Understanding health disparities in Pakistani, Bangladeshi and Asian Indian immigrants: the role of socio-cultural context, acculturation and resilience resources

The overall goal of this project is to characterize CVD risk factors, psychosocial risks, and protective factors among Pakistanis and Bangladeshis in the U.S. and compare to Indian immigrants already enrolled in the MASALA study. We plan to recruit 600 Bangladeshi and 550 Pakistani adults between the age of 40-84 years from the greater New York City and Chicago areas in this next wave of the MASALA study. Specific Aims Aim 1. Characterize cardiovascular risk factors (obesity, diabetes, hypertension, dyslipidemia, smoking) among Pakistani and Bangladeshis in the U.S. and compare the age- and sex-adjusted prevalence of cardiovascular risk factors with 965 Asian Indians already enrolled in MASALA. Aim 2a. Determine whether multilevel psychosocial risks (i.e. discrimination, Islamophobia, socioeconomic position, acculturative stress) and protective factors (i.e., social capital, social networks, social cohesion) are associated with behavioral risk factors (diet, physical activity, tobacco use) and with psychological outcomes (depressive symptoms, anxiety). Aim 2b. Determine whether multilevel psychosocial risks and protective factors are associated with cardiovascular risk factors. Aim 3. Determine whether multilevel psychosocial risks and protective factors mediate differences in risk factor burden among Indians, Pakistanis and Bangladeshis.