{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T07:54:34Z","timestamp":1788422074377,"version":"build-2803163510"},"reference-count":33,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,3,4]],"date-time":"2019-03-04T00:00:00Z","timestamp":1551657600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["U48 DP005008"],"award-info":[{"award-number":["U48 DP005008"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["sigmapubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Nursing Scholarship"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>It is reported that while immigrants are, initially, healthier than the native\u2010born upon resettlement, this advantage erodes over time. In the United States, uninsured aging immigrants are increasingly experiencing severe complications of cardiovascular disease (<jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content>). The purpose of this study was to compare overall <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content> risk and explore the importance of health insurance coverage on <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content> risk relative to other health access barriers, from 2007 to 2012, in recent and long\u2010term immigrants &gt;50 years of age.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study was based on secondary cross\u2010sectional analysis of the National Health and Nutrition Examination Survey (<jats:italic>N<\/jats:italic> = 1,920). The primary outcome, <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content> risk category (high or low), was determined using the American College of Cardiology and American Heart Association Pooled Cohort equation. Differences between immigrant groups were examined using independent\u2010samples <jats:italic>t<\/jats:italic> tests and chi\u2010square analysis. The association between insurance and <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content> risk was explored using a hierarchical block logistic regression model, in which variables were entered in a predetermined order. Changes in pseudo <jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup> measured whether health insurance explained variance in cardiac risk beyond other variables.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Recent immigrants had lower overall <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content> risk than long\u2010term immigrants but were twice as likely to be uninsured and had higher serum glucose and lipid levels. Based on regression models, being uninsured contributed to <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content> risk beyond other health access determinants, and <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content> risk was pronounced among recent immigrants who were uninsured.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Health insurance coverage plays an essential part in a comprehensive approach to mitigating <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content> risk for aging immigrants, particularly recent immigrants whose cardiovascular health is susceptible to deterioration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical Relevance<\/jats:title><jats:p>Nurses are tasked with recognizing the unique social and physical vulnerabilities of aging immigrants and accounting for these in care plans. In addition to helping them access healthcare coverage and affordable medication, nurses and clinicians should prioritize low\u2010cost lifestyle interventions that reduce <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content> risk, especially diet and exercise programs.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jnu.12465","type":"journal-article","created":{"date-parts":[[2019,3,5]],"date-time":"2019-03-05T04:48:29Z","timestamp":1551761309000},"page":"326-336","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Cardiovascular Risk in Middle\u2010Aged and Older Immigrants: Exploring Residency Period and Health Insurance Coverage"],"prefix":"10.1111","volume":"51","author":[{"given":"Tina R.","family":"Sadarangani","sequence":"first","affiliation":[{"name":"Upsilon, Assistant Professor\/Faculty Fellow New York University Rory Meyers College of Nursing  New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chau","family":"Trinh\u2010Shevrin","sequence":"additional","affiliation":[{"name":"Associate Professor, Department of Population Health New York University School of Medicine  New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Chyun","sequence":"additional","affiliation":[{"name":"Upsilon, Dean and Professor University of Connecticut School of Nursing  Storrs CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary","family":"Yu","sequence":"additional","affiliation":[{"name":"Associate Research Scientist New York University Rory Meyers College of Nursing  New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Kovner","sequence":"additional","affiliation":[{"name":"Upsilon, Mathy Mezey Professor of Geriatric Nursing New York University Rory Meyers College of Nursing  New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,3,4]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000001441"},{"key":"e_1_2_9_3_1","unstructured":"American Association of Retired Persons. 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