Not One Enclave: Disaggregation and Cardiometabolic Health in Asian Ethnic Enclaves

Area of Science:

• Public Health
• Sociology
• Urban Studies

Background:

• Asian American (AA) subgroups face disparities in cardiometabolic (CMB) conditions.
• The role of residential segregation, or ethnic enclaves, in these disparities is understudied, especially considering region of origin and nativity.

Purpose of the Study:

• To examine the relationship between residence in East and South Asian enclaves and CMB risks (obesity, hypertension, diabetes) among Asian Americans in New York City.
• To investigate if these associations differ by nativity and to assess the mediating roles of neighborhood socioeconomic status, built environment, social cohesion, and institutional support.

Main Methods:

• Utilized six years of population-based survey data (N>6,000) linked with community data.
• Employed concentration-based and spatial clustering to identify East and South Asian enclaves.
• Used logistic regression to analyze associations between enclave residence and CMB risks, adjusting for neighborhood characteristics.

Main Results:

• Residence in an East Asian enclave was associated with lower odds of obesity (OR=0.63).
• Residence in a South Asian enclave was linked to higher odds of diabetes (OR=1.42) and hypertension (OR=1.46).
• These associations were significant only for foreign-born individuals; enclave effects partially attenuated after adjustment for neighborhood factors.

Conclusions:

• Asian enclaves are not uniformly health-promoting, with distinct impacts based on ethnic subgroup and nativity.
• Findings suggest unmeasured enclave factors, such as cultural and food environments, influence health outcomes.
• Emphasizes the need for disaggregated approaches to understand Asian American health disparities.