Socio-Ecological Framework and Prevalence of Cardio-Metabolic Disorders between Northern and Southern Indian Immigrants in the United States Open Access
Dub, Bhanuja (2017)
Abstract
Background: Asian Indians are at increased risk for cardio-metabolic disorders compared to those of European decent, most particularly hypertension, dyslipidemia, and type 2 diabetes. There are limited, if any, published results regarding the association between multilevel risk factors and prevalence of these health outcomes among Asian Indian immigrants living in the United States.
Purpose: Utilizing the Socio-Ecological Framework, this study aimed to analyze individual interpersonal, and community level psychosocial risk factors and the association with hypertension, dyslipidemia, and type 2 diabetes using data from a population based study of South Asian immigrants to the United States.
Methods: This study consisted of secondary data analysis of baseline data from 757 Indian born participants from the MASALA study. Backward stepwise logistic regression analyses were conducted for each primary health outcome to determine the relationships between Northern versus Southern Indian region of origin and multilevel correlates of interest to primary health outcomes, adjusting for key covariates.
Results: Odds of having hypertension were associated with being older (OR=1.09, p<.001), lacking access to healthcare (OR=0.51, p=.042), and higher anger levels (OR=1.05, p=.045). Odds of having elevated triglycerides were associated with being male (OR=.56, p=.001), and lower consumption of total fat (OR=.98, p=.008). Odds of having decreased HDL levels were associated with being male (OR=.51, p<.001), being older (OR=1.03, p=.006), having a longer duration of residence in the United States (OR=1.3, p=.007), higher consumption of fat (OR=1.04, <.001), and higher anger levels (OR=1.06, p=.010). Odds of having type 2 diabetes were associated with being male (OR=.48, p<.001), increasing age (OR=1.05, p<.001), and higher anger levels (OR=1.06, p=.030).
Conclusion: Findings indicate that there are differences in state of origin in the prevalence of hypertension, decreased HDL levels, and elevated triglyceride levels. There may be other environmental factors or factors related to migration to the U.S. that may be affecting these differences. Understanding any differences in multilevel risk factors that can contribute to cardio-metabolic disorders among this population can help inform future culturally competent interventions aiming to prevent and treat heart disease.
Table of Contents
Introduction.......1
Background.......1
Theoretical Framework.......2
Proposal.......2
Literature Review.......5
Social Ecological Framework (SEF).......7
Individual.......7
Interpersonal.......9
Community.......10
Methods.......12
Study Design, Participants, and Sampling.......12
Measures.......13
Statistical Analysis.......16
Results.......17
Participant Characteristics & Differences Between Northern and Southern Indian Immigrants.......17
Cardio-Metabolic Health Outcomes.......17
Hypertension.......18
Dyslipidemia.......18
Diabetes.......19
Discussion.......21
Conclusions.......21
Limitations.......24
Implications and Future Research.......25
Appendix.......26
References.......32
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