The association between neighborhood context, allostatic load, and metabolic dysfunction-associated steatosis liver disease in Mexican-origin farmworkers along the Southern Arizona US/Mexico border

Background

Mexican-origin farmworkers experience disproportionately high rates of chronic diseases which increase their risk for metabolic dysfunction-associated steatosis liver disease (MASLD). While it has been found that neighborhood-level factors influence health as much as individual-level characteristics, including allostatic load (ALoad), these factors have been less examined in MASLD research. This study examined the association between perceived neighborhood environment, ALoad, and MASLD. It also examined whether ALoad is a mediator between perceived neighborhood context and MASLD.

Methods

Multivariable binary logistic and linear regressions were fitted to analyze data from a community-based sample of 151 Mexican-origin farmworkers residing in the Southern Arizona border region. Self-reported data on six dimensions of neighborhood context was collected. Allostatic load was calculated as an index of physiological dysregulation. Hepatic steatosis and fibrosis were assessed by liver stiffness measurements (LSM) and controlled attenuation parameter (CAP) through FibroScan®. MASLD were identified as having a CAP score of ≥288 dB/m.

Results

The mean age was 49.7 ± 14.1 years, mean BMI 31.9 ± 6.5 kg/m2, and 9.9 % had type 2 diabetes. The mean CAP score was, M = 265.8 ± 61.0 with 41.1 % of the sample exhibiting MASLD status. Perceived neighborhood violence was not associated with MASLD status; however, it was negatively associated with ALoad, (p = 0.003). ALoad was a negative mediator between perceived violence and MASLD status (p = 0.004).

Conclusion

The results of this study inform the development of culturally relevant strategies to reduce Mexican-origin farmworkers’ risk for MASLD that are highly responsive to the structural and systemic forces that shape their lived experience.