Association of US Nativity and Length of US Residence With Cardiometabolic Risk Factors, by Disaggregated Race and Ethnicity.

BACKGROUND

The prevalence of cardiometabolic risk factors may vary by disaggregated race and ethnicity categories, and by acculturation-related factors. We evaluated the association between nativity and length of US residence, and prevalence of diabetes, hypertension, and hypercholesterolemia by select disaggregated race and ethnicity groups.

METHODS

We conducted a pooled cross-sectional study of 218 158 US adults from the Medical Expenditure Panel Survey (2013-2022). Nativity (US born, non-US born) and length of US residence (≥15 years or <15 years) were used as select proxies for acculturation. Self-reported cardiometabolic risk factors included diabetes, hypertension, and hypercholesterolemia.

RESULTS

Results showed substantial heterogeneity among both aggregated and disaggregated racial and ethnic groups. Nativity (US born versus non-US born) was significantly associated with increased hypertension prevalence among Hispanic adults (odds ratio [OR], 1.26 [95% CI, 1.15-1.39]), whereas among detailed categories the OR varied from 0.68 (95% CI, 0.51-0.93) among Puerto Rican adults to 1.34 (95% CI, 1.18-1.52) among Mexican adults. For the association between length of US residence and hypercholesterolemia, the OR for all Non-Hispanic Asian adults was 1.18 (95% CI, 0.92-1.51), whereas results varied in detailed categories from 1.00 (95% CI, 0.64-1.57) among Indian adults to 1.69 (95% CI, 1.08-2.64) among Chinese adults.

CONCLUSION

The association between US nativity or length of US residence and cardiometabolic risk factors varies by disaggregated race and ethnicity among Hispanic and Non-Hispanic Asian adults. Future studies may evaluate comprehensive measures of acculturation and assess other race and ethnicity groups to inform tailored efforts to improve cardiometabolic risk factor prevention and treatment.