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Ðoàn LN, Chau MM, Ahmed N, Cao J, Chan SWC, Yi SS. Turning the Health Equity Lens to Diversity in Asian American Health Profiles. Annu Rev Public Health 2024; 45:169-193. [PMID: 38134402 DOI: 10.1146/annurev-publhealth-060222-023852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2023]
Abstract
The monolithic misrepresentation of Asian American (AsAm) populations has maintained assumptions that AsAm people are not burdened by health disparities and social and economic inequities. However, the story is more nuanced. We critically review AsAm health research to present knowledge of AsAm health profiles from the past two decades and present findings and opportunities across three topical domains: (a) general descriptive knowledge, (b) factors affecting health care uptake, and (c) effective interventions. Much of the literature emphasized underutilization of health care services; low knowledge and awareness among AsAms about health-related risk factors, prevention, diagnosis, and treatment; inadequate efforts by health systems to improve language access, provider-patient communication, and trust; and the critical roles of community- and faith-based organizations and leaders in health promotion initiatives. Future opportunities for AsAm health research will require adoption of and significant investment in community-engaged research infrastructure to increase representation, funding, and research innovation for AsAm communities.
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Affiliation(s)
- Lan N Ðoàn
- Section for Health Equity, Department of Population Health, NYU Grossman School of Medicine, New York University, New York, NY, USA;
| | - Michelle M Chau
- Section for Health Equity, Department of Population Health, NYU Grossman School of Medicine, New York University, New York, NY, USA;
| | - Naheed Ahmed
- Institute for Excellence in Health Equity, NYU Grossman School of Medicine, New York University, New York, NY, USA
| | - Jiepin Cao
- Section for Health Equity, Department of Population Health, NYU Grossman School of Medicine, New York University, New York, NY, USA;
| | - Sze Wan Celine Chan
- Section for Health Equity, Department of Population Health, NYU Grossman School of Medicine, New York University, New York, NY, USA;
| | - Stella S Yi
- Section for Health Equity, Department of Population Health, NYU Grossman School of Medicine, New York University, New York, NY, USA;
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2
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Immigration Status as a Social Determinant of Stroke Care. Med Care 2023; 61:117-119. [PMID: 36662628 DOI: 10.1097/mlr.0000000000001821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Ra CK, Pehlivan N, Kim H, Sussman S, Unger JB, Businelle MS. Smoking prevalence among Asian Americans: Associations with education, acculturation, and gender. Prev Med Rep 2022; 30:102035. [PMID: 36531113 PMCID: PMC9747624 DOI: 10.1016/j.pmedr.2022.102035] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 10/25/2022] [Accepted: 10/27/2022] [Indexed: 11/06/2022] Open
Abstract
There is evidence that smoking prevalence rates are related to acculturation, education, and gender among Asian Americans. However, no studies have examined how smoking rates among Asian Americans vary based on acculturation, education, and gender together. This study used National Health Interview Survey (NHIS) data (2010-2018) to examine cigarette smoking prevalence among Asian American men and women aged 18 and older (N = 14,680). Multivariate logistic regression models were used to estimate associations between educational attainment (i.e., college graduate or higher vs some college or lower), years spent in the United States (U.S.) as a proxy for acculturation (i.e., less than 10 years (less acculturated) vs 10 years or more (more acculturated) vs U.S.-born), and cigarette smoking prevalence across gender controlling for age, marital status, poverty (at/above vs below poverty threshold), country of origin (Chinese vs Filipino vs Asian Indian vs Other Asian), and the survey year. Current smoking prevalence was 9.0 % among all Asian Americans - 5.0 % among women and 13.5 % among men. Among respective gender-specific subgroups, U.S.-born Asian women without a college degree and more acculturated Asian immigrant men without a college degree had the highest odds of smoking (OR: 4.096 [95 % CI: 2.638, 6.360] and 1.462 [95 % CI: 1.197, 1.774], respectively). Findings indicated that less educated U.S.-born Asian women and less educated Asian immigrant men are at greatest risk for smoking. Smoking prevalence among Asian Americans is highly related to acculturation, education, and gender. Findings may inform development of policies and programs that are targeted toward smoking cessation among Asian Americans.
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Affiliation(s)
- Chaelin K. Ra
- Rutgers Cancer Institute of New Jersey, Division of Medical Oncology, Robert Wood Johnson Medical School, Rutgers University, NJ, United States,TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States,Corresponding author
| | - Nazife Pehlivan
- Graduate School of Public Health, Department of Public Health, Seoul National University, Seoul, South Korea
| | - Ho Kim
- Graduate School of Public Health, Department of Public Health, Seoul National University, Seoul, South Korea
| | - Steve Sussman
- Population and Public Health Sciences, Keck School of Medicine, University of Southern California, CA, United States
| | - Jennifer B. Unger
- Population and Public Health Sciences, Keck School of Medicine, University of Southern California, CA, United States
| | - Michael S. Businelle
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States,Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
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Vyas MV, Fang J, Austin PC, Kapral MK. Proportion of life spent in Canada and stroke incidence and outcomes in immigrants. Ann Epidemiol 2022; 74:58-65. [PMID: 35853587 DOI: 10.1016/j.annepidem.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 06/28/2022] [Accepted: 07/08/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND To evaluate the association between the proportion of life spent in a host nation and stroke incidence and outcomes among Canadian immigrants. METHODS We conducted a retrospective cohort study of 1.2 million adult Canadian immigrants (mean age 40 [±14.6] years, 50.5% women) who were followed between 2003 and 2018 using linked administrative health data. Using multivariable cause-specific hazard models, we evaluated the overall and sex-specific associations between the proportion of life spent in Canada (φ), modeled as restricted cubic splines, and ischemic stroke incidence and outcomes. RESULTS Compared to the median proportion of life in Canada (φ = 0.2), a J-shaped association between the proportion of life in Canada and ischemic stroke incidence and outcomes was observed. The adjusted hazard ratios of stroke incidence increased with both progressively lower and higher levels of φ [e.g., (HRφ =0.05 vs.φ = 0.20, 1.15; 1.09-1.21) and (HRφ = 0.50 vs. φ = 0.20, 1.45; 1.27-1.66)]. In sex-stratified analyses, the associations between φ and stroke incidence and outcomes were significant in men, but not in women. CONCLUSIONS Stroke incidence and outcomes among immigrants varies with the proportion of life spent in Canada. Future work should identify factors driving the observed associations and the sex differences.
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Affiliation(s)
- Manav V Vyas
- Division of Neurology, Department of Medicine, University of Toronto, Canada; ICES, Toronto, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Canada.
| | | | - Peter C Austin
- ICES, Toronto, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Canada
| | - Moira K Kapral
- ICES, Toronto, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Canada; Division of General Internal Medicine, Department of Medicine, University of Toronto, Canada
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Juárez SP, Honkaniemi H, Gustafsson NK, Rostila M, Berg L. Health Risk Behaviours by Immigrants’ Duration of Residence: A Systematic Review and Meta-Analysis. Int J Public Health 2022; 67:1604437. [PMID: 35990194 PMCID: PMC9388735 DOI: 10.3389/ijph.2022.1604437] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 06/28/2022] [Indexed: 12/02/2022] Open
Abstract
Objectives: The aim was to systematically review and synthesise international evidence on changes in health risk behaviours by immigrants’ duration of residence. Methods: We searched literature databases for peer-reviewed quantitative studies published from 2000 to 2019, examining alcohol, drug and tobacco use; physical inactivity; and dietary habits by duration of residence. Results: Narrative synthesis indicated that immigrants tend to adopt health risk behaviours with longer residence in North America, with larger variation in effect sizes and directionality in other contexts. Random-effects meta-analyses examining the pooled effect across all receiving countries and immigrant groups showed lower odds of smoking (OR 0.54, 0.46–0.63, I2 = 68.7%) and alcohol use (OR 0.61, 0.47–0.75, I2 = 93.5%) and higher odds of physical inactivity (OR 1.71, 1.40–2.02, I2 = 99.1%) among immigrants than natives, but did not provide support for a universal trend by duration of residence. Conclusion: Findings suggest that duration of residence could serve as an effective instrument to monitor immigrants’ health changes. However, differences in receiving country contexts and immigrant populations’ composition seem to be important to predict the level and direction of behavioural change. Systematic Review Registration:https://www.crd.york.ac.uk/prospero/, PROSPERO CRD42018108881.
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Affiliation(s)
- Sol P. Juárez
- Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden
- Department of Public Health Sciences, Faculty of Social Sciences, Stockholm University, Stockholm, Sweden
- *Correspondence: Sol P. Juárez,
| | - Helena Honkaniemi
- Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden
- Department of Public Health Sciences, Faculty of Social Sciences, Stockholm University, Stockholm, Sweden
| | - Nina-Katri Gustafsson
- Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden
- Department of Public Health Sciences, Faculty of Social Sciences, Stockholm University, Stockholm, Sweden
| | - Mikael Rostila
- Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden
- Department of Public Health Sciences, Faculty of Social Sciences, Stockholm University, Stockholm, Sweden
| | - Lisa Berg
- Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden
- Department of Public Health Sciences, Faculty of Social Sciences, Stockholm University, Stockholm, Sweden
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Liem A, Renzaho AMN, Hannam K, Lam AIF, Hall BJ. Acculturative stress and coping among migrant workers: A global mixed-methods systematic review. Appl Psychol Health Well Being 2021; 13:491-517. [PMID: 33811751 DOI: 10.1111/aphw.12271] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 02/03/2021] [Accepted: 03/13/2021] [Indexed: 02/02/2023]
Abstract
No existing review has synthesized key questions about acculturation experiences among international migrant workers. This review aimed to explore (1) What are global migrant workers' experiences with acculturation and acculturative stress? (2) What are acculturative stress coping strategies used by migrant workers? And (3) how effective are these strategies for migrant workers in assisting their acculturation in the host countries? Peer-reviewed and gray literature, without time limitation, were searched in six databases and included if the study: focused on acculturative stress and coping strategies; was conducted with international migrant workers; was published in English; and was empirical. Eleven studies met the inclusion criteria. Three-layered themes of acculturation process and acculturative stress were identified as: individual layer; work-related layer; and social layer. Three key coping strategies were identified: emotion-focused; problem-focused; and appraisal-focused. These coping strategies were used flexibly to increase coping effectiveness and evidence emerged that a particular type of acculturative stress might be solved more effectively by a specific coping strategy. Migrant workers faced numerous challenges in their acculturative process. Understanding this process and their coping strategies could be used in developing research and interventions to improve the well-being of migrant workers.
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Affiliation(s)
- Andrian Liem
- Department of Communication, Centre for Macau Studies, University of Macau, Macau, China
| | - Andre M N Renzaho
- School of Social Sciences, Western Sydney University, Penrith South, NSW, Australia
- Translational Health Research Institute, Western Sydney University, Penrith South, NSW, Australia
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Vic, Australia
| | - Kevin Hannam
- University of Saint Joseph, Macau, China
- University of Johannesburg, Johannesbuurg, South Africa
- Nebrija University, Madrid, Spain
- Technological Higher Education Institute, Hong Kong, China
| | - Agnes I F Lam
- Department of Communication, Centre for Macau Studies, University of Macau, Macau, China
| | - Brian J Hall
- NYU Shanghai, Shanghai, China
- School of Global Public Health, New York University, New York, NY, USA
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Berg L, Gustafsson NK, Honkaniemi H, Juárez SP. Health risk behaviours among migrants by duration of residence: protocol for a systematic review and meta-analysis. BMJ Open 2020; 10:e038388. [PMID: 33109655 PMCID: PMC7592271 DOI: 10.1136/bmjopen-2020-038388] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION International migrants' health has often been found to deteriorate in new countries, partly due to changes in health risk behaviours such as alcohol consumption, tobacco use, physical inactivity, and poor dietary habits. However, limited efforts have been made to comprehensively evaluate the extent to which migrants adopt unhealthy risk behaviours with longer duration of residence. This systematic review and meta-analysis will summarise evidence on international migrants' behavioural patterns by duration of residence in multiple country contexts. METHODS AND ANALYSIS PubMed/MEDLINE, Web of Science and ProQuest databases will be searched for quantitative or mixed-method observational studies published in peer-reviewed scientific journals between 1 January 2000 and 31 December 2019. Studies comparing foreign-born individuals by duration of residence will be included. Information on study characteristics, descriptive statistics and measures of effect will be extracted. All included studies will be quality assessed using a modified Newcastle-Ottawa scale. The review will include narrative synthesis and, if sufficient and comparable data are available, random effects meta-analyses. The review will be conducted in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. ETHICS AND DISSEMINATION Ethical approval is not required since previously published information from peer-reviewed studies will be assessed. The results of this review will be published in peer-reviewed journals and presented at scientific conferences. Other forms of dissemination will include communication to broader audiences using well-established channels, including through university-based press releases. Progress will be regularly updated on the International Prospective Register of Systematic Reviews to ensure full transparency. PROSPERO REGISTRATION NUMBER CRD42018108881.
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Affiliation(s)
- Lisa Berg
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
- Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Stockholm, Sweden
| | - Nina-Katri Gustafsson
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
- Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Stockholm, Sweden
| | - Helena Honkaniemi
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
- Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Stockholm, Sweden
| | - Sol Pia Juárez
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
- Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Stockholm, Sweden
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Byrne G, Murphy F, Eustace-Cook J, Mooney M, O'Brien F, O'Donnell S, Corry M, Lynch AM, Neenan K, McKee G. Prevalence of tobacco smoking among European migrants residing in EU 15 countries: a quantitative systematic review protocol. JBI Evid Synth 2020; 18:2647-2657. [PMID: 32740029 DOI: 10.11124/jbisrir-d-19-00396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVES The objective of this systematic review is to summarize the prevalence of tobacco smoking in European migrants residing in EU 15 countries. INTRODUCTION Most of the migration within the World Health Organization European Region is intracontinental. The prevalence of smoking varies greatly across the European Region. Migrants may choose to adopt the smoking behaviors of their host countries or retain the smoking behaviors of their countries of origin. Several studies have identified the high prevalence of smoking of some migrant groups in comparison to their host countries, but no systematic reviews have been completed on intracontinental migrants within the European Region. INCLUSION CRITERIA Epidemiological studies, which include data on the prevalence of tobacco smoking in European migrants aged ≥ 15 years of age living in the following EU 15 countries host countries for ≥ 1 year: Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, Netherlands, Portugal, Spain, Sweden, and the United Kingdom. METHODS MEDLINE, Embase, CINAHL, PsycINFO, ASSIA, and Web of Science will be searched to identify published studies. General gray literature (eg, Open Grey) as well as gray literature for migrants (Migrant Health Research Portal) and tobacco will be searched. The JBI methodology for systematic reviews of prevalence will be used in this review. Data synthesis will use meta-analysis where appropriate and narrative synthesis.
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Affiliation(s)
- Gobnait Byrne
- Trinity Centre for Practice and Healthcare Innovation, Trinity College Dublin: A JBI Affiliated Group, Dublin, Ireland.,School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Fiona Murphy
- Trinity Centre for Practice and Healthcare Innovation, Trinity College Dublin: A JBI Affiliated Group, Dublin, Ireland.,School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | | | - Mary Mooney
- Trinity Centre for Practice and Healthcare Innovation, Trinity College Dublin: A JBI Affiliated Group, Dublin, Ireland.,School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Frances O'Brien
- Trinity Centre for Practice and Healthcare Innovation, Trinity College Dublin: A JBI Affiliated Group, Dublin, Ireland.,School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Sharon O'Donnell
- Trinity Centre for Practice and Healthcare Innovation, Trinity College Dublin: A JBI Affiliated Group, Dublin, Ireland.,School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Margarita Corry
- Trinity Centre for Practice and Healthcare Innovation, Trinity College Dublin: A JBI Affiliated Group, Dublin, Ireland.,School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Aileen M Lynch
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Kathleen Neenan
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Gabrielle McKee
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
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Li CC, Matthews AK, Dong X, Simon M. The Influence of Smoking Status on the Health Profiles of Older Chinese American Men. J Am Geriatr Soc 2020; 67:S577-S583. [PMID: 31403203 DOI: 10.1111/jgs.15889] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 02/06/2019] [Accepted: 02/22/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To examine the influence of smoking status on the health profiles of community-dwelling older Chinese American men in the greater Chicago, IL, area. DESIGN This study utilized a cross-sectional study design to analyze data obtained from the larger Population Study of Chinese Elderly in Chicago (PINE). SETTING A population-based study conducted in Chicago. PARTICIPANTS Baseline data from Chinese American men who participated in PINE (N = 1492). MEASURES Demographic characteristics measured included age, education years, marital status, income, health insurance coverage, and smoking pack-years. Self-reported smoking status included never smoker, current smoker, and former smoker. Health profile indicators included perceived health status, past 12-month changes in health, chronic medical conditions (heart diseases, stroke, cancer, diabetes, hypertension, high cholesterol, thyroid disease, and osteoarthritis), quality of life, and depression and anxiety. RESULTS The mean age of the study sample was 72.5 years. Of the sample, 65% reported a smoking history, with 25.1% current smokers and 40.1% former smokers. Current smokers were younger, less educated, and uninsured. Former smokers had the poorest overall health profiles. Compared to former smokers, current smokers were less likely to have heart disease (odds ratio [OR] = 0.59; 95% confidence interval [CI] = 0.39-0.90), hypertension (OR = 0.54; 95% CI = 0.41-0.72), high cholesterol (OR = 0.74; 95% CI = 0.56-0.99), thyroid disease (OR = 0.44; 95% CI = 0.21-0.90), depression (rate ratio [RR] = 0.76; 95% CI = 0.58-0.99), and anxiety (RR = 0.72; 95% CI = 0.59-0.89), and they had fewer overall chronic medical conditions (RR = 0.79; 95% CI = 0.70-0.88) after controlling for demographic factors and smoking pack-year history. Compared to never smokers, former and current smokers reported poorer self-rated health (OR = 1.58; 95% CI = 1.11-2.26) and lower perceived quality of life (OR = 2.11; 95% CI = 1.04-4.29). CONCLUSIONS Consistent with prior research, smoking rates were elevated among this sample of older Chinese men. Counter to study hypotheses, former smokers had worse overall health. Study findings suggest the need for health promotion interventions for both current and former smokers. J Am Geriatr Soc 67:S577-S583, 2019.
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Affiliation(s)
- Chien-Ching Li
- Department of Health Systems Management, Rush University, Chicago, Illinois
| | - Alicia K Matthews
- Department of Health Systems Science, University of Illinois at Chicago, Chicago, Illinois
| | - XinQi Dong
- Rutgers Biomedical Health Sciences, Rutgers University, New Brunswick, New Jersey
| | - Melissa Simon
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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10
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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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11
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Contextual Factors Related to Conventional and Traditional Tobacco Use Among California Asian Indian Immigrants. J Community Health 2019; 43:280-290. [PMID: 28852903 DOI: 10.1007/s10900-017-0419-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
California's tobacco control program contracted for tobacco use surveillance of Asian Indian Americans to address the paucity of information about tobacco use in this community, given their growing proportion of California's population. This study examined correlates of conventional (CTU) and Asian Indian traditional tobacco use (TTU) in a population-based sample of predominantly immigrant Asian Indian adults residing in California (N = 3228). The analytic sample (n = 2140) was limited to self-identified immigrants from India. Descriptive statistics, bivariate analyses, and multivariate logistic regressions were conducted to examine correlates of tobacco use among Asian Indian immigrants related to their acculturation and religious affiliation. While 65% of the sample had ever used traditional tobacco products (paan masala, gutka, bidis), only 25% had ever used conventional tobacco (cigarettes, cigar, pipe, chewing tobacco, snuff). Less than 5% reported tobacco use in the past 30 days. Rates of ever TTU and CTU were higher among men than women. Ethnic enclave residence was not associated with tobacco use. Impaired mental health was associated with CTU, and number of years spent in the U.S. was positively associated with both CTU and TTU. Individuals affiliated with Sikhism were less likely to use tobacco than individuals affiliated with Hinduism. Few population-based studies in the U.S. address both CTU and TTU use among Asian Indian immigrants. Tobacco use in Asian Indian immigrants may be seriously underestimated if surveillance is limited to conventional tobacco products. Interventions to reduce tobacco use should address mental health issues and consider religious affiliation.
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12
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Immigration factors and potentially avoidable hospitalizations in Canada. SSM Popul Health 2018; 7:100336. [PMID: 30581968 PMCID: PMC6299159 DOI: 10.1016/j.ssmph.2018.100336] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 12/03/2018] [Accepted: 12/06/2018] [Indexed: 11/22/2022] Open
Abstract
Objective Estimate the effect of immigration characteristics on the risk of a hospitalization for an ambulatory care sensitive condition (ACSC). Research design We analyzed data on the Canadian resident adult population aged 18 to 74 years who responded to the 2006 long form Census. The Census data were linked to the Canadian Institute for Health Information (CIHI)’s Discharge Abstract Database (DAD) for fiscal years 2006–2007, 2007–2008, and 2008–2009. We conducted a logistic regression on the binary variable we created for an ACSC admission. Measures The CIHI definition of ACSC hospitalizations was used to identify potentially avoidable hospitalizations in the DAD. Immigration factors analyzed included years in Canada, ethnic origin, and ability to speak one of the official languages. Results There were 3,342,450 respondents aged between 18 and 74. Using the Canadian at birth as our reference population, recent immigrants (up to five years in Canada) had lower odds of an ACSC hospitalization, regardless of their ethnic origins, with the exception of immigrants from Oceania and from other North American countries for whom the effect was not significant. The protective effect was still present in children of immigrants (AOR=0.89). Immigrants from the Caribbean, from Southern, Eastern, and Western Europe, as well as those from East Asia had lower odds across categories of time spent in Canada. The protective effect was stronger in immigrants from East Asia and lower in those of Oceanic and other North American countries. Conclusions Our results suggest that the healthy immigrant effect dissipates with time in Canada but remains even in children of immigrants. The protective effect differs depending on the ethnic origin of the immigrant. Immigrants generally arrive in a country with a higher health status than that of the local population. Immigrants and children of immigrants have lower odds of having an ACSC hospitalization are lower than Canadians at birth. Odds of an ACSC hospitalization vary depending on immigration characteristics such as the ethnic origin and the time lived in Canada.
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Katigbak C, Maglalang DD, Chao YY, Au H, Liang W, Zuo S. Cultural Perspectives on Tobacco Use and Cessation Among Chinese American Immigrants: A Community-Engaged Qualitative Study. J Transcult Nurs 2018; 30:350-358. [PMID: 30556472 DOI: 10.1177/1043659618817583] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Tobacco use is a preventable cause of death among ethnic minorities. Chinese Americans have high smoking rates and underutilize evidence-based cessation therapies. Community members' perspectives on tobacco use and cessation may help bridge treatment gaps and ensure that cessation approaches are aligned with cultural values. METHODS Focus group methods were used to explore cultural factors influencing tobacco use and cessation among 50 Chinese immigrants. Emerging themes were identified using thematic analysis. RESULTS The three emerging themes are (a) tobacco use is influenced by Chinese American immigrants' socioecological environment, (b) self-discipline determines the ability to quit, and (c) complex family dynamics influence quitting. DISCUSSION Cessation approaches framed within cultural perspectives may help bridge treatment gaps. Innovations such as leveraging soft technologies that are widely used in the community may extend the reach of health promotion campaigns and treatments.
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Affiliation(s)
| | | | - Ying-Yu Chao
- 2 Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - Helen Au
- 1 Boston College, Chestnut Hill, MA, USA
| | | | - Sai Zuo
- 3 Chinese Consolidated Benevolent Association of New England, Boston, MA, USA
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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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Mao A, Bottorff JL, Oliffe JL, Sarbit G, Kelly MT. Chinese immigrant men smokers' sources of cigarettes in Canada: A qualitative study. Tob Induc Dis 2017; 15:18. [PMID: 28344543 PMCID: PMC5361810 DOI: 10.1186/s12971-017-0123-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 03/16/2017] [Indexed: 11/10/2022] Open
Abstract
Background Immigrants often experience economic hardship in their host country and tend to belong to economically disadvantaged groups. Individuals of lower socioeconomic status tend to be more sensitive to cigarette price changes. This study explores the cigarette purchasing patterns among Chinese Canadian male immigrants. Methods Semi-structured in-depth interviews were conducted with 22 Chinese Canadian immigrants who were smoking or had quit smoking in the last five years. Results Because of financial pressures experienced by participants, the high price of Canadian cigarettes posed a significant challenge to their continued smoking. While some immigrants bought fully-taxed cigarettes from licensed retailers, more often they sought low-cost cigarettes from a variety of sources. The two most important sources were cigarettes imported during travels to China and online purchases of Chinese cigarettes. The cigarettes obtained through online transactions were imported by smoking or non-smoking Chinese immigrants and visitors, suggesting the Chinese community were involved or complicit in sustaining this form of purchasing behavior. Other less common sources included Canada-USA cross border purchasing, roll your-own pouch tobacco, and buying cigarettes available on First Nations reserves. Conclusions Chinese Canadian immigrant men used various means to obtain cheap cigarettes. Future research studies could explore more detailed features of access to expose gaps in policy and improve tobacco regulatory frameworks.
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Affiliation(s)
- Aimei Mao
- Kiang Wu Nursing College of Macau, Est. Repouso No.35, R/C, Macau, China
| | - Joan L Bottorff
- Institute for Healthy Living and Chronic Disease Prevention, University of British Columbia, Kelowna, Canada.,Faculty of Health Sciences, Australian Catholic University, Melbourne, Australia
| | - John L Oliffe
- School of Nursing, University of British Columbia, Vancouver, Canada
| | - Gayl Sarbit
- Institute for Healthy Living and Chronic Disease Prevention, University of British Columbia, Kelowna, Canada
| | - Mary T Kelly
- Institute for Healthy Living and Chronic Disease Prevention, University of British Columbia, Kelowna, Canada
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