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Immigrant enclaves: Conferring health advantages or creating health disparities in Chinese immigrants?

Award Number: R01MD012621
ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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PROJECT SUMMARY The US has the world's largest immigrant population. As most arrive from countries with lower prevalence of obesity and related chronic conditions, a common trajectory is for these rates to rise to converge with or even exceed rates in US whites. This rise underlies the development of numerous health disparities among immigrant/ethnic groups. A primary theory to explain the rise in risk is acculturation, but few longitudinal studies on acculturative and health trajectories have been conducted among immigrants, and trajectories are also likely to be heterogeneous: Acculturation may be limited in ethnic enclaves (self-contained neighborhoods with high residential density of immigrants), and ethnic enclaves themselves differ. Despite a presumed, beneficial `ethnic density effect,' for example, traditional immigrant enclaves can be settings for economic exploitation and curtailed social ties and networks; newer, emerging enclaves outside of city centers might provide the same social resources without the disadvantages of a self-contained, traditional enclave. The experience of Chinese immigrants, among the fastest growing US ethnic groups, is uniquely informative in this regard, exhibiting considerable spatial diversity and variability in chronic disease risk. Indeed, Asian immigrants encapsulate the entire range of risk, from low to high, as a result of environmental and individual-level factors still to be clarified. Immigrant enclaves offer a framework in which to examine disease risk transitions and to explore the combined roles of acculturative and psychosocial pathways. Towards this end, we propose to study health trajectories in a sample of Chinese immigrants using a longitudinal design to capture changes in acculturation, psychosocial factors, and markers of cardiometabolic risk (CMR). We will recruit a cohort of 600 Chinese immigrants in the Philadelphia region, including residents of traditional, emerging, and non-enclave neighborhoods. Specific aims are to: (1) Compare CMR of immigrants in three neighborhood types (traditional, emerging, and non-enclaves); and (2) Explore pathways that may mediate enclave effects on health – in particular, acculturative and psychosocial factors. Data collection will include interviews (including acculturation and measures of psychosocial stress and social resources); 4 days of dietary recalls; anthropometry; blood pressure; and blood samples for assessing risk markers including triglycerides, high-density lipoprotein cholesterol (HDL-C), and fasting glucose. Overall, we seek to determine whether and how conditions in one context set a better trajectory for immigrants, or underlie the development of future health disparities. Our model challenges two primary and widely held beliefs: that US Chinese immigrants are a low risk population, and that enclave residence uniformly provides health benefits that keep immigrants at low CMR. The proposed work will allow for a direct comparison across enclaves (distinguishing between traditional and emerging enclaves) and non-enclaves, and will characterize the extent of CMR in the US Chinese population – a growing, increasingly segregated, and understudied segment of the US population.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2024 ( Subtotal = $0 )
2024	2022	THE INSTITUTE FOR CANCER RESEARCH	333 COTTMAN AVE	PHILADELPHIA	PA	19111	PHILADELPHIA	USA	Minority Health and Health Disparities Research	000	5	1/24/2024	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2022 ( Subtotal = $854,414 )
2022	2022	INSTITUTE FOR CANCER RESEARCH, THE	333 COTTMAN AVE	PHILADELPHIA	PA	19111	PHILADELPHIA	USA	Minority Health and Health Disparities Research	000	5	12/16/2021	NON-COMPETING CONTINUATION	$768,973
2022	2022	INSTITUTE FOR CANCER RESEARCH, THE	333 COTTMAN AVE	PHILADELPHIA	PA	19111	PHILADELPHIA	USA	Minority Health and Health Disparities Research	001	5	4/17/2022	NON-COMPETING CONTINUATION	$85,441
														Subtotal = $854,414

Issue Date FY: 2021 ( Subtotal = $730,452 )
2021	2021	INSTITUTE FOR CANCER RESEARCH, THE	333 COTTMAN AVE	PHILADELPHIA	PA	19111	PHILADELPHIA	USA	Minority Health and Health Disparities Research	000	4	12/18/2020	NON-COMPETING CONTINUATION	$651,495
2021	2021	INSTITUTE FOR CANCER RESEARCH, THE	333 COTTMAN AVE	PHILADELPHIA	PA	19111	PHILADELPHIA	USA	Minority Health and Health Disparities Research	002	4	3/15/2021	NON-COMPETING CONTINUATION	$0
2021	2021	INSTITUTE FOR CANCER RESEARCH, THE	333 COTTMAN AVE	PHILADELPHIA	PA	19111	PHILADELPHIA	USA	Minority Health and Health Disparities Research	001	4	3/11/2021	NON-COMPETING CONTINUATION	$78,957
														Subtotal = $730,452

Issue Date FY: 2020 ( Subtotal = $789,578 )
2020	2020	INSTITUTE FOR CANCER RESEARCH, THE	333 COTTMAN AVE	PHILADELPHIA	PA	19111	PHILADELPHIA	USA	Minority Health and Health Disparities Research	001	3	1/6/2020	NON-COMPETING CONTINUATION	$14,349
2020	2020	INSTITUTE FOR CANCER RESEARCH, THE	333 COTTMAN AVE	PHILADELPHIA	PA	19111	PHILADELPHIA	USA	Minority Health and Health Disparities Research	000	3	12/25/2019	NON-COMPETING CONTINUATION	$775,229
														Subtotal = $789,578

Issue Date FY: 2019 ( Subtotal = $775,191 )
2019	2019	INSTITUTE FOR CANCER RESEARCH, THE	333 COTTMAN AVE	PHILADELPHIA	PA	19111	PHILADELPHIA	USA	Minority Health and Health Disparities Research	000	2	12/17/2018	NON-COMPETING CONTINUATION	$775,191
														Subtotal = $775,191

Issue Date FY: 2018 ( Subtotal = $715,381 )
2018	2018	INSTITUTE FOR CANCER RESEARCH, THE	333 COTTMAN AVE	PHILADELPHIA	PA	19111	PHILADELPHIA	USA	Minority Health and Health Disparities Research	001	1	6/22/2018	NEW	$73,269
2018	2018	INSTITUTE FOR CANCER RESEARCH, THE	333 COTTMAN AVE	PHILADELPHIA	PA	19111	PHILADELPHIA	USA	Minority Health and Health Disparities Research	000	1	5/2/2018	NEW	$642,112
														Subtotal = $715,381

Grand Total All Awards = $3,865,016

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Immigrant enclaves: Conferring health advantages or creating health disparities in Chinese immigrants?

Award Number: R01MD012621

ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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