Introduction: Leaving Africa to live in the United States is stressful. Due to oversecretion of glucocortoids and catecholamines, stress has biologic consequences. No data exists on whether Africans who come to America for reasons associated with high stress have a higher rate of conditions such as obesity, diabetes and hypertension than Africans who come for low stress reasons.
Goals: Working with the Africans in America cohort and using allostatic load score (ALS) to measure biologic stress, our objectives were to (a) rank by ALS the 5 most common reasons for immigration (work, study, asylum/refugee, family unification and lottery); (b) divide the cohort in to 2 groups: high stress (combining the individuals with the 3 reasons with the highest ALS) and low stress (combining the individuals with the lowest ALS); (c) compare body size, visceral adipose tissue (VAT), glucose, BP, sleep duration and smoking in Africans with high and low stress.
Methods: OGTT and abdominal CT scans were performed in 114 African immigrants (68% male, age 41±10, range22-62y) born in subSaharan Africa but living in Washington, DC.
Results: Ranked from highest to lowest, ALS for each reason for immigration was: work 3.18±1.71; asylum/refugee 2.68±1.46; study 2.66±1.88; family 1.77±1.27; lottery 1.60±1.27. Hence, high stress reasons for immigration were: work, asylum/refugee and study. Low stress reasons were: family and lottery. ALS in high vs. low stress reasons for immigration were: 2.81±1.74 vs. 1.72±1.25, P<0.01. BP did not vary by group. However, Africans with high stress had a higher BMI, more VAT and hyperglycemia than Africans with low stress (Table). Africans with high stress also had a greater tendency to sleep <7h per night and smoke (Table).
Conclusions: High stress reasons for immigration include work, asylum/refugee and study. As obesity, hyperglycemia, and behaviors such as decreased sleep duration and smoking are associated with high stress reasons for immigration, medical histories when possible should include reason for immigration.