Neighborhood, social connectedness, and allostatic load - Modified Project Summary/Abstract Section The Asian American population is one of the fastest-growing groups in the United States (US), and Asians of Chinese origin represent the largest single US Asian subgroup. Among Chinese Americans, the majority (62%) are foreign-born. Although Chinese immigrants report better health than their US-born counterparts, this health advantage decreases over time with increasing duration of residence. The downward health trajectory has been primarily attributed to behavioral changes, but immigration also encompasses extensive stress and social isolation. Social isolation, in turn, may increase chronic disease risk through dysregulation in multiple systems – neuroendocrine, cardiovascular, metabolic, inflammatory, immune – which together are indicative of allostatic load (AL). Indeed, studies of other US foreign-born populations have noted that longer US residence is associated with higher AL. Despite these findings, the question of whether immigrants’ experiences of social isolation affect disease risk and health has not been well studied. Social connectedness, or the extent to which one perceives oneself to be closely and meaningfully connected with other individuals, groups, and society as a whole, is a possible strategy to address social isolation, but the conditions and contexts that foster social connectedness are not well understood. Living in enclave neighborhoods may have positive effects among Chinese immigrants including greater social support and less loneliness. It has been suggested that enclaves provide the necessary structural conditions – namely, physical and social spaces – for social connectedness to develop, although this has yet to be confirmed in large-scale studies. Thus, we propose a comprehensive investigation of the following interrelated questions: Do post-migration experiences of social isolation/connectedness have biologic correlates among foreign-born Chinese? And do enclave neighborhoods contribute to social connectedness in this population; if so, how? To address these questions, we will recruit a cohort of 600 foreign-born Chinese across the Philadelphia region, including residents of enclave neighborhoods as well as residents of neighborhoods lacking the resources of recognized enclaves. Specific aims are to: (1) Examine associations of social connectedness and social isolation with AL in a cohort of US Chinese immigrants; and (2) Explore whether and how enclave residence and engagement with enclave-based resources are associated with social connectedness. Data collection will include questionnaires (e.g., social connectedness, isolation, engagement with enclave resources), blood pressure, anthropometry, and fasting blood samples analyzed for markers of AL. Addresses of residences and locations of activities (e.g., shopping, religious services) will be geocoded. Longitudinal assessments will be obtained at 2-year follow-up to identify changes in markers of AL and correlates of changes in those measures. Project findings will identify the most vulnerable individuals and neighborhoods to target for outreach and pinpoint the critical resources for promoting positive health trajectories in this population.
