Co-occurrence of Chronic Disease Lifestyle Risk Factors in Middle-Aged and Older Immigrants: A Cross-Sectional Analysis of 264,102 Australians

Prev Med. 2015 Dec;81:209-15. doi: 10.1016/j.ypmed.2015.09.004. Epub 2015 Sep 13.


Background: The way in which lifestyle risk factors for chronic disease co-occur among people with different cultural backgrounds is largely unknown.

Methods: This study investigated chronic disease risk among immigrants aged ≥45 years in Australia by combining common lifestyle risk factors into a weighted chronic disease risk index (CDRI). Among 64,194 immigrants and 199,908 Australian-born participants in the 45 and Up Study (2006-2009), Poisson regression was used to derive relative risks (RR) and 95% confidence intervals (CI) for five risk factors (smoking, alcohol use, overweight/obesity, physical activity, diet) by place of birth adjusting for socio-demographic characteristics. Multiple linear regression was used to determine adjusted mean differences (AMDs) in CDRI score by place of birth and years lived in Australia.

Results: Immigrants had higher RRs of smoking than Australian-born participants, lower RRs of excessive alcohol consumption and overweight/obesity, and no difference in RR for physical inactivity and insufficient fruit/vegetable intake. Participants born in the Middle East/North Africa (AMD 3.5, 95% CI 2.7, 4.3), Eastern/Central Europe (1.3, 0.8, 1.9), and Western Europe (0.5, 0.1, 0.8) had higher mean CDRI scores than Australian-born participants, while participants born in East Asia (-7.2, -7.8, -6.6), Southeast Asia (-6.6, -7.2, -6.1), Central/South Asia (-3.1, -4.0, -2.1), Sub-Saharan Africa (-1.9, -2.6, -1.2) and the United Kingdom/Ireland (-0.2, -0.5, 0.0) had lower scores. CDRI score among immigrants generally approximated that of Australian-born participants with greater years lived in Australia.

Conclusions: This study reveals differences in potential risk of chronic disease among different immigrant groups in Australia.

Keywords: Alcohol consumption; Australia; Body mass index; Chronic disease; Fruit; Immigrants; Physical activity; Smoking; Vegetables.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Alcohol Drinking / epidemiology*
  • Australia
  • Body Mass Index
  • Chronic Disease*
  • Cross-Sectional Studies
  • Diet* / statistics & numerical data
  • Emigrants and Immigrants / statistics & numerical data*
  • Exercise*
  • Female
  • Global Health
  • Humans
  • Life Style
  • Linear Models
  • Male
  • Middle Aged
  • Obesity / epidemiology*
  • Risk Factors
  • Smoking / epidemiology*