Abstract P397: Living in Ethnic-enclave Neighborhoods May Attenuate the Negative Effect of Acculturation on Blood Pressure in Refugees and Maintain Immigrant Health Effect

Background: Researchers have long hypothesized that acculturation (duration of U.S. residence [DOR]) is associated with increases in blood pressure in immigrant populations. However, little is known about the potential effects of acculturation on hypertension (HTN) in refugees living in ethnic-enclave neighborhoods. We conducted a cross-sectional study of Somali refugees and immigrants (a largely enclaved population) living in Minneapolis-St. Paul, Minnesota. Method: We analyzed data from 1155 Somali refugees/immigrants who arrived in United States from 1990 to 2015 and are participating in an ongoing study of Somali refugees in the Twin Cities. Using 10 years as a threshold, the study population was divided into two groups based on DOR: short (&lt 10 years) or long (&gt= 10 years). Main outcome was HTN, which was defined using the protocol of international HTN studies. Differences between the two groups were determined by chi-squared test and t-test. Multivariate logistic regression was used to determine association between HTN and DOR. Results: Of 1155 subjects, 572 (49.6%) had DOR &gt= 10 years. Mean DOR was 9.8 ± 6.0 years (median of 10), and 58.1% (559 of 1155) were women. The short DOR group was younger (mean age 44.6 ± 18.0 vs 51.4 ± 18.1 years, P&lt 0.001. There was no difference in mean systolic blood pressure (SBP) between groups (117 mmHg vs 119 mmHg, P=0.087) and no correlation between SBP and DOR (linear R 2 =0.012). Prevalence of HTN was 29.5% (341 of 1155), with 179 of these 341 (52.5%) having uncontrolled HTN. HTN increased with aging: 4.1% (19 of 457) for age group 18-39, 15.3% (47 of 306) for ages 40-59, and 29.7% (114 of 384) for ages 60 + . After adjusting for body mass index, marital status, English language (written and spoken), health insurance, income / poverty ratio, language spoken at home, employment, education and DOR, age was the only predicator of HTN. Even after matching two groups by age, the distribution of HTN was similar between the two age-matched DOR groups (P=0.1879). Conclusions: DOR (acculturation) was not a predictor of HTN in this highly enclaved refugee/immigrant sample. Further studies are needed to identify which cultural and neighborhood environment factors may operate to blunt the effects of acculturation on blood pressure.