Role of birthplace in chronic disease in adults and very old individuals: National cohorts in the UK and USA, 2009-2010

Objectives: To understand the role of birthplace in chronic disease in adults and very old individuals. Study design: Two national and population-based studies (UK Longitudinal Household Survey and US National Health and Nutrition Examination Surveys) in 2009-2010 were included. Method: Information on demographics, lifestyle factors and self-reported chronic diseases was obtained by household interview. Analyses included Chi-squared test, t-test and logistic regression modelling. Results: In the UK, there were more cases of heart failure and myocardial infarction in adults (aged 20-79 years) born in Scotland, and more cases of coronary heart disease in adults born in Northern Ireland. There were fewer cases of asthma, depression and hypothyroidism in adults born in Northern Ireland and not born in the UK, and fewer cases of cancer, chronic bronchitis and epilepsy in adults not born in the UK. In USA, there were fewer cases of asthma, cancer, chronic bronchitis, heart failure and heart attack, but more cases of liver disease in adults born in Mexico. Similarly, there were fewer cases of asthma, cancer and chronic bronchitis in adults born in other Spanish or non-Spanish countries, although there were more cases of liver disease in other Spanish-born adults and more cases of diabetes in other non-Spanish-born adults. In very old (≥80 years) individuals, there were more cases of chronic bronchitis in those born in Wales, more cases of myocardial infarction in those born in Northern Ireland, and more cases of diabetes and liver disease in those not born in the UK. Overall, diabetes was more common in foreign-born adults, and respiratory illness and cancer were more common in native-born adults. Conclusions: It is suggested that future health policy and public health programmes should consider birthplace.