Daily psychosocial stress and cardiometabolic health of older Chinese Americans

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Project Summary Despite being one of the fastest-growing immigrant populations in the United States, older Chinese Americans remain understudied in health research. The penetration of the model minority stereotype has caused the overlook of significant disadvantages and health burdens experienced by older Chinese Americans, particularly foreign-born older Chinese Americans. The double disadvantage of being a member of an ethnic minority and foreign-born puts foreign-born older Chinese Americans at high risk of experiencing psychosocial stressors, including anti-Asian racism and social isolation. These psychosocial stressors are key risk factors for poor physical health, including poor cardiometabolic health. Indeed, existing studies have shown a fast decline in cardiometabolic health after immigrating to the United States among older Chinese immigrants. However, there is a lack of a fine-grained characterization of psychosocial stressors and the processes through which these psychosocial stressors affect cardiometabolic health in older Chinese immigrants. Existing studies on this topic were largely focused on non-Hispanic Whites or other ethnic minorities. To address this gap, we aim to adopt a mixed-methods approach, along with the ecological momentary assessment, to identify the key psychosocial stressors related to cardiometabolic health in a sample of 80 older Chinese immigrants. Specifically, our proposed aims are: Aim 1a: Investigate the intermediate role of daily emotion (negative and positive emotion) and salivary cortisol (a biological marker of stress) through which psychosocial stressors (e.g., racial discrimination) affect systemic inflammation (CRP, IL-6) and metabolic syndrome; Aim 1b: Explore whether key sociocultural factors (living in ethnic enclaves, English proficiency, socioeconomic status) will attenuate the associations examined in Aim 1a; and Aim 2: Identify additional cultural, environmental, family, and individual factors that further explain the association between psychosocial stress and cardiometabolic health through semi-structured interviews in a subsample of 16 participants from Aim 1. Findings from this proposed study will contribute to our understanding of key psychosocial stressors and related biopsychological processes contributing to poor cardiometabolic health in older Chinese immigrants. As a result, this project will guide the design of future culturally-tailored, time-sensitive, personalized psychosocial interventions that aim to reduce racial disparities in cardiometabolic health and promote healthy equity in older Chinese Americans.