Health Behaviors Among Asian Americans: Moderating Effects of Acculturation

Background and purpose: With an increasing number of ethnic minorities in the U.S., there has been a growing attention to ethnic/racial disparities in health behaviors. Asian Americans (AA) are one of the fastest growing minority groups in the U.S. and projected to increase from 1.6 million in 2012 to 6.0 million in 2050 (U.S. Census Bureau, 2012). However, little is known about health behaviors of AA. The purpose of the present study was to explore the health behaviors among AA. Specifically we aim to examine factors affecting health behaviors among AA and explore the moderating effects of acculturation on the relationships between enabling factors and health behaviors.

Methods: The data were extracted from the 2015 California Health Interview Survey. The present study included 1568 self-identified AA. An outcome variable of health behaviors was created using six variables about cigarette smoking (1=not at all, 0=all or some day), drinking soda (1= less than 3 times/week, 0=4 or more/week), eating fast food (1= less than one time/week, 0= one or more/week), leisure walking (1=150 minutes or more/ week, 0= less than 150 minutes/week), binge drinking (1= never, 0=yes) and physician visit for preventive care in past year (1= yes, 0=no) and summed scores were used. Guided by the Andersen’s behavioral model and prior research, predisposing factors (age, gender, education, and marital status), need (perceived health and psychological health), enabling factors (income, insurance, having a usual source of health care, and communication satisfaction with physicians) and acculturation (U.S. born and English proficiency) were examined as predictors of health behaviors. Furthermore, moderating effects of acculturation variables on the relationships between enabling factors and health behaviors were examined. A hierarchical regression analysis was performed using SPSS 23.

Results: The majority of AA were foreign-born (72%) and female (57%) and used a language other than English at home (73%). Statistical results showed that being older and female and having better physical and psychological health were associated with more health behaviors. Having better communication with physicians was also associated with more health behaviors. Out of four interaction terms, the moderating effect of U.S. born on the relationships between having a usual health source and health behaviors was found; AA with a usual health care source are more likely to perform higher health behaviors than those without a usual health care course regardless of place of birth; however, differences in health behaviors between AA with and without a usual health care source are greater among U.S. born AA than among foreign born AA.

 

Implications: The present study provides an insight into the current state of health behaviors among AA and identifies factors influencing their health behaviors. The finding of the present study implies that U.S. born AA without a usual health care source can be a vulnerable group with fewer health behaviors. Targeted educational interventions can be implemented for younger, male and U.S. born AA without a usual health care source. In addition, quality communication with physicians needs to be promoted to improve health behaviors among this population.