Immigrant enclaves: Conferring health advantages or creating health disparities in Chinese immigrants?

移民飞地：为中国移民带来健康优势还是造成健康差异？

• 批准号: 10320742
• 负责人: Carolyn Y. Fang
• 金额: $ 85.44万
• 依托单位: RESEARCH INST OF FOX CHASE CAN CTR
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-05-02 至 2024-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10320742
• 关键词: Acculturation; Adoption; Affect; Anthropometry; Asian; Asian population; Behavior; Belief; Blood Pressure; Blood specimen; Buffers; Businesses; Cardiometabolic Disease; Chinese; Chinese population; Chronic; Chronic Disease; Cities; Community Developments; Community Outreach; Country; Data Collection; Developing Countries; Development; Disadvantaged; Economics; Encapsulated; Ethnic group; Exhibits; Future; Generations; Health; Health Benefit; Health Transition; High Density Lipoprotein Cholesterol; Immigrant; Individual; Institution; Intervention; Interview; Life Style; Literature; Longitudinal Studies; Low Prevalence; Maintenance; Measures; Mediating; Mediator of activation protein; Metabolic syndrome; Minority; Modeling; Neighborhoods; Obesity; Pathway interactions; Perception; Persons; Philadelphia; Population; Prevention; Preventive; Process; Psychosocial Factor; Psychosocial Stress; Research; Resources; Risk; Risk Marker; Role; Sampling; Testing; Time; Triglycerides; Trust; Work; base; cardiometabolic risk; cohesion; cohort; density; dietary; disorder risk; expectation; experience; fasting glucose; health disparity; high risk; longitudinal design; novel; physical conditioning; programs; protective effect; psychosocial; recruit; residence; social; social capital; socioeconomics; theories

PROJECT SUMMARY The US has the world's largest immigrant population. As most arrive from countries with lower prevalence of obesity and related chronic conditions, a common trajectory is for these rates to rise to converge with or even exceed rates in US whites. This rise underlies the development of numerous health disparities among immigrant/ethnic groups. A primary theory to explain the rise in risk is acculturation, but few longitudinal studies on acculturative and health trajectories have been conducted among immigrants, and trajectories are also likely to be heterogeneous: Acculturation may be limited in ethnic enclaves (self-contained neighborhoods with high residential density of immigrants), and ethnic enclaves themselves differ. Despite a presumed, beneficial `ethnic density effect,' for example, traditional immigrant enclaves can be settings for economic exploitation and curtailed social ties and networks; newer, emerging enclaves outside of city centers might provide the same social resources without the disadvantages of a self-contained, traditional enclave. The experience of Chinese immigrants, among the fastest growing US ethnic groups, is uniquely informative in this regard, exhibiting considerable spatial diversity and variability in chronic disease risk. Indeed, Asian immigrants encapsulate the entire range of risk, from low to high, as a result of environmental and individual-level factors still to be clarified. Immigrant enclaves offer a framework in which to examine disease risk transitions and to explore the combined roles of acculturative and psychosocial pathways. Towards this end, we propose to study health trajectories in a sample of Chinese immigrants using a longitudinal design to capture changes in acculturation, psychosocial factors, and markers of cardiometabolic risk (CMR). We will recruit a cohort of 600 Chinese immigrants in the Philadelphia region, including residents of traditional, emerging, and non-enclave neighborhoods. Specific aims are to: (1) Compare CMR of immigrants in three neighborhood types (traditional, emerging, and non-enclaves); and (2) Explore pathways that may mediate enclave effects on health – in particular, acculturative and psychosocial factors. Data collection will include interviews (including acculturation and measures of psychosocial stress and social resources); 4 days of dietary recalls; anthropometry; blood pressure; and blood samples for assessing risk markers including triglycerides, high-density lipoprotein cholesterol (HDL-C), and fasting glucose. Overall, we seek to determine whether and how conditions in one context set a better trajectory for immigrants, or underlie the development of future health disparities. Our model challenges two primary and widely held beliefs: that US Chinese immigrants are a low risk population, and that enclave residence uniformly provides health benefits that keep immigrants at low CMR. The proposed work will allow for a direct comparison across enclaves (distinguishing between traditional and emerging enclaves) and non-enclaves, and will characterize the extent of CMR in the US Chinese population – a growing, increasingly segregated, and understudied segment of the US population.

项目摘要 美国拥有世界上最大的移民人口。当大多数人到达的国家患病率较低 肥胖和相关的慢性疾病，一个常见的轨迹是使这些速率上升到融合甚至 美国白人的比率超过了。这崛起是基础的发展 移民/族裔。解释风险上升的主要理论是培养，但很少有纵向研究 在移民中已经进行了关于培养和健康轨迹，也很可能 要异质：适应性可能受到族裔飞地的限制（具有高度的社区 移民的住宅密度），族裔飞地本身不同。尽管有一个有益的种族 密度效应，例如，传统的移民飞地可以是经济剥削的设置，并限制 社会关系和网络；较新的，新兴的飞地城市中心可能会提供相同的社会 没有灾难的资源，传统的飞地。中文的经历 移民是美国成长最快的美国族裔，在这方面具有独特的信息，展示了 慢性疾病风险的大量空间多样性和可变性。确实，亚洲移民封装了 由于环境和个人水平因素，从低到高的风险范围仍有待阐明。 移民飞地提供了一个框架，用于检查疾病风险转变并探索合并的框架 培养和社会心理途径的作用。为此，我们建议在A中研究健康轨迹 使用纵向设计的中国移民样本来捕捉培养，社会心理的变化 心脏代谢风险（CMR）的因素和标记。我们将招募一组600名中国移民 费城地区，包括传统，新兴和非安克拉夫社区的居民。具体目标 为：（1）比较三种邻里类型的移民CMR（传统，新兴和非迷信）； （2）探索可能介导飞地对健康影响的途径，特别是适应性和 社会心理因素。数据收集将包括访谈（包括培养和措施 社会心理压力和社会资源）；饮食召回4天；人体测定法；血压;和鲜血 评估包括甘油三酸酯，高密度脂蛋白胆固醇（HDL-C）和 禁食葡萄糖。总体而言，我们试图确定一个环境中的条件以及如何设定更好的轨迹 对于移民，或者是未来健康差异的发展。我们的模型挑战了两个主要和 人们普遍存在的信念：美国中国移民是低风险人口，而飞地统一的住所 提供健康益处，使移民处于低CMR。拟议的工作将允许直接比较 跨飞地（区分传统和新兴的飞地）和非迷信，将 表征美国中国人口中CMR的程度 - 一个日益增长，越来越隔离，并且 美国人口的研究部分。