Previous research has shown that immigrants living in their own ethnic enclave are at decreased risk of poor health outcomes, but this question has not been studied in relation to gestational diabetes, an important early marker of lifecourse cardiovascular health. We ascertained gestational diabetes, census tract of residence, and individual-level covariates for Sub-Saharan African, Chinese, South Central Asian, Non-Hispanic Caribbean, Dominican, Puerto Rican, Mexican, and Central and South American migrant women using linked birth-hospital discharge data for 89,703 singleton live births in New York City for the years 2001-2002. Using 2000 census data, for each immigrant group we defined a given census tract as part of an ethnic enclave based on the population distribution for the corresponding ethnic group. We estimated odds ratios for associations between living in an ethnic enclave and risk of gestational diabetes adjusted for neighborhood deprivation, percent commercial space, education, age, parity, and insurance status, using multilevel logistic regression. Overall, we found no effect of ethnic enclave residence on gestational diabetes in most immigrant groups. Among South Central Asian and Mexican women, living in a residential ethnic enclave was associated with an increased odds of gestational diabetes. Several explanations are proposed for these findings. Mechanisms explaining an increased risk of gestational diabetes in South Central Asian and Mexican ethnic enclaves should be examined. © 2014 Elsevier Ltd.

Immigrant Neighborhood Pregnancy gestational diabetes

Diabetes, Gestational China Puerto Rico educational status immigrant Asian Chinese Sub-Saharan Africa pregnancy diabetes mellitus insurance demography health risk enclave human South American epidemiology risk assessment Ethnic Groups statistics and numerical data ethnic group controlled study Central America African Central American ethnology Dominican (Dominica) neighborhood Residence Characteristics Dominican Republic United States cluster analysis Young Adult womens status migrant Humans cardiovascular disease New York [New York (STT)] Emigrants and Immigrants female South America Mexican population distribution pregnancy high risk population Caribbean Islands Article adult diabetes Puerto Rican age New York City Mexico [North America] age distribution parity ethnicity disease association New York [United States] immigrant population