Filipino Immigrants Are More Likely to Be Obese the Longer They Live in the United States

The longer Filipinos live in the United States, the more likely they are to be obese. However, this is only true for Filipinos who came to the United States at a relatively young age, before the age of 30. This is one conclusion of an NIMHD-funded study on the health of this immigrant population.

Many immigrants come to the United States healthier than the general U.S. population. But that advantage tends to disappear over time. NIMHD-supported researchers studied whether this was true for Filipino immigrants living in and around New York City. Their results were published this year in the journal Family and Community Health.1

Dr. Chau Trinh-Shevrin, associate professor at the New York University School of Medicine and principal investigator at the NYU Center for the Study of Asian American Health.

The researchers thought Filipino immigrants might not follow the usual pattern for immigrant health. Since the Philippines was a United States colony for more than four decades, many Filipinos adopt aspects of American culture before migrating to the United States. Therefore, the change might not be as drastic for them as for immigrants from other countries. However, this study found that Filipinos who had lived in the United States for longer than 10 years were more at risk for being overweight or obese than those who had lived in the United States for fewer than 5 years.

The Philippines is the fourth largest country of origin of immigrants to the United States. "Yet people tend to forget that this is a large immigrant population," says Chau Trinh-Shevrin, Dr.P.H., principal investigator at the New York University (NYU) Center for the Study of Asian American Health (CSAAH). This was the first study to find a link between the amount of time spent in the United States and risk for obesity in Filipino immigrants.

People may not be used to thinking about health disparities in Asian Americans, says Trinh-Shevrin. "The whole model minority stereotype has persisted for many years, in terms of thinking about Asian Americans as being healthier, wealthier, and wiser." Studies show that Asian Americans as a whole are doing well, but certain Asian Americans groups, such as immigrants, experience health and other disparities.2

The study did not look at why Filipinos gain weight after coming to the United States. But Trinh-Shevrin speculates that immigrants might eat less healthy, more processed foods due to the wide availability of inexpensive fast food options and be less physically active than in the Philippines. Why are Filipinos who migrate at a younger age most at risk? "When you come under 30, you’re more likely to adapt to a particular food environment," says Trinh-Shevrin. Immigrants in their 20s likely work longer hours and might not have a spouse to cook for them, which means they might choose more convenient calorie-rich options. Younger immigrants also might have a smaller social network to reinforce their cultural practices, which includes traditional foods.

"Stress is also really challenging for immigrant populations," adds Trinh-Shevrin. Immigrants often face discrimination or social stigma. Many immigrants are under financial stress because they cannot find well-paying jobs or they send most of their money back home to their families. Undocumented workers have the added stress of fear of being deported. In turn, stress can lead to high blood pressure, cravings for sugary or fried foods, and less attention to one’s health and wellbeing.

The data comes from the Asian American Partnership in Research and Empowerment (Project AsPIRE), an 8-year-long study aimed at reducing high blood pressure in Filipinos in the New York metro area. Project AsPIRE is an example of the community-based approach that CSAAH uses to study and address health disparities in Asian Americans. CSAAH staff worked with members of the Filipino community to identify high blood pressure and obesity as concerns, form a health coalition, and develop Project AsPIRE to address these problems.3

The study, which ended in 2013, was funded by NIMHD. Community health workers, fluent in English and Tagalog, held workshops on blood pressure, healthy diets, and exercise and met one-on-one with people to address any problems in getting medical care. Researchers gathered information and health data from the participants to learn more about risks for obesity and high blood pressure. A randomized controlled trial of AsPIRE showed that it was successful in managing blood pressure, improving diet, and increasing exercise in the Filipino community.4

In 2014, Project AsPIRE was highlighted as an innovative evidence-based intervention by the Agency for Healthcare Research and Quality. The project later received funding from the NIH National Heart, Lung, and Blood Institute to train community health workers in other cities with large Filipino populations.

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