Cardiovascular Risk in Middle-Aged and Older Immigrants: Exploring Residency Period and Health Insurance Coverage.
Cardiovascular Risk in Middle-Aged and Older Immigrants: Exploring Residency Period and Health Insurance Coverage.
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中年和老年移民的心血管风险：探索居住期和健康保险覆盖范围。
DOI：
10.1111/jnu.12465
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Kovner,Christine
中科院分区：
文献类型：
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作者：
Sadarangani,TinaR;Trinh-Shevrin,Chau;Chyun,Deborah;Yu,Gary;Kovner,Christine
据报道，虽然移民最初在重新安置时比本地出生的人更健康，但随着时间的推移，这种优势会逐渐消失。在美国，没有保险的老年移民越来越多地经历心血管疾病（CVD）的严重并发症。本研究的目的是比较整体心血管疾病的风险和探索的重要性，健康保险覆盖心血管疾病的风险相对于其他健康准入的障碍，从2007年至2012年，在最近和长期移民>50 years.MethodsThis study was based on secondary cross-sectional analysis of the National Health and Nutrition Examination Survey（N= 1，920）.主要结果，心血管疾病风险分类（高或低），使用美国心脏病学会和美国心脏协会合并队列方程确定。使用独立样本检验和卡方分析检查移民群体之间的差异。保险和心血管疾病风险之间的关联是使用分层块逻辑回归模型进行探讨的，其中变量以预定的顺序输入。pseudoR 2的变化衡量是否健康保险解释方差心脏风险超出其他variables.ResultsRecent移民有较低的总体心血管疾病风险比长期移民，但有两倍的可能是未投保，并有较高的血糖和血脂水平。回归模型的基础上，没有保险的心血管疾病的风险超过其他健康访问的决定因素，心血管疾病的风险是显着的最近的移民谁是uninsurance.ConclusionsHealth保险覆盖面发挥了重要作用，在一个全面的方法来减轻心血管疾病的风险老龄化移民，特别是最近的移民，他们的心血管健康容易恶化。临床相关性护士的任务是认识到独特的社会和老年移民的身体脆弱性，并在护理计划中考虑这些问题。除了帮助他们获得医疗保险和负担得起的药物外，护士和临床医生还应优先考虑降低CVD风险的低成本生活方式干预措施，特别是饮食和运动计划。
PurposeIt is reported that while immigrants are, initially, healthier than the native‐born upon resettlement, this advantage erodes over time. In the United States, uninsured aging immigrants are increasingly experiencing severe complications of cardiovascular disease (CVD). The purpose of this study was to compare overall CVD risk and explore the importance of health insurance coverage on CVD risk relative to other health access barriers, from 2007 to 2012, in recent and long‐term immigrants >50 years of age.MethodsThis study was based on secondary cross‐sectional analysis of the National Health and Nutrition Examination Survey (N= 1,920). The primary outcome, CVD risk category (high or low), was determined using the American College of Cardiology and American Heart Association Pooled Cohort equation. Differences between immigrant groups were examined using independent‐samplesttests and chi‐square analysis. The association between insurance and CVD risk was explored using a hierarchical block logistic regression model, in which variables were entered in a predetermined order. Changes in pseudoR2measured whether health insurance explained variance in cardiac risk beyond other variables.ResultsRecent immigrants had lower overall CVD risk than long‐term immigrants but were twice as likely to be uninsured and had higher serum glucose and lipid levels. Based on regression models, being uninsured contributed to CVD risk beyond other health access determinants, and CVD risk was pronounced among recent immigrants who were uninsured.ConclusionsHealth insurance coverage plays an essential part in a comprehensive approach to mitigating CVD risk for aging immigrants, particularly recent immigrants whose cardiovascular health is susceptible to deterioration.Clinical RelevanceNurses are tasked with recognizing the unique social and physical vulnerabilities of aging immigrants and accounting for these in care plans. In addition to helping them access healthcare coverage and affordable medication, nurses and clinicians should prioritize low‐cost lifestyle interventions that reduce CVD risk, especially diet and exercise programs.