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Ryu S, Morey BN, Shi Y, Lee S. Acculturation and self-rated health among Chinese and Korean immigrants aged 49 to 75. Front Public Health 2023; 11:1272428. [PMID: 38179574 PMCID: PMC10766358 DOI: 10.3389/fpubh.2023.1272428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 12/04/2023] [Indexed: 01/06/2024] Open
Abstract
Background Given the rapidly growing Asian populations in the U.S. due to immigration, and the aging demographic of Asian immigrants, it is crucial to understand how acculturation shapes health among older adult Asian immigrants. We study the relationship between acculturation and self-rated health (SRH) and moderating roles of age and Asian subgroup. Methods Our cross-sectional study consisted of 200 Chinese and 200 Korean immigrants aged 49-75 living in Baltimore-Washington DC metropolitan area, who were recruited from primary care physicians' clinics in Maryland and Northern Virginia. The participants completed the survey either in-person or by phone in their preferred language. Multidimensional proxies were used to measure acculturation: years living in the U.S. (≥23 years, <23 years), English proficiency (fluently/well, so-so, poorly/not at all), and ethnic identity (very Asian, mostly Asian, bicultural/westernized). SRH was measured using the question "How would you rate your general health?" (excellent/very good/good, fair/poor). Poisson regression models with robust error variance examined associations between acculturation and SRH, accounting for socioeconomic and health insurance factors. Results Speaking English so-so and fluently/well had 0.73 (95% confidence intervals (CI): 0.55-0.97) and 0.51 (95% CI: 0.30-0.87) times the prevalence of having fair or poor SRH compared to speaking English poorly/not at all, respectively. The magnitudes and statistical significance of these associations were stronger among Chinese participants than Korean participants. Moreover, individuals who self-identified as bicultural/westernized had 0.63 times the prevalence of having fair or poor SRH (95% CI: 0.43-0.92) as those who self-identified as very Asian. The association was more pronounced among older participants (≥58) compared to younger participants (<58). Conclusion Further research should identify the possible mechanisms linking acculturation with health to find effective strategies to enhance health among aging Asian immigrant populations.
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Affiliation(s)
- Soomin Ryu
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Brittany N. Morey
- Program in Public Health, Department of Health, Society, and Behavior, University of California, Irvine, Irvine, CA, United States
| | - Yuxi Shi
- Department of Medicine, School of Medicine, University of California, Irvine, Irvine, CA, United States
| | - Sunmin Lee
- Department of Medicine, School of Medicine, University of California, Irvine, Irvine, CA, United States
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Mou T, Brown O, Dong S, Abbasy S, Leung V, Simon M. Exploratory mixed methods study on care-seeking behaviors of Asian Americans with pelvic floor symptoms. Int Urogynecol J 2023; 34:2557-2564. [PMID: 37285090 PMCID: PMC10246519 DOI: 10.1007/s00192-023-05574-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 05/07/2023] [Indexed: 06/08/2023]
Abstract
INTRODUCTION AND HYPOTHESIS The objective was to evaluate whether younger age was associated with noncare-seeking behavior among Asian Americans with pelvic floor symptoms, and secondarily, to explore multilevel factors that may contribute to noncare-seeking behavior in this population. METHODS We performed a concurrent mixed methods study and heterogeneously sampled Asian Americans with urinary incontinence, urgency-frequency, vaginal bulge, or anal incontinence. We stratified the participants into two groups, care seekers vs noncare seekers. Using Anderson's model as the main framework, we administered validated questionnaires and conducted semi-structured interviews to explore factors associated with care-seeking behaviors. RESULTS Seventy-eight surveys and 20 interviews were completed and analyzed. Most participants reported urinary leakage (67%), followed by urinary urgency-frequency (50%), anal incontinence (18%), and vaginal bulge (17%). The mean age of the study cohort was 46.1 ± 16.2 years. We found noncare seekers to be younger and with an increased proportion of lifetime spent in the USA than care seekers. When controlling for age, proportion of lifetime spent in the USA, symptom severity, and individual-level resources, both younger age and increased proportion of lifetime spent in USA remained independently associated with noncare-seeking behavior. From qualitative data, we found that noncare seekers often experienced anti-Asian racism across workplace, neighborhoods, and health care settings. Additionally, noncare seekers also reported symptom minimization and decreased self-efficacy when coping with their pelvic floor symptoms. CONCLUSIONS We found that one's age and proportion of lifetime spent in the USA may affect the extent of exposure to anti-Asian racism that is associated with symptom minimization, increased perceived barrier, and noncare-seeking behavior.
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Affiliation(s)
- Tsung Mou
- Urogynecology and Pelvic Reconstructive Surgery, Tufts Medical Center, Boston, MA, USA.
| | - Oluwateniola Brown
- Division of Female Pelvic Medicine and Reconstructive Surgery, Northwestern University, Chicago, IL, USA
| | - Siyuan Dong
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
| | - Shameem Abbasy
- Department of Obstetrics and Gynecology, Swedish Hospital Part of NorthShore, Chicago, IL, USA
| | - Vania Leung
- Department of Academic Internal Medicine and Geriatrics, University of Illinois at Chicago, Chicago, IL, USA
| | - Melissa Simon
- Department of Obstetrics and Gynecology, Northwestern University, Chicago, IL, USA
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Shah MK, Gandrakota N, Gujral UP, Islam N, Narayan KMV, Ali MK. Cardiometabolic Risk in Asian Americans by Social Determinants of Health: Serial Cross-sectional Analyses of the NHIS, 1999-2003 to 2014-2018. J Gen Intern Med 2023; 38:571-581. [PMID: 36418646 PMCID: PMC9971386 DOI: 10.1007/s11606-022-07933-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 11/01/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Diabetes and hypertension are common in Asian Americans and vary by subgroup. There may be further variation by social determinants of health (SDOHs), but few studies have examined this previously. OBJECTIVE To examine the associations of SDOHs and diabetes and hypertension within and across Asian subgroups in the USA DESIGN: Series cross-sectional analyses SETTING: National Health Interview Surveys (NHIS) from 1999 to 2018 PARTICIPANTS: Asian-American adults (Chinese, Filipino, Asian Indian, and Other Asian [Korean, Vietnamese, Japanese, and other]) MEASUREMENTS: Self-reported diabetes and hypertension prevalence in pooled 5-year increments over 1999-2018 and multivariable regression models to assess the adjusted prevalence of diabetes or hypertension by poverty, marital status, education, and years in the USA, adjusting for age, sex, BMI, and health insurance status RESULTS: From 1999-2003 to 2014-2018, the age- and sex-adjusted prevalence of diabetes increased for Other Asians (absolute change: 4.6%) but not for other subgroups; age- and sex-adjusted hypertension prevalence significantly increased for Asian Indians and Other Asians (absolute change: 5-7.5%). For Filipinos, high school education or less was associated with an increase in diabetes prevalence over time (difference from 1999-2003 to 2014-2018: +6.0 (95% CI: 2.0-10.0)), while for Asian Indians, college education or higher was associated with an increase in diabetes prevalence for the same period (difference: +2.7 (95% CI: 0.01-5.4). Differences over the 2 time periods (1999-2003 and 2014-2018) show that Filipino and Other Asians, who lived in the USA for ≥10 years, increased in diabetes prevalence. Similar variations in associations of SDOHs by Asian subgroup were seen for hypertension. LIMITATIONS Self-reported primary outcomes and multi-year data were pooled due to small sample sizes. CONCLUSIONS The influence of SDOHs on cardiometabolic risk is not uniform among Asian Americans, implying tailored strategies may be needed for different population subgroups. PRIMARY FUNDING SOURCE NIH.
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Affiliation(s)
- Megha K Shah
- Department of Family and Preventive Medicine, Emory University School of Medicine, Dunwoody, GA, USA.
| | - Nikhila Gandrakota
- Department of Family and Preventive Medicine, Emory University School of Medicine, Dunwoody, GA, USA
| | - Unjali P Gujral
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Nadia Islam
- Department of Population Health, NYU School of Medicine, New York, NY, USA
| | - K M Venkat Narayan
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Mohammed K Ali
- Department of Family and Preventive Medicine, Emory University School of Medicine, Dunwoody, GA, USA
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
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Nguyen JP, Hoang D, Zhou K, Harvey DJ, Dam Q, Meyer OL. Associations between caregiving status, acculturation, and psychological distress in a diverse sample. Int Psychogeriatr 2022:1-9. [PMID: 36468427 PMCID: PMC10239787 DOI: 10.1017/s1041610222000928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
OBJECTIVES Increasingly diverse caregiver populations have prompted studies examining culture and caregiver outcomes. Still, little is known about the influence of sociocultural factors and how they interact with caregiving context variables to influence psychological health. We explored the role of caregiving and acculturation factors on psychological distress among a diverse sample of adults. DESIGN Secondary data analysis of the California Health Interview Survey (CHIS). PARTICIPANTS The 2009 CHIS surveyed 47,613 adults representative of the population of California. This study included Latino and Asian American Pacific Islander (AAPI) caregivers and non-caregivers (n = 13,161). MEASUREMENTS Multivariate weighted regression analyses examined caregiver status and acculturation variables (generational status, language of interview, and English language proficiency) and their associations with psychological distress (Kessler-6 scale). Covariates included caregiving context (e.g., support and neighborhood factors) and demographic variables. RESULTS First generation caregivers had more distress than first-generation non-caregivers (β=0.92, 95% CI: (0.18, 1.65)); the difference in distress between caregivers and non-caregivers was smaller in the third than first generation (β=-1.21, 95% CI: (-2.24, -0.17)). Among those who did not interview in English (β=1.17, 95% CI: (0.13, 2.22)) and with low English proficiency (β=2.60, 95% CI: (1.21, 3.98)), caregivers reported more distress than non-caregivers. CONCLUSIONS Non-caregivers exhibited the "healthy immigrant effect," where less acculturated individuals reported less distress. In contrast, caregivers who were less acculturated reported more distress.
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Affiliation(s)
- Julia P. Nguyen
- Department of Neurology, University of California, Davis, School of Medicine, Sacramento, CA 95817, USA
| | - Diane Hoang
- Foresight Mental Health, Oakland, CA 94612, USA
| | - Kieran Zhou
- Shanghai Unionlab Co., Ltd. Shanghai, CN, USA
| | - Danielle J. Harvey
- Department of Public Health Sciences, University of California, Davis, CA 95616, USA
| | - QuynhAnh Dam
- San Francisco State University, San Francisco, CA 94132, USA
| | - Oanh L. Meyer
- Department of Neurology, University of California, Davis, School of Medicine, Sacramento, CA 95817, USA
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Kwan PP, Watts J, Prudencio JM, Chu L, Co DE, Chen E. Differences in diabetes risk factors among Asian Americans. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-022-01779-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Medina HN, Callahan KE, Koru-Sengul T, Maheshwari S, Liu Q, Goel N, Pinheiro PS. Elevated breast cancer mortality among highly educated Asian American women. PLoS One 2022; 17:e0268617. [PMID: 35584182 PMCID: PMC9116645 DOI: 10.1371/journal.pone.0268617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 05/04/2022] [Indexed: 11/17/2022] Open
Abstract
Background Postmenopausal breast cancer (PMBC) is the most commonly diagnosed and the second leading cause of cancer death among women in the US. Research examining the association between PMBC and education level has been inconsistent; no study in the US has examined how educational level impacts PMBC mortality in Asian American women, a largely immigrant population with above-average educational attainment. Methods California Vital Statistics data from 2012–2017 were analyzed to derive age-adjusted mortality rate ratios (MRRs) by education level (associates degree or above referred to as “higher education”, high school, less than high school) and race [Non-Hispanic White (NHW), Asian/Pacific Islander (Asian), and its two largest subpopulations: Chinese and Filipino] from negative binomial regression models. Results PMBC mortality for both NHWs and Asians was greater among women with higher education compared to those who did not complete high school: NHWs had 22% higher PMBC mortality (MRR 1.22; 95% CI: 1.14–1.31) and Asians had 2.6 times greater PMBC mortality (MRR 2.64; 95% CI: 2.32–3.00) than their counterparts who did not complete high school. Asians in the lowest education level had 70% lower mortality than NHWs (MRR 0.30; 95% CI: 0.27–0.34). This mortality advantage among Asians was greatly reduced to only 27% lower among the highest educated (MRR 0.73; 95% CI: 0.68–0.78). For higher educated Filipina women, no mortality advantage was evident compared to NHWs (MRR 0.96; 95% CI: 0.88–1.05). Conclusion PMBC mortality for higher educated Asian women is elevated in comparison to their counterparts with less education. Given that PMBC survival is greater among those with higher education, our findings strongly suggest an excess in the incidence of PMBC (more than double) among higher educated Asian women; this warrants more research into potentially modifiable causes of PMBC in this burgeoning population.
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Affiliation(s)
- Heidy N. Medina
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - Karen E. Callahan
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada Las Vegas, Las Vegas, Nevada, United States of America
| | - Tulay Koru-Sengul
- Sylvester Comprehensive Cancer Center, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - Sfurti Maheshwari
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada Las Vegas, Las Vegas, Nevada, United States of America
| | - Qinran Liu
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - Neha Goel
- Division of Surgical Oncology, Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - Paulo S. Pinheiro
- Sylvester Comprehensive Cancer Center, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, United States of America
- * E-mail:
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Oh KM, Park B, Jacobsen KH. A Qualitative Analysis of Barriers to Colorectal Cancer Screening among Korean Americans. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:261-270. [PMID: 31664665 DOI: 10.1007/s13187-019-01621-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Colorectal cancer (CRC) is the second most-commonly diagnosed cancer among Korean Americans after breast cancer, with incidence rates exceeding that of lung, prostate, and stomach cancers. However, CRC screening rates are lower among Korean Americans than the general U.S. population. To understand barriers to screening in this population, we conducted 11 focus groups with 51 Korean Americans ages 40+ in the Washington, DC, metropolitan area between 2011 and 2016. Our analysis used the Health Belief Model as a framework. Motivators to seek screening include a family or personal history of cancer or gastrointestinal disease (high perceived susceptibility), knowing people with CRC (high severity), favorable test results reducing worry (high benefits), and physician recommendations (cues to action). Barriers to screening include the common misperception that Korean lifestyles prevent CRC (low susceptibility), the belief that cancer is normal for older adults (low severity), the assumption that screening only benefits symptomatic people (low benefits), the costs and potential risks of testing along with a preference for traditional Korean approaches to wellness (high barriers), and lack of health insurance (low self-efficacy). Interventions seeking to increase the rate of cancer screening in the Korean American community will benefit from emphasizing the burden from CRC among Korean Americans (increasing perceived susceptibility to CRC), explaining that colonoscopies can prevent CRC rather than just diagnosing it (increasing perceived benefits of screening), reducing anxieties about test procedures and embarrassment (reducing perceived barriers to screening), and improving clinical communication (improving cues to action and self-efficacy).
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Affiliation(s)
- Kyeung Mi Oh
- School of Nursing, George Mason University, 4400 University Dr., Fairfax, VA, 22032, USA.
| | - Byeonghwa Park
- School of Management and Marketing, Kean University, 1000 Morris Ave, Union, NJ, 07083, USA
| | - Kathryn H Jacobsen
- Department of Global & Community Health, George Mason University, 4400 University Dr., Fairfax, VA, 22030, USA
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Healthy immigrant effect in non-European Union immigrants in Portugal: after a decade of (non-)integration! Public Health 2020; 186:95-100. [PMID: 32795770 DOI: 10.1016/j.puhe.2020.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 06/26/2020] [Accepted: 07/03/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVES The aim of the study was to characterise the existence of the healthy immigrant effect (HIE; better health initially, worsening with an increase in the length of residence) in a big city from a Western European country, particularly in a non-European Union immigrant population. STUDY DESIGN This is a cross-sectional study. METHODS We used data from the National Health Survey 2014 to compare the health status of the immigrant and Portuguese populations with different lengths of residence. After descriptive statistics, binary logistic regressions models, with adjusted levels and 95% confidence intervals, were used. RESULTS Immigrants were healthier than the Portuguese population (<10 years: odds ratio [OR] = 0.07; 95% confidence interval [CI] = [0.01; 0.51]; ≥10 years: OR = 0.62; 95% CI = [0.19; 2.03]), but had an increased likelihood of suffering from chronic diseases and risk behaviours with the increase in their length of stay in Portugal. After living in Portugal for more than 10 years, the immigrants showed no statistical difference in the main health indicators. CONCLUSIONS There was a tendency for the health status of immigrants to deteriorate over 10 years of residence in Portugal. To better understand the reasons behind the HIE, specific and tailored studies must be developed.
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Kroenke CH, Le GM, Conroy SM, Canchola AJ, Shariff-Marco S, Gomez SL. Egocentric social networks, lifestyle behaviors, and body size in the Asian Community Health Initiative (CHI) cohort. PLoS One 2020; 15:e0232239. [PMID: 32374741 PMCID: PMC7202641 DOI: 10.1371/journal.pone.0232239] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 04/10/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Social networks have been shown to influence lifestyle behaviors in non-Latinx white (NLW) populations. We examined their influence in Asian American, Native Hawaiian and Pacific Islander (AANHPI) women. METHODS We included 477 AANHPI women from the Asian Community Health Initiative Study who provided egocentric (degree, density, composition) and epidemiologic (size, types of ties) social network data and data on alcohol intake, physical activity, smoking, diet, and body size. We used logistic regression to evaluate associations of social network measures and dichotomous outcomes, and linear regression for continuous outcomes. RESULTS In multivariable-adjusted analyses, higher degree and/or proportion of friends were significantly related to higher Western diet, higher odds of any alcohol consumption, and lower odds of physical inactivity and body mass index (BMI)≥23 kg/m2. Additionally, a higher proportion of NLW in women's networks was related to lower Asian diet but also lower waist size. Community participation was related to higher Western diet and lower Asian diet. By contrast, degree and/or proportion of relatives were positively related to BMI, waist size and to a higher odds of BMI≥23 kg/m2 and of ever smoking 100 cigarettes. Being married was related to fewer alcoholic drinks per week and higher Asian diet. A higher density of relationships with frequent contact was also associated with higher Asian diet. CONCLUSIONS AANHPI women with larger proportions of friends and NLWs in their networks had more Western health behaviors and smaller body size. Norms for health behaviors and body size may be influenced by the size, composition, and structure of social networks, relevant to chronic disease prevention.
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Affiliation(s)
- Candyce H. Kroenke
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States of America
| | - Gem M. Le
- Division of General Internal Medicine, Department of Medicine, UCSF Center for Vulnerable Populations, UCSF, San Francisco, CA, United States of America
| | - Shannon M. Conroy
- Division of General Internal Medicine, Department of Medicine, UCSF Center for Vulnerable Populations, UCSF, San Francisco, CA, United States of America
| | - Alison J. Canchola
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, United States of America
- Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, United States of America
| | - Salma Shariff-Marco
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, United States of America
- Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, United States of America
| | - Scarlett Lin Gomez
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, United States of America
- Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, United States of America
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Fernández-Niño JA, Vásquez-Rodríguez AB, Flórez-García VA, Rojas-Botero ML, Luna-Orozco K, Navarro-Lechuga E, Acosta-Reyes JL, Rodríguez Pérez DA. [Lifestyles and health status of migrants in a settlement of Barranquilla, Colombia, 2018]. ACTA ACUST UNITED AC 2019; 20:530-538. [PMID: 30843992 DOI: 10.15446/rsap.v20n4.75773] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 07/10/2018] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To describe the lifestyles and health status of returning Venezuelan and Colombian migrants in Villa Caracas, Barranquilla, in 2018. METHODS Descriptive, cross-sectional study with systematic sampling of dwellings. 229 people over 15 years of age from 90 homes were included. RESULTS Differences were found in the routes to arrive, commuting times and stay in the settlement between Venezuelan and returning Colombian migrants. Housing conditions and access to public services are limited: less than half of the dwellings have access to aqueduct, sewerage and bathrooms. In general, self-reported health status of migrants is very good or good and the prevalence of noncommunicable diseases was relatively low, with the exception of high blood pressure. Most of the people who consulted the emergency department reported effective access. Clinically significant depressive symptoms were found in 20% of the surveyed population. CONCLUSIONS The migrants of Villa Caracas are under high social vulnerability conditions given their economic and environmental conditions. Despite their lack of enrollment in the Colombian health system, they reported access to emergency care.
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Affiliation(s)
- Julián A Fernández-Niño
- JF: MD. M. Sc. Salud Pública; M. Sc. Bioestadística Ph. D. Epidemiología. Departamento de Salud Pública, Universidad del Norte. Barranquilla, Colombia.
| | - Ana B Vásquez-Rodríguez
- AV: Enfermería. M. Sc. Infecciones y Salud en el Trópico. Facultad de Medicina, Universidad Nacional de Colombia. Bogotá, Colombia.
| | - Víctor A Flórez-García
- VF: Biología. M. Sc. Epidemiología. Departamento de Salud Pública, Universidad del Norte. Barranquilla, Colombia.
| | - Maylen L Rojas-Botero
- MR: Gerencia en Sistemas de Información en Salud. M. Sc. Epidemiología; Ph. D.(c) Epidemiología. Facultad Nacional de Salud Pública, Universidad de Antioquia. Medellín, Colombia.
| | - Karen Luna-Orozco
- KL: MD. Esp. Medicina Interna. Departamento de Salud Pública, Universidad del Norte. Barranquilla, Colombia.
| | - Edgar Navarro-Lechuga
- EN: MD. M. Sc. Epidemiología. Departamento de Salud Pública, Universidad del Norte. Barranquilla, Colombia.
| | - Jorge L Acosta-Reyes
- JA: MD. M. Sc. Epidemiología Clínica. Departamento de Salud Pública, Universidad del Norte. Barranquilla, Colombia.
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Cramm JM, Nieboer AP. Acculturation is associated with older Turkish immigrants' self-management abilities. BMC Public Health 2019; 19:1228. [PMID: 31488086 PMCID: PMC6727562 DOI: 10.1186/s12889-019-7471-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 08/11/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The few previous studies investigating acculturation and self-management have suggested that increased participation in (or adaptation to) the host culture is associated with better health and disease management. However, research on the relationship between acculturation strategies (attachment to the Dutch and Turkish cultures) and broader self-management abilities among older Turkish immigrants in the Netherlands is lacking. This study aimed to investigate this relationship in this population. METHODS Turkish immigrants aged > 65 years and residing in Rotterdam, the Netherlands (n = 2350), were identified using the municipal register. In total, 680 respondents completed the questionnaire (32% response rate). RESULTS The average age of the respondents was 72.90 (standard deviation, 5.02; range, 66-95) years and 47.6% of respondents were women. The majority (80.3%) of respondents reported having low educational levels. Women, single individuals, less-educated respondents, and those with multimorbidity experienced lower levels of attachment to the Dutch culture and reported poorer self-management abilities. Slightly stronger relationships were found between self-management and attachment to the Dutch culture than attachment to the Turkish culture. Multimorbidity negatively affected the self-management abilities of older Turkish people living in the Netherlands. CONCLUSIONS The study findings indicate that especially attachment to the Dutch culture matters for the self-management abilities of older Turkish immigrants in the Netherlands. Given the high prevalence of multimorbidity in this population, investment in their self-management abilities is expected to be beneficial. Special attention is needed for women, single individuals, less-educated people, and those with multimorbidity. Interventions aiming to better integrate these groups into Dutch society are also expected to be beneficial for their self-management abilities.
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Affiliation(s)
- Jane M Cramm
- Department of Social Medical Sciences, Erasmus School of Health Policy and Management, Erasmus University Rotterdam, P.O. Box 1738, 3000, Rotterdam, DR, The Netherlands.
| | - Anna P Nieboer
- Department of Social Medical Sciences, Erasmus School of Health Policy and Management, Erasmus University Rotterdam, P.O. Box 1738, 3000, Rotterdam, DR, The Netherlands
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Toselli S, Gualdi-Russo E, Mazzuca P, Campa F. Ethnic differences in body composition, sociodemographic characteristics and lifestyle in people with type 2 diabetes mellitus living in Italy. Endocrine 2019; 65:558-568. [PMID: 31368082 DOI: 10.1007/s12020-019-02031-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 07/19/2019] [Indexed: 01/02/2023]
Abstract
This study aimed to compare immigrants and Italian natives with type 2 diabetes mellitus (DM2) in terms of anthropometric parameters and lifestyle-related characteristics and to investigate the relationship between ethnicity and glycemic control in men and women with DM2 living in Italy. The sample included 100 immigrants (55 Albanians and 45 Africans) and 100 Italians, followed by the Public Health Clinics of Rimini. The association of ethnicity with sex, socioeconomic status, anthropometric and hematological characteristics, and lifestyle were examined. In addition, differences among groups in glycemic control were evaluated. Among males, African participants presented significantly lower values than other groups in adiposity parameters and triglycerides. The highest percentage of obesity and of normal weight was found in Italians and in Africans, respectively. Among females, there were scanty differences, but Italians presented higher WHR values than the other groups. No statistical differences appeared in hematological parameters among groups. There were no significant differences in glycemic control among groups and sexes. Also considering the differences between subjects with optimal (L) or nonoptimal (H) glycemic control, the differences in lifestyle, anthropometric, and hematological variables remained scarce. Among all groups, significantly higher values of glucose were detected in H than in L. A similar condition appeared for triglycerides in males. Immigrant and native Italian diabetics did not present any difference in their clinical characteristics, but Italians generally presented worst lifestyle habits. The percentage of subjects with poor metabolic control of diabetes was not low, but similar in immigrants and natives.
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Affiliation(s)
- Stefania Toselli
- Departments of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Emanuela Gualdi-Russo
- Department of Biomedical Sciences and Surgical Specialties, University of Ferrara, Ferrara, Italy
| | - Paolo Mazzuca
- Unit of Internal Medicine, Diabetes and Metabolic Disease Center, Romagna Health District, Rimini, Italy
| | - Francesco Campa
- Departments of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
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Serafica R, Thomas Reyes A. Acculturative Stress as Experienced by Filipino Grandparents in America: A Qualitative Study. Issues Ment Health Nurs 2019; 40:421-430. [PMID: 30917066 DOI: 10.1080/01612840.2018.1543740] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The aim of this qualitative study was to describe the factors that contribute to acculturative stress among recent older adult immigrants (N = 40) who co-reside with their children in the USA. Results of the qualitative analysis yielded three main themes with corresponding subthemes. The main themes were (a) aging in America, (b) losing sense of agency, and (c) feeling alienated/Being needed. Nurses and practitioners who interact with grandparents who are recent immigrants need to explore issues related to isolation and emotional distress. Assisting these individuals in the development of supportive environments may help moderate their acculturative stress.
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Affiliation(s)
- Reimund Serafica
- a School of Nursing , University of Nevada, Las Vegas , Las Vegas , Nevada , USA
| | - Andrew Thomas Reyes
- a School of Nursing , University of Nevada, Las Vegas , Las Vegas , Nevada , USA
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Ellis L, Abrahão R, McKinley M, Yang J, Somsouk M, Marchand LL, Cheng I, Gomez SL, Shariff-Marco S. Colorectal Cancer Incidence Trends by Age, Stage, and Racial/Ethnic Group in California, 1990–2014. Cancer Epidemiol Biomarkers Prev 2018; 27:1011-1018. [DOI: 10.1158/1055-9965.epi-18-0030] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 03/06/2018] [Accepted: 05/10/2018] [Indexed: 12/18/2022] Open
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Sentell T, Ahn HJ, Miyamura J, Taira DA. Thirty-Day Inpatient Readmissions for Asian American and Pacific Islander Subgroups Compared With Whites. Med Care Res Rev 2018; 75:100-126. [PMID: 28885123 PMCID: PMC5664159 DOI: 10.1177/1077558716676595] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Asian and Pacific Islander (API) 30-day potentially preventable readmissions (PPRs) are understudied. Hawaii Health Information Corporation data from 2007-2012 statewide adult hospitalizations ( N = 495,910) were used to compare API subgroup and White PPRs. Eight percent of hospitalizations were PPRs. Seventy-two percent of other Pacific Islanders, 60% of Native Hawaiians, and 52% of Whites with a PPR were 18 to 64 years, compared with 22% of Chinese and 21% of Japanese. In multivariable models including payer, hospital, discharge year, residence location, and comorbidity, PPR disparities existed for some API subpopulations 65+ years, including Native Hawaiian men (odds ratio [OR] = 1.14; 95% confidence interval [CI] = 1.04-1.24), Filipino men (OR = 1.19; 95% CI = 1.04-1.38), and other Pacific Islander men (OR = 1.30; 95% CI = 1.19-1.43) and women (OR = 1.23; 95% CI = 1.02-1.51) compared with Whites, while many API groups 18 to 64 years had significantly lower PPR odds. Distinct PPR characteristics across API subpopulations and age groups can inform policy and practice. Further research should determine why elderly API have higher PPR rates, while nonelderly rates are lower.
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Affiliation(s)
| | | | - Jill Miyamura
- Hawaii Health Information Corporation, Honolulu, HI, USA
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The Healthy Immigrant Effect on Mental Health: Determinants and Implications for Mental Health Policy in Spain. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2018; 43:616-27. [PMID: 26143493 DOI: 10.1007/s10488-015-0668-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Since the mid-1990s, Spain has started to receive a great number of migrant populations. The migration process can have a significantly negative impact on mental health of immigrant population and, consequently, generate implications for the delivery of mental health services. The aim of this article is to provide empirical evidence to demonstrate that the mental health of immigrants in Spain deteriorates the longer they are resident in the country. An empirical approach to this relationship is carried out with data from the National Survey of Health of Spain 2011-2012 and poisson and negative binomial models. Results show that immigrants who reside <10 years in Spain appear to be in a better state of mental health than that observed for the national population. Studying health disparities in the foreign population and its evolution are relevant to ensure the population's access to health services and care. The need for further research is especially true in the case of the immigrant population's mental health in Spain because there is scant evidence available on their situation.
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Jin K, Gullick J, Neubeck L, Koo F, Ding D. Acculturation is associated with higher prevalence of cardiovascular disease risk-factors among Chinese immigrants in Australia: Evidence from a large population-based cohort. Eur J Prev Cardiol 2017; 24:2000-2008. [PMID: 29064273 DOI: 10.1177/2047487317736828] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Background Acculturation is associated with increased prevalence of cardiovascular disease (CVD) risk-factors among immigrants in Western countries. Little is known about acculturation effects on CVD risks among Chinese immigrants, one of the fastest growing populations in Western countries. In this study, we aim to examine the association between acculturation and CVD risk-factors among Chinese immigrants, Australia's third-largest foreign-born group. Methods We accessed a subsample of Chinese immigrants ( n = 3220) within the 45-and-Up Study (2006-2009). Poisson regression model with a robust error variance examined the association between acculturation and CVD risk-factors, and prevalence ratios were reported, adjusted for socio-demographic characteristics. Indicators of acculturation included age at migration, length of Australian residence and language spoken at home. The outcomes were self-reported CVD diagnosis and six risk-factors (hypertension, diabetes, high cholesterol, smoking, overweight/obesity, physical inactivity). Results Mean age of Chinese participants was 58.9-years (SD = 10.7) and 55.5% were women. Chinese migrating to Australia aged <18 years were significantly more likely to report diabetes (prevalence ratio = 1.71; p < 0.01), overweight/obesity (prevalence ratio = 1.49; p < 0.001) and ≥ 3 CVD risk-factors (prevalence ratio = 1.47; p < 0.05) compared with those who migrated after 18-years-old. Chinese immigrants who lived in Australia for ≥ 30 years were significantly more likely to have diabetes (prevalence ratio = 1.84; p < 0.01) and ≥ 3 CVD risk-factors (prevalence ratio = 1.84; p < 0.01). There were no significant differences by language spoken at home. The association between indicators of acculturation and CVD risk-factors appeared to differ by sex. Conclusion Greater acculturation was associated with adverse CVD risk-factors among Chinese immigrants in Australia.
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Affiliation(s)
- Kai Jin
- 1 Sydney Nursing School, University of Sydney, Australia
| | - Janice Gullick
- 1 Sydney Nursing School, University of Sydney, Australia
| | - Lis Neubeck
- 2 School of Health and Social Care, Edinburgh Napier University, UK
| | - Fung Koo
- 1 Sydney Nursing School, University of Sydney, Australia
| | - Ding Ding
- 3 Charles Perkins Centre, Sydney School of Public Health, University of Sydney, Australia
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Finno-Velasquez M, Palmer L, Prindle J, Tam CC, Putnam-Hornstein E. A birth cohort study of Asian and Pacific Islander children reported for abuse or neglect by maternal nativity and ethnic origin. CHILD ABUSE & NEGLECT 2017; 72:54-65. [PMID: 28756353 PMCID: PMC5659890 DOI: 10.1016/j.chiabu.2017.07.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 07/11/2017] [Accepted: 07/14/2017] [Indexed: 05/24/2023]
Abstract
Research identifying racial and ethnic disparities in child protective services (CPS) involvement in the U.S. has focused on the overrepresentation of Black children and the growing Latino child population. Little attention has been paid to children of Asian origin, the most underrepresented group of children in the U.S. CPS system. The objective of this analysis was to examine subgroup patterns of CPS involvement in California for Asian and Pacific Islander (API) children prospectively based on maternal nativity and ethnic origin. We extracted data for API children born in California in 2006 and 2007 (N=138,858) from population-based birth records and linked those records to CPS records spanning the first 5 years of life (through 2012). We assessed distributional differences in risk indicators for the full birth cohort of API children and calculated a summary risk variable representing the cumulative number of risks present at birth. Generalized linear models were used to estimate API children's adjusted relative risk of CPS report by subgroup. Overall, 12.2% of children born in California in the 2006-2007 birth cohort were API. The majority of API children had foreign-born mothers (80.9%). Children of U.S.-born Hawaiian, Guamanian, or Samoan mothers had the highest rate, with 20.4% being reported to CPS by their 5th birthday. The lowest rates of child abuse and neglect reporting were observed among children of foreign-born Asian Indian (2.5%), Korean (2.7%), and Chinese (2.8%) mothers, compared to 5.4% of all Asian and Pacific Islander children, and 14.8% of children in general population. Findings underscore the presence of disparities in CPS involvement among API children, which has implications for health and well-being across the life course and for targeted maltreatment prevention strategies.
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Affiliation(s)
| | | | - John Prindle
- University of Southern California, United States
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The Relationship Between Self-Rated Health and Acculturation in Hispanic and Asian Adult Immigrants: A Systematic Review. J Immigr Minor Health 2017; 18:468-78. [PMID: 25894534 DOI: 10.1007/s10903-015-0208-y] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
We systematically reviewed studies to identify the association between acculturation and self-rated health (SRH) and the impact of nativity and language use in Asian and Hispanic adult immigrants. Six electronic databases were searched. Data on nativity and limited English proficiency (LEP) was extracted and analyzed. Nine studies met review criteria. A positive association between acculturation and fair/poor SRH among Asians and Hispanics was found. For both Asians and Hispanics, six out of eight studies showed nativity and all three studies reporting LEP were associated with worse SRH compared to whites. Nativity and LEP were found to be risk factors for reporting worse SRH in Hispanics compared to Asians. The degree of association between nativity and LEP and worse SRH was found to vary by Asian and Hispanic subgroup. Further studies are needed to accurately assess the health status of these populations, which will be essential to eliminating disparities.
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Bernal O, Latorre Castro ML, García Ubaque JC, Zamora D, Otero Wandurraga JA, Palencia F, Caballero Suárez MV, Castro Ospino IC, Castillo-Rodríguez L. Vigilancia y análisis de zonas de frontera, puertos de entrada y de población inmigrante1. Rev Salud Publica (Bogota) 2017; 19:259-267. [DOI: 10.15446/rsap.v19n2.53685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 06/14/2017] [Indexed: 11/09/2022] Open
Abstract
Objetivo Realizar una revisión de la literatura sobre los sistemas de información devigilancia sanitaria y epidemiológica en zonas de frontera y puntos de entrada enColombia.Materiales y Métodos Se desarrolló una revisión sistemática de literatura mediantela metodología Prisma, términos MeSH y DECS. Para ello, se consultaron, las basesde datos PubMed y BVS entre el 2000 y el 2014. Se incluyeron 51 documentos deacuerdo con los criterios de inclusión-exclusión, a partir de los cuales se discutieronlas categorías propuestas: servicios de salud, salud mental, estado de salud y determinantessociales.Resultados El análisis permite evidenciar que la vigilancia epidemiológica y sanitariade fronteras y puntos de entrada en el ámbito mundial, está enfocado principalmenteen ejes como salud mental, eventos transmisibles y eventos de condiciones no transmisibles.Adicionalmente, se da importancia a la atención integral en los servicios desalud y al análisis del estado de salud de la población inmigrante bajo el enfoquediferencial territorial, étnico y cultural. Sin embargo, hay pocas experiencias con unenfoque intersectorial, así como de determinantes sociales, en los territorios con condicionesde zonas de fronteras y/o puntos de entrada.Conclusiones Las diferencias de contexto, sistemas de salud, sistemas de informacióny prioridades de cada país, hacen que el intercambio y la cooperación entre lasfronteras tengan serios retos. Debido a esto, es necesario contar con instrumentos decooperación entre países limítrofes y análisis e información, con base en el modeloDeterminantes Sociales de la Salud.
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Wilson KB, Thorpe RJ, LaVeist TA. Dollar for Dollar: Racial and ethnic inequalities in health and health-related outcomes among persons with very high income. Prev Med 2017; 96:149-153. [PMID: 28237367 DOI: 10.1016/j.ypmed.2016.08.038] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 07/25/2016] [Accepted: 08/24/2016] [Indexed: 11/17/2022]
Abstract
Racial and ethnic disparities in health have been well-documented, and low SES is widely considered to be a driver of this relationship. However, the race-social class-health interrelationship is complex, as several studies have found race disparities between racial/ethnic minorities and whites at middle- income levels. Research on higher income persons is complicated by the lack of data for persons with incomes about $75,000. Most national datasets collect income data in categories with the highest income category being $75,000 and above. In our study, we examined racial/ethnic disparities in health status and behaviors among persons of very high income, reported income of $175,000 or above per year. Data are from the Medical Expenditure Panel Surveys (MEPS). Our findings revealed health disparities in 10 of the 16 health-related outcomes selected. African Americans were most dissimilar to whites at this income and with disadvantages on 6 health outcomes relative to whites. While results also showed some disparities for Asian Americans and Hispanic Americans relative to whites, these groups were advantaged, relative to whites on several health outcomes. Our findings indicate that income does not fully explain racial/ethnic disparities in health. Most public interventions are targeted to low income persons. However, public health interventions should target minority individuals of very high income as well, especially African Americans.
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Shah SM, Ali R, Loney T, Aziz F, ElBarazi I, Al Dhaheri S, Farooqi MH, Blair I. Prevalence of Diabetes among Migrant Women and Duration of Residence in the United Arab Emirates: A Cross Sectional Study. PLoS One 2017; 12:e0169949. [PMID: 28099445 PMCID: PMC5242528 DOI: 10.1371/journal.pone.0169949] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 12/24/2016] [Indexed: 01/03/2023] Open
Abstract
Background The prevalence rate of type 2 diabetes mellitus (T2DM) is one of the highest in United Arab Emirates (UAE), however data for the expatriate population is limited. This study aimed to identify the prevalence of T2DM amongst migrant women and test the hypothesis that acculturation (measured by years of residency) is associated with an increased risk of T2DM. Methods This was a cross-sectional study and we recruited a representative sample (n = 599, 75% participation rate) of migrant women aged 18 years and over in Al Ain, UAE. The American Diabetes Association criteria were used to diagnose T2DM. An adapted WHO STEPS questionnaire was used to collect socio-demographic, lifestyle and clinical data. Logistic regression analysis was performed to identify correlates of T2DM including length of UAE residence. Results The mean age of participants was 34.1 (± 9.5) years. Of the study participants, based on HbA1C levels, 18.6% (95% CI: 13.9–24.4) had prediabetes and 10.7% (95% CI: 7.2–15.6) had T2DM. Prevalence of prediabetes was 8.5% for Filipinos, 16.7% for Arabs and 30.3% for South Asians. Similarly the prevalence of T2DM was 1.7% for Filipinos, 12.2% for Arabs and 16.7% for South Asians. Significant correlates of overall T2DM (measured and known diabetes) included length of UAE residence for more than 10 years (Adjusted Odds Ratio [AOR] 2.74, 95% CI: 1.21–6.20), age ≥40 years (AOR = 3.48, 95% CI: 1.53–7.87) and South Asian nationality (AOR 2.10, 95% CI: 0.94–4.70). Conclusion Diabetes is a significant public health problem among migrant women in the UAE, particularly for South Asians. Longer length of residence in the UAE is associated with a higher prevalence of diabetes.
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Affiliation(s)
- Syed M. Shah
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Raghib Ali
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Tom Loney
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Faisal Aziz
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Iffat ElBarazi
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | | | - M. Hamed Farooqi
- Dubai Diabetes Center, Dubai Health Authority, Dubai, United Arab Emirates
| | - Iain Blair
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- * E-mail:
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Fuller-Thomson E, Roy A, Tsz-Kit Chan K, Kobayashi KM. Diabetes among non-obese Filipino Americans: Findings from a large population-based study. Canadian Journal of Public Health 2017; 108:e36-e42. [PMID: 31820422 DOI: 10.17269/cjph.108.5761] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 11/24/2016] [Indexed: 01/12/2023]
Abstract
OBJECTIVES Filipino Americans form the second-largest Asian American and Pacific Islanders subgroup. Growing evidence suggests that Filipino Americans have higher rates of diabetes than non-Hispanic whites. The key objectives of this study are 1) to determine the prevalence of diabetes in non-obese Filipino Americans compared to non-obese non-Hispanic whites, and 2) to identify risk factors for diabetes in non-obese Filipino men and women. METHODS Secondary analysis of population-based data from combined waves (2007, 2009 and 2011) of the adult California Health Interview Survey (CHIS). The study sample was restricted to non-obese Filipino Americans (n = 1629) and non-Hispanic whites (n = 72 072). RESULTS Non-obese Filipino Americans had more than twice the odds of diabetes compared to non-Hispanic whites, even after correcting for several known risk factors (OR = 2.80, p < 0.001). For non-obese Filipino men, older age, poverty, cigarette smoking, and being overweight are associated with increased odds for diabetes, while older age was the only factor associated with diabetes among Filipina women. DISCUSSION Diabetes prevention approaches need to be targeted towards non-obese Filipino Americans, due to their high risk of diabetes.
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Affiliation(s)
- Esme Fuller-Thomson
- Faculties of Social Work & Medicine, University of Toronto, 246 Bloor Street West, Toronto, ON, M5S 1V4, Canada. .,Institute for Life Course and Aging, University of Toronto, Toronto, ON, Canada.
| | - Adity Roy
- Institute for Life Course and Aging, University of Toronto, Toronto, ON, Canada
| | | | - Karen M Kobayashi
- Department of Sociology and Institute on Aging and Lifelong Health, University of Victoria, Victoria, BC, Canada
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Nguyen HHD, Smith C, Reynolds GL, Freshman B. The effect of acculturation on obesity among foreign-born Asians residing in the United States. J Immigr Minor Health 2016; 17:389-99. [PMID: 24781781 DOI: 10.1007/s10903-014-0027-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This study examined the relationship between acculturation and obesity in foreign-born Asians residing in the United States, using the 2009 California Health Interview Survey secondary data (N = 2,871). Two series of proxies and/or behavioral variables were used to measure level of acculturation: (a) length of US residency (years and percent of life) and (b) English language use and proficiency. It was hypothesized that acculturation measured with both proxies would positively predict obesity among foreign-born Asian adults who live in the United States. Results did not support the relationship between obesity and residency length, and greater English use and proficiency seemed to predict lower obesity. However, additional exploratory analysis was performed for each Asian ethnicity and the results showed that the hypothesized links were partly supported for Filipino subgroup, but the links for Vietnamese subgroup were in the opposite direction of the hypotheses and inconsistent with previous literature.
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Affiliation(s)
- Hannah-Hanh D Nguyen
- Department of Management and Industrial Relations, Shidler College of Business, University of Hawaii at Manoa, Honolulu, HI, USA,
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Nieto-Martínez R, González-Rivas JP, Florez H, Mechanick JI. Transcultural Endocrinology: Adapting Type-2 Diabetes Guidelines on a Global Scale. Endocrinol Metab Clin North Am 2016; 45:967-1009. [PMID: 27823615 DOI: 10.1016/j.ecl.2016.06.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Type-2 diabetes (T2D) needs to be prevented and treated effectively to reduce its burden and consequences. White papers, such as evidence-based clinical practice guidelines (CPG) and their more portable versions, clinical practice algorithms and clinical checklists, may improve clinical decision-making and diabetes outcomes. However, CPG are underused and poorly validated. Protocols that translate and implement these CPG are needed. This review presents the global dimension of T2D, details the importance of white papers in the transculturalization process, compares relevant international CPG, analyzes cultural variables, and summarizes translation strategies that can improve care. Specific protocols and algorithmic tools are provided.
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Affiliation(s)
- Ramfis Nieto-Martínez
- Department of Physiology, School of Medicine, Universidad Centro-Occidental "Lisandro Alvarado" and Cardio-metabolic Unit 7, Av. Andrés Bello con Av. Libertador, Apartado 516, Barquisimeto, Venezuela; Department of Physiology, School of Medicine, University of Panamá, Vía Transísmica, Apartado 0824, Estafeta Universitaria, Panamá, República de Panamá.
| | - Juan P González-Rivas
- The Andes Clinic of Cardio-Metabolic Studies, Av. Miranda entre calles Bermúdez y Arismendi, Apartado 3112, Timotes, Venezuela
| | - Hermes Florez
- Miami Veterans Affairs Medical Center, University of Miami Miller School of Medicine, 1201 Northwest 16th Street, CLC 207, Miami, FL 33125, USA
| | - Jeffrey I Mechanick
- Division of Endocrinology, Diabetes, and Bone Disease, Icahn School of Medicine at Mount Sinai, 1192 Park Avenue, New York, NY 10128, USA
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Chun KM, Kwan CML, Strycker LA, Chesla CA. Acculturation and bicultural efficacy effects on Chinese American immigrants' diabetes and health management. J Behav Med 2016; 39:896-907. [PMID: 27412776 PMCID: PMC5014659 DOI: 10.1007/s10865-016-9766-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Accepted: 07/04/2016] [Indexed: 10/21/2022]
Abstract
The primary goal of this study was to examine effects of bicultural efficacy, or perceived confidence in dealing with bicultural acculturation stressors, on type 2 diabetes management and health for first-generation, Cantonese-speaking, Chinese American immigrants (N = 162) recruited for a larger community-based diabetes intervention study (Chesla et al. in Res Nurs Health 36(4):359-372, 2013. doi: 10.1002/nur.21543 ). The current study also tested whether a new Bicultural Efficacy in Health Management (BEFF-HM) scale is a more robust predictor of diabetes and health outcomes than proxy (years in the U.S.) and general acculturation measures. Hierarchical regression analyses of cross-sectional data revealed that high BEFF-HM was significantly related to positive outcomes on five of six diabetes and health measures as hypothesized after accounting for participant characteristics, proxy and general acculturation measures, and social support. Proxy and general acculturation measures failed to predict any study outcome supporting our secondary hypothesis that BEFF-HM is a better predictor of Chinese American immigrants' diabetes and health management. An immigrant-focused research approach advances understanding of acculturation and bicultural efficacy effects on health by identifying key acculturation domains for study.
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Affiliation(s)
- Kevin M Chun
- Department of Psychology, University of San Francisco, 2130 Fulton Street, San Francisco, CA, USA.
| | - Christine M L Kwan
- Sau Po Centre on Ageing, The University of Hong Kong, Pok Fu Lam Road, Hong Kong, Hong Kong
| | | | - Catherine A Chesla
- Department of Family Health Care Nursing, University of California, San Francisco, CA, USA
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Shoemaker ML, White MC. Breast and cervical cancer screening among Asian subgroups in the USA: estimates from the National Health Interview Survey, 2008, 2010, and 2013. Cancer Causes Control 2016; 27:825-9. [PMID: 27106576 DOI: 10.1007/s10552-016-0750-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 04/12/2016] [Indexed: 11/26/2022]
Abstract
PURPOSE This study describes variations in mammography and Pap test use across and within subgroups of Asian women in the USA. METHODS Using data from the National Health Interview Survey (2008, 2010, and 2013), we calculated weighted proportions for selected Asian subgroups (Asian Indian, Chinese, Filipino, Other Asian) of women reporting mammography and Pap test use. RESULTS The proportion of women aged 50-74 years who reported a mammogram within the past 2 years did not differ significantly across Asian subgroups. The proportion of women aged 21-65 years who received a Pap test within the past 3 years differed significantly across Asian subgroups, with lower proportions among Asian Indian, Chinese, and Other Asian women. Recent immigrants, those without a usual source of care, and women with public or no health insurance had lower proportions of breast and cervical cancer screening test use. CONCLUSIONS Patterns of mammography and Pap test use vary among subgroups of Asian women, by length of residency in the USA, insurance status, usual source of care, and type of cancer screening test. These findings highlight certain Asian subgroups continue to face significant barriers to cancer screening test use.
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Affiliation(s)
- Meredith L Shoemaker
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Mailstop F-76, Atlanta, GA, 30341, USA.
| | - Mary C White
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Mailstop F-76, Atlanta, GA, 30341, USA
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Solanki PA, Ko NY, Qato DM, Calip GS. Risk of cancer-specific, cardiovascular, and all-cause mortality among Asian and Pacific Islander breast cancer survivors in the United States, 1991-2011. SPRINGERPLUS 2016; 5:82. [PMID: 26844029 PMCID: PMC4728166 DOI: 10.1186/s40064-016-1726-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 01/15/2016] [Indexed: 01/21/2023]
Abstract
Asian and Pacific Islander (API) women in the United States (U.S.) are a heterogeneous group reported to have better prognosis after breast cancer (BC) compared to their Non-Hispanic White (NHW) counterparts. Few studies have examined differences in BC survival between individual API ethnic groups. We conducted a retrospective cohort study of 462,005 NHW and 44,531 API women diagnosed with incident, stage I-III BC between 1991 and 2011 in the Surveillance, Epidemiology and End Results (SEER) 18 registries. SEER-reported API ethnicity was grouped as Chinese, Japanese, Filipino, Hawaiian, Korean, Vietnamese, Asian Indian and Pakistani, and Pacific Islander. Multivariable Cox proportional hazards models were used to estimate hazard ratios (HR) and 95 % confidence intervals (CI) for risk of BC-specific, cardiovascular and all-cause mortality comparing API to NHW women. We also estimated mortality risk comparing U.S.-born to non-U.S.-born women. Compared to NHW women, API women overall had lower BC-specific, cardiovascular and all-cause mortality. BC-specific mortality risk was lowest among Japanese women (HR 0.69, 95 % CI 0.63-0.77). Other women had similar (Filipino, HR 0.93, 0.86-1.00; Hawaiian, HR 1.01, 0.89-1.17) or greater (Pacific Islander, HR 1.44, 1.17-1.78) risk of BC-specific death. Compared to non-U.S. born API women, findings were suggestive of increased cardiovascular (HR 1.12, 1.03-1.20) and all-cause mortality (HR 1.29, 1.08-1.54) among U.S.-born API women. Mortality risk varies greatly between BC survivors from different API backgrounds. Further research is warranted to understand these disparities in BC survivorship and the social and cultural factors that possibly contribute to greater mortality among later-generation API women born in the United States.
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Affiliation(s)
- Pooja A Solanki
- Department of Epidemiology and Biostatistics, University of Illinois at Chicago, 1603 W. Taylor St., Chicago, IL 60612 USA
| | - Naomi Y Ko
- Section of Hematology Oncology, Boston University, Boston Medical Center, 725 Albany St., Boston, MA 02118 USA
| | - Dima M Qato
- Department of Epidemiology and Biostatistics, University of Illinois at Chicago, 1603 W. Taylor St., Chicago, IL 60612 USA ; Center for Pharmacoepidemiology and Pharmacoeconomic Research, University of Illinois at Chicago, 833 S. Wood St., Chicago, IL 60612 USA
| | - Gregory S Calip
- Center for Pharmacoepidemiology and Pharmacoeconomic Research, University of Illinois at Chicago, 833 S. Wood St., Chicago, IL 60612 USA ; Population Health, Behavior and Outcomes Program, University of Illinois Cancer Center, 1801 W. Taylor St., Chicago, IL 60612 USA
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Effoe VS, Chen H, Moran A, Bertoni AG, Bluemke DA, Seeman T, Darwin C, Watson KE, Rodriguez CJ. Acculturation is associated with left ventricular mass in a multiethnic sample: the Multi-Ethnic Study of Atherosclerosis. BMC Cardiovasc Disord 2015; 15:161. [PMID: 26631068 PMCID: PMC4668673 DOI: 10.1186/s12872-015-0157-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 11/24/2015] [Indexed: 12/29/2022] Open
Abstract
Background Acculturation involves stress-related processes and health behavioral changes, which may have an effect on left ventricular (LV) mass, a risk factor for cardiovascular disease (CVD). We examined the relationship between acculturation and LV mass in a multiethnic cohort of White, African-American, Hispanic and Chinese subjects. Methods Cardiac magnetic resonance assessment was available for 5004 men and women, free of clinical CVD at baseline. Left ventricular mass index was evaluated as LV mass indexed by body surface area. Acculturation was characterized based on language spoken at home, place of birth and length of stay in the United States (U.S.), and a summary acculturation score ranging from 0 = least acculturated to 5 = most acculturated. Mean LV mass index adjusted for traditional CVD risk factors was compared across acculturation levels. Results Unadjusted mean LV mass index was 78.0 ± 16.3 g/m2. In adjusted analyses, speaking exclusively English at home compared to non-English language was associated with higher LV mass index (81.3 ± 0.4 g/m2 vs 79.9 ± 0.5 g/m2, p = 0.02). Among foreign-born participants, having lived in the U.S. for ≥ 20 years compared to < 10 years was associated with greater LV mass index (81.6 ± 0.7 g/m2 vs 79.5 ± 1.1 g/m2, p = 0.02). Compared to those with the lowest acculturation score, those with the highest score had greater LV mass index (78.9 ± 1.1 g/m2 vs 81.1 ± 0.4 g/m2, p = 0.002). There was heterogeneity in which measure of acculturation was associated with LV mass index across ethnic groups. Conclusions Greater acculturation is associated with increased LV mass index in this multiethnic cohort. Acculturation may involve stress-related processes as well as behavioral changes with a negative effect on cardiovascular health.
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Affiliation(s)
- Valery S Effoe
- Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Blvd, Winston Salem, NC, 27127, USA.
| | - Haiying Chen
- Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Blvd, Winston Salem, NC, 27127, USA.
| | - Andrew Moran
- Department of Medicine, Columbia University College of Physicians & Surgeons, New York, NY, USA.
| | - Alain G Bertoni
- Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Blvd, Winston Salem, NC, 27127, USA.
| | - David A Bluemke
- National Institutes of Health/Clinical Center, Bethesda, MD, USA.
| | - Teresa Seeman
- Division of Geriatrics, University of California at Los Angeles, Los Angeles, CA, USA.
| | - Christine Darwin
- University of California at Los Angeles Research Center, Los Angeles, CA, USA.
| | - Karol E Watson
- Division of Cardiology, University of California at Los Angeles School of Medicine, Los Angeles, CA, USA.
| | - Carlos J Rodriguez
- Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Blvd, Winston Salem, NC, 27127, USA.
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Gomez SL, Glaser SL, Horn-Ross PL, Cheng I, Quach T, Clarke CA, Reynolds P, Shariff-Marco S, Yang J, Lee MM, Satariano WA, Hsing AW. Cancer research in Asian American, Native Hawaiian, and Pacific Islander populations: accelerating cancer knowledge by acknowledging and leveraging heterogeneity. Cancer Epidemiol Biomarkers Prev 2015; 23:2202-5. [PMID: 25368394 DOI: 10.1158/1055-9965.epi-14-0624] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The Asian American, Native Hawaiian, and Pacific Islander population is large, growing, and extremely heterogeneous. Not only do they bear unique burdens of incidence and outcomes for certain cancer types, they exhibit substantial variability in cancer incidence and survival patterns across the ethnic groups. By acknowledging and leveraging this heterogeneity through investing in cancer research within these populations, we have a unique opportunity to accelerate the availability of useful and impactful cancer knowledge. See all the articles in this CEBP Focus section, "Cancer in Asian and Pacific Islander Populations."
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Affiliation(s)
- Scarlett Lin Gomez
- Cancer Prevention Institute of California, Fremont, California. Division of Epidemiology, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California.
| | - Sally L Glaser
- Cancer Prevention Institute of California, Fremont, California. Division of Epidemiology, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California
| | - Pamela L Horn-Ross
- Cancer Prevention Institute of California, Fremont, California. Division of Epidemiology, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California
| | - Iona Cheng
- Cancer Prevention Institute of California, Fremont, California. Division of Epidemiology, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California
| | - Thu Quach
- Cancer Prevention Institute of California, Fremont, California. Division of Epidemiology, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California
| | - Christina A Clarke
- Cancer Prevention Institute of California, Fremont, California. Division of Epidemiology, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California
| | - Peggy Reynolds
- Cancer Prevention Institute of California, Fremont, California. Division of Epidemiology, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California
| | - Salma Shariff-Marco
- Cancer Prevention Institute of California, Fremont, California. Division of Epidemiology, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California
| | - Juan Yang
- Cancer Prevention Institute of California, Fremont, California
| | - Marion M Lee
- University of California, San Francisco, San Francisco, California
| | | | - Ann W Hsing
- Cancer Prevention Institute of California, Fremont, California. Division of Epidemiology, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California
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Nelson-Peterman JL, Toof R, Liang SL, Grigg-Saito DC. Long-Term Refugee Health: Health Behaviors and Outcomes of Cambodian Refugee and Immigrant Women. HEALTH EDUCATION & BEHAVIOR 2015; 42:814-23. [PMID: 26157042 DOI: 10.1177/1090198115590779] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Refugees in the United States have high rates of chronic disease. Both long-term effects of the refugee experience and adjustment to the U.S. health environment may contribute. While there is significant research on health outcomes of newly resettled refugees and long-term mental health experiences of established refugees, there is currently little information about how the combined effects of the refugee experience and the U.S. health environment are related to health practices of refugees in the years and decades after resettlement. We examined cross-sectional survey data for Cambodian refugee and immigrant women 35 to 60 years old (n = 160) from an established refugee community in Lowell, Massachusetts, to examine the potential contributors to health behaviors and outcomes among refugees and immigrants postresettlement. In our representative sample, we found that smoking and betel nut use were very low (4% each). Fewer than 50% of respondents walked for at least 10 minutes on 2 or more days/week. Using World Health Organization standards for overweight/obese for Asians, 73% of respondents were overweight/obese and 56% were obese, indicating increased risk of chronic disease. Depression was also high in this sample (41%). In multivariate models, higher acculturation and age were associated with walking more often; lower education and higher acculturation were related to higher weight; and being divorced/separated or widowed and being older were related to higher risk of depression. The interrelated complex of characteristics, health behaviors, and health outcomes of refugees merits a multifaceted approach to health education and health promotion for long-term refugee health.
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Affiliation(s)
| | - Robin Toof
- University of Massachusetts Lowell, Lowell, MA, USA
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Shi L, Zhang D, van Meijgaard J, MacLeod KE, Fielding JE. The Interaction Between an Individual's Acculturation and Community Factors on Physical Inactivity and Obesity: A Multilevel Analysis. Am J Public Health 2015; 105:1460-7. [PMID: 25973827 DOI: 10.2105/ajph.2014.302541] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined whether the interactions between primarily speaking English at home and community-level measures (median household income and immigrant composition) are associated with physical inactivity and obesity. METHODS We pooled the 2005 and 2007 Los Angeles County Health Survey data to construct a multilevel data set, with community-level median household income and immigrant density as predictors at the community level. After controlling for individual-level demographic variables, we included the respondent's perceived community safety as a covariate to test the hypothesis that perceived public safety mediates the association between acculturation and health outcomes. RESULTS The interaction between community median household income and primarily speaking English at home was associated with lower likelihoods of physical inactivity (odds ratio [OR] = 0.644; 95% confidence interval [CI] = 0.502, 0.825) and obesity (OR = 0.674; 95% CI = 0.514, 0.882). These odds remained significant after we controlled for perceived community safety. CONCLUSIONS Resources in higher-income areas may be beneficial only to residents fully integrated into the community. Future research could focus on understanding how linguistic isolation affects community-level social learning and access to resources and whether this differs by family-level acculturation.
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Affiliation(s)
- Lu Shi
- Lu Shi is with the Department of Public Health Science, Clemson University, Clemson, SC. Donglan Zhang, Jeroen van Meijgaard, and Jonathan E. Fielding are with the Center for Health Advancement, Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles. Kara E. MacLeod is with the Institute for Health Promotion and Disease Prevention Research, Keck School of Medicine, University of Southern California, Los Angeles
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Toselli S, Gualdi-Russo E, Boulos DNK, Anwar WA, Lakhoua C, Jaouadi I, Khyatti M, Hemminki K. Prevalence of overweight and obesity in adults from North Africa. Eur J Public Health 2015; 24 Suppl 1:31-9. [PMID: 25107996 DOI: 10.1093/eurpub/cku103] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The share of North African immigrants in Europe is growing continuously. In this review, we aimed to systematically analyse and describe the literature on weight status and physical activity in North African adults, both in their home country and after immigration to Europe. Existing data on North African residents and on North African immigrants in Europe were analysed by a systematic search on PUBMED. There is a wide variation among countries in the prevalence of overweight/obesity, with immigrants showing higher values. The overall results revealed a higher prevalence of overweight and obesity in females than in males in North African residents. Females also show higher levels of obesity among immigrants. In particular, literature reports indicate that 1.3-47.8% of North African residents and 3.6-49.4% of North African immigrants in adult age are overweight or obese. Physical inactivity is higher than 20% in males and 40% in females in North African residents. The highest frequency of physically inactive or lightly active people among immigrants was observed in first-generation Sudanese and Moroccans in Amsterdam (males: 57.1%; females: 74.2%), with increasing rates in second-generation females. The results underline a higher health risk in North African immigrants than in residents. Specific public health strategies should be adopted in various populations of North African origin to control the obesity epidemic.
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Affiliation(s)
- Stefania Toselli
- 1 Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Emanuela Gualdi-Russo
- 2 Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - Dina N K Boulos
- 3 Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Egypt
| | - Wagida A Anwar
- 3 Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Egypt
| | - Chérifa Lakhoua
- 4 CERP-Tunisia (Centre for Studies and Research Prospects), University of Carthage, Tunisia
| | - Imen Jaouadi
- 4 CERP-Tunisia (Centre for Studies and Research Prospects), University of Carthage, Tunisia
| | | | - Kari Hemminki
- 6 German Cancer Research Center, Heidelberg, Germany7 Center for Primary Health Care Research, Clinical Research Center, Lund University, Malmö, Sweden
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Katigbak C, Van Devanter N, Islam N, Trinh-Shevrin C. Partners in health: a conceptual framework for the role of community health workers in facilitating patients' adoption of healthy behaviors. Am J Public Health 2015; 105:872-80. [PMID: 25790405 PMCID: PMC4386525 DOI: 10.2105/ajph.2014.302411] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2014] [Indexed: 11/04/2022]
Abstract
We formulated a conceptual framework that begins to answer the national call to improve health care access, delivery, and quality by explaining the processes through which community health workers (CHWs) facilitate patients' adoption of healthy behaviors. In September 2011 to January 2012, we conducted a qualitative study that triangulated multiple data sources: 26 in-depth interviews, training documents, and patient charts. CHWs served as partners in health to immigrant Filipinos with hypertension, leveraging their cultural congruence with intervention participants, employing interpersonal communication techniques to build trust and rapport, providing social support, and assisting with health behavior change. To drive the field forward, this work can be expanded with framework testing that may influence future CHW training and interventions.
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Affiliation(s)
- Carina Katigbak
- At the time of the study, Carina Katigbak and Nancy Van Devanter were with the College of Nursing, and Nadia Islam and Chau Trinh-Shevrin were with the Department of Population Health, School of Medicine, New York University, New York, NY
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Erber Oakkar E, Stevens J, Bradshaw PT, Cai J, Perreira KM, Popkin BM, Gordon-Larsen P, Young DR, Ghai NR, Caan B, Quinn VP. Longitudinal study of acculturation and BMI change among Asian American men. Prev Med 2015; 73:15-21. [PMID: 25602913 DOI: 10.1016/j.ypmed.2015.01.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 12/05/2014] [Accepted: 01/11/2015] [Indexed: 01/21/2023]
Abstract
BACKGROUND Cross-sectional studies examining the association between Western acculturation and BMI in Asians have been inconsistent, and studies on BMI change are lacking. OBJECTIVE This study examined the associations between indicators of acculturation (generational status, length of US residence, and age at immigration) and overweight (BMI ≥25kg/m(2)) as well as 5-year BMI changes in 7,073 Chinese, Japanese, Korean, Filipino, and Vietnamese men who lived in the US and were 44-71years old at baseline of the California Men's Health Study (2002-2003). METHODS Indicators of acculturation were reported at baseline. Repeated clinical measures of BMI were extracted from electronic health records (2005-2012). RESULTS Using generalized estimating equations we found that lower generational status, shorter duration of US residence and older age at immigration were inversely associated with being overweight. However, analysis of BMI curves using linear mixed models showed that shorter length of US residence and older age at immigration were associated with larger 5-year increases in BMI. CONCLUSIONS Asian immigrants who were less acculturated had larger BMI increases as they became more acculturated but had not achieved overweight status. Healthy weight interventions among Asians immigrants may be most effective when targeting weight maintenance early in the process of acculturation.
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Affiliation(s)
- Eva Erber Oakkar
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - June Stevens
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Patrick T Bradshaw
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jianwen Cai
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Krista M Perreira
- Department of Public Policy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Barry M Popkin
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Penny Gordon-Larsen
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Deborah R Young
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Nirupa R Ghai
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Bette Caan
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Virginia P Quinn
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
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Colorectal Cancer Screening among Chinese, Cambodian, and Vietnamese Immigrants in Chicago. J Racial Ethn Health Disparities 2015; 2:473-80. [PMID: 26863553 DOI: 10.1007/s40615-015-0095-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 02/13/2015] [Accepted: 02/27/2015] [Indexed: 10/23/2022]
Abstract
Asian Americans are now the most rapidly growing minority group in the USA. Over 60 % of Asian Americans in the USA are immigrants. Cancer has been the leading cause of death among Asian Americans since 1980. Understanding the barriers to screening is essential to reduce the unnecessary burden of cancer. Little is known about colorectal cancer screening behavior among foreign-born Asian Americans and how socio-demographic factors may influence the behavior. Even less is known about disaggregated Asian subgroups. Using data from the Chicago Asian Community Survey, a local health assessment survey of three Asian subgroups in Chicago, Chinese, Cambodian, and Vietnamese, this study found that the colorectal cancer screening rate were much lower among foreign-born Asian Americans in Chicago (30 %) than the national rate for the general population (59 %). Furthermore, we studied disaggregated data to determine colorectal cancer screening differences between communities. Findings from this study provide a critical evidence base to inform future research and intervention designs.
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Simons E, Blansit K, Tsuei T, Brooks R, Ueda S, Kapp DS, Chan JK. Foreign- vs US-born Asians and the association of type I uterine cancer. Am J Obstet Gynecol 2015; 212:43.e1-6. [PMID: 25043758 DOI: 10.1016/j.ajog.2014.07.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 05/21/2014] [Accepted: 07/11/2014] [Indexed: 01/30/2023]
Abstract
OBJECTIVE The purpose of this study was to determine the association of type I endometrioid uterine cancer in US-born vs immigrant Asian women. STUDY DESIGN Data were obtained from the Surveillance, Epidemiology, and End Results Program from 2001-2009. Chi-squared, Kaplan-Meier, and binomial logistic regression analyses were used for statistics. RESULTS Of 4834 Asian women with uterine cancer, 62% were US-born and 38% were immigrants. Of these women, 2972 (61%) had type I (grade 1 or 2, endometrioid histologic type) uterine cancer. Compared with patients with type II disease (grade 3, clear cell and serous histologic type), patients with type I disease were younger (age 55 vs 59 years; P < .01) and had lower stage disease (90% vs 71%; P < .01). US-born Asian women had a significantly higher proportion of type I uterine cancers in contrast to their immigrant counterparts (65% vs 56%; P < .01). Of all immigrants, the proportion of type I cancers was lowest in Japanese women followed by Chinese and Filipino women, respectively (48% vs 52% vs 58%; P < .01). The 5-year disease-specific survivals of US-born vs immigrant Asian women with type I cancer was 92% for both groups. Over 3 time periods (2001-2003, 2004-2006, and 2007-2009), there was an increase in type I cancers among US-born Asian women (61% to 65% to 68%; P < .01). CONCLUSION US-born Asian women are more likely to be diagnosed with type I uterine cancer compared with immigrants. Over the study period, there was a trend towards an increase in type I cancers among US-born Asian women.
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A bi-national comparative study of health behaviors of Koreans in South Korea and Korean Americans in California. J Immigr Minor Health 2014; 15:1073-81. [PMID: 22918692 DOI: 10.1007/s10903-012-9706-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Few studies have compared health behaviors of Koreans in their home country and Korean Americans. Using 2009 data from the Community Health Survey (South Korea) and the California Health Interview Survey (USA), we compared native Koreans and Korean Americans, grouped by level of acculturation, on prevalence of specific health behaviors and self-rated health, and conducted multiple logistic regression comparing the odds of these behaviors among the groups adjusted for demographic variables. While Korean Americans exhibit healthier behaviors than Koreans in some areas (e.g., reduced smoking and binge drinking in men, increased utilization of flu vaccinations), we also identified problem behaviors (e.g., increased body weight in Korean American men, uptake of alcohol drinking and smoking among Korean American women). Findings support the critical need for health promotion programs addressing these health behaviors to prevent future health problems among Korean Americans.
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Jun WH, Hong SS, Yang S. Effects of a Psychological Adaptation Improvement Program for International Marriage Migrant Women in South Korea. Asian Nurs Res (Korean Soc Nurs Sci) 2014. [DOI: 10.1016/j.anr.2014.08.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Maskarinec G, Jacobs S, Morimoto Y, Chock M, Grandinetti A, Kolonel LN. Disparity in diabetes risk across Native Hawaiians and different Asian groups: the multiethnic cohort. Asia Pac J Public Health 2014; 27:375-84. [PMID: 25164594 DOI: 10.1177/1010539514548757] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
We evaluated the impact of body mass index (BMI) and lifestyle risk factors on ethnic disparity in diabetes incidence among 89 198 Asian, Native Hawaiian, and white participants of the Multiethnic Cohort who completed multiple questionnaires. After 12 years of follow-up, 11 218 new cases were identified through self-report and health plan linkages. BMI was lowest in Chinese/Koreans, Japanese, and Filipinos (22.4, 23.5, and 23.9 kg/m(2)). Using Cox regression, the unadjusted hazard ratios were 1.9 (Chinese/Korean), 2.1 (Japanese, Mixed-Asian), 2.2 (Filipino), 2.5 (Native Hawaiian), and 2.6 (part-Asian) as compared with whites. With BMI added, the risk for Japanese, Filipinos, Chinese/Koreans, and mixed-Asians increased (8%-42%) but declined in part-Asians and Native Hawaiians (17%-31%). When lifestyle and dietary factors were also included, the risk was attenuated in all groups (6%-14%). Despite their lower BMI, Asian Americans have a higher diabetes risk than whites, but dietary and lifestyle factors do not account for the excess risk.
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Affiliation(s)
| | - Simone Jacobs
- German Institute of Human Nutrition, Potsdam-Rehbrücke, Germany
| | | | - Marci Chock
- University of Hawaii Cancer Center, Honolulu, HI, USA
| | | | - Laurence N Kolonel
- Office of Public Health Studies, University of Hawaii, Honolulu, HI, USA
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Religion, acculturation, and incarceration: determinants of substance use among Hispanic adults in the United States. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2014; 2014:459596. [PMID: 25214855 PMCID: PMC4158458 DOI: 10.1155/2014/459596] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 07/21/2014] [Accepted: 08/12/2014] [Indexed: 12/05/2022]
Abstract
Objective. The influence of religion, acculturation, and incarceration on substance abuse has been studied, though predominantly among adolescents. Little research exists on how such factors influence substance use among Hispanic adults. The objective of this study was to assess key determinants of substance use among Hispanic adults. Methods. Public access 2012 National Survey on Drug Use and Health was utilized. Univariate and multivariable logistic regression analyses were conducted while accounting for complex survey design to obtain population-weighted estimates. Receiver operator curve analysis was used to evaluate the relative contribution of each variable. Results. Importance of religious influence in life and Spanish language interview were associated with lower odds of substance use, while history of incarceration increased the likelihood of substance use among Hispanic adults. Other factors associated with lower odds were increasing age, being female, and currently married. Other factors associated with increased odds were high school graduate and some college in addition to living above the 200% federal poverty level. Discussion. Results from this study add to the limited body of the literature on determinants of substance use among Hispanic adults. Health education measures should target acculturated Hispanic adults and those with incarceration history to reduce substance use.
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Ladabaum U, Clarke CA, Press DJ, Mannalithara A, Myer PA, Cheng I, Gomez SL. Colorectal cancer incidence in Asian populations in California: effect of nativity and neighborhood-level factors. Am J Gastroenterol 2014; 109:579-88. [PMID: 24492754 PMCID: PMC5746419 DOI: 10.1038/ajg.2013.488] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Accepted: 12/20/2013] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Heritable and environmental factors may contribute to differences in colorectal cancer (CRC) incidence across populations. We capitalized on the resources of the California Cancer Registry (CCR) and California's diverse Asian population to perform a cohort study exploring the relationships between CRC incidence, nativity, and neighborhood-level factors across Asian subgroups. METHODS We identified CRC cases in the CCR from 1990 to 2004 and calculated age-adjusted CRC incidence rates for non-Hispanic Whites and US-born vs. foreign-born Asian ethnic subgroups, stratified by neighborhood socioeconomic status (SES) and "ethnic enclave." Trends were studied with joinpoint analysis. RESULTS CRC incidence was lowest among foreign-born South Asians (22.0/100,000; 95% confidence interval (CI): 19.7-24.5/100,000) and highest among foreign-born Japanese (74.6/100,000; 95% CI: 70.1-79.2/100,000). Women in all Asian subgroups except Japanese, and men in all Asian subgroups except Japanese and US-born Chinese, had lower CRC incidence than non-Hispanic Whites. Among Chinese men and Filipino women and men, CRC incidence was lower among foreign-born than US-born persons; the opposite was observed for Japanese women and men. Among non-Hispanic Whites, but not most Asian subgroups, CRC incidence decreased over time. CRC incidence was inversely associated with neighborhood SES among non-Hispanic Whites, and level of ethnic enclave among Asians. CONCLUSIONS CRC incidence rates differ substantially across Asian subgroups in California. The significant associations between CRC incidence and nativity and residence in an ethnic enclave suggest a substantial effect of acquired environmental factors. The absence of declines in CRC incidence rates among most Asians during our study period may point to disparities in screening compared with Whites.
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Affiliation(s)
- Uri Ladabaum
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California, USA
- Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Christina A. Clarke
- Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California, USA
- Cancer Prevention Institute of California, Fremont, California, USA
| | - David J. Press
- Cancer Prevention Institute of California, Fremont, California, USA
| | - Ajitha Mannalithara
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California, USA
- Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Parvathi A. Myer
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California, USA
- Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Iona Cheng
- Cancer Prevention Institute of California, Fremont, California, USA
| | - Scarlett Lin Gomez
- Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California, USA
- Cancer Prevention Institute of California, Fremont, California, USA
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De Souza LR, Fuller-Thomson E. Acculturation and disability rates among Filipino-Americans. J Immigr Minor Health 2014; 15:462-71. [PMID: 23054536 DOI: 10.1007/s10903-012-9708-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Filipinos are the fastest growing Asian subgroup in America. Among immigrants, higher acculturation (adaptation to host society) predicts disability outcomes and may relate to disability prevalence among older Filipinos. We conducted a secondary analysis of the 2006 American Community Survey using a representative sample of older Filipinos (2,113 males; 3,078 females) to measure functional limitations, limitations in activities of daily living, blindness/deafness and memory/learning problems. Filipino males who were Americans by birth/naturalization had higher odds of blindness/deafness (OR 2.94; 95% CI = 1.69, 5.12) than non-citizens. Males who spoke English at home had higher odds of blindness/deafness (OR 1.82; 95% CI = 1.05, 3.17) and memory/learning problems (OR 2.28; 95% CI = 1.25, 4.15), while females had higher odds of memory/learning problems (OR 1.75; 95% CI = 1.13, 2.73). Acculturation is associated with greater odds of disabilities for Filipino men. Males may be more sensitive to acculturation-effects than females due to culturally prescribed roles and gender-specific experiences at the time of immigration.
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Affiliation(s)
- Leanne R De Souza
- Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada.
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Franzen-Castle L, Smith C. Environmental, Personal, and Behavioral Influences on BMI and Acculturation of Second Generation Hmong Children. Matern Child Health J 2014; 18:73-89. [DOI: 10.1007/s10995-013-1235-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Obesity trends by ethnicity in Hawai'i: The last ten years (1999-2008). Obes Res Clin Pract 2013; 5:e267-360. [PMID: 24331135 DOI: 10.1016/j.orcp.2011.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2010] [Revised: 02/22/2011] [Accepted: 03/21/2011] [Indexed: 11/21/2022]
Abstract
SUMMARY Obesity levels are rising rapidly in United States of America however, less is known about the obesity trends regarding the specific ethnicities prevalent in Hawai'i, which may inform efforts to eliminate disparities.: OBJECTIVE The purpose of this report is to analyze the body mass index (BMI) trends of the four major ethnicities in Hawai'i (White, Japanese, Hawaiian, and Filipino) over the last ten years. METHOD The BMI data overall and by ethnicity from 1999 to 2008 were utilized from the Behavioral Risk Factor Surveillance System (BRFSS). RESULTS We found that all ethnicities experienced a 47% increase in mean percent of obese persons. The Hawaiian ethnic group had the largest number of obese individuals, but they experienced the smallest increase. The Filipino ethnic group had less obese individuals, but they experienced the largest percentage increase. CONCLUSION Based on these findings, obesity prevention efforts aimed at Hawai'i's multicultural population need to be improved and increased.
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Association between Acculturation and Binge Drinking among Asian-Americans: Results from the California Health Interview Survey. JOURNAL OF ADDICTION 2013; 2013:248196. [PMID: 24804139 PMCID: PMC4008089 DOI: 10.1155/2013/248196] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Revised: 10/26/2013] [Accepted: 11/04/2013] [Indexed: 11/21/2022]
Abstract
Objective. Evaluate the association between acculturation and binge drinking among six Asian-American subgroups. Methods. A cross-sectional analysis of public access adult portion of 2007, 2009, and 2011/2012 California Health Interview Survey data was conducted. Univariate and multivariable logistic regression analyses were utilized with any binge drinking in the past year as the outcome variable and language spoken at home and time in USA as proxy measures of acculturation. Results. A total of 1,631 Asian-Americans (N = 665,195) were identified as binge drinkers. Binge drinking was positively associated with being first generation South Asian (OR = 3.05, 95% CI = 1.55, 5.98) and monolingual (English only) Vietnamese (OR = 3.00; 95% CI = 1.58, 5.70), especially among females. Other factors associated with increased binge drinking were being female (Chinese only), not being current married (South Asian only), and being an ever smoker (all subgroups except South Asians). Conclusion. First generation South Asians and linguistically acculturated Vietnamese, especially females, are at an increased risk of binge drinking. Future studies and preventive measures should address the cultural basis of such health risk behaviors among Asian-American adults.
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Son J. Assimilation and health service utilization of Korean immigrant women. QUALITATIVE HEALTH RESEARCH 2013; 23:1528-1540. [PMID: 24108090 DOI: 10.1177/1049732313507142] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
In this case study, I present descriptive findings with regard to immigrant incorporation and health service utilization. Using focus groups and survey of Korean immigrant women in Wisconsin, I examine whether the ways in which they adapt to the U.S. society is relevant to their health services utilization and the alternatives they seek when available health services are less than satisfactory. The findings suggest that adherence to Korean identity appears to be associated with health service utilization. This is evident in the immigrants' evaluation of the U.S. health services as compared to those of Korea, and the consideration given by these immigrants to seeking health services in Korea instead of the United States. Such concerns on the part of these immigrants have important implications for health researchers, as they highlight the significance of immigrants' transnational experiences and their sense of personal agency in the use of health care.
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Affiliation(s)
- Juyeon Son
- 1University of Wisconsin-Oshkosh, Oshkosh, Wisconsin, USA
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Gomez SL, Noone AM, Lichtensztajn DY, Scoppa S, Gibson JT, Liu L, Morris C, Kwong S, Fish K, Wilkens LR, Goodman MT, Deapen D, Miller BA. Cancer incidence trends among Asian American populations in the United States, 1990-2008. J Natl Cancer Inst 2013; 105:1096-110. [PMID: 23878350 PMCID: PMC3735462 DOI: 10.1093/jnci/djt157] [Citation(s) in RCA: 215] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Revised: 04/17/2013] [Accepted: 04/18/2013] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND National cancer incidence trends are presented for eight Asian American groups: Asian Indians/Pakistanis, Chinese, Filipinos, Japanese, Kampucheans, Koreans, Laotians, and Vietnamese. METHODS Cancer incidence data from 1990 through 2008 were obtained from 13 Surveillance, Epidemiology, End Results (SEER) registries. Incidence rates from 1990 through 2008 and average percentage change were computed using SEER*Stat and Joinpoint software. The annual percentage change (APC) in incidence rates was estimated with 95% confidence intervals (95% CIs) calculated for both the rate and APC estimates. Rates for non-Hispanic whites are presented for comparison. RESULTS Prostate cancer was the most common malignancy among most groups, followed by lung, colorectal, liver, and stomach cancers. Breast cancer was generally the most common cancer in women, followed by colorectal and lung cancers; liver, cervix, thyroid, and stomach cancers also ranked highly. Among men, increasing trends were observed for prostate (Asian Indians and Pakistanis: APC 1990-2003 = 2.2, 95% CI = 0.3 to 4.1; Filipinos: APC 1990-1994 = 19.0, 95% CI = 4.5 to 35.4; Koreans: APC 1990-2008 = 2.9, 95% CI = 1.8 to 4.0), colorectal (Koreans: APC 1990-2008 = 2.2, 95% CI = 0.9 to 3.5), and liver cancers (Filipinos: APC 1990-2008 = 1.6, 95% CI = 0.4 to 2.7; Koreans: APC 1990-2006 = 2.1, 95% CI = 0.4 to 3.7; Vietnamese: APC 1990-2008 = 1.6, 95% CI = 0.3 to 2.8), whereas lung and stomach cancers generally remained stable or decreased. Among women, increases were observed for uterine cancer (Asian Indians: APC 1990-2008 = 3.0, 95% CI = 0.3 to 5.8; Chinese: APC 2004-2008 = 7.0, 95% CI = 1.4 to 12.9; Filipina: APC 1990-2008 = 3.0, 95% CI = 2.4 to 3.7; Japanese: APC 1990-2008 = 1.1, 95% CI = 0.1 to 2.0), colorectal cancer (Koreans: APC 1990-2008 = 2.8, 95% CI = 1.7 to 3.9; Laotians: APC: 1990-2008 = 5.9, 95% CI = 4.0 to 7.7), lung cancer (Filipinas: APC 1990-2008 = 2.1, 95% CI = 1.4 to 2.8; Koreans: APC 1990-2008 = 2.1, 95% CI = 0.6 to 3.6), thyroid cancer (Filipinas: APC 1990-2008 = 2.5, 95% CI = 1.7 to 3.3), and breast cancer in most groups (APC 1990-2008 from 1.2 among Vietnamese and Chinese to 4.7 among Koreans). Decreases were observed for stomach (Chinese and Japanese), colorectal (Chinese), and cervical cancers (Laotians and Vietnamese). CONCLUSIONS These data fill a critical knowledge gap concerning the cancer experience of Asian American groups and highlight where increased preventive, screening, and surveillance efforts are needed-in particular, lung cancer among Filipina and Korean women and Asian Indian/Pakistani men, breast cancer among all women, and liver cancer among Vietnamese, Laotian, and Kampuchean women and Filipino, Kampuchean, and Vietnamese men.
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Liu L, Noone AM, Gomez SL, Scoppa S, Gibson JT, Lichtensztajn D, Fish K, Wilkens LR, Goodman MT, Morris C, Kwong S, Deapen D, Miller BA. Cancer incidence trends among native Hawaiians and other Pacific Islanders in the United States, 1990-2008. J Natl Cancer Inst 2013; 105:1086-95. [PMID: 23878354 PMCID: PMC3735461 DOI: 10.1093/jnci/djt156] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Lack of annual population estimates for disaggregated Native Hawaiian and Other Pacific Islander (NHOPI) populations limits the ability to examine cancer incidence rates and trends to understand the cancer burdens among NHOPIs. METHODS Utilizing 1990 and 2000 population census data, we estimated the annual populations by age and sex for Native Hawaiians, Samoans, and Guamanians/Chamorros for 1990-2008 in regions covered by 13 of the National Cancer Institute's SEER registries. Cancer diagnoses during 1990-2008 from these registries were used to calculate the age-adjusted (2000 US Standard) incidence rates by sex, calendar year/period, and cancer type for each population. The annual percentage change (APC) in incidence rates was estimated with the 95% confidence intervals (95% CIs) calculated for both the rate and APC estimates. RESULTS Statistically significant declining trends were found in Native Hawaiians, in men for lung and stomach cancers (APC = -2.3%; 95% CI = -3.3 to -1.3; and APC = -3.8%; 95% CI = -6.0 to -1.6, respectively), and in women for breast cancer (APC = -4.1%; 95% CI = -5.7 to -2.5) since 1998 and lung cancer (APC = -6.4%; 95% CI = -10.7 to -1.8) since 2001. Rising incidence trends were experienced by Samoans, especially by Samoan women for breast (APC = 2.7%; 95% CI = 0.9 to 4.5) and uterus (APC = 7.3%; 95% CI = 6.2 to 8.4) cancers. With limited data, Guamanians/Chamorros demonstrated lower, but increasing, incidence rates than other NHOPIs. CONCLUSIONS Population-based cancer incidence rates for disaggregated NHOPI populations help identify disparities in cancer burden and provide valuable information to improve cancer control efforts among NHOPIs.
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Affiliation(s)
- Lihua Liu
- Los Angeles Cancer Surveillance Program, University of Southern California, Los Angeles, CA 90089-9238, USA.
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Lee S, Chen L, He X, Miller MJ, Juon HS. A cluster analytic examination of acculturation and health status among Asian Americans in the Washington DC metropolitan area, United States. Soc Sci Med 2013; 96:17-23. [PMID: 24034947 DOI: 10.1016/j.socscimed.2013.07.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Revised: 07/01/2013] [Accepted: 07/05/2013] [Indexed: 11/28/2022]
Abstract
Previous studies reported mixed findings on the relationship between acculturation and health status among Asian Americans due to different types of acculturation measures used or different Asian subgroups involved in various studies. We aim to fill the gap by applying multiple measures of acculturation in a diverse sample of Asian subgroups. A cross sectional study was conducted among Chinese, Korean and Vietnamese Americans in Washington D.C. Metropolitan Area to examine the association between health status and acculturation using multiple measures including the Suinn-Lew Asian Self-Identity Acculturation (SL-ASIA) scale, clusters based on responses to SL-ASIA, language preference, length of stay, age at arrival in the United Sates and self-identity. Three clusters (Asian (31%); Bicultural (47%); and American (22%)) were created by using a two-step hierarchical method and Bayesian Information Criterion values. Across all the measures, more acculturated individuals were significantly more likely to report good health than those who were less acculturated after adjusting for covariates. Specifically, those in the American cluster were 3.8 times (95% Confidence Interval (CI): 2.2, 6.6) more likely and those in the Bicultural cluster were 1.7 times more likely (95% CI: 1.1, 2.4) to report good health as compared to those in the Asian cluster. When the conventional standardized SL-ASIA summary score (range:-1.4 to 1.4) was used, a one point increase was associated with 2.2 times greater odds of reporting good health (95% CI: 1.5, 3.2). However, the interpretation may be challenging due to uncertainty surrounding the meaning of a one point increase in SL-ASIA summary score. Among all the measures used, acculturation clusters better approximated the acculturation process and provided us with a more accurate test of the association in the population. Variables included in this measure were more relevant for our study sample and may have worked together to capture the multifaceted acculturation process.
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Affiliation(s)
- Sunmin Lee
- 2234C School of Public Health Building, College Park, MD 20742, USA.
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