Does neighbourhood composition modify the association between acculturation and unhealthy dietary behaviours?
OBJECTIVE
Studies have shown that immigrants' acculturation is associated with numerous unhealthy behaviours. Yet, the role of environmental factors in modifying the effect of acculturation on health behaviours has received little attention. This study aims to create a more nuanced understanding of the health effects of acculturation by examining how neighbourhood immigrant composition modifies the association between individuals' eating patterns and acculturation.


METHODS
Cross-sectional Data from Los Angeles County Health Survey 2007 adult sample were linked to data on retail food establishments and US Census 2000 neighbourhood characteristics. Acculturation was measured by language spoken at home and years stayed in the US. Eating fast food more than once per week and eating zero serving of fruit or vegetables during the previous day were used as proxy indicators for unhealthy dietary behaviour. Multilevel logistic regression models were performed in the full sample and in the sample with only Latino adults.


RESULTS
Immigrants' lack of acculturation and living in a neighbourhood with a high percentage immigrants were associated with healthier dietary behaviour. We also identified that lack of acculturation conveyed a significantly stronger protective effect on regular fast-food consumption for immigrants living in neighbourhoods with higher percentage immigrants (OR: 0.34, 95% CI: 0.12 to 0.93).


CONCLUSIONS
Among immigrants in Los Angeles County, living in a neighbourhood with a high density of other immigrants attenuates the negative effects of acculturation on healthy eating behaviours. Healthy eating promotion efforts should build on this protective effect in outreach to acculturating immigrant communities.
Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA.
Donglan
D
Zhang
Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA.
Jeroen
J
van Meijgaard
Department of Public Health Science, Clemson University, Clemson, South Carolina, USA.
Lu
L
Shi
Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA.
Brian
B
Cole
Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA.
Jonathan
J
Fielding
D000069:Acculturation; D000328:Adult; D003430:Cross-Sectional Studies; D004032:Diet / Q000208:ethnology / Q000706:statistics & numerical data*; D057140:Fast Foods / Q000706:statistics & numerical data; D005247:Feeding Behavior / Q000208:ethnology*; D005260:Female; D005638:Fruit; D015438:Health Behavior / Q000208:ethnology*; D006306:Health Surveys; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D015141:Los Angeles; D008297:Male; D008875:Middle Aged; D065840:Protective Factors; D012111:Residence Characteristics / Q000145:classification / Q000706:statistics & numerical data*; D012147:Restaurants / Q000145:classification / Q000706:statistics & numerical data; D012931:Social Environment; D014675:Vegetables
DIET; Environmental epidemiology; HEALTH BEHAVIOUR; INTERNATIONAL HLTH