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 a key risk factor leading to elevated risks of cardiometabolic diseases. However, there is limited knowledge of how psychosocial stress affects cardiometabolic health among Asian Americans, especially older foreign-born Asian Americans who disproportionately encounter psychosocial stress due to racism, language barriers, and low socioeconomic status. Notably, a lack of knowledge of key biobehavioral 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 biobehavioral 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 study aims. We propose to: (Aim 1) investigate day-to-day associations among psychosocial stressors (e.g., social isolation), biobehavioral processes (e.g., salivary diurnal cortisol) and blood pressure, and (Aim 2) examine the moderation roles of sociocultural factors (e.g., filial piety, acculturation) on the longer-term effects of psychosocial stressors on cardiometabolic health over two years. Completion of the proposed study will generate new knowledge to facilitate the understanding of the interplay of psychosocial stress and sociocultural factors in determining cardiometabolic health and their underlying mechanisms in older Chinese Americans. As a result, this project will guide the design of future culturally relevant, personalized psychobehavioral interventions that aim to promote cardiometabolic health in this at-risk but underserved population.