Understanding health disparities in Pakistani, Bangladeshi and Asian Indian immigrants: the role of socio-cultural context, acculturation and resilience resources

了解巴基斯坦、孟加拉国和亚洲印度移民的健康差异：社会文化背景、文化适应和复原力资源的作用

• 批准号: 10443757
• 负责人: NADIA S ISLAM
• 金额: $ 69.23万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-02 至 2026-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10443757
• 关键词: Acculturation; Adopted; Adult; Affect; Age; Americas; Area; Asian Indian; Asian population; Assimilations; Atherosclerosis; Bangladesh; Bangladeshi; Canada; Cardiovascular Diseases; Cardiovascular system; Characteristics; Chicago; Clinical; Cohort Studies; Communities; Complex; Country; Cultural Backgrounds; Data; Data Aggregation; Development; Diabetes Mellitus; Diet; Discrimination; Dyslipidemias; Enrollment; Ethnic group; Genetic Variation; Goals; Health Sciences; Hypertension; Immigrant; Immigrant community; Immigration; India; Interview; Knowledge; Longitudinal Studies; Longitudinal cohort study; Measures; Mediating; Mediator of activation protein; Methods; Muslim population group; Neighborhoods; New York; New York City; Obesity; Pakistan; Participant; Pattern; Physical activity; Population; Poverty; Prevalence; Prevention strategy; Process; Public Health; Race; Recording of previous events; Reporting; Resources; Risk; Risk Factors; Role; Sampling; San Francisco; Science; Smoking; Social Network; Social support; Socioeconomic Status; South Asian; Structure; Subgroup; Surveys; Testing; Tobacco use; United Kingdom; United States; base; biopsychosocial; burden of illness; cardiovascular health; cohesion; cohort; coping; ethnic diversity; experience; health disparity; low socioeconomic status; protective factors; recruit; resilience; social capital; social culture; stressor

PROJECT SUMMARY South Asians, comprised predominantly of Asian Indians, Pakistanis and Bangladeshi immigrants, are the second fastest growing ethnic group in the United States. Our team has created the first longitudinal study of South Asians called the Mediators of Atherosclerosis in South Asians Living in America (MASALA), which has demonstrated significantly poorer cardiovascular health in the aggregated South Asian population compared to other major U.S. race/ethnic groups. However, MASALA has very limited information about the cardiovascular health profiles for Pakistanis and Bangladeshis since MASALA included 83% Asian Indian but only 6% Pakistani and 0.5% Bangladeshi immigrants. Studies from the South Asian subcontinent, the United Kingdom, and Canada have shown significantly higher burden of cardiovascular disease among Bangladeshis and Pakistanis compared to Indians. Socio-cultural context, including socioeconomic position, immigration history, cultural background, and neighborhood factors vary across these three South Asian subgroups and affect how immigrants experience and adjust to a new context, and how they activate resilience resources to cope with stressors that impact cardiovascular health disparities. Our goal is to expand the MASALA study cohort to include more Pakistani and Bangladeshi immigrants leveraging new and existing measures to characterize and understand cardiovascular health disparities in immigrant populations. We propose to recruit 600 Bangladeshi and 550 Pakistani adults between the age of 40-84 years from greater New York City and Chicago areas to add to the ongoing MASALA cohort and compare them to Asian Indians enrolled in MASALA. Our specific aims are to: 1) Determine whether and the extent to which Pakistani and Bangladeshi immigrants have worse cardiovascular health (diet, physical activity, tobacco use, diabetes, hypertension, dyslipidemia, obesity) compared to Indian immigrants already enrolled in MASALA. 2) Identify multilevel risk and protective factors associated with cardiovascular health within and across South Asian subgroups. Test whether acculturation strategies and resilience resources mediate or moderate the association between socio-cultural context and cardiovascular health and explain disparities across the three subgroups. 3) To further interpret our quantitative results, conduct in-depth interviews to elucidate how immigration, acculturation, discrimination, and resilience resources influence South Asians’ cardiovascular health. Studying diverse immigrant populations advances the science of health disparities by understanding how biopsychosocial and ecological characteristics may associate and interact with country of origin to influence cardiovascular health. Our mixed- methods approach for studying the complex, multilevel interactions influencing cardiovascular health disparities in South Asian immigrants offers promise for the development of more effective public health and clinical prevention strategies to reduce CVD disparities.

项目概要 南亚人主要由亚洲印度人、巴基斯坦人和孟加拉国移民组成，是 我们的团队对美国增长第二快的族群进行了第一项纵向研究。 南亚人将其称为“居住在美国的南亚人动脉粥样硬化的调解者”(MASALA)， 与其他国家相比，南亚人群的心血管健康状况明显较差 然而，MASALA 有关心血管的信息非常有限。 巴基斯坦人和孟加拉国人的健康概况，因为 MASALA 包括 83% 的亚裔印度人，但只有 6% 来自南亚次大陆、英国的巴基斯坦移民和 0.5% 孟加拉国移民。 和加拿大的孟加拉国人和加拿大人的心血管疾病负担明显更高 巴基斯坦人与印度人的社会文化背景相比，包括社会经济地位、移民历史、 这三个南亚亚群体的文化背景和邻里因素各不相同，以及如何 移民经历和适应新环境，以及他们如何激活弹性资源来应对 我们的目标是将 MASALA 研究队列扩大到 包括更多的巴基斯坦和孟加拉国移民，利用新的和现有的措施来描述和描述 了解移民人群的心血管健康差异 我们建议招募 600 名孟加拉国人。 以及来自大纽约市和芝加哥地区的 550 名年龄在 40 至 84 岁之间的巴基斯坦成年人 添加到正在进行的 MASALA 队列中，并将他们与参加 MASALA 的亚洲印度人进行比较。 目标是： 1) 确定巴基斯坦和孟加拉国移民的情况是否更糟以及程度更糟 心血管健康（饮食、体力活动、吸烟、糖尿病、高血压、血脂异常、肥胖） 与已加入 MASALA 的印度移民相比 2) 确定多层次风险和保护因素。 测试文化适应是否与南亚亚群内部和之间的心血管健康相关。 战略和复原力资源调解或调节社会文化背景和 心血管健康并解释三个亚组之间的差异 3) 进一步解释我们的研究。 定量结果，进行深入访谈，以阐明移民、文化适应、歧视和 复原力资源影响南亚人的心血管健康 研究不同的移民人群。 通过了解生物心理社会和生态如何促进健康差异的科学 特征可能与原籍国相关并相互作用，从而影响心血管健康。 研究影响心血管健康差异的复杂、多层次相互作用的方法 南亚移民为发展更有效的公共卫生和临床提供了希望 减少 CVD 差异的预防策略。