The association between length of residence and obesity among Hispanic immigrants

doi:10.1016/j.amepre.2004.07.005

American Journal of Preventive Medicine

Volume 27, Issue 4, November 2004, Pages 323-326

https://doi.org/10.1016/j.amepre.2004.07.005 Get rights and content

Background

Objective

This study sought to determine whether length of residence in the United States was associated with obesity (body mass index [BMI]>30 kg/m²) among Hispanic immigrants.

Methods

Data for 2420 foreign-born Hispanic adults aged ≥18 years were obtained from the 1998 National Health Interview Survey.

Results

The prevalence of obesity among those with 0 to 4, 5 to 9, 10 to 14, and ≥15 years of residence in the United States was 9.4%, 14.5%, 21.0%, and 24.2%, respectively. A logistic regression model adjusted for smoking, physical inactivity, self-assessed health, chronic conditions, functional limitations, nonspecific psychological distress, several sociodemographic characteristics, and access to health services found that longer-term Hispanic immigrants (≥15 years) experienced a nearly four-fold greater risk of obesity than did recent immigrants (<5 years).

Conclusions

The higher risk for obesity associated with length of residence may be due to acculturation processes such as the adoption of the unhealthy dietary practices (i.e., a diet high in fat and low in fruits and vegetables) and sedentary lifestyles of the host country. The results of this study may facilitate the planning of public health interventions that are directed at subgroups of the Hispanic population.

Introduction

Newly arrived Hispanic immigrants are generally healthier than the U.S.-born population, but this distinction tends to diminish over time as immigrants adapt to a new and different sociocultural environment.1, 2, 3 For the past 2 decades, there has been widespread evidence of a Hispanic paradox in the United States in which most Hispanic groups are characterized by low socioeconomic status but better-than-expected health status.4, 5 As Hispanic immigrants' length of residence increases, however, so does the prevalence of poor health behaviors and chronic conditions.6, 7 Greater length of residence in the United States is likely to be associated with increased acculturation, including adoption of positive and negative aspects of the host culture (e.g., diets and lifestyles).⁸ Adoption of poorer diet and lifestyles means that the protective health behaviors associated with many immigrants' native cultures may be lost.⁹ It is evident that migration-induced adaptation to a new cultural system is “likely to disrupt attachments to supportive networks in the society of origin,” and is accompanied by “problems of acquiring the language, the behavioral norms, and values characteristic of the host society.”³

In spite of the growing interest in this area, there have been few published studies of the effect of the length of residence on obesity with a nationally representative sample of adult Hispanic immigrants. Therefore, the primary objective of this research was to examine the hypothesis that length of residence in the United States is associated with an increased likelihood of obesity among adult Hispanic immigrants. Hispanic cultural adaptation and obesity are important topics of research, given the high U.S. immigration rate¹⁰ and the growing epidemic of obesity.¹¹

Section snippets

Methods

A multiple logistic regression was conducted to assess the effects of length of residence in the United States and other factors on obesity (body mass index [BMI]>30 kg/m²) relative to normal weight (BMI=20.0 to 24.9 kg/m²). We analyzed data from the 1998 National Health Interview Survey (NHIS), using a sample size of 2420 Hispanic immigrants (i.e., from Mexico, Central and South America, or the Caribbean) aged ≥18 years. Important strengths of the NHIS include its population-based nature, high

Results

Table 1 shows the characteristics of the sample, as well as the number and proportion of those classified as normal weight and obese. The mean age of the sample was 38.9 (SE=0.37) years. Less than half (42.9%) had at least a high school education. Over half (54.4%) of all participants were from Mexico, 8.2% were from Cuba, and 37.4% were from other Latin American countries. The overall proportion of obesity among Hispanic immigrants was 19.7%. Interestingly, the rate of obesity among U.S.-born

Discussion

The results indicate strong support for the hypothesis that Hispanic immigrants' length of residence in the United States is associated with increasing levels of obesity, even after statistical adjustment for an array of other factors, including socioeconomic characteristics, demographic characteristics, smoking, health status, differential access to health services, and psychological well-being. More specifically, longer-term immigrants (≥15 years) had a nearly four-fold higher risk of obesity

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Brief reportThe association between length of residence and obesity among Hispanic immigrants

Background

Objective

Methods

Results

Conclusions

Introduction

Section snippets

Methods

Results

Discussion

Soc Sci Med

Soc Sci Med

Health outcomes among Hispanic subgroups: data from the National Health Interview Survey, 1992–95

Adv Data

Socioeconomic, cultural, and behavioral factors affecting Hispanic health outcomes

J Health Care Poor Underserved

Acculturation and mental health status among Hispanics

Am Psychol

Understanding the Hispanic paradox

Ethn Dis

Interpreting the paradoxical in the Hispanic paradox: demographic and epidemiologic approaches

Ann N Y Acad Sci

Ethnic-immigrant differentials in health behaviors, morbidity, and cause-specific mortality in the United States: an analysis of two national databases

Hum Biol

The Abbreviated Multidimensional Acculturation Scale: Empirical validation with two Latino/Latina samples

Cultur Divers Ethn Minority Psychol

Brief report
The association between length of residence and obesity among Hispanic immigrants