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.