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Journal of Immigrant and Minority Health

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01.10.2012 | Original Paper

Disentangling the Effects of Migration, Selection and Acculturation on Weight and Body Fat Distribution: Results from a Natural Experiment Involving Vietnamese Americans, Returnees, and Never-Leavers

verfasst von: Hongyun Fu, Mark J. VanLandingham

Erschienen in: Journal of Immigrant and Minority Health | Ausgabe 5/2012

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Abstract

We distinguish between selection and true migration effects on weight and body fat for Vietnamese immigrants; and examine the role of acculturation on these outcomes. Data (n = 703) were collected among three population-based samples of working-age Vietnamese immigrants, repatriated emigrants and never-migrated Vietnamese nationals. This allows for a decomposition exercise to separate the effects of migration effects from selection effects on body mass index (BMI) and waist-hip ratio (WHR). Immigrants are more likely to be overweight and to have high WHR, relative to both never-leavers and returnees, a pattern reflecting the importance of migration over selection. Among immigrants, coming to the US at a younger age is associated with higher BMI and WHR levels. And longer length of residence in the US is related to higher BMI. While higher Vietnamese language proficiency is related to a lower BMI level, being bilingual (proficient in both English and Vietnamese) is associated with lower risks for being overweight. The distinct pattern of results suggests that more problematic weight status and fat distribution among Vietnamese immigrants relative to Vietnamese nationals are not artifacts of the types of persons choosing to emigrate, but rather are due to acculturation to American diet and lifestyles. While efforts to promote and maintain traditional patterns of diet and lifestyle are likely to help Vietnamese and other immigrants avoid the perils of American patterns, facilitating a bi-cultural orientation is perhaps the most realistic approach for preserving protective features of the culture of origin with regard to body weight and fat distribution.

The original samples included 736 respondents. However, 27 individuals who did not meet the study criterion and 6 individuals with missing information on the key outcomes variables were excluded from the final analysis. The final analyses in this study included a final sample of 703 working age adults.

Many more men than women left Vietnam after the war; see Goodkind [23] for a discussion of some of the implications.

Educational attainment (not shown) also differs among the samples, especially between immigrants and nationals. This is due primarily to better opportunities for educational attainment among immigrants after their arrival in America. We thus employ occupational status as our preferred measure of socioeconomic status throughout the paper.

With regards to socioeconomic factors, older age and being male are consistently and significantly associated with higher levels of BMI and waist-hip ratio, and with higher likelihood of having problematic weight status. Being married is related to a higher likelihood of having high BMI (OR = 2.38, p < 0.03). There is no significant association between occupational status and the any of the weight-related health outcomes measured. Adding the control variables in the model only slightly reduced the magnitudes of associations between migration status and our obesity related health outcomes. Migration status is the most significant predictor of weight-related health outcomes in all of the models.

The main Vietnamese enclave flooded badly after Hurricane Katrina.

On the other hand, returnees received substantial benefits from UNHCR and other organizations that the never-leavers did not receive [77].

Abraido-Lanza AF, Chao MT, Florez KR. Do healthy behaviors decline with greater acculturation? Implications for the Latino mortality paradox. Soc Sci Med. 2005;61:1243–55.PubMedCrossRef

Afable-Munsuz A, Ponce NA, Rodriguez M. Immigrant generation and physical activity among Mexican, Chinese & Filipino adults in the U.S. Soc Sci Med. 2010;70(12):1997–2005.

American Obesity Association. AOA fact sheets: obesity in the U.S. Available at http://www.obesity.org/subs/fastfacts/obesity_US.shtml. Accessed Feb 2004.

Anderson JM, Moeschberger MS, Chen P, Kunn Wewers ME, Guthrie R. An acculturation scale for Southeast Asians. Soc Psychiatry Psychiatr Epidemiol. 1993;28:134–41.PubMedCrossRef

Antecol H, Bedard K. Unhealthy assimilation: why do immigrants converge to American health status levels? Demography. 2006;43(2):337–60.PubMedCrossRef

Araneta MR, Morton DJ, Lantion-Ang L, Grandinetti A, Lim-Abrahan MA, Chang H, Barrett-Connor E, Rodriguez BL, Wingard DL. Hyperglycemia and type 2 diabetes among Filipino women in the Philippines, Hawaii, and San Diego. Diabetes Res Clin Pract. 2006;71(3):306–12.PubMedCrossRef

Bates LM, Acevedo-Garcia D, Alerga M, Krieger N. Immigration and generational trends in body mass index and obesity in the United States: results of the National Latino and Asian American Survey, 2002–2003. Am J Public Health. 2007;97:70–7.

Bhatnagar D, Anand IS, Durrington PN, Patel DJ, Wander GS, Mackness MI, Creed F, Tomenson B, Chandrashekhar Y, Winterbotham M, et al. Coronary risk factors in people from the Indian subcontinent living in west London and their siblings in India. Lancet. 1995;345:405–9.PubMedCrossRef

Björntorp P. Etiology of the metabolic syndrome. In: Bray GA, Bouchard C, James WPT, editors. Handbook of obesity. New York: Marcel Dekker; 1998. p. 573–600.

10.

Bronee SE. The history of the comprehensive plan of action. Int J Refug Law. 1993;5(4):534–43.CrossRef

11.

Banister J. Vietnam population dynamics and prospects. Berkeley: University of California; 1993.

12.

Campi A. From refugees to Americans: thirty years of Vietnamese immigration to the United States. Immigration Policy Brief, American Immigration Law Foundation. 2005. Available at http://www.ailf.org/ipc/refugeestoamericansprint.asp. Accessed on 25 Mar 2007.

13.

Candib LM. Obesity and diabetes in vulnerable populations: reflection on proximal and distal causes. Ann Fam Med. 2007;5(6):547–56.PubMedCrossRef

14.

Davis J, Busch J, Hammatt Z, Novotny R, Harrigan R, Grandinetti A, et al. The relationship between ethnicity and obesity in Asian and Pacific Islander populations: a literature review. Ethn Dis. 2004;14:111–8.PubMed

15.

Dey AN, Lucas GW. Physical and mental health characteristics of U.S. and foreign-born adults: United States, 1998–2003. Advance data from vital and health statistics, vol 36. Hyattsville, MD: National Center for Health Statistics; 2006. pp. 1–19.

16.

Dobbelsteyn CJ, Joffres MR, MacLean DR, Flowerdew G. A comparative evaluation of waist circumference, waist-to-hip ratio and body mass index as indicators of cardiovascular risk factors. The Canadian heart health surveys. Int J Obes Relat Metab Disord. 2001;25(5):652–61.PubMedCrossRef

17.

Franzen L, Smith C. Acculturation and environmental change impacts dietary habits among adult Hmong. Appetite. 2009;1:173–83.CrossRef

18.

Fox GP, Cowell JM, Johnson MM. Effects of family disruption on Southeast Asian refugee women. Int Nurs Rev. 1995;42(1):27–30.PubMed

19.

Fu H, VanLandingham MJ. Mental health consequences of international migration for Vietnamese Americans and the mediating effect of social networks: results from a natural experiment approach. Demography. 2012. doi:10.1007/s13524-011-0088-2.

20.

Fujimoto WY, Bergstrom RW, Boyko EJ, Kinyoun JL, Leonetti DL, Newell-Morris LL, et al. Diabetes and diabetes risk factors in second- and third-generation Japanese Americans in Seattle, Washington. Diabetes Res Clin Pract. 1994;24(suppl):S43–52.PubMedCrossRef

21.

Gee GC, Ro A, Gavin A, Takeuchi D. Disentangling the effects of racial and weight discrimination on body mass index and obesity among Asian Americans. Am J Public Health. 2008;98:493–500.PubMedCrossRef

22.

Goel MS, McCarthy EP, Phillips RS, Wee CC. Obesity among US immigrant subgroups by duration of residence. J Am Med Assoc. 2004;292:2860–7.CrossRef

23.

Goodkind D. The Vietnamese double marriage squeeze. Int Migr Rev. 1997;31(1):108–27.CrossRef

24.

Gordon-Larsen P, Adair LS, Popkin BM. The relationship of ethnicity, socioeconomic factors, and overweight in U.S. adolescents. Obes Res. 2003;11:121–9.PubMedCrossRef

25.

Hazuda HP, Haffner SM, Stern MP, Clayton WE. Effects of acculturation and socioeconomic status on obesity and diabetes in Mexican Americans. Am J Epidemiol. 1988;128:1289–301.PubMed

26.

Hazuda HP, Mitchell BD, Haffner SM, Stern MP. Obesity in Mexican American subgroups: findings from the San Antonio Heart Study. Am J Clin Nutr. 1991;53(6 Suppl):1529S–1534S.

27.

Helton A. Refugee determinations under the comprehensive plan of action: overview and assessment. Int J Refug Law. 1993;5(4):129–39.

28.

Hull D. Migration, adaptation, and illness: a review. Soc Sci Med. 1979;13A(1):25–36.

29.

Iacoviello L, Arnout J, Buntinx F, Cappuccio FP, Dagnelie PC, de Lorgeril M, et al. Dietary habit profile in European communities with different risk of myocardial infarction: the impact of migration as a model of gene-environment interaction. Nutr Metab Cardiovasc Dis. 2001;11(suppl):122–126.

30.

Jasso G, Massey DS, Rosenzweig MR, Smith JP. Immigrant health: selectivity and acculturation. In: Bulatao RA, Cohen B, editors. Critical perspectives on racial and ethnic differences in health in late life. Washington DC: National Academy Press; 2004. p. 227–66.

31.

Kalra P, Srinivasan S, Ivey S, Greenlund K. Knowledge and practice: the risk of cardiovascular disease among Asian Indians. Results from focus groups conducted in Asian Indian communities in Northern California. Ethn Dis. 2004;14:497–504.PubMed

32.

Kaplan MS, Huguet N, Newsom JT, McFarland BH. The association between length of residence and obesity among Hispanic immigrants. Am J Prev Med. 2004;27:323–6.PubMedCrossRef

33.

Kaushal N. Adversities of acculturation? Prevalence of obesity among immigrants. Health Econ. 2009;18:291–303.PubMedCrossRef

34.

Kelly GP. From Vietnam to America: a chronicle of the Vietnamese immigrants to the United States. Boulder, Co.: Westview Press; 1977.

35.

Kelly GP. Coping with America: refugees from Vietnam, Cambodia, and Laos in the 1970s and 1980s. Ann Am Acad Political Soc Sci. 1986;487:138–149 (Immigration and American Public Policy).

36.

Koya DL, Egede LE. Association between length of residence and cardiovascular disease risk factors among an ethnically diverse group of United States immigrants. J Gen Intern Med. 2007;22(6):841–6.PubMedCrossRef

37.

Landman J, Cruickshank JK. A review of ethnicity, health and nutrition-related diseases in relation to migration in the United Kingdom. Public Health Nutr. 2001;4:647–57.PubMed

38.

Lauderdale DS, Rathouz PJ. Body mass index in a US national sample of Asian Americans: effects of nativity, years since immigration and socioeconomic status. Int J Obes Relat Metab Disord. 2000;24(9):1188–94.PubMedCrossRef

39.

Lee MM, Wu-Williams A, Whittemore AS, Zheng S, Gallagher R, Teh CZ, et al. Comparison of dietary habits, physical activity and body size among Chinese in North America and China. Int J Epidemiol. 1994;23:984–90.PubMedCrossRef

40.

Lindstrom DP, Massey DS. Selective emigration, cohort quality, and models of immigrant assimilation. Soc Sci Res. 1994;23:315–49.CrossRef

41.

Liou D, Bauer KD. Exploratory investigation of obesity risk and prevention in Chinese Americans. J Nutr Educ Behav. 2007;39(3):134–41.PubMedCrossRef

42.

Lv N, Cason K. Dietary pattern change and acculturation of Chinese Americans in Pennsylvania. J Am Diet Assoc. 2004;104(5):771–8.PubMedCrossRef

43.

McGarvey ST. Obesity in Samoans and a perspective on its etiology in Polynesians. Am J Clin Nutr. 1991;53:1586S–94S.PubMed

44.

McDonald JT, Kennedy S. Insights into the ‘healthy immigrant effect’: health status and health service use of immigrants in Canada. Soc Sci Med. 2004;59:1613–27.PubMedCrossRef

45.

McDonald JT, Kennedy S. Is migration to Canada associated with unhealthy weight gain? Overweight and obesity among Canada’s immigrants. Soc Sci Med. 2005;61(2):2469–81.PubMedCrossRef

46.

McNeely MJ, Boyko EJ. Type 2 diabetes prevalence in Asian-Americans. Diabetes Care. 2004;27:66–9.PubMedCrossRef

47.

Misra A, Ganda OP. Migration and its impact on adiposity and type 2 diabetes. Nutrition. 2007;23:696–708.PubMedCrossRef

48.

Mokdad AH, Marks JS, Stroup DF, Gerberding JL. Actual causes of death in the United States, 2000. JAMA. 2004;291:1238–45.PubMedCrossRef

49.

Montero D. Vietnamese Americans: patterns of resettlement and socioeconomic adaptation in the United States. Boulder, Colo.: Westview Press; 1979.

50.

Norris F, VanLandingham M, Vu L. PTSD in Vietnamese Americans following Hurricane Katrina: prevalence, patterns, and predictors. J Trauma Stress. 2009;22–2:91–101.CrossRef

51.

Novotny R, Williams AE, Vinoya AC, Oshiro CE, Vogt TM. US acculturation, food intake, and obesity among Asian-Pacific hotel workers. J Am Diet Assoc. 2009;109(10):1712–8.PubMedCrossRef

52.

Ogden CL, Flegal KM, Carroll MD, Johnson CL. Prevalence and trends in overweight among U.S. children and adolescents, 1999–2000. J Am Med Assoc. 2002;288(14):1728–1732.

53.

Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KM. Prevalence of overweight and obesity in the United States, 1999–2004. JAMA. 2006;295:1549–55.PubMedCrossRef

54.

Palinkas PA, Pickwell SM. Acculturation as a risk factor for chronic disease among Cambodian refugees in the United States. Soc Sci Med. 1995;40(12):1643–53.PubMedCrossRef

55.

Palloni A, Arias E. Paradox lost: explaining the Hispanic adult mortality advantage. Demography. 2004;41:385–415.PubMedCrossRef

56.

Patel JV, Vyas A, Cruickshank JK, Prabhakaran D, Hughes E, Reddy KS, et al. Impact of migration on coronary heart disease risk factors: comparison of Gujaratis in Britain and their contemporaries in villages of origin in India. Atherosclerosis. 2006;185:297–306.PubMedCrossRef

57.

Popkin BM, Udry JR. Adolescent obesity increases significantly in second and third generation US immigrants: the national longitudinal study of adolescent. J Nutr. 1998;128(4):701–6.PubMed

58.

Robinson WC. Term of refuge: the Indochinese Exodus and the international response. London: Zed Books; 1998.

59.

Reeves TJ, Bennett CE. We the people: Asians in the United States. Census 2000 Special Reports, CENSR-17. Figure 1, pg. 4. Washington, DC: U.S. Census Bureau; Dec 2004.

60.

Roshania R, Narayan KM, Oza-Frank R. Age at arrival and risk of obesity among US immigrants. Obesity. 2008;16(12):2669–75.PubMedCrossRef

61.

Rosmond R, Nisson A, Björntorp P. Psychiatric ill health and distribution of body fat mass among female immigrants in Sweden. Public Health. 2000;114:45–51.PubMed

62.

Rosmond RG, Björntorp P. Psychiatric Ill-health of women and its relationship to obesity and body fat distribution. Obes Res. 1998;6:338–45.PubMed

63.

Salant T, Lauderdale DS. Measuring culture: a critical review of acculturation and health in Asian immigrant populations. Soc Sci Med. 2003;57(1):71–90.PubMedCrossRef

64.

Salmond CE, Joseph JG, Prior IA, Stanley DG, Wessen AF. Longitudinal analysis of the relationship between blood pressure and migration: the Tokelau Island migrant study. Am J Epidemiol. 1985;122:291–301.PubMed

65.

Salmond CE, Prior IA, Wessen AF. Blood pressure patterns and migration: a 14-year cohort study of adult Tokelauans. Am J Epidemiol. 1989;130:37–52.PubMed

66.

Singh GK, Siahpush M. All-cause and cause-specific mortality of immigrants and native born in the United States. Am J Public Health. 2001;91(3):392–9.PubMedCrossRef

67.

Singh GK, Siahpush M. Ethnic-immigrant differentials in health behaviors, morbidity, and cause-specific mortality in the United States: an analysis of two national databases. Hum Biol. 2002;74:83–109.PubMedCrossRef

68.

Song YJ, Hofstetter CR, Hovell MF, Paik HY, Park HR, Lee J, Irvin V. Acculturation and health risk behaviors among Californians of Korean descent. Prev Med. 2004;39(1):147–56.PubMedCrossRef

69.

Stein B. The Geneva conferences and the Indochinese refugee crisis. Int Migr Rev. 1979;13(4):716–23.CrossRef

70.

Stern MP, Wei M. Do Mexican Americans really have low rates of cardiovascular disease? Prev Med. 1999;29(6):S90–5.PubMedCrossRef

71.

Stillman S, McKenzie D, Gibson J. Migration and mental health: evidence from a natural experiment. J Health Econ. 2009;28(3):677–87.PubMedCrossRef

72.

Stone S, McGowan JE. Wrapped in the wind’s shawl: refugees in Southeast Asia and the Western World. San Rafael, CA: Presidio Press; 1980.

73.

Sundquist J, Winkleby M. Country of birth, acculturation status and abdominal obesity in a national sample of Mexican-American women and men. Int J Epidemiol. 2000;29:470–7.PubMedCrossRef

74.

Surgeon General. The surgeon general’s call to action to prevent and decrease overweight and obesity. US Department of Health and Human Services, Public Health Service, Office of the Surgeon General, Rockville, MD; 2001.

75.

Unger JB, Reynolds K, Shakib S, Spruijt-Metz D, Sun P, Johnson CA. Acculturation, physical activity, and fast-food consumption among Asian-American and Hispanic adolescents. J Community Health. 2004;29:467–81.PubMedCrossRef

76.

UNHCR. Note on the Work of the Coordinating Committee for the international conference on Indochinese refugees, A/CONF. 1989. 148/4, 30 May, Annex V. P32.

77.

UNHCR. Reintegration programmes for refugees in South-East Asia—lessons learned from UNHCR’s experience. (UNHCR Evaluation and Policy Analysis Unit, 2002). Available online at http://www.unhcr.org/research/RESEARCH/3ccff9134.pdf. Assessed on May 2008.

78.

US Census Bureau. Census of the United States of America. Washington D.C.: U.S. Government; 2000.

79.

Van Hook J, Balistreri KS. Immigrant generation, socioeconomic status and economic development of countries of origin: a longitudinal study of body mass index among children. Soc Sci Med. 2007;65:976–89.PubMedCrossRef

80.

Vu L, VanLandingham M. Physical and mental health consequences of Katrina on Vietnamese immigrants in New Orleans: a pre and post-disaster assessment. J Immigr Minor Health. 2011. doi:10.1007/s10903-011-9504-3.

81.

Willett WC, Dietz WH, Colditz GA. Guidelines for healthy weight. N Engl J Med. 1999;341:427–34.PubMedCrossRef

82.

Wing RR, Matthews KA, Kuller LH, Meilahn EN, Plantinga P. Waist to hip ratio in middle-aged women: associations with behavioral and psychosocial factors and with changes in cardiovascular risk factors. Arterioscler Thromb. 1991;11:1250–7.PubMedCrossRef

83.

WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363:157–163.

84.

Wolin KY, Colditz G, Stoddard AM, Emmons KM, Sorensen G. Acculturation and physical activity in a working class multiethnic population. Prev Med. 2006;42:266–72.PubMedCrossRef

85.

Zhang XQ, Kelly PM, Locke C, Winkels A, Adger WN. Structure and implications of migration in a transitional economy: beyond the planned and spontaneous dichotomy in Vietnam. The Centre for Social and Economic Research on the Global Environment Working Paper GEC 2001.01-01, University of East Anglia and University College London; 2001. ISSN 0967-8875.

86.

Zhou M, Bankston CL. Growing up American: how Vietnamese children adapt to life in the United States. New York: Sage; 1998.

Titel: Disentangling the Effects of Migration, Selection and Acculturation on Weight and Body Fat Distribution: Results from a Natural Experiment Involving Vietnamese Americans, Returnees, and Never-Leavers
verfasst von: Hongyun Fu
Mark J. VanLandingham
Publikationsdatum: 01.10.2012
Verlag: Springer US
Erschienen in: Journal of Immigrant and Minority Health / Ausgabe 5/2012
Print ISSN: 1557-1912
Elektronische ISSN: 1557-1920
DOI: https://doi.org/10.1007/s10903-012-9595-5

Springer Medizin

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