Acculturation and diabetes in African migrants to the United States (U.S.)
Date
2019
Authors
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Publisher
University of Delaware
Abstract
Objective: Utilizing mixed methods analysis, this study sought to analyze the association between acculturation and diabetes in African migrants to the United States (U.S.) ☐ Methods: An analysis of cross-sectional data from the 2010-2017 National Health Interview Surveys was performed, and semi-structured interviews were conducted in both French and English with Congolese migrants (N=20) living in Minnesota and the D.M.V area (Washington, D.C., Maryland and Virginia). ☐ Results: The prevalence of self-reported diabetes among African migrants was 6.1%, and being acculturated was associated with higher odds of diabetes diagnosis (Odds Ratio (OR) =2.2; 95% CI =1.1-4.4). BMI explained 18.9% of the total effect of acculturation on diabetes (Z_Mediation= 2.11, p=0.036). Qualitative interviewing of a specific African migrant group, Congolese, revealed that contextual characteristics that influenced acculturation included: support, gender norms, religious commitment, instability in the Congo, racism and migrant discrimination in the U.S. Findings also indicated that acculturative scales designed for Congolese migrants should include cultural identity, language, friendship, fashion sense, and knowledge of sports and politics to capture the process. Analysis of diabetes risk factors (diet, physical activity and stress) showed that even though Congolese migrants sought to maintain their pre-immigration eating habits, their diet in the U.S. was affected by accessibility and cost. Going to the gym was not particularly relevant to the Congolese culture, and the reduction in physical activity levels was accentuated by time constraints and weather conditions. Stress increased after immigration and was mainly caused by financial problems. Insight into contextual factors, acculturation, and diabetes-promoting behaviors provided potential intervention targets to reduce the risk of diabetes in the population. ☐ Conclusions: Acculturation is associated with diabetes in African migrants .To gain a better picture of the cardiometabolic health of African migrants, future research should develop better instruments to quantitatively test a comprehensive model that incorporates contextual characteristics, acculturation, diabetes, and its mediating factors. Additionally, culturally appropriate intervention programs targeting the population should be implemented to avert a diabetes crisis within the population.
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Keywords
Acculturation, African immigration, Cardiometabolic, Chronic diseases, Congolese, Diabetes