"Everything is Different:" Exploring Changes to Neighborhood Context, Physical Activity, and Food Behaviors Among Immigrants Settling in Emerging U.S. Latino Communities

United States (U.S.) Latinos face high risks of chronic conditions such as diabetes and cardiovascular disease. Foreign-born Latinos in nontraditional immigrant-receiving communities (“emerging Latino communities”) may face unique barriers to engaging in healthy behaviors that can prevent disease. Upon arrival to the U.S., immigrant Latinos experience changes to their built and social environments that alter eating habits, social networks, physical activity options, and access to care in ways that may be unique in areas with small Latino populations. The Context Matters study in St. Louis, MO and Birmingham, AL aimed to characterize these changes to daily context and identify the mechanisms behind changes to health behavior after immigration. From September 2022 – April 2024, we conducted semi-structured interviews with service providers to local Latino communities in St. Louis and Birmingham and interviews as well as facilitated focus groups with Latinos who had immigrated to either city within ten years. Using structural vulnerability and ‘necessity versus choice-based physical activity models’ frameworks, we developed interview and focus group guides to ask participants about changes to context and daily living following immigration from Latin America. We used a hybrid deductive-inductive approach for thematic analysis. Across both study sites, we conducted 21 interviews with community service providers and facilitated focus groups or interviews with 25 Latino immigrants. Participants described common differences between Latin American places of origin and the two emerging communities: in active living opportunities, feelings of neighborhood cohesion, and food and healthcare environments. Social class and norms additionally informed views on physical activity, transportation, diet, and care-seeking. This study provides additional depth to literature on chronic disease prevention among immigrant Latinos by identifying unique challenges to healthy behavior in emerging Latino communities. Our results support health lifestyles theories, finding that social class, economic stratification, place, and culture are necessary constructs for understanding changes to individual health behavior. Future research in emerging immigrant communities may benefit from assessing how patterns of health behaviors vary among subgroups and measuring environmental, social, and political contexts longitudinally and at multiple levels of effect.