State-level immigrant policies, diabetes prevalence, and cardiovascular health behaviors in people of Latin American and Asian American origin
- UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
- Md Towfiqul Alam (Creator)
- Institution
- The University of North Carolina at Greensboro (UNCG )
- Web Site: http://library.uncg.edu/
- Advisor
- Sandra Echeverria
Abstract: Type 2 Diabetes (T2DM) and low physical activity (PA) are key risk factors for cardiovascular morbidity and mortality in the United States (U.S.). An emerging body of evidence in public health research suggests that state-level policies shape health in immigrant and racial/ ethnic marginalized groups. For immigrants, state-level policies can be inclusive and create contexts that expand immigrants’ eligibility and rights, or they can be restrictive and limit access to public services, education, employment, and healthcare and even criminalize immigrants by linking local criminal justice systems with immigration enforcement. The present dissertation examined the association between state-level criminalizing and inclusive immigrant policies and prevalence of type 2 diabetes and physical activity for Latino and Asian American groups, the two largest immigrant groups and fastest-growing segments of the population in the U.S. Individual-level characteristics, diabetes status and meeting recommendations for physical activity were obtained from the Behavioral Risk Factor Surveillance System (BRFSS) (T2DM: n=201,824; PA: n=80,516). Existing policy datasets were used to classify the state immigrant policy context as low, medium, and high, and census data used to obtain the percent of foreign-born individuals in each state. Weighted multilevel models examined variability in T2DM and PA across state-level criminalizing and inclusive policy contexts after accounting for the complex survey design of BRFSS. Results indicated that Latinos living in low inclusion immigrant policy contexts had significantly higher odds of T2DM (Odds Ratio [OR]: 1.21, 95% confidence interval [CI]: 1.03-1.43, p-value <0.05) than those living in high inclusion contexts. Criminalizing policy contexts did not show significant associations with type 2 diabetes for either population group. The physical activity models showed that a high-criminalizing immigrant policy context was associated with significantly lower odds of meeting the recommended levels of physical activity among Latinos (OR: 0.79, 95% CI: 0.62-1.01, p-value = 0.05), while inclusive policy contexts did not have significant associations with physical activity for either group. In conclusion, state-level policies appear to shape health in distinct ways. Higher criminalizing policies were associated with health behaviors (i.e., short-term effect) while low inclusion policy contexts were associated with diabetes (i.e., long-term effect). Public health professionals, immigrants, advocates, and policymakers must work together to improve the health of vulnerable but resilient populations that represent this country’s future.
State-level immigrant policies, diabetes prevalence, and cardiovascular health behaviors in people of Latin American and Asian American origin
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Created on 5/1/2023
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Additional Information
- Publication
- Dissertation
- Language: English
- Date: 2023
- Keywords
- Asian American, Diabetes, Latino, Multilevel modeling, Physical activity, State-level immigrant policy
- Subjects
- Emigration and immigration $x Government policy $z United States $z States
- Immigrants $z United States
- Type 2 diabetes $x Risk factors $z United States
- Asian Americans $x Health and hygiene
- Latin Americans $x Health and hygiene