Neighborhood, social connectedness, and allostatic load in US Chinese immigrants

点击翻译按钮获取中文摘要

PROJECT SUMMARY Asian Americans are the fastest-growing racial/ethnic group in the United States (US), and Asians of Chinese origin represent the largest single US Asian subgroup. Among Chinese Americans, the majority (62%) are foreign-born. Although Chinese immigrants report better health than their US-born counterparts, this health ad- vantage decreases over time with increasing duration of residence. The downward health trajectory has been primarily attributed to behavioral acculturation, but immigration also encompasses extensive stress and social isolation. Social isolation, in turn, may increase chronic disease risk through dysregulation in multiple systems – neuroendocrine, cardiovascular, metabolic, inflammatory, immune – which together are indicative of allostatic load (AL). Indeed, studies of other US immigrant populations (mostly African or Latinx) have noted that longer US residence is associated with higher AL. Despite these findings, the question of whether immigrants’ experi- ences of social isolation affect disease risk and health has not been well studied. Social connectedness, or the extent to which one perceives oneself to be closely and meaningfully connected with other individuals, groups, and society as a whole, is a possible strategy to address social isolation, but the conditions and contexts that foster social connectedness are not well understood. Living in ethnic enclaves (i.e. neighborhoods with a greater proportion of people of the same ethnicity) may have positive effects among Chinese immigrants including greater social support and less loneliness. It has been suggested that enclaves provide the necessary structural conditions – namely, physical and social spaces – for social connectedness to develop, although this has yet to be confirmed in large-scale studies. Thus, we propose a comprehensive investigation of the following interrelated questions: Do post-migration experiences of social isolation/connectedness have biologic correlates among foreign-born Chinese? And do ethnic enclaves contribute to social connectedness in this population; if so, how? To address these questions, we will recruit a cohort of 600 foreign-born Chinese across the Philadelphia region, including residents of ethnic enclaves as well as residents of neighborhoods lacking the co-ethnic density and resources of recognized enclaves. Specific aims are to: (1) Examine associations of social connectedness and social isolation with AL in a cohort of US Chinese immigrants; and (2) Explore whether and how enclave resi- dence and engagement with enclave-based resources are associated with social connectedness. Data collection will include questionnaires (e.g., social connectedness, isolation, engagement with enclave resources), blood pressure, anthropometry, and fasting blood samples analyzed for markers of AL. Addresses of residences and locations of activities (e.g., shopping, religious services) will be geocoded. Longitudinal assessments will be obtained at 2-year follow-up to identify changes in markers of AL and correlates of changes in those measures. Project findings will identify the most vulnerable individuals and neighborhoods to target for outreach and pinpoint the critical community-level resources for promoting positive health trajectories in this immigrant population.