Cardiovascular Risk in Middle-Aged and Older Immigrants: Exploring Residency Period and Health Insurance Coverage.
Tina R Sadarangani, Chau Trinh-Shevrin, Deborah Chyun and 2 others
PMID 30834719WHAT IT FOUND
In older immigrants, lacking health insurance was associated with a 1.7-fold higher likelihood of cardiovascular risk.
Uninsured recent immigrants were more likely to be at high risk than uninsured long-term immigrants.
Key findings
01Lack of health insurance coverage was associated with a 1.7-fold increase in the likelihood of being at risk for cardiovascular disease in the adjusted model.
02In stratified analysis, uninsured immigrants living in the United States for less than 10 years had an odds ratio of 2.55 (95% CI 1.88-3.45) for high cardiovascular risk, compared with an odds ratio of 1.53 (95% CI 1.35-1.73) for uninsured long-term immigrants.
03Recent immigrants had higher plasma glucose, total cholesterol, and triglycerides and lower HDL cholesterol than long-term immigrants, while a greater proportion of long-term immigrants were at high cardiovascular risk by the Pooled Cohort Equations.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The cross-sectional design cannot show that lack of insurance caused higher cardiovascular risk. The models explained only a small part of the variation in cardiovascular risk. The study could not analyze differences among racial and ethnic subgroups because the data were insufficient. Some access barriers, such as discrimination, were not measured. Private insurance plans were not analyzed for service level or out-of-pocket costs. Recent immigrants were younger, and age is weighted heavily in the risk score.
Declared interests
The supplied text does not report a conflict-of-interest or funding statement.
The easy way to misread this
Do not conclude that lack of insurance caused higher cardiovascular risk. The analysis is cross-sectional, and it did not follow people over time or test whether gaining insurance changed risk.