title: Nativity, language spoken at home, length of time in the United States, and race/ethnicity: associations with self-reported hypertension.
abstract: BACKGROUND
  Characterization of health conditions in recent immigrant subgroups, including foreign-born whites and Asians, is limited but important for identifying emerging health disparities. Hypertension, a major modifiable risk factor for cardiovascular disease, has been shown to be associated with acculturation, but the acculturative experience varies for different racial/ethnic groups. Assessing the impact of race/ethnicity on the relationship between acculturation-related factors and hypertension is therefore of interest.
  
  
  METHODS
  Data from the 2005-2008 waves (n = 36,550) of the NYC Community Health Survey were combined to estimate self-reported hypertension prevalence by nativity, language spoken at home, and time spent in the United States. Multivariable analyses were used to assess (i) the independent associations of acculturation-related factors and hypertension and (ii) potential effect modification by race/ethnicity. Sensitivity analysis recalibrating self-reported hypertension using measured blood pressures from a prior NYC population-based survey was performed. Prevalence was also explored by country of origin.
  
  
  RESULTS
  Being foreign vs. US born was associated with higher self-reported hypertension in whites only. Speaking Russian vs. English at home was associated with a 2-fold adjusted odds of self-reported hypertension. Living in the United States for ≥10 years vs. less time was associated with higher self-reported hypertension prevalence in blacks and Hispanics. Hypertension prevalence in Hispanics was slightly lower when using a recalibrated definition, but other results did not change substantively.
  
  
  CONCLUSIONS
  Race/ethnicity modifies the relationship between acculturation-related factors and hypertension. Consideration of disease prevalence in origin countries is critical to understanding health patterns in immigrant populations. Validation of self-reported hypertension in Hispanic populations is indicated.
authors.affiliation: Bureau of Chronic Disease Prevention and Tobacco Control, New York City Department of Health and Mental Hygiene, New York, New York.
authors.forename: Stella
authors.initials: S
authors.lastname: Yi
authors.forename: Tali
authors.initials: T
authors.lastname: Elfassy
authors.forename: Leena
authors.initials: L
authors.lastname: Gupta
authors.forename: Christa
authors.initials: C
authors.lastname: Myers
authors.forename: Bonnie
authors.initials: B
authors.lastname: Kerker
mesh_terms: D000069:Acculturation; D000328:Adult; D001208:Asia / Q000208:ethnology; D044466:Asian People / Q000706:statistics & numerical data; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000208:ethnology*; D007802:Language; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D015995:Prevalence; D012426:Russia / Q000208:ethnology; D057566:Self Report; D014481:United States; D044465:White People / Q000706:statistics & numerical data
keywords: New York City.; blood pressure; emigration; hypertension; immigration; minority groups; nativity status