Spirituality moderates the relationship of psychosocial stress to metabolic risk factors among Afro-Caribbean immigrants in the US Virgin Islands.
OBJECTIVE
Spirituality may contribute to the health advantage of foreign-born blacks compared to United States (US)-born blacks. The objective of this study was to test the hypothesis that spirituality attenuates the association of psychosocial stress to stress-associated metabolic risk factors among foreign-born Caribbean blacks living in a US jurisdiction.


METHODS
Data on demographic factors, anthropometric measurements (height, weight and waist), fasting glucose and insulin, lifestyle behaviors (smoking and alcohol use), psychosocial stress and spirituality were collected from a population-based sample of 319 Afro-Caribbean immigrants, ages 20 and older, who were recruited between 1995 and 2000 in the Virgin Islands of the United States (USVI). Glucose and insulin measurements were used to estimate insulin resistance by the homeostasis model assessment (HOMA-IR) method. Participants were classified into three levels of spirituality, "low", "medium" and "high" based on the distribution of spirituality scores. Stepwise regression analyses were used to identify the significant predictors of waist circumference and HOMA-IR within each level of spirituality.


RESULTS
The predictors of waist circumference and HOMA-IR varied across the levels of spirituality. Psychosocial stress was an independent predictor of waist and HOMA-IR only among participants with a low level of spirituality.


CONCLUSIONS
Spirituality appears to attenuate the association of psychosocial stress to waist circumference and insulin resistance among Afro-Caribbean immigrants in the USVI.
Inter-American Center for Public Health Improvement, Inc., P.O. Box, 3414, Christiansted, St. Croix, VI 00822. phone: 340-244-9227.
Eugene S
ES
Tull
Department Health Promotion and Development, School of Nursing, University of Pittsburgh, 440 Victoria Building, 3500 Victoria Street, Pittsburgh, PA 15261-2543. phone:412-624-8977.
Willa M
WM
Doswell
Department of Behavioral Sciences, Athens State University, 300 N Beaty Street, Athens, AL 35611. phone: 256 216-3329.
Malcolm A
MA
Cort
D000328:Adult; D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D017691:Caribbean Region / Q000208:ethnology; D054242:Emigrants and Immigrants / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007333:Insulin Resistance / Q000208:ethnology; D008297:Male; D008659:Metabolic Diseases / Q000208:ethnology*; D008875:Middle Aged; D012307:Risk Factors; D029181:Spirituality; D013315:Stress, Psychological / Q000208:ethnology*; D014767:United States Virgin Islands; D055105:Waist Circumference / Q000208:ethnology
Afro-Caribbean; Insulin Resistance; Psychosocial stress; Spirituality; Waist Circumference