Tina R Sadarangani1, Chau Trinh-Shevrin2, Deborah Chyun3, Gary Yu4, Christine Kovner5. 1. Upsilon, Assistant Professor/Faculty Fellow, New York University Rory Meyers College of Nursing, New York, NY, USA. 2. Associate Professor, Department of Population Health, New York University School of Medicine, New York, NY, USA. 3. Upsilon, Dean and Professor, University of Connecticut School of Nursing, Storrs, CT, USA. 4. Associate Research Scientist, New York University Rory Meyers College of Nursing, New York, NY, USA. 5. Upsilon, Mathy Mezey Professor of Geriatric Nursing, New York University Rory Meyers College of Nursing, New York, NY, USA.
Abstract
PURPOSE: It is reported that while immigrants are, initially, healthier than the native-born upon resettlement, this advantage erodes over time. In the United States, uninsured aging immigrants are increasingly experiencing severe complications of cardiovascular disease (CVD). The purpose of this study was to compare overall CVD risk and explore the importance of health insurance coverage on CVD risk relative to other health access barriers, from 2007 to 2012, in recent and long-term immigrants >50 years of age. METHODS: This study was based on secondary cross-sectional analysis of the National Health and Nutrition Examination Survey (N = 1,920). The primary outcome, CVD risk category (high or low), was determined using the American College of Cardiology and American Heart Association Pooled Cohort equation. Differences between immigrant groups were examined using independent-samples t tests and chi-square analysis. The association between insurance and CVD risk was explored using a hierarchical block logistic regression model, in which variables were entered in a predetermined order. Changes in pseudo R2 measured whether health insurance explained variance in cardiac risk beyond other variables. RESULTS: Recent immigrants had lower overall CVD risk than long-term immigrants but were twice as likely to be uninsured and had higher serum glucose and lipid levels. Based on regression models, being uninsured contributed to CVD risk beyond other health access determinants, and CVD risk was pronounced among recent immigrants who were uninsured. CONCLUSIONS: Health insurance coverage plays an essential part in a comprehensive approach to mitigating CVD risk for aging immigrants, particularly recent immigrants whose cardiovascular health is susceptible to deterioration. CLINICAL RELEVANCE: Nurses are tasked with recognizing the unique social and physical vulnerabilities of aging immigrants and accounting for these in care plans. In addition to helping them access healthcare coverage and affordable medication, nurses and clinicians should prioritize low-cost lifestyle interventions that reduce CVD risk, especially diet and exercise programs.
PURPOSE: It is reported that while immigrants are, initially, healthier than the native-born upon resettlement, this advantage erodes over time. In the United States, uninsured aging immigrants are increasingly experiencing severe complications of cardiovascular disease (CVD). The purpose of this study was to compare overall CVD risk and explore the importance of health insurance coverage on CVD risk relative to other health access barriers, from 2007 to 2012, in recent and long-term immigrants >50 years of age. METHODS: This study was based on secondary cross-sectional analysis of the National Health and Nutrition Examination Survey (N = 1,920). The primary outcome, CVD risk category (high or low), was determined using the American College of Cardiology and American Heart Association Pooled Cohort equation. Differences between immigrant groups were examined using independent-samples t tests and chi-square analysis. The association between insurance and CVD risk was explored using a hierarchical block logistic regression model, in which variables were entered in a predetermined order. Changes in pseudo R2 measured whether health insurance explained variance in cardiac risk beyond other variables. RESULTS: Recent immigrants had lower overall CVD risk than long-term immigrants but were twice as likely to be uninsured and had higher serum glucose and lipid levels. Based on regression models, being uninsured contributed to CVD risk beyond other health access determinants, and CVD risk was pronounced among recent immigrants who were uninsured. CONCLUSIONS: Health insurance coverage plays an essential part in a comprehensive approach to mitigating CVD risk for aging immigrants, particularly recent immigrants whose cardiovascular health is susceptible to deterioration. CLINICAL RELEVANCE: Nurses are tasked with recognizing the unique social and physical vulnerabilities of aging immigrants and accounting for these in care plans. In addition to helping them access healthcare coverage and affordable medication, nurses and clinicians should prioritize low-cost lifestyle interventions that reduce CVD risk, especially diet and exercise programs.
Authors: Leah Zallman; David H Himmelstein; Steffie Woolhandler; David H Bor; John Z Ayanian; Andrew P Wilper; Danny McCormick Journal: J Immigr Minor Health Date: 2013-10
Authors: Héctor E Alcalá; Stephanie L Albert; Dylan H Roby; Jacob Beckerman; Philippe Champagne; Ron Brookmeyer; Michael L Prelip; Deborah C Glik; Moira Inkelas; Rosa-Elenna Garcia; Alexander N Ortega Journal: Medicine (Baltimore) Date: 2015-08 Impact factor: 1.817
Authors: Carla Castillo-Laborde; Macarena Hirmas-Adauy; Isabel Matute; Anita Jasmen; Oscar Urrejola; Xaviera Molina; Camila Awad; Catalina Frey-Moreno; Sofia Pumarino-Lira; Fernando Descalzi-Rojas; Tomás José Ruiz; Barbara Plass Journal: Public Health Rev Date: 2022-09-02