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Social Inequities in Cardiovascular Health: Unexplored Immigrant and Mobility Effects

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Environmental Health".

Deadline for manuscript submissions: closed (31 October 2020) | Viewed by 12020

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Special Issue Editor

Dr. Sandra E. Echeverria

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Guest Editor

Department of Public Health Education, The University of North Carolina at Greensboro, Greensboro, North Carolina, USA
Interests: social determinants of cardiovascular disease and risk factors; cardiovascualr health of immigrants; Latino health; translational social inequities research

Special Issue Information

Dear Colleagues,

Cardiovascular disease is a leading cause of death and morbidity around the world, representing 31% of all global deaths. A rich body of research has shown that social inequities shape cardiovascular disease (CVD) and cardiovascular health. Social inequities are rooted in the social position and hierarchy that individuals possess due to economic resources/wealth, occupation, education, race/ethnicity, gender, sexual orientation, and other characteristics associated with resources, influence, prestige, and social inclusion, and which according to the World Health Organization shape where people are born, live, work, and age. This body of work has shown that specific social conditions such as neighborhood of residence, built environment characteristics, work conditions, education and income, and race/ethnicity, including racial discrimination and immigrant status, increase risk of cardiovascular disease and CVD risk factors. There has also been growing evidence that these social inequities influence disease over the life course and across generations, and translational approaches are urgently needed to more effectively stem cardiovascular disease.

In this themed issue, we build on this body of evidence and seek research studies that explicitly examine how these social conditions pattern health in immigrant groups. We are especially interested in studies that examine social inequities in cardiovascular disease and risk factors for immigrant groups or mobility patterns for which we have limited empirical evidence, such as second-generation Latinos, Asian Americans or African-origin groups living in the United States, emerging immigrant groups in Europe, and cross-national migration in developing nations. There is also emerging evidence to suggest that patterns in cardiovascular health may differ for older vs. younger immigrants and that in recent decades, patterns in cardiovascular health for immigrants have converged with their native-born counterparts. We welcome studies exploring emerging patterns in cardiovascular health, especially given rising tensions in immigrant-related policies and the globalization of the obesity and diabetes epidemic.

We hope you will contribute to this Special Issue and advance a more nuanced, timely understanding of how and for whom social conditions are shaping inequities in cardiovascular disease for immigrants and their descendants around the globe.

Dr. Sandra Echeverria
Guest Editor

Manuscript Submission Information

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Keywords

Cardiovascular disease
Cardiovascular risk factors
Social determinants
Immigrants
Health and nonhealth policies

Published Papers (4 papers)

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Research

12 pages, 704 KiB

Open AccessArticle

Educational Attainment and Prevalence of Cardiovascular Health (Life’s Simple 7) in Asian Americans

by Md Towfiqul Alam, Sandra E. Echeverria, Melissa J. DuPont-Reyes, Elizabeth Vasquez, Rosenda Murillo, Tailisha Gonzalez and Fatima Rodriguez

Int. J. Environ. Res. Public Health 2021, 18(4), 1480; https://doi.org/10.3390/ijerph18041480 - 4 Feb 2021

Cited by 10 | Viewed by 3144

Abstract

Asian Americans have a high burden of cardiovascular disease, yet little is known about the social patterning of cardiovascular health (CVH) in this population. We examined if education (<high school diploma, high school diploma, some college, and college degree+) was associated with CVH and if this varied by time in the United States (U.S.). Our study population included Asian Americans 20+ years of age sampled in the 2011-16 National Health and Nutrition Examination Survey (n = 1634). Ideal cardiovascular health was based on a composite score of adiposity, total cholesterol, blood pressure, blood glucose, smoking, physical activity, and diet. We fit sequential weighted multivariate logistic regression models for all analyses. The prevalence of ideal cardiovascular (CV) health was 17.1% among those living in the U.S. <10 years, 7.1% for those living in the U.S. >10+ years, and 15.9% for the U.S.-born. All models showed that low education compared to high education was associated with lower odds of having ideal CVH. This pattern remained in adjusted models but became non-significant when controlling for nativity (odds ratio = 0.34, 95% confidence interval: 0.10, 1.13). Models stratified by time in the U.S. were less consistent but showed similar education gradients in CVH. Low education is a risk factor for attaining ideal cardiovascular health among Asian Americans, regardless of time in the U.S. Full article

(This article belongs to the Special Issue Social Inequities in Cardiovascular Health: Unexplored Immigrant and Mobility Effects)

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14 pages, 1299 KiB

Open AccessArticle

Africans Who Arrive in the United States before 20 Years of Age Maintain Both Cardiometabolic Health and Cultural Identity: Insight from the Africans in America Study

by Elyssa M. Shoup, Thomas Hormenu, Nana H. Osei-Tutu, M. C. Sage Ishimwe, Arielle C. Patterson, Christopher W. DuBose, Annemarie Wentzel, Margrethe F. Horlyck-Romanovsky and Anne E. Sumner

Int. J. Environ. Res. Public Health 2020, 17(24), 9405; https://doi.org/10.3390/ijerph17249405 - 15 Dec 2020

Cited by 5 | Viewed by 2234

Abstract

The overall consensus is that foreign-born adults who come to America age < 20 y achieve economic success but develop adverse behaviors (smoking and drinking) that lead to worse cardiometabolic health than immigrants who arrive age ≥ 20 y. Whether age of immigration affects the health of African-born Blacks living in America is unknown. Our goals were to examine cultural identity, behavior, and socioeconomic factors and determine if differences exist in the cardiometabolic health of Africans who immigrated to America before and after age 20 y. Of the 482 enrollees (age: 38 ± 1 (mean ± SE), range: 20–65 y) in the Africans in America cohort, 23% (111/482) arrived age < 20 y, and 77% (371/482) arrived age ≥ 20 y. Independent of francophone status or African region of origin, Africans who immigrated age < 20 y had similar or better cardiometabolic health than Africans who immigrated age ≥ 20 y. The majority of Africans who immigrated age < 20 y identified as African, had African-born spouses, exercised, did not adopt adverse health behaviors, and actualized early life migration advantages, such as an American university education. Due to maintenance of cultural identity and actualization of opportunities in America, cardiometabolic health may be protected in Africans who immigrate before age 20. In short, immigrant health research must be cognizant of the diversity within the foreign-born community and age of immigration. Full article

(This article belongs to the Special Issue Social Inequities in Cardiovascular Health: Unexplored Immigrant and Mobility Effects)

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18 pages, 964 KiB

Open AccessArticle

Perceived Discrimination, Psychological Distress and Cardiovascular Risk in Migrants in Spain

by María José Martos-Méndez, Alba García-Cid, Luis Gómez-Jacinto and Isabel Hombrados-Mendieta

Int. J. Environ. Res. Public Health 2020, 17(12), 4601; https://doi.org/10.3390/ijerph17124601 - 26 Jun 2020

Cited by 7 | Viewed by 3242

Abstract

The aim of the present study is to determine the effect of discrimination and psychological distress on the cardiovascular health of immigrants, as well as to analyse potential differences based on age, gender, length of residence in host country and geographic origin. The sample was formed by 1714 immigrants from Africa, Eastern Europe and Latin America. Of the sample, 48.7% were men and 51.3% were women. Most relevant results show that discrimination (t = 4.27; p = 0.000) and psychological distress (t = 4.35; p = 0.000) experienced by immigrants predict their cardiovascular risk. Furthermore, psychological distress mediates the relation between discrimination and risk (t = 4.03; p = 0.000). Significant differences between men and women were found, as well as differences based on ethnicity, although to a lesser extent. Age affects the relation between discrimination, psychological distress and arterial hypertension and hypercholesterolemia. Results are notably relevant for the design of preventive health programmes for immigrants and intervention strategies in order to prevent diseases that may imply cardiovascular risks and seriously affect immigrants’ health. Full article

(This article belongs to the Special Issue Social Inequities in Cardiovascular Health: Unexplored Immigrant and Mobility Effects)

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13 pages, 654 KiB

Open AccessArticle

Stress Measured by Allostatic Load Varies by Reason for Immigration, Age at Immigration, and Number of Children: The Africans in America Study

by Thomas Hormenu, Elyssa M. Shoup, Nana H. Osei-Tutu, Arsene F. Hobabagabo, Christopher W. DuBose, Lilian S. Mabundo, Stephanie T. Chung, Margrethe F. Horlyck-Romanovsky and Anne E. Sumner

Int. J. Environ. Res. Public Health 2020, 17(12), 4533; https://doi.org/10.3390/ijerph17124533 - 24 Jun 2020

Cited by 11 | Viewed by 2870

Abstract

Stress leads to physiologic dysfunction and cardiometabolic disease. Allostatic load score (ALS) measures stress-induced cardiovascular, metabolic, and inflammatory biomarkers. We estimated the odds of high ALS by reason for and age at immigration, duration of American residence, number of children, and socioeconomic status in 193 African immigrants (male: 65%, age 41 ± 10 y (mean ± Standard Deviation (SD)), range 22–65 y). ALS was calculated with High-ALS defined as ALS ≥ 3.0 and Low-ALS defined as ALS < 3.0. Oral glucose tolerance tests (OGTT) were performed, the cardiovascular disease (CVD) risk estimated, and TNF-α, an inflammatory cytokine, measured. Logistic regression was used to estimate odds of High-ALS. In the High- and Low-ALS groups, ALS were 4.0 ± 1.2 vs. 1.3 ± 0.7, diabetes prevalence: 14% vs. 4%, CVD risk: 23% vs. 8%, TNF-α levels: 15 ± 9 vs. 11 ± 6 pg/mL, respectively (all p ≤ 0.01). Immigrants were more likely to be in the High-ALS group if their reason for immigration was work or asylum/refugee (OR 2.18, p = 0.013), their age at immigration was ≥30 y (OR 3.28, p < 0.001), their duration of residence in United States was ≥10 y (OR 3.16, p = 0.001), or their number of children was ≥3 (OR 2.67, p = 0.019). Education, income, health insurance, marital status, and gender did not affect High-ALS odds. Factors adversely influencing allostatic load and cardiometabolic health in African immigrants were age at and reason for immigration, duration of residence in America, and number of children. Full article

(This article belongs to the Special Issue Social Inequities in Cardiovascular Health: Unexplored Immigrant and Mobility Effects)

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