Cardiovascular Disease Risk Factors Among Immigrant and US-Born Adults in New York City

Abstract

Objectives: Immigrant adults tend to have better health than native-born adults despite lower incomes, but the health advantage decreases with length of residence. To determine whether immigrant adults have a health advantage over US-born adults in New York City, we compared cardiovascular disease (CVD) risk factors among both groups.

Methods: Using data from the New York City Health and Nutrition Examination Survey 2013-2014, we assessed health insurance coverage, health behaviors, and health conditions, comparing adults ages ≥20 born in the 50 states or the District of Columbia (US-born) with adults born in a US territory or outside the United States (immigrants, following the National Health and Nutrition Examination Survey) and comparing US-born adults with (1) adults who immigrated recently (≤10 years) and (2) adults who immigrated earlier (>10 years).

Results: For immigrant adults, the mean time since arrival in the United States was 21.8 years. Immigrant adults were significantly more likely than US-born adults to lack health insurance (22% vs 12%), report fair or poor health (26% vs 17%), have hypertension (30% vs 23%), and have diabetes (20% vs 11%) but significantly less likely to smoke (18% vs 27%) (all P < .05). Comparable proportions of immigrant adults and US-born adults were overweight or obese (67% vs 63%) and reported CVD (both 7%). Immigrant adults who arrived recently were less likely than immigrant adults who arrived earlier to have diabetes or high cholesterol but did not differ overall from US-born adults.

Conclusions: Our findings may help guide prevention programs and policy efforts to ensure that immigrant adults remain healthy.

Keywords: cardiovascular disease; diabetes; hypertension; immigrant health; non–US-born; urban health.

Figure

Prevalence of cardiovascular disease (CVD) and risk factors among US-born and immigrant New York City adults, adjusted for age, New York City Health and Nutrition Examination Survey (NYC HANES) 2013-2014. US-born refers to people born in 1 of the 50 states or the District of Columbia. Immigrant refers to people born in a US territory or outside the United States. Adults are household residents ages ≥20. The differences between the 2 populations in hypertension, diabetes, cigarette smoking, and no physical activity were significant at P < .05, using t tests for significance. Abbreviation: BMI, body mass index. Data source: NYC HANES 2013-2014.