Social Determinants of Physical Self-Rated Health among Asian Americans; Comparison of Six Ethnic Groups

Abstract

Background: A growing literature has revealed ethnic group differences in determinants and meanings of their self-rated health (SRH). Aim: To explore ethnic variations in the effects of socioeconomic determinants on poor physical SRH of Asians in the United States. Methods: Data came from the National Asian American Survey (NAAS), 2008, with 4977 non-U.S. born Asian Americans, including Asian Indian (n = 1150), Chinese (n = 1350), Filipino (n = 603), Japanese (n = 541), Korean (n = 614), and Vietnamese (n = 719) Americans. Demographic factors (age and gender), socioeconomic status (SES; education, employment, income, and marital status), and physical SRH were measured. Ethnic-specific logistic regressions were applied for data analysis where physical SRH was the outcome and demographic and social determinants were predictors. Results: According to logistic regressions, no social determinant was consistently associated with physical SRH across all ethnic groups. Being married was associated with better physical SRH in Asian Indians and worse SRH in the Filipino group. Education was associated with better SRH in Asian Indian, Chinese, Korean, and Vietnamese Americans. High income was associated with better SRH in Chinese, Filipino, and Vietnamese Americans. Employment was associated with better SRH in Filipino Americans. Conclusion: Social determinants of physical SRH vary across ethnic groups of Asian Americans. Different ethnic groups are differently vulnerable to various social determinants of health. Application of single item SRH measures may be a source of bias in studies of health with ethnically diverse populations. Policy makers should be aware that the same change in social determinants may not result in similar change in the health of ethnic groups.