Abstract
Introduction:
Limited disaggregated Asian subgroup data exist on the association between cardiovascular (CV) risk factors and acculturation level.
Hypothesis:
The association between acculturation levels and CV risk factors will differ by Asian subgroups.
Methods:
We used the National Health Interview Survey, a nationally representative US survey, years 2014-18. Acculturation was defined using the sum of: (a) years in the US (b) citizenship (c) English proficiency. An acculturation index was created and categorized as low, moderate, or high (scores of 0-1, 2 and ≥ 3, respectively). Self-reported risk factors included high cholesterol, obesity, tobacco use, physical activity level, diabetes and hypertension. Age-adjusted, weighted proportions were used to compare the prevalence of CV risk factors between Asian subgroups using Rao-Scott Chi Square.
Results:
Study sample consisted of 10,891 adults, representing 7.5 million US adults ≥ 18 years (46 % male; mean age 48.3 [SD 15.7]). The distribution by race/ethnicity was Asian Indian 15.1%, Chinese 12.9%, Filipino 10.2%, other Asian 18.2%, and NHW 43.7%. We found a positive association between prevalence of high cholesterol and acculturation level among all Asian subgroups, with increases of 50 to 90% when comparing low vs high acculturation (
Table
). Filipinos had a higher prevalence of obesity and tobacco use associated with higher acculturation level (p< 0.05), but this was not observed among other Asian subgroups. In contrast, physical activity levels were higher among Asian subgroups with higher acculturation levels. No differences were seen for prevalence of hypertension or diabetes based on acculturation level.
Conclusion:
This study demonstrates that acculturation level was associated with higher prevalence of CV risk factors with significant variability among Asian subgroups. It highlights the need for more studies to better understand these differences based on acculturation level and can help inform targeted, culturally specific interventions.