Colón-López Vivian, Haan Mary N, Aiello Allison E, Ghosh Debashis
Center for Evaluation and Sociomedical Research, School of Public Health, University of Puerto Rico, San Juan, Puerto Rico 00936-5067.
Ann Epidemiol. 2009 Jan;19(1):8-14. doi: 10.1016/j.annepidem.2008.08.010. Epub 2008 Oct 14.
In this study, we evaluated the influence of age at migration on cardiovascular mortality among older Mexican Americans immigrants.
A population-based cohort of Mexican-origin (N = 907) participants ages 60+ was followed up to 8 years. The association between migration before age 20 compared with after age 20 and mortality was analyzed with the use of multivariate Cox proportional models.
Compared with those who migrated later, those who migrated before the age of 20 years had higher income and education, were more likely to speak English, were culturally more Anglo, and more likely to be men. Immigration before 20 years of age was associated with greater rates of cardiovascular mortality (hazard ratio, 2.39; 95% confidence interval, 1.16 - 4.94) compared with those migrating at older ages, even after adjustment for age, sex, education, income, and baseline cardiovascular health. No age at migration differences were observed for noncardiovascular deaths.
Mexican Americans who migrated in early life experienced greater cardiovascular disease death rates than later migrants. Early experiences related to migration may have consequences for late-life disease that are not mitigated by the higher socioeconomic status achieved by early migrants. Health or economic selection related to migration may play a role although accounting for health and socioeconomic status actually increased differences between early and later migrants.
在本研究中,我们评估了移民年龄对墨西哥裔美国老年移民心血管疾病死亡率的影响。
对一个以墨西哥裔为基础的队列(N = 907)中60岁及以上的参与者进行了长达8年的随访。使用多变量Cox比例模型分析20岁之前移民与20岁之后移民和死亡率之间的关联。
与那些较晚移民的人相比,20岁之前移民的人收入和受教育程度更高,更有可能说英语,在文化上更倾向于盎格鲁文化,且男性比例更高。即使在对年龄、性别、教育、收入和基线心血管健康进行调整之后,20岁之前移民的人心血管疾病死亡率也更高(风险比,2.39;95%置信区间,1.16 - 4.94)。在非心血管疾病死亡方面,未观察到移民年龄的差异。
早年移民的墨西哥裔美国人比后来移民的人经历了更高的心血管疾病死亡率。与移民相关的早期经历可能会对晚年疾病产生影响,而早期移民所获得的较高社会经济地位并不能减轻这种影响。与移民相关的健康或经济选择可能起到了一定作用,尽管在考虑了健康和社会经济地位之后,实际上增加了早期和后期移民之间的差异。