Psychosocial and cultural determinants of cardiometabolic health among older Chinese Americans

Project Summary Cardiometabolic diseases contribute to more than 1 in 4 deaths in U.S. adults, including Asian Americans. Psychosocial stress is believed to be a key risk factor leading to elevated risks of cardiometabolic diseases, beyond traditional factors such as poor diet and physical inactivity. However, there is limited knowledge of how

psychosocial stress affects cardiometabolic health among Asian Americans, especially older foreign-born Asian American who disproportionately encounter psychosocial stress due to racism, language barriers, and low socioeconomic status. Notably, a lack of knowledge of key biopsychological mechanisms through which

psychosocial stress affects cardiometabolic health hampers public health efforts to develop effective interventions to promote cardiometabolic health in the understudied Asian American population, which is projected to reach 46 million by 2060. To address these important scientific gaps, the proposed study is to

investigate key biopsychological processes through which daily psychosocial stress affects cardiometabolic health among 300 older foreign-born Chinese Americans. We will use a prospective design and harness the power of ecological momentary assessment and biospecimen sampling to achieve three specific aims. We

propose to: (Aim 1) determine the mediation effects of biopsychological processes (daily negative emotion, saliva cortisol secretion, daily sleep quality) on the associations between psychosocial stressors (e.g., social isolation) and cardiometabolic health (e.g., blood pressure, Hemoglobin A1C); (Aim 2) investigate micro-level

day-to-day associations among psychosocial stressors, biopsychological processes, and blood pressure; and (Aim 3) examine the moderation roles of sociocultural factors (e.g., acculturation, social cohesion) on the longer-term effects of psychosocial stressors on cardiometabolic health. Completion of the proposed study will

provide new knowledge to facilitate the understanding of key psychosocial stressors and related biopsychological processes contributing to poor cardiometabolic health in older Chinese Americans. As a result, this project will guide the design of future culturally-tailored, time-sensitive, personalized psychosocial

interventions that aim to promote cardiometabolic health in this population.