Title : Hyperlipidemia, acculturation, and health insurance coverage in United States foreign-born individuals

Background: Hyperlipidemia is one of the modifiable risk factors for cardiovascular diseases (CVD), the leading cause of death among minority populations in the United States, including foreign-born adults. Therefore, preventing and treating hyperlipidemia alongside other CVD risk factors is critical for avoiding CVD. Prior research has examined disparities in health insurance coverage, length of stay, and blood cholesterol levels with mixed findings over time among new immigrants. This study examined whether language spoken at home, length of stay in the United States, and health insurance coverage are associated with high cholesterol among foreign-born adults.

Methods: This study analyzed data from 2,666 foreign-born adults ≥20 years in the National Health and Nutrition Examination Survey (NHANES) 2017–March 2020. Multiple logistic regression models assessed associations between length of stay in the United States, insurance status, and high cholesterol, adjusting for sociodemographic factors, dietary quality, health insurance coverage, cholesterol treatment, cholesterol checkups, hospital utilization, and comorbidities.

Results: Length of stay in the United States (OR = 1.59; p = 0.02) and health insurance coverage (OR = 1.20; p = 0.03) were significantly associated with increased odds of high cholesterol.

Speaking multiple languages at home was also associated with lower odds of high cholesterol (OR = 0.42; p = 0.02). The primary language spoken at home alone was not associated with cholesterol status.

Conclusion: Length of residence and health insurance status are key predictors of hyperlipidemia among United States foreign-born adults. Findings highlight the need for targeted screening, culturally tailored interventions, and policies addressing immigrant cardiovascular risk.

Dr. Debola Ola is a medical and public health practitioner with over 10 years of experience in clinical care, research, epidemiology, and public health. With an MD, MPH, and Dr.PH background, she has a strong academic and professional foundation in clinical medicine, epidemiology, biostatistics, and population health, as well as a systems-level perspective on improving public health outcomes. She currently works with the Healthcare Safety Unit of the Texas Department of State Health Services.

Her published doctoral scholarly research identified areas for further study, interventions, and policies to reduce health disparities in hyperlipidemia among foreign-born adults in the United States.