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.

项目概要 美国拥有世界上最多的移民人口，因为大多数移民来自艾滋病流行率较低的国家。 肥胖和相关的慢性病，​​一个共同的轨迹是这些比率上升到收敛甚至 超过美国白人的比例上升是造成众多健康差异的原因。 解释风险上升的主要理论是文化适应，但纵向研究很少。 对移民的文化和健康轨迹进行了研究，轨迹也很可能 异质性：文化适应可能会受到种族飞地的限制（自给自足的社区，人口密度高） 尽管存在假定的有益的“种族”，但种族飞地本身也有所不同。 密度效应”，例如，传统的移民飞地可以成为经济剥削和限制的场所 社会联系和网络；市中心以外的新兴飞地可能提供相同的社会关系 资源，没有自给自足的传统飞地的缺点 中国的经验。 移民是美国增长最快的族裔群体之一，在这方面提供了独特的信息，表现出 事实上，亚洲移民体现了慢性病风险的巨大空间多样性和变异性。 由于环境和个人因素造成的从低到高的整个风险范围仍有待澄清。 移民飞地提供了一个框架，可在其中检查疾病风险转变并探索综合 为此，我们建议研究健康轨迹。 中国移民样本使用纵向设计来捕捉文化适应、心理社会的变化 我们将在研究中招募 600 名中国移民。 费城地区，包括传统、新兴和非飞地社区的居民。 目的是： (1) 比较三种社区类型（传统社区、新兴社区和非飞地）的移民 CMR； (2) 探索可能介导飞地对健康影响的途径——特别是文化和文化影响 数据收集将包括访谈（包括文化适应和测量） 心理社会压力和社会资源）；4天的人体测量； 用于评估风险标志物的样本，包括甘油三酯、高密度脂蛋白胆固醇 (HDL-C) 和 总的来说，我们试图确定在一种情况下是否以及如何设定更好的轨迹。 对于移民来说，或者是未来健康差异发展的基础，我们的模型挑战了两个主要因素和因素。 广泛持有的信念：美国华人移民是低风险人群，并且统一居住在飞地 提供健康福利，使移民保持在较低的 CMR 水平。拟议的工作将允许进行直接比较。 跨越飞地（区分传统飞地和新兴飞地）和非飞地，并将 描述美国华人人口中 CMR 的程度——不断增长、日益隔离和 美国人口中未被充分研究的部分。