Duration of US Residence and Obesity Risk in NYC Chinese Immigrants

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ORIGINAL PAPER

Duration of US Residence and Obesity Risk in NYC Chinese Immigrants Aimee Afable1 • Ming-Chin Yeh1 • Tushar Trivedi1 • Erin Andrews1 Judith Wylie-Rosett1



Ó Springer Science+Business Media New York 2015

Abstract We evaluated whether duration of time in the US is associated with obesity risk in NYC Chinese immigrants. We analyzed cross-sectional survey data on 2072 men and women. Duration of US residence was categorized into B5, 6–15, and 15 years and over. Obesity was defined using WHO Asian standards: BMI of 27.5 kg/m2 or greater. Diet and physical activity (PA) were assessed as potential explanatory variables. After adjusting for covariates, increased time in the US was associated with an increased obesity risk (OR 1.49; 95 % CI 1.06, 2.08 for 15 years or more vs. B5 years); and in separate analysis, with having reported no work related PA (OR 0.76; 95 % CI 0.59, 0.99). Findings suggest that increased time living in the US is associated with an increased obesity risk, a finding possibly explained by a shift to more sedentary lifestyle characteristic of the transition of immigrants to the US. Keywords Obesity  Chinese-origin  Assimilation  Acculturation

Introduction Obesity is increasing in the US [1, 2] and in many regions around the world including Asia [3–8] and Latin America [9] due to increasing wealth and urbanization [10]. These two regions also are the biggest contributors of immigrants

& Aimee Afable [email protected] 1

Department of Community Health Sciences, SUNY Downstate School of Public Health, 450 Clarkson Avenue, Mail Stop Code 43, Brooklyn, NY 11203, USA

to the US [11–13]. Because immigrant populations experience rapid change in exposures they provide a unique opportunity to study the impact of environmental change on the progression to obesity. US immigrants are a dynamic population. There are 40 million immigrants in the US, representing a twofold increase in just two decades (1990–2010), and a growth rate that is unparalleled in US history [14]. Recent data indicate that Asia has now replaced Latin America as the major region of origin for the foreign-born population in the US. For example, among foreign-born population arriving 2008 or later, over 40 % originate from Asia, compared to 25 % from Mexico or Central America [15]. Among the newly arrived from Asia, Chinese-origin immigrants constitute the largest proportion [15]. Immigrant Health Advantage It is well-documented that immigrants arrive with a health advantage despite an adverse socio-economic profile [16– 19]. One leading explanation for this advantage is that immigrants may compose a selected group who are healthier than their counterparts left behind in their origin country [20]. A second explanation is that the cultural orientation immigrants bring with them to the US protects them from adverse health outcomes. It has been suggested that the protective culture of immigrants encourages healthy behaviors and strong social support systems; facilitates access to health information and health