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Yousef S, Colman I, Papadimitropoulos M, Manuel D, Hossain A, Faris M, Wells GA. Vitamin D and Chronic Diseases among First-Generation Immigrants: A Large-Scale Study Using Canadian Health Measures Survey (CHMS) Data. Nutrients 2022; 14:nu14091760. [PMID: 35565728 PMCID: PMC9099619 DOI: 10.3390/nu14091760] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/13/2022] [Accepted: 04/18/2022] [Indexed: 02/04/2023] Open
Abstract
Background: Nearly 22% of the Canadian population are first-generation immigrants. We investigated immigrants’ health status and health deterioration over time in terms of the prevalence of chronic diseases (CDs) and their relationship to vitD status. Methods: We used cycles three (2012–2013) and four (2014–2015) of the Canadian Health Measures Survey. These data contained unique health information and direct physical/blood measures, including serum 25-hydroxyvitamin D (S-25(OH)D). Indicators of health status and deterioration were the prevalence of CDs diagnosed by healthcare professionals, self-reported general and mental health, and CD-related biomarkers. Results: The data (n = 11,579) included immigrants from more than 153 countries. Immigrants were healthier than non-immigrants for most health status measures. The prevalence of CDs was higher among those who migrated to Canada aged ≥ 18 years. A longer time in Canada after immigration was associated with a higher risk for CDs. The mean S-25(OH)D was lower among immigrants, higher among patients with CDs, and inversely associated with glycated hemoglobin, total cholesterol/high-density lipoprotein ratio, immunoglobulin E, serum ferritin, and blood hemoglobin. After adjusting for covariates, no association was found between S-25(OH)D and the prevalence of CDs. Conclusions: Lower levels of accumulated S-25(OH)D among immigrants may impact their health profile in terms of CD-related biomarkers, which partially explains immigrants’ health deterioration over time. We recommend further longitudinal research to investigate immigrants’ vitD and health deterioration.
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Affiliation(s)
- Said Yousef
- Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada; (I.C.); (A.H.); (G.A.W.)
- Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada
- Correspondence:
| | - Ian Colman
- Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada; (I.C.); (A.H.); (G.A.W.)
| | - Manny Papadimitropoulos
- Eli Lilly Canada Inc., Toronto, ON M5X 1B1, Canada;
- Faculty of Pharmacy, University of Toronto, Toronto, ON M5S 3M2, Canada
| | - Douglas Manuel
- Ottawa Hospital Research Institute, Ottawa, ON K1Y 4E9, Canada;
- Institute for Clinical Evaluative Sciences, Ottawa, ON K1Y 4E9, Canada
- Department of Family Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada
| | - Alomgir Hossain
- Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada; (I.C.); (A.H.); (G.A.W.)
- Institute for Clinical Evaluative Sciences, Ottawa, ON K1Y 4E9, Canada
| | - MoezAlIslam Faris
- Department of Clinical Nutrition and Dietetics, Research Institute of Medical and Health Sciences (RIMHS), College of Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates;
| | - George A. Wells
- Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada; (I.C.); (A.H.); (G.A.W.)
- Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada
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Lee M, Nam JH, Yi E, Bhimla A, Nelson J, Ma GX. Differences in Subjective Memory Impairment, Depressive Symptoms, Sleep, and Physical Activity in African American and Asian American Elderly. Brain Sci 2021; 11:1155. [PMID: 34573176 PMCID: PMC8472213 DOI: 10.3390/brainsci11091155] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 08/26/2021] [Accepted: 08/28/2021] [Indexed: 01/11/2023] Open
Abstract
Background: Subjective memory impairment (SMI) is associated with negative health outcomes including mild cognitive impairment and Alzheimer's disease. However, ethnic differences in SMI and disparities in risk factors associated with SMI among minority populations are understudied. The study examined the ethnic differences in SMI, whether SMI was associated with depressive symptoms, sleep, and physical activity (PA), and whether the associations vary across racial/ethnic groups. Methods: Participants included 243 African and Asian Americans (including Chinese, Vietnamese, and Korean Americans) aged 50 or older. Demographic information, SMI, depressive symptoms, daily sleeping hours, and PA levels were assessed. Results: Vietnamese Americans reported the highest SMI score. Depressive symptoms, sleeping hours, and PA levels were significantly associated with SMI. Depressive symptoms were the only significant factor across all ethnic groups. Significant interaction effects were found between ethnicity and health behaviors in predicting SMI. In particular, Vietnamese American participants with greater depressive symptoms and physical inactivity were significantly more likely to experience SMI compared to other ethnic groups Conclusions: Our findings demonstrate ethnic differences in SMI and its association with depressive symptoms, sleep, and PA, which highlight the importance of considering the unique cultural and historical backgrounds across different racial/ethnic groups when examining cognitive functioning in elderly.
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Affiliation(s)
- Minsun Lee
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA; (M.L.); (J.-H.N.); (E.Y.); (A.B.)
| | - Jin-Hyeok Nam
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA; (M.L.); (J.-H.N.); (E.Y.); (A.B.)
| | - Elizabeth Yi
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA; (M.L.); (J.-H.N.); (E.Y.); (A.B.)
| | - Aisha Bhimla
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA; (M.L.); (J.-H.N.); (E.Y.); (A.B.)
| | - Julie Nelson
- Philadelphia Senior Center, Philadelphia, PA 19147, USA;
| | - Grace X. Ma
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA; (M.L.); (J.-H.N.); (E.Y.); (A.B.)
- Department of Clinical Sciences, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA
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Yousef S, Manuel D, Colman I, Papadimitropoulos M, Hossain A, Faris M, Wells GA. Vitamin D Status among First-Generation Immigrants from Different Ethnic Groups and Origins: An Observational Study Using the Canadian Health Measures Survey. Nutrients 2021; 13:2702. [PMID: 34444863 PMCID: PMC8400966 DOI: 10.3390/nu13082702] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 07/30/2021] [Accepted: 08/03/2021] [Indexed: 12/15/2022] Open
Abstract
One in five Canadians are first-generation immigrants. Evidence suggests the baseline risk for vitamin D (vitD) deficiency is increased among immigrants who move from equatorial to northern countries. We investigated the prevalence and determinants of vitD deficiency/insufficiency among first-generation immigrants compared with native-born Canadians and identified explanatory covariables. We used a cross-sectional design with data from the national Canadian Health Measures Survey (Cycles 3 and 4) (11,579 participants aged 3-79 years). We assessed serum 25-hydroxyvitamin D (S-25(OH)D) levels, sociodemographic and environmental factors, immigration status, length of time in Canada, vitD-rich food intake, ethnicity, and place of birth. Immigrants had lower mean S-25(OH)D than non-immigrants (51.23 vs. 62.72 nmol/L, p < 0.001). Those with younger age at the time of immigration (<18 years) had a high risk for low vitD, and S-25(OH)D levels increased with the length of time they had lived in Canada. The highest deficiency levels were in immigrants born in Morocco, India, and Lebanon compared with native-born Canadians. Ethnicity was the factor most strongly associated with S-25(OH)D. Compared with the white ethnic grouping, the Japanese had the highest level of vitD deficiency, followed by Arabs and Southeast Asians. Ethnic variations, dietary intake, and lifestyle factors are the main predictors of/explanatory factors for vitD status among Canadian immigrants.
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Affiliation(s)
- Said Yousef
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada; (I.C.); (A.H.); (G.A.W.)
- Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada
| | - Douglas Manuel
- Ottawa Hospital Research Institute, Ottawa, ON K1Y 4E9, Canada;
- Institute for Clinical Evaluative Sciences, Ottawa, ON K1Y 4E9, Canada
- Department of Family Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada
| | - Ian Colman
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada; (I.C.); (A.H.); (G.A.W.)
| | - Manny Papadimitropoulos
- Eli Lilly Canada Inc., Toronto, ON M5X 1B1, Canada;
- Faculty of Pharmacy, University of Toronto, Toronto, ON M5S 3M2, Canada
| | - Alomgir Hossain
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada; (I.C.); (A.H.); (G.A.W.)
- Institute for Clinical Evaluative Sciences, Ottawa, ON K1Y 4E9, Canada
| | - MoezAlIslam Faris
- Department of Clinical Nutrition and Dietetics, College of Health Sciences/Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah 27272, United Arab Emirates; or
| | - George A. Wells
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada; (I.C.); (A.H.); (G.A.W.)
- Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada
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Lee M, Lu W, Mann-Barnes T, Nam JH, Nelson J, Ma GX. Mental Health Screening Needs and Preference in Treatment Types and Providers in African American and Asian American Older Adults. Brain Sci 2021; 11:597. [PMID: 34063018 PMCID: PMC8148007 DOI: 10.3390/brainsci11050597] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 04/30/2021] [Indexed: 11/19/2022] Open
Abstract
Older African Americans and Asian Americans in the U.S. underuse mental health services, despite their vulnerability to diverse mental health problems. This study examined their perspectives on the importance of various mental health problems, mental health treatment, and provider type preference. A total of 243 participants residing in Philadelphia were recruited through community-based organizations. Chi-square, ANOVA, and logistic regression were conducted to examine ethnic differences in demographic characteristics, mental health screening needs, and treatment preferences. African Americans were more likely to endorse the screening needs for depression (AOR: 3.77; 95% CI: 1.19-11.93, p < 0.05) and less likely to endorse the screening needs for suicide (AOR: 0.24; 95% CI: 0.08-0.76, p < 0.05) compared to Asian Americans. For treatment preferences, African Americans were more likely to seek help from primary care physicians (AOR: 8.26; 95% CI: 1.71-32.86, p < 0.01) and less likely to prefer medication as a treatment option (AOR: 0.36; 95% CI: 0.09-0.79, p < 0.05) than Asian Americans. African Americans and Asian Americans prioritized mental health screening needs differently and had different treatment preferences, indicating that matching community needs and preferences regarding mental health services is critical to improve mental service utilization rates in the targeted populations.
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Affiliation(s)
- Minsun Lee
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, 3440 N. Broad Street, Philadelphia, PA 19140, USA; (M.L.); (W.L.); (T.M.-B.); (J.-H.N.)
| | - Wenyue Lu
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, 3440 N. Broad Street, Philadelphia, PA 19140, USA; (M.L.); (W.L.); (T.M.-B.); (J.-H.N.)
| | - Tyrell Mann-Barnes
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, 3440 N. Broad Street, Philadelphia, PA 19140, USA; (M.L.); (W.L.); (T.M.-B.); (J.-H.N.)
| | - Jin-Hyeok Nam
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, 3440 N. Broad Street, Philadelphia, PA 19140, USA; (M.L.); (W.L.); (T.M.-B.); (J.-H.N.)
| | - Julie Nelson
- Philadelphia Senior Center, Philadelphia, PA 19147, USA;
| | - Grace X. Ma
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, 3440 N. Broad Street, Philadelphia, PA 19140, USA; (M.L.); (W.L.); (T.M.-B.); (J.-H.N.)
- Department of Clinical Sciences, Lewis Katz School of Medicine, Temple University, 3500 N. Broad Street, Philadelphia, PA 19140, USA
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Lee M, Bhimla A, Ma GX. Depressive Symptom Severity and Immigration-Related Characteristics in Asian American Immigrants. J Immigr Minor Health 2020; 22:935-945. [PMID: 32221768 PMCID: PMC7442700 DOI: 10.1007/s10903-020-01004-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The study examined immigration factors associated with depressive symptom severity among Asian American immigrants. Participants were 458 Chinese, Korean and Vietnamese adults. Depressive symptom severity was measured by PHQ-9. Overall, the likelihood of being moderately to severely depressed was significantly increased among immigrants living in the US for < 10 years and Korean Americans compared to Chinese Americans. However, mild level of depressive symptoms was not associated with any immigration-related factors. The positive impact of shorter duration of living in the US and a younger age at immigration (≤ 17) on depressive symptoms was evident among women but not among men. For men, marital status and education level were significant predictors of being moderately to severely depressed. Differentiating immigrant factors and identifying depressive symptom severity can help drive community and clinical interventions to detect and treat depression early among Asian American immigrants.
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Affiliation(s)
- Minsun Lee
- Lewis Katz School of Medicine, Center for Asian Health, Temple University, Philadelphia, PA, USA.
| | - Aisha Bhimla
- Lewis Katz School of Medicine, Center for Asian Health, Temple University, Philadelphia, PA, USA
| | - Grace X Ma
- Lewis Katz School of Medicine, Center for Asian Health, Temple University, Philadelphia, PA, USA
- Department of Clinical Sciences, Lewis Katz School of Medicine, Temple University, 3440 N Broad St., Kresge Bldg, Ste. 325, Philadelphia, PA, 19140-4106, USA
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A Multi-Level Analysis on School Connectedness, Family Support, and Adolescent Depression: Evidence from the National Longitudinal Study of Adolescent Health, 1995–1996. SOCIAL SCIENCES-BASEL 2018. [DOI: 10.3390/socsci7050072] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Depression Symptom Patterns and Social Correlates among Chinese Americans. Brain Sci 2018; 8:brainsci8010016. [PMID: 29337888 PMCID: PMC5789347 DOI: 10.3390/brainsci8010016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 01/11/2018] [Accepted: 01/11/2018] [Indexed: 01/04/2023] Open
Abstract
The aim of this study is to examine and compare the depression symptoms pattern and social correlates in three groups: foreign-born Chinese Americans, US-born Chinese Americans, and non-Hispanic whites. This study used data from the Collaborative Psychiatric Epidemiology Surveys (CPES). The study sample consists of 599 Chinese Americans (468 for the foreign-born and 121 for the US-born) and 4032 non-Hispanic whites. Factor analysis was used to examine the depression symptom patterns by each subgroup. Four depression symptoms dimensions were examined: negative affect, somatic symptoms, cognitive symptoms, and suicidality. Logistic regression was used to investigate the effects of sociodemographic (age, gender, marital status, and education), physical health condition, and social relational factors (supports from and conflict with family and friends) on specific types of depression symptoms separately for the three subgroups. The findings showed little differences in depression symptom patterns but clear variation in the social correlates to the four depression dimensions across the three ethnocultural groups, foreign-born Chinese Americans, US-born Chinese Americans, and non-Hispanic whites. Clinicians should take into account the sociocultural factors of patients when making diagnosis and suggesting treatments. In addition, psychiatrists, psychologists, or other mental health service providers should offer treatment and coping suggestions based on the specific symptom dimensions of patients, and patients’ ethnocultural backgrounds.
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