africa (5%), Middle East (3%), Indian subcontinent (6.5%), Asia (7.5%), and Southeast Asia (9%)
Summary
Ethnic minority populations in the United States (US) are disproportionately affected by cardiovascular disease (CVD) risk factors, including hypertension, overweight/obesity, and diabetes. Most studies on immigrants in the US are limited to Asians and Hispanics; only a few have examined the prevalence of CVD risk factors across diverse immigrant populations. The prevalence of diagnosed hypertension, overweight/obesity, and diagnosed diabetes was examined and contrasted among a socioeconomically diverse sample of immigrants. In 2015 one in three deaths was attributed to CVD, with approximately one death occurring every 40 s [1]. Ethnic minority populations in the US are disproportionately affected by hypertension, diabetes, and overweight/ obesity among other chronic conditions, mirroring global trends [1]. [6] Approximately 17.5 million deaths per year—31% of the deaths reported worldwide—are attributed to CVD. The global prevalence of diabetes has almost doubled from 4.7% in 1980 to 8.5% in 2014. [5] Across World Health Organization (WHO) regions, the prevalence of hypertension is highest in Africa, where it was 46%, and lowest in the Americas at 35%. [6] Approximately 17.5 million deaths per year—31% of the deaths reported worldwide—are attributed to CVD. [1]
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