Impact of Acculturation and Lifestyle Health Behaviors on Cardiovascular Health among Filipinos in California

Background: Cardiovascular disease (CVD) is the leading cause of death among all major racial and ethnic groups in the United States (US) and worldwide. Filipinos are the second largest Asian immigrant group in the US. Healthful lifestyle behaviors are cardioprotective factors, but have been under-, overestimated, or not studied among Asian American subgroups.Objective: The purpose of this dissertation was to describe the cardiovascular health, cardiovascular mortality, cardiometabolic and lifestyle health behaviors, acculturation, and predictors associated with CVD in the Filipino American population. Methods: A systematic review of the literature was conducted which focused on the cardiovascular mortality, disease and clinical and behavioral risks of Filipinos in the US. Two secondary analyses of the 2011-2012 California Health Interview Survey dataset were conducted which focused on the cardiovascular health, CVD, acculturation, metabolic and lifestyle health behavior of Filipino Americans (n = 555).Results: The systematic review suggested that Filipino Americans are at high risk for developing cardiovascular disease, for having CVD-related clinical health risks, for engaging in unhealthy CVD lifestyle behaviors, and dying from CVD, as compared to White, non-Hispanic and other Asian Americans in general and by gender. The prevalence of CVD was 7.4% among Filipinos in California. Hypertension, diabetes, physical inactivity, being overweight/obese, and inadequate consumption of fruits and vegetables were prevalent among Filipinos. Multivariate logistic regression analysis indicated that only hypertension was a significant predictor of CVD, controlling for the effects of age, gender, being born in the US, and diabetes. When taking into consideration acculturation factors in chronic diseases and health behaviors, US-born Filipinos had a significantly lower proportion of chronic diseases as compared to Filipinos not born in the US. Filipinos who lacked English proficiency reported more hypertension as compared to Filipinos who reported proficiency in English. A higher proportion of several positive health behaviors were reported among Filipinos not born in the US and those who did not speak English at home ate the recommended 35 or more servings per week of fruits and vegetables compared to their counterparts.Conclusions: Further research is needed for culturally-appropriate interventions, education, and prevention programs which focus on health behaviors and chronic diseases, such as CVD, for Filipino Americans