Food insecurity, acculturation and diagnosis of CHD and related health outcomes among immigrant adults in the USA

Objective: To deepen understanding of the relationship between food insecurity, acculturation, and diagnosis of CHD and related health outcomes among immigrant adults. Design: Using cross-sectional, nationally representative data from the National Health Interview Survey 2011 to 2015, we address two research questions. First, what is the relationship of household food insecurity and acculturation with: CHD, angina pectoris, heart attack, self-rated poor health and obesity? Second, what is the association of food insecurity with these health outcomes over years of living in the USA? We estimate multivariate logistic regressions without (question 1) and with (question 2) an interaction term between food insecurity and acculturation for CHD and related health outcomes. Setting: USA. Participants: Low-income immigrant adults. Results: Food insecurity and acculturation are both associated with diagnosis of CHD and related health outcomes among immigrant adults. Food insecurity and acculturation are associated with the health of female immigrants more than males. Also, the differences by food security status in the probability of having several poor health outcomes (self-rated heath, obesity, women's angina pectoris) are largest for those in the USA for less than 5 years, decrease for those who have lived in the USA for 5-14 years, and are larger again for those in the USA for 15 or more years. Conclusions: Recent and long-term food-insecure immigrants are more vulnerable to CHD and related health outcomes than those in the USA for 5-14 years. Further research is needed to understand why.