purchase PRIMA-1MET br Funding br Acknowledgement This paper

Funding
Acknowledgement This paper uses unit record data from the Household, Income and Labour Dynamics in Australia (HILDA) Survey. The HILDA Project was initiated and is funded by the Australian Government Department of Families, Housing, Community Services and Indigenous Affairs (FaHCSIA) and is managed by the Melbourne Institute of Applied Economic and Social Research (MIAESR). The findings and views reported in this purchase PRIMA-1MET paper , however, are those of the author and should not be attributed to either FaHCSIA or the MIAESR.
Introduction Exposure to stressors over the life course is thought to accelerate biological aging by promoting physiological dysregulation and influencing disease trajectories (). Allostatic load (AL) is an index of physiological dysfunction from a failure to adapt to chronic and repeated exposure to stressors (Ben-Shlomo & Kuh, 2002). As a multisystem model of biological risk, AL has been a useful construct in conceptualizing how chronic adversity imposes “wear and tear” on biological systems, increasing morbidity and mortality over the life course (McEwen & Seeman, 1999), and contributing to health disparities in the US (Geronimus, Hicken, Keene, & Bound, 2006). Studies suggest that AL increases with age (Crimmins, Johnston, Hayward, & Seeman, 2003) and can vary by sex (Goldman et al., 2004; Yang & Kozloski, 2011). While some available evidence links AL with cardiovascular disease (CVD) risk factors in Hispanics/Latinos in the US (), there has been a scarcity of studies examining patterns of AL accumulation by age and sex in this vulnerable population. A greater understanding of the accumulation of biological mediators of risk may help to explain the increased burden of disease among US Hispanics/Latinos. Emerging evidence suggests that place of birth (nativity) has an influence on AL. Data from the National Health and Nutrition Examination Surveys (NHANES 1999–2002) showed that while Hispanics/Latinos tend to have CVD risk factor values at high risk levels than do non-Hispanic whites, US-born Hispanics/Latinos (who were predominantly of Mexican origin) had higher levels of AL than foreign-born Hispanics/Latinos (Crimmins, Kim, Alley, Karlamangla, & Seeman, 2007). Similar results from a cross-sectional study of Mexican adults residing in Texas City, TX, showed differences across groups that persisted after controlling for socioeconomic status, smoking, and physical activity (Peek et al., 2010). These findings may suggest an “unhealthy assimilation” effect where increased stress from discrimination (Paradies, 2006), worsening dietary habits (), physical inactivity (Ham, Yore, Kruger, Heath, & Moeti, 2007), and adoption of unhealthy behaviors such smoking and drinking (; ) confer a physiological toll and a deterioration in health with time spent in the US (Antecol & Bedard, 2006). Because each major Hispanic/Latino group living in the US has a distinct history and culture, it is informative to investigate heterogeneity in the relationship between nativity, duration in the US, age at immigration and AL across Hispanic heritage backgrounds. Moreover, the few studies that have investigated these relationships have had limited age ranges and modest sample sizes, precluding the study of AL across age groups.
Methods
Results Table 1 depicts the continuous distributions of each physiological marker in the AL index stratified by sex. Mean age was 40 years in men and 42 years in women. On average, men had higher levels of WHR, LDL-c, triglycerides, fasting glucose, SBP, and pulse pressure than women, whereas women had higher mean levels of BMI, HDL-c, resting heart rate, HRV, lung function, CRP and WBC than men (all P values<0.0001). Table 2 shows age-adjusted, sex and age-stratified mean AL scores across socio-demographic and behavioral characteristics. We found differences by Hispanic heritage backgrounds (P<0.0001), such that South Americans had the lowest and Puerto Ricans had the highest mean AL scores in both men and women. A notable exception was for Hispanic/Latino men at the oldest age group (55–74 years), where Cubans exhibited the highest levels. When we considered socioeconomic factors, lower income and education levels were associated with higher mean AL scores at all age categories in women (all P values<0.01 for increasing trend in AL across lower income and education categories). However, no associations between income or education with AL were observed in men. With regard to health behaviors, mean AL scores increased linearly across categories of never, former, and current smoking amongst young (adj means: 2.11, 2.38, 2.64 respectively, P=0.007) and middle-aged women (adj means: 3.61, 4.13, 4.28 respectively, P=0.0007). We found differences in the relationship of alcohol consumption with AL between men and women. In men aged 18–54, individuals who were classified as low-risk drinkers had the lowest and at-risk drinkers had the highest mean AL scores; whereas amongst women aged 40–74, at-risk drinkers had the lowest but never drinkers had the highest scores. When dietary habits were considered, we found that mean AL scores decreased with better diet quality in both men and women, but only at younger (18–39) and older (55–74) ages. Lastly, AL scores were lower amongst individuals who met criteria for being physically active as compared to those who did not, irrespective of sex and age.