Ethnic enclaves and gestational diabetes among immigrant women in New York City
Introduction
A growing body of literature suggests that living in a neighborhood of shared ethnic ancestry, or ‘ethnic enclave’, has a positive influence on immigrant health (Pickett and Wilkinson, 2008). Research regarding the influence of ethnic enclaves on pregnancy health has been limited, however, by the use of broad ethnic categories and a lack of focus on immigrant women. Gestational diabetes is a substantial public health problem among immigrant women, and therefore is a particularly relevant health outcome to study in relation to ethnic enclaves. An investigation of how ethnic enclaves influence the risk of gestational diabetes among specific immigrant groups will inform our understanding of how neighborhoods influence immigrant health.
Section snippets
Background
Gestational diabetes is a significant public health problem affecting approximately 7% of pregnancies, with implications for the mother's and infant's health across the lifecourse (Trial, 2004). Gestational diabetes mellitus, defined as diabetes with onset during pregnancy, is a common but serious pregnancy complication that can result in increased morbidity to both the infant and mother, including perinatal mortality, preterm birth, cesarean section, macrosomia, and trauma during delivery (
Data sources and study sample
We used a dataset consisting of New York City birth certificate data linked to hospitalization data for the years 2001–2002 for 242,097 births. The birth data were geocoded to the mother's 2000 census tract by the New York City Department of Mental Health and Hygiene. Of 242,097 eligible singleton live births, we excluded 4675 (1.9%) with missing data on the census tract of mother's residence, and 17,920 (7.5%) whose mother's residence was outside of New York City, leaving a total of 210,926
Results
The percentage of women with gestational diabetes varied geographically, with apparent clustering in Queens (Fig. 1). Neighborhoods with a percentage of gestational diabetes in the highest quintile (8% or higher) were present in every borough. A large number of neighborhoods in the lowest quintile of gestational diabetes percentage were located in Manhattan, Brooklyn, and Staten Island. Gestational diabetes also varied substantially among immigrant groups - the percentage with gestational
Discussion
In contrast to our hypothesis that living in an ethnic enclave is protective of gestational diabetes, we found no association between ethnic enclave residence and gestational diabetes in most immigrant groups. Two exceptions included a greater risk of gestational diabetes among South Central Asian women living in an ethnic enclave defined at the 90th and 95th percentile of ethnic concentration, and among Mexican women living in an ethnic enclave defined at the 95th percentile of ethnic
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2023, Women's Health IssuesPrevalence and risk factors contributing to the occurrence of diabetes mellitus in Chinese international migrants: A narrative review
2023, Diabetes Research and Clinical PracticeRisk and adverse outcomes of gestational diabetes in migrants: A population cohort study
2020, Diabetes Research and Clinical PracticeCitation Excerpt :A first finding of this study was that, even after adjusting for all these differences, the risk of GDM was about 60% higher among migrants, with a peak for those of Asian origin (especially from South Asia). This agrees with previous studies comparing natives and migrants to other countries [11,12] and further suggests that altered glucose metabolism in pregnancy is considerably modulated by different ethnicities, even in women coming from HMPC countries. An indirect proof of this concept is the relation between pre-gestational overweight-obesity and GDM in this population.
Research progress on etiology of gestational diabetes mellitus
2018, Global Health JournalEthnic enclaves and birth outcomes of immigrants from India in a diverse U.S. state
2018, Social Science and MedicineCitation Excerpt :Similar findings emerged: Ethnic enclave residence was not associated with very low birthweight or birthweight among immigrants from India. A second set of supplementary analyses (available upon request) replicated all analyses using an alternative definition of ethnic enclave [membership in the top 10% of the distribution of percent born in South Central Asia, closely following Janevic et al. (2014)]; multilevel logistic regression results were extremely similar to those presented here. A third set of supplementary analyses replicated all models presented in Table 4 and Appendix Table A, excluding neighborhood-level controls for affluence and disadvantage.
The role of obesity in the risk of gestational diabetes among immigrant and U.S.-born women in New York City
2018, Annals of EpidemiologyCitation Excerpt :Diet may differ based on immigrant status and acculturation, and to the extent that the diet from the sending country is higher in elements such as saturated fats that are known to increase the risk of GDM independent of BMI [35], cultural norms around diet may result in a greater role of diet in GDM among immigrant women. In support of the hypothesis that less acculturated women may be at higher risk of GDM, a study of ethnic enclaves and gestational diabetes in New York City found that among South Central Asian and Mexican women, living in their ethnic enclave was associated with an increased risk of GDM [36]. The life course perspective on cardiometabolic risk ties together potential explanations for difference in the role of obesity in GDM risk between immigrant and U.S.-born women [37].