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Morey BN, Garcia S, Lin K, Canchola AJ, Alexeeff SE, Kurtovich EM, Uong S, Aoki RLF, Guan A, Torres JM, Shariff-Marco S, Yao S, Kushi LH, Gomez SL, Kroenke CH. A validation study for measuring Asian- and Hispanic-serving sociocultural institutions in neighborhoods using business listing data and potential implications for health. Soc Sci Med 2024; 356:117143. [PMID: 39032193 PMCID: PMC11330724 DOI: 10.1016/j.socscimed.2024.117143] [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: 02/23/2024] [Revised: 07/05/2024] [Accepted: 07/12/2024] [Indexed: 07/22/2024]
Abstract
Ethnic enclaves influence the health of Asian American and Hispanic or Latinx/a/o populations, likely via neighborhood social, economic, and built environments. To facilitate studies aiming to disentangle these specific neighborhood mechanisms, we describe the creation and validation of two novel measures-Asian-serving and Hispanic-serving sociocultural institutions (SCIs)-to estimate the social, cultural, and economic character of ethnic enclaves in California. Business listing data were used to identify SCIs or businesses that promote cultural and social identity, including arts, civic, historical, religious, social service, and membership organizations. Keyword searches of business names were used to identify potential Asian- or Hispanic-serving SCIs. An online audit of 1,627 businesses within 12 cities confirmed the validity of using keyword searches to assess whether census tracts were high or low in Asian- or Hispanic-serving SCIs (sensitivity: 63%-100%, specificity: 86%-95%; positive predictive value: 63%-89%). In exploratory regression analyses, high presence of SCIs (compared to low presence) may be associated with neighborhood-level health indicators, including greater percentages of residents who had an annual checkup in majority Asian census tracts and lower percentages of residents who were current smokers in majority Asian and Hispanic census tracts. This approach advances methodology in measurement of neighborhood sociocultural environments.
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Affiliation(s)
- Brittany N Morey
- Department of Health, Society, & Behavior, Program in Public Health, University of California Irvine, 856 Health Sciences Quad, Suite 3527, Irvine, CA, 92697-3957, USA.
| | - Samantha Garcia
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1441 Eastlake Ave., Los Angeles, CA, 90033, USA
| | - Katherine Lin
- Department of Epidemiology & Biostatistics, School of Medicine, University of California San Francisco, 550 16th. Street, San Francisco, CA, 94158, USA
| | - Alison J Canchola
- Department of Epidemiology & Biostatistics, School of Medicine, University of California San Francisco, 550 16th. Street, San Francisco, CA, 94158, USA
| | - Stacey E Alexeeff
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA
| | - Elaine M Kurtovich
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA
| | - Stephen Uong
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY, 10032, USA
| | - Rhonda-Lee F Aoki
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA
| | - Alice Guan
- Department of Epidemiology & Biostatistics, School of Medicine, University of California San Francisco, 550 16th. Street, San Francisco, CA, 94158, USA
| | - Jacqueline M Torres
- Department of Epidemiology & Biostatistics, School of Medicine, University of California San Francisco, 550 16th. Street, San Francisco, CA, 94158, USA
| | - Salma Shariff-Marco
- Department of Epidemiology & Biostatistics, School of Medicine, University of California San Francisco, 550 16th. Street, San Francisco, CA, 94158, USA; Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, 1450 3rd Street, San Francisco, CA, 94158, USA
| | - Song Yao
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY, 14263, USA
| | - Lawrence H Kushi
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA
| | - Scarlett Lin Gomez
- Department of Epidemiology & Biostatistics, School of Medicine, University of California San Francisco, 550 16th. Street, San Francisco, CA, 94158, USA; Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, 1450 3rd Street, San Francisco, CA, 94158, USA
| | - Candyce H Kroenke
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA
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Baek K, Bell C, Montgomery SB, Ortiz L, Kumar A, Alemi Q. Community-Based Mental Health Challenges and Implications: Examining Factors Influencing Distress and Help-Seeking Behaviors among Korean American Church Leaders and Members in Greater Los Angeles. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1094. [PMID: 39200703 PMCID: PMC11354220 DOI: 10.3390/ijerph21081094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2024] [Revised: 08/12/2024] [Accepted: 08/16/2024] [Indexed: 09/02/2024]
Abstract
There is limited research on the factors that impact mental distress among Korean American (KA) church leaders even though their unique social situation can create many barriers to seeking mental health assistance. This study compared factors impacting mental distress and help-seeking behaviors between KA church leaders (CLs) and church members (CMs) in the greater Los Angeles area. The respondents (N = 243) were mostly female, married, educated, first-generation immigrants with a mean age of 47.9 years (SD = 19.7). The Hopkins Symptoms Checklist 10 was used to measure anxiety and depression. Hierarchal linear regressions showed that health status exerted the strongest effect on both anxiety and depression among CLs and CMs. Beyond health status, education (only for depression), informal resource use, and resiliency impacted mental distress scores for CLs. Only resiliency and religious coping predicted depression scores among CMs. To effectively reach this population, community-based organizations and behavioral health specialists should consider collaborating with churches to promote and provide essential mental health support. Our findings also highlight that the needs of church leaders (CLs) and church members (CMs) differ, which should guide the development of culturally tailored interventions that build on the resilience of both groups.
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Affiliation(s)
- Kelly Baek
- 1898 Business Center Drive, Department of Social Work & Social Ecology, School of Behavioral Health, Loma Linda University, San Bernardino, CA 92408, USA (S.B.M.); (L.O.); (Q.A.)
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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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Zhang H, Chen D, Wu J, Zou P, Cui N, Li D, Shao J, Tang L, Xue E, Ye Z, Wang X. Heterogenous subtypes of health literacy among individuals with Metabolic syndrome: a latent class analysis. Ann Med 2023; 55:2268109. [PMID: 37851734 PMCID: PMC10586064 DOI: 10.1080/07853890.2023.2268109] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 10/02/2023] [Indexed: 10/20/2023] Open
Abstract
Objective To explore the heterogenous subtypes and the associated factors of health literacy among patients with metabolic syndrome.Methods A cross-sectional study was conducted, and 337 patients with metabolic syndrome were recruited from Sir Run Run Shaw Hospital in Zhejiang Province from December 2021 to February 2022. The Social Support Questionnaire, Short version of the Health Literacy Scale European Questionnaire (HLS-EU-Q16), and MacArthur Scale of Subjective Social Status were used for investigation. Latent class analysis (LCA) was performed to explore the heterogenous subtypes of health literacy among Metabolic syndrome patients. Univariate analysis and logistic regression were used to identify the predictors of the latent classes.Results The findings of LCA suggested that three heterogeneous subtypes of health literacy among individuals with metabolic syndrome were identified: high levels of health literacy, moderate levels of health literacy, and low levels of health literacy. The multinomial logistic regression results indicated that compared with low levels of health literacy class, the high levels of health literacy class were predicted by age (OR 0.932, 95%CI[0.900-0.966]), socio-economic status (OR 1.185, 95%CI[1.058-1.328]), and social support (OR 1.065, 95%CI[1.012-1.120]). Compared with low levels of health literacy class, the moderate levels of health literacy class were predicted by age (OR 0.964, 95%CI[0.934-0.995]), socio-economic status (OR 1.118, 95%CI[1.006-1.242]), male (OR 0.229, 95%CI[0.092-0.576]).Conclusion The levels of health literacy among patients with metabolic syndrome can be divided into three heterogenous subtypes. The results can inform policy-makers and care professionals to design targeted interventions for different subgroups among patients with metabolic syndrome who are male, at older age, have less social support, and with disadvantaged socio-economic status to improve health literacy.
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Affiliation(s)
- Hui Zhang
- Department of Nursing, Guizhou Provincial People’s Hospital, Guiyang, China
| | - Dandan Chen
- Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, China
| | - Jingjie Wu
- Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, China
| | - Ping Zou
- Scholar Practitioner Program, School of Nursing, Nipissing University, Toronto, Ontario, Canada
| | - Nianqi Cui
- School of Nursing, Kunming Medical University, Kunming, China
| | - Dejie Li
- Department of Nursing, Guizhou Provincial People’s Hospital, Guiyang, China
| | - Jing Shao
- Department of Nursing, Zhejiang University School of Medicine, Hangzhou, China
| | - Leiwen Tang
- Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, China
| | - Erxu Xue
- Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, China
| | - Zhihong Ye
- Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, China
| | - Xiyi Wang
- School of Nursing, Shanghai JiaoTong University, Shanghai, China
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Wong MJ, Santos C, Thomas Tobin CS. Racial/ethnic differences in social support and health among Asian American and non-Hispanic White midlife women: Results from the Study of Women's Health Across the Nation (SWAN). ETHNICITY & HEALTH 2023; 28:182-199. [PMID: 35138201 DOI: 10.1080/13557858.2022.2035691] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 01/25/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Although prior research suggests Asian Americans experience physical health advantages relative to other racial/ethnic groups, increasing evidence points to health inequalities within Asian American subgroups. Disparities are especially pronounced among middle-aged Asian American women, who remain an understudied population, despite studies showing that midlife corresponds with distinct social stressors and changes in the availability of protective resources, such as social support. Thus, the purpose of the study was to examine racial/ethnic differences in social support and self-rated health (SRH) among middle-aged women. DESIGN With data from the Study of Women's Health Across the Nation (SWAN; N = 1258), we used modified Poisson regression models to estimate incidence rate ratios (IRR), examining how social support shaped the risk of fair-to-poor SRH by race/ethnicity. We tested interactions between perceived stress, social support and race/ethnicity to determine whether the stress-buffering role of social support varies by group. RESULTS Results demonstrate racial/ethnic differences in SRH. Higher levels of social support were linked to higher fair-to-poor SRH among Chinese American women (IRR = 1.24; 95% CI [1.02, 1.52]); while greater social support conferred lower risk among White women. Interaction analyses revealed additional nuances in the stress-buffering effects of social support among Chinese American women, such that the health benefits of social support depended on levels of perceived stress (IRR = 0.75; 95% CI [0.57, 1.00]). CONCLUSIONS These findings highlight important distinctions in the ways that psychosocial factors shape health across racial/ethnic groups. In particular, this study helps advance our understanding of important subgroup differences in the stress-buffering role of social support for Asian American midlife women. Interventions should focus on identifying sources of social strain among Asian American women that can increase the risk for poor health and identify alternative sources of support that mitigate stressors to improve health.
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Affiliation(s)
- Michele J Wong
- Department of Social Welfare, University of California, 337 Charles E. Young Drive, Los Angeles, CA, United States
| | - Carlos Santos
- Department of Social Welfare, University of California, 337 Charles E. Young Drive, Los Angeles, CA, United States
| | - Courtney S Thomas Tobin
- Department of Community Health Sciences, University of California, Los Angeles, CA, United States
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Morey BN, Ryu S, Shi Y, Lee S. The Mediating Role of Sleep Disturbance on the Association Between Stress and Self-Rated Health Among Chinese and Korean Immigrant Americans. Prev Chronic Dis 2023; 20:E04. [PMID: 36701271 PMCID: PMC9923937 DOI: 10.5888/pcd20.220241] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
INTRODUCTION Disturbed sleep may be a factor that links stress with poor health, especially among groups experiencing high levels of stress caused by racial and ethnic minority and nativity status. The objective of this study was to describe the potential mediating role of sleep disturbance in the associations between various types of stress and self-rated health among Chinese and Korean Americans. METHODS Our cross-sectional study consisted of 400 Chinese and Korean immigrants aged 50 to 75 years recruited from August 2018 through June 2020 from physicians' clinics in the Baltimore-Washington, DC, metropolitan area. We used the Patient Reported Outcomes Measurement Information System (PROMIS) short-form questionnaire to measure sleep disturbance. Linear regression analyses examined associations between 3 types of stress (acculturative stress, perceived stress, and distress) and self-rated health, accounting for demographic, socioeconomic, and health insurance factors. The Karlson-Holm-Breen method was used to estimate the total and direct effects of stresses on self-rated health and the indirect effects of stresses on health through sleep disturbance. RESULTS Greater acculturative stress (β = 0.08; 95% CI, 0.01-0.14), perceived stress (β = 0.05; 95% CI, 0.03-0.08), and distress (β = 0.09; 95% CI, 0.05-0.13) were all associated with poorer self-rated health. Sleep disturbance was a partial mediator, with sleep disturbance accounting for 21.7%, 14.9%, and 18.7% of the associations between acculturative stress, perceived stress, and distress and self-rated health, respectively. CONCLUSION Because sleep disturbance partially mediates the associations between stress and poor self-rated health, future interventions and research may consider mitigating sleep disturbances and stress among racial and ethnic minority populations to address health disparities.
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Affiliation(s)
- Brittany N Morey
- Department of Health, Society, and Behavior, Program in Public Health, University of California Irvine, 653 E Peltason Dr, Anteater Instruction and Research Building (AIRB) 2022, Irvine, CA 92697-3957
| | - Soomin Ryu
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor
| | - Yuxi Shi
- Department of Medicine, School of Medicine, University of California, Irvine
| | - Sunmin Lee
- Department of Medicine, School of Medicine, University of California, Irvine
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Jia D, Zhang K, Xu Y. The Relationship Between Social Support and Relapse Tendency Among Those Who Struggle With Drug Addiction: Multiple Mediators of Exercise Self-Efficacy and Health-Related Quality of Life. JOURNAL OF DRUG ISSUES 2023. [DOI: 10.1177/00220426231152912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Based on social support theory and exercise promotion health theory, we verified the mediating role of exercise self-efficacy and health-related quality of life in the relationship between social support and the relapse tendency of Chinese people who struggle with drug addiction. Samples who had received traditional Chinese health-promoting exercise interventions over 3 months were recruited from two drug rehabilitation centres in Zhejiang Province ( n = 415). The participants completed the Social Support Rating Scale, Exercise Self-Efficacy Scale, Health Survey Short Form Questionnaire Chinese version, and Relapse Tendency Scale. Correlation analysis showed significant positive correlations between social support, exercise self-efficacy, and quality of life. In contrast, social support, exercise self-efficacy, and quality of life were negatively correlated with relapse tendency. In addition, intermediary effect analysis showed that social support has a direct negative predictive effect on relapse tendency in two ways: as an independent intermediary of exercise self-efficacy and as a chain intermediary of exercise self-efficacy and quality of life. Good exercise habits and adherence, as well as early establishment of social support, are beneficial not only for reducing craving and relapse behaviour but also for enhancing the quality of life of people who struggle with drug addiction, thereby facilitating the recovery efficacy for maintenance.
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Affiliation(s)
- Dongming Jia
- Zhejiang Police Vocational College, Hangzhou, People’s Republic of China
| | - Kai Zhang
- National Police University for Criminal Justice, Baoding, People’s Republic of China
| | - Yuming Xu
- Affiliated Hospital of Hangzhou Normal University, Hangzhou, People’s Republic of China
- School of Physical Education, Hangzhou Normal University, Hangzhou, People’s Republic of China
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Tan T, Liu W, Zhao Q, Hou Y, Yang Y, Wu X, Wang Y, Chen Y, Hu G. Anxiety, depression, psychological stress and coping style in medical postgraduates in southeastern China when restricted to commuting between the campus and hospital during the COVID-19 pandemic. Front Psychiatry 2022; 13:1035075. [PMID: 36683983 PMCID: PMC9853534 DOI: 10.3389/fpsyt.2022.1035075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 12/07/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND As the COVID-19 epidemic was gradually brought under control, a new autumn semester began in 2020. How was the mental health of postgraduates as they experienced quarantine at home, only commuting between the school and hospital? METHODS The research was conducted in a cross-sectional online survey in October 2020. The data were collected from 1,645 medical postgraduates (master's and doctoral students) by using the demographic information questionnaire, the Self-rating Depression Scale (SDS), the Self-rating Anxiety Scale (SAS), the Questionnaire on Psychological Stressors of Postgraduates (QPSP), the Simplified Coping Style Questionnaire (SCSQ) and the Social Support Rate Scale (SSRS). One-way ANOVA and Pearson correlation were used to explore the relationships among anxiety, depression, psychological stressors, social support and coping style. Structural equation modeling (SEM) was conducted to assess the mediation model. RESULTS Among the total of 1,645 medical postgraduates, 21.6% (n = 356) had self-rated depression symptoms, and 9.4% (n = 155) had self-rated anxiety symptoms. The main disturbances they experienced were employment, academic and interpersonal pressure. The master of third grade students had the highest employment pressure, and the master of second grade students had the highest academic and interpersonal pressure. Negative coping played a negative mediating role and social support played a positive mediating role in the relationships between perceived stress and anxiety (β = 0.027, P < 0.01; β = 0.124, P < 0.01) and depression (β = 0.016, P < 0.01; β = 0.193, P < 0.01). CONCLUSION Medical postgraduates in China restricted to studies on campus and in the hospital experienced psychological distress. Our results suggest that providing employment and learning guidance, while strengthening social support and guiding positive coping may be effective at improving the mental health of the medical graduate students, mediating their perceived stress and negative emotions.
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Affiliation(s)
- Tianci Tan
- Graduate School of Southern Medical University, Guangzhou, China
| | - Wenting Liu
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Qianqian Zhao
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Yanfei Hou
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Yuan Yang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xiaxin Wu
- School of Nursing, Peking University, Beijing, China
| | - Yuying Wang
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Yu Chen
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Guangli Hu
- Graduate School of Southern Medical University, Guangzhou, China
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