Chinese American Research Articles

Body fat variation and redistribution across different stages of life measured by dual-energy x-ray absorptiometry.

The global obesity epidemic of all ages has increased the demand for accurate management of body fat in each stage of life. The primary aim of this study was to provide reference centiles of body fat indices for Chinese children and adults and compare those with ethnicities from USA using dual-energy x-ray absorptiometry (DXA). The samples were drawn from two nationwide cross-sectional surveys of China Body Composition Life-course Study (2013-2023) and the US National Health and Nutrition Examination Survey (2011-2018). Age- and sex-specific centile curves were generated for a set of fat measurements, including total fat mass (FM), fat mass index (FMI), body fat percentage (BF%), trunk-to-leg fat ratio (TLR), android-to-gynoid fat ratio (AGR) and visceral-to-subcutaneous fat ratio (VSR), using the general additive model for location scale and shape method. The age-related variations from childhood to adulthood were generally similar among Chinese, Non-Hispanic Whites, Non-Hispanic Blacks and Mexican American population, with distinct levels across races and ethnicities. For whole-body fat (FM, FMI, and BF%), Mexican American population consistently presented the highest levels before 40 years old, followed by Non-Hispanic White, Non-Hispanic Black and Chinese individuals. For central fats indices, although the TLR and AGR levels in Chinese males were second to Mexican American counterparts in most stages of life, the VSR was much higher in Chinese than other races and ethnicities from eight years old. DXA-based centiles for body fat quantity and distribution in Chinese population aged 3-60 years old were presented, and their differences with other race and ethnicity were noted across periods from early childhood to middle adulthood. Our findings will promote age-, sex- and ethnic-specific assessment of life-course body fat and obesity-related risks in clinical practice.

A meta-analysis on racial discrimination and alcohol use among Asian Americans.

Racial discrimination has been identified as a contributing risk factor for alcohol use among racially minoritized individuals. The aims of this study were to quantify the relationship between racial discrimination and alcohol use among Asian Americans, examine gender, age and generational status as moderators, and characterize ethnic group representation across the literature. A systematic literature search was conducted using PsycINFO, CINAHL, Web of Science, PubMed, Embase, and OpenDissertations. A random effects model using Pearson's r effect sizes was conducted on separate alcohol outcomes. Meta-regression analyses tested for moderating effects, and heterogeneity was examined by identifying outliers and subgroup differences. Risk of bias was assessed using a funnel plot and Egger's regression test. Twenty-two effect sizes were extracted from 18 studies, representing 8926 participants. A significant positive association was found between racial discrimination and alcohol consumption (k = 9, r = 0.13, 95% CI = [0.07, 0.19], I2 = 80.7%, p = 0.002) and problematic alcohol use (k = 12, r = 0.27, 95% CI = [0.12, 0.40] I2 = 93.7%, p = 0.002), but not binge use (k = 3, r = 0.08, 95% CI = [-0.49, 0.60], I2 = 95.0%, p = 0.64). Age, gender, and generational status were not significant moderators (p's > 0.10). When ethnic groups were reported, Chinese Americans were most represented (36.9%), while Indian Americans were notably underrepresented (1.18%). There is a small positive association between racial discrimination and alcohol consumption and problematic alcohol use among Asian Americans. Research should seek to fill gaps identified by this review, including the dearth of longitudinal work needed to establish temporal precedence, the limited understanding of racial discrimination on binge use and underrepresented ethnic groups in this field of research, and reducing heterogeneity between studies.

Characteristics, patterns, and prevalence of impacted mandibular second molars in Chinese Americans – A radiographic study.

Characteristics, patterns, and prevalence of impacted mandibular second molars in Chinese Americans – A radiographic study.

Attitude toward physical activity among Asian American family caregivers of persons living with dementia

This qualitative study aimed to explore attitudes toward physical activity behaviors in the context of dementia caregiving among Asian Indian, Chinese, Korean, and Vietnamese American family caregivers of persons living with dementia. We used qualitative data from verbatim transcripts of current caregivers (N = 21) from focus groups and individual interviews. Ethnically or linguistically matched moderators facilitated focus groups and interviews in four languages. Finalized themes included: (1) Physical activity and exercise are different.; (2) Exercise has many benefits.; (3) Health issues and stress from caregiving demotivate engaging in regular exercise.; (4) Prioritizing and planning exercises are necessary; and (5) Social support is essential to engage in physical activity. Caregiving limits the type of exercise some can do, depending on care recipients’ conditions. Efforts to help caregivers prioritize exercise and seek social support from others, including healthcare professionals, would be greatly needed to promote physical activity among this population.

Assistance with Oral Hygiene Care Among Family Dementia Caregivers in Chinese American Communities in New York City

Assistance with Oral Hygiene Care Among Family Dementia Caregivers in Chinese American Communities in New York City

Immigrant Status, Social Support From Children, and Resilience for Older Parents' Perceived Oral Health Among Chinese Americans.

Background: Improving the oral health of older immigrants is an important public health priority in the United States, but the role of children's support has received little attention. This study investigated the relationship between support from adult children and perceived oral health among foreign-born and U.S.-born Chinese Americans. We also examined the mediating role of resilience. Methods: Data were derived from a sample of 377 Chinese American older adults aged 55 or older in Honolulu, Hawai'i. Using a path analysis with structural equation models, we conducted a comparison of self-rated oral health and oral health problems between foreign-born and U.S.-born Chinese Americans. Results: For foreign-born participants, more emotional support from children was directly associated with better perceived oral health and indirectly linked to perceived oral health via resilience. For U.S.-born Chinese Americans, financial support from children was directly related to worse perceived oral health. Conclusions: This study provides evidence for resilience pathways linking social support from children and older immigrants' oral health, which can help health professionals and family counselors develop culturally tailored interventions.

Community Archives as Agency: Intersectionality as a Framework to Document Chinese American Experiences in the United States

The U.S. has a history of anti-immigrant and anti-Asian. Asian Americans strive for agency in defining their identities. Intertwined with their history of exclusion is the absence and misrepresentation of Asian Americans in archives. In this dissertation, I first explore Chinese Americans’ understanding of their identity and its reflection of social inequality. Then, I investigate what they want to preserve to document their history to counter injustice. Lastly, I examine how Chinese Americans want to use community archives to enhance agency and fight against social injustice. I use interviews, workshops, and ethnographic methods to collect conversations with 17 participants who self-identify as Chinese descendants in the U.S. My dissertation finds that participants’ racial and ethnic identities shape their experiences of discrimination, pressure to assimilate to White society, a lack of belonging, and difficulty fitting into the Asian American Pacific Islander group. Furthermore, gender identity influences their experiences. For example, Chinese American women often face social expectations to prioritize family over themselves. Alongside unjust experiences, community members share lived experiences of resilience, joy, and achievements. My dissertation proposes intersectionality as a framework to understand the representational value of community archives. The intersectionality framework asserts, “it is not enough to simply ‘add race and stir’” (Smooth, 2013). My dissertation finds that participants challenge a thing-oriented approach that prioritizes preservation alone. Instead, they prefer an engagement-oriented approach that uses archives to transform counter-stories into agency, specifically into what Yosso (2005) calls cultural wealth, such as aspirational and social capital.

The Female Body and the Environment: A Transnational Study of Mo Yan’s Feng ru Fei tun, Murakami Haruki’s Nejimaki-dori Kuronikuru, and Gabriel García Márquez’s El amor en los tiempos del cólera

The female body is often depicted in parallel with the environment in many literary works. This article examines how the female body can prompt a rethinking of the environment by analyzing three literary works, Mo Yan’s Feng ru Fei tun, published in 1996 Murakami Haruki’s Nejimaki-dori Kuronikuru, published in 1994-1995, and Gabriel García Márquez’s El amor en los tiempos del cólera, published in 1985, which root in Chinese, Japanese, and Latin American cultures, respectively. This paper argues that, on the one hand, the female body parallels the environment by displaying non-human characteristics and relating to natural elements in these three works; on the other hand, it deconstructs the boundary between the environment and humans by playing a crucial role in constructing human identity. This paper draws on theories of posthumanism, material feminism, and ecofeminism to explore the depiction of the female body and its role in rethinking the environment. The cultural hybridity of local and non-local worldviews—a key reason for situating this study within a transnational comparative framework—serves as a crucial element in demonstrating how the female body bridges the environment and human identity across all three works. This analysis aims to deconstruct the anthropocentric perspective on the environment, thereby rethinking the role of the female body in this context.

Chinese American Pain Experience Project (CAPE): Perceptions, Expectations, and Attitudes on Pain Management among Chinese American Postoperative Patients.

Chinese Americans are one of the fastest growing racial and ethnic groups and represent the largest subgroup of the Asian American population in the US and in New York City (NYC) where they number 573,528 in 2021. Despite their numbers, current pain perceptions, expectations, and attitudes of Chinese Americans remains poorly understood, especially as related to postoperative pain. A better understanding of pain experience among Chinese American patients is needed to inform strategies on improving pain management satisfaction. A total of 27 Chinese American postoperative patients from a NYC health system were recruited for face-to-face surveys and interviews with a trained bilingual and bicultural Community Health Worker. Questions from the Survey on Disparities in Quality of Healthcare and Kleinman's Explanatory Model of Illness were integrated into the survey and topic guide. Topics of discussion included satisfaction with healthcare and pain management during hospital stay and health beliefs and practices. More than half of participants experienced language challenges that made it difficult to communicate with healthcare staff. In general, high levels of satisfaction with pain management were reported; however, participants reported feeling less comfortable asking healthcare teams questions. Common themes across interviews included: (1) pain was an expected outcome of the procedure and was thus perceived as tolerable; (2) the wish to not be a burden to others; (3) concerns about side effects of pain medications; and (4) a cultural and language mismatch between healthcare teams and patients on words being used to elicit pain and discomfort. Our project findings can inform pain management strategies and tools to serve the Chinese American patient population.

Asian American Diversity and Representation in the Health Care Workforce, 2007 to 2022

Asian American individuals comprise over 40 ethnoracial groups but are regularly aggregated into 1 category within health workforce analysis, thus obscuring substantial inequities in representation. To describe trends in Asian American diversity across the 4 most populous US health professions (physicians, registered nurses, nursing assistants, and home health aides) and to characterize subgroup representation within professions. Serial cross-sectional study from American Community Survey (ACS) population estimates of people reporting health profession occupations from 2007 to 2022. The ACS samples US residents every day, with approximately 3.5 million surveyed each year. Based on their sampling methods, the ACS then produces estimates of the entire US population for 1-year, 3-year, and 5-year periods. Data were analyzed from April to August 2024. For each year and subgroup, the proportions of the US population, the profession, and Asian American individuals within the profession were calculated. The representation quotient (RQ) of each subgroup was then calculated, defined as the proportion of the subgroup within the profession of interest divided by the proportion of the subgroup within the US population. Trends were examined over the 15-year period. Over the 15-year period, Indian Americans composed the largest percentage of Asian American physicians (mean [SD], 40.6% [1.6%]), followed by Chinese Americans (mean [SD], 18.9% [1.4%]). Pakistani and Indian Americans had the highest relative representation (mean [SD] RQ, 8.9 [0.9] and 7.8 [0.9], respectively). Conversely, Cambodian and Hmong Americans remained largely underrepresented (mean [SD] RQ, 0.2 [0.2] for both). Filipinx Americans accounted for more than half of Asian American registered nurses and nursing assistants, with high relative representation (mean [SD] RQ, 5.6 (0.3) and 2.9 [0.4], respectively). Bangladeshi and Chinese American relative representation were high among home health aides (mean [SD] RQ, 4.1 [1.5] and 2.7 [0.5], respectively). Asian American individuals accounted for an estimated 22% of physicians (approximately 260 693 respondents), 10% of registered nurses (approximately 420 418 respondents), 4.8% of nursing assistants (approximately 93 913 respondents), and 8.3% of home health aides (approximately 60 968 respondents) in 2022. By examining disaggregated data, this study found persistent inequities among Asian American subgroups in the health workforce. Reducing Asian American populations to a single racialized group erases subgroup differences rooted in histories of racism, colonialism, and xenophobia; enables false narratives of Asian American overrepresentation and success; and hampers progress in advancing health justice.

Invisible Borders and Trauma in The Joy Luck Club Between Amy Tan’s Novel (1989) and Wayne Wang’s Cinematic Adaptation (1993)

This research paper is an analytical, comparative study of Amy Tan’s twentieth-century diasporic novel, The Joy Luck Club (1989). It investigates the impact of invisible borders on both mothers and daughters in their cultural fluctuation between Chinese roots and American novelty. The boundaries that separate the two worlds can become so blurred out when one decides to move beyond topographical and physical terrains. In a Chinese-American milieu, there is the heavy weight of cultural limitations and taboos that are unspoken of in the midst of the immigrants’ hybrid lives. While the differences between book and screen adaptation have previously been described as minor sub-plot deviations, these changes still hold great significance in how Western societies perceive other cultures. The aim is to assess the level of intergenerational trauma Tan’s characters have sustained through a set of socially imposed borders and the ways they have decided to deal with it in both novel and film adaptation. The research relies on Hannah Arendt’s socio-cultural theory of the seemingly stateless identity and its correlation with the immigrants’ intergenerational trauma to examine how this kind of pressure put upon the characters affects their lives in the United States.

Chinese American College Students’ Self-Meaning Making Through the Lens of Critical Whiteness Studies

Chinese Americans are historically perceived as perpetual foreigners and honorary whites in American political, cultural, and racial discourses. Utilizing Critical Whiteness Studies as a theoretical framework and Critical Race Hermeneutics as an analytic tool, this article examines how Chinese American young adults construct who they are against whiteness as the norm, the epistemology of ignorance, and white emotionality. Instead of passive victims, Chinese American college students actively challenge this hegemony, privilege, and oppression in unique ways.

Increases in Psychological Stress Are Associated With Higher Fasting Glucose in US Chinese Immigrants.

The majority of Chinese Americans is foreign-born, and it is well-documented that immigration to the United States (US) leads to increased risk for chronic diseases including type 2 diabetes. Increased disease risk has been attributed to changes in lifestyle behaviors following immigration, but few studies have considered the psychosocial impact of immigration upon biomarkers of disease risk. To examine associations ofpsychological stress and social isolation with markers of type 2 diabetes risk over time among US Chinese immigrants. In this longitudinal study of 614 Chinese immigrants, participants completed assessments of perceived stress, acculturative stress, negative life events, and social isolation annually atthree time points. Fasting blood samples were obtained at each time point to measure blood glucose, glycated hemoglobin, and insulin resistance. Mean duration between baseline and follow-up assessments was approximately 2 years. Increases in migration-related stress, perceived stress and social isolation were associated with significant increases in fasting glucose at follow-up independent of age, body mass index, length of US residence, and other potential covariates. Moreover, increases in glucose varied depending on perceived stress levels at baseline, such that those with higher baseline stress had a steeper increase in glucose over time. Psychological stress and social isolation are associated with increases in fasting glucose in a sample of US Chinese immigrants. Findings suggest that the unique experiences of immigration maybe involved in the risk of developing type 2 diabetes, a condition that is prevalent among US Chinese despite relatively low rates of obesity.

Racial Disparities in Nasopharyngeal Carcinoma Characteristics and Survival

Objective: To investigate and compare the distribution of histological subtypes, stage at presentation, and survival outcomes among Chinese American, Non-Hispanic White, and African American patients with nasopharyngeal carcinoma (NPC). Materials and methods: We identified Chinese American, Non-Hispanic White, and African American patients with NPC who were diagnosed between 2010 and 2017. Statistical analyses were conducted using the chi-square test, propensity score matching, Kaplan-Meier analysis, and multivariate Cox proportional hazards models. Results: A total of 1646 eligible patients with NPC were included. Non-Hispanic White accounted for 1049 (63.7%), African Americans for 265 (16.1%), and Chinese Americans for 332 (20.2%), and their median age at diagnosis was 59, 55, and 53 years, respectively ( P < .001). Chinese Americans most frequently harbored undifferentiated non-keratinizing squamous cell carcinoma subtype (n = 134, 40.4%) than Non-Hispanic White (n = 164, 15.6%) or African American patients (n = 44, 16.7%) ( P < .001). Histological subtype distribution was similar between Non-Hispanic White and African American patients ( P = .338). African American patients had the highest rate of stage III to IV disease (n = 206, 77.7%) compared to Non-Hispanic White (n = 704, 67.1%) and Chinese American patients (n = 210, 63.2%) ( P = .009). No significant difference in stage distribution was observed between Chinese American and Non-Hispanic White patients ( P = .494). Non-Hispanic White patients [hazard ratio (HR) 1.344, 95% confidence interval (CI) 1.007-1.479, P = .045] and African American patients (HR 2.314, 95% CI 1.405-3.813, P < .001) had significantly worse overall survival compared to Chinese American patients. However, race was not associated with NPC-specific survival in the multivariate analysis. Similar results were found after propensity score matching. Conclusions: Race influences the distribution of histological subtypes, stage at presentation, and survival outcomes in NPC.

Human hypofunctional NCF1 variants promote pulmonary fibrosis in the bleomycin-induced mouse model and patients with systemic sclerosis via expansion of SPP1+ monocytes-derived macrophages

ObjectiveWe assessed the role of a systemic lupus erythematosus causal hypofunctional variant, neutrophil cytosolic factor 1 (NCF1)-p.Arg90His (p.R90H) substitution, in systemic sclerosis (SSc).MethodsAssociation of NCF1-H90 with SSc was performed in...

The Impact of Social Determinants of Health and Acculturation on Quality of Life in Older Chinese American Adults With Chronic Pain: A Quantitative Study.

As of 2019, the United States houses 5.3 million Chinese Americans (CA), with 689,000 being older adults. The purpose of this study was to examine the relationships between social determinants of health (SDOH) and acculturation on quality of life in CA older adults, an underresearched area. Using a quantitative correlational descriptive design, CA older adults (n = 110) in NYC with chronic pain were examined. Data were collected by utilizing the PRAPARE Screening Tool, Asian American Acculturation Scale, and SF-12 Questionnaire. Regression revealed a negative correlation between SDOH and quality of life (p = .001). The acculturation's impact was nonsignificant (p = .647). While SDOH significantly impacted the quality of life, acculturation did not significantly predict the quality of life for older Chinese American adults with chronic pain. Further research is warranted to explore the nuanced dynamics between acculturation, SDOH, and quality of life in this population.

The Spiritual Journey of Chinese Americans Viewed from the Cultural Connotation of The Joy Luck Club

Chinese-American writers who live in both Chinese and American cultures are the most sensitive to cultural conflict and integration. Amy Tan is one of those writers who probe deeply into the relationship between the Chinese and American cultures. The Joy Luck Club, a novel that tells stories of four Chinese mothers and their American-born daughters, has caused a great sensation inside and outside the United States and made Tan a famous writer. From the perspective of intercultural communication, Cultural conflicts between four couples of mother and daughter, between husbands and wives arising from the difference in cultural background are looked into from the angles of Chinese obedience to parents and American independence and democracy, Chinese women’s submissiveness and American women’s independence, Chinese family’s honor and American individual achievement, Chinese high-context culture and American low- context culture, Chinese superstition and American science. The causes of the conflicts are also discussed in the aspects of Chinese culture and American culture. Chinese mothers are deeply influenced by the concept of "Three Obedience and Four Virtues", "Resign oneself to Adversity", Etc. However, American daughters are born in the culture that emphasizes "Individualism, Equality, Independence and Freedom." In this thesis, it is also put forward that despite the conflicts, mutual compatibility of two cultures is unavoidable and an inescapable tendency, which reflects the development from the clash to the coexistence of the two cultures in the context of globalization.

Psychophysiological distinctions in emotional responding: sensitivity to perceiving loss of connection.

Emotion involves oneself in relation to a subject of attention; e.g., sadness is to be sad about something/someone. This study examined emotional responses to perceiving a loss of connection from oneself. Evidence suggests that Europeans tend to perceive salient objects in the foreground, while East Asians are more likely to perceive holistically, considering the interrelationships between the context and the object. We studied how this distinction affected European Americans' (EA) and Chinese Americans' (CA) sensitivity to perceiving the loss of connection. Both groups were exposed to loss by playing Cyberball, a ball-tossing video game, and then watched a film clip on grief. We hypothesized that EA would respond with increasing heart rate (HR) variance around the mean when perceiving loss. CA were predicted to show no difference from controls. We also hypothesized that EA would feel sadder, in terms of decreased HR and increased respiratory sinus arrhythmia (RSA), earlier during the film clip. In total, 53 subjects were recruited, of which 40 were EA (47.5% women, age 21.08 ± 1.94 years) and 13 were CA (61.5% women, age 21.05 ± 1.74 years); 25 subjects (19 EA, 6 CA) received 2 out of 48 balls tossed in Cyberball and the controls received 10. ECG, respiration, and facial electromyography (fEMG) data were acquired. The results during Cyberball showed that EA's HR variance relative to baseline (HR SDc/b) had an upward trend on perceiving loss. Contrary to prediction, CA also showed higher levels of HR variance relative to baseline. The ANOVA of HR SDc/b revealed that the interaction effect of two factors, time and condition, was statistically significant (p = 0.009). However, as predicted, EA in the experimental condition had decreased HR and increased RSA, a sign of withdrawal in sadness, 30 to 60 s into the sad clip. fEMG data at the corrugator muscle revealed that EA activated higher peak intensity 5.5 s earlier than CA (increased 1.571 vs. 0.844). This difference, however, was not statistically significant. The evidence suggests that increased exposure to loss automatically led to increased HR variance in both groups even when subjects were informed that players were computer-generated. However, the effect was stronger on EA to increase their arousal and sensitivity to grief thereafter.

Discussion of Emotions Among Newly Diagnosed Non-Hispanic White and Chinese American Patients With Breast Cancer and Their Oncologists.

This qualitative study analyzed how Chinese American (CA) and non-Hispanic White (NHW) breast cancer patients and their oncologists communicated about patients' emotional concerns. Data included twenty-four recordings of clinical encounters between oncologists and four CA and eight NHW women with a new breast cancer diagnosis between 2013 and 2015. Using an interactional sociolinguistics approach to discourse analysis, we examined how CA and NHW patients and their oncologists initiated conversations about patients' emotions. We also categorized oncologists' responses by whether oncologists turned toward, turned away, or remained neutral to patients' emotions. When bringing up emotions with oncologists, NHW patients brought up social and personal life topics, whereas CA patients only brought up biomedical topics. We also observed that oncologists initiated discussions about emotions with only English-speaking patients of both racial groups. There were no observed differences in how oncologists remained neutral to or turned away from both CA and NHW patients' emotional expressions. When oncologists turned away from patients' emotions, they did so to solve administrative or biomedical problems. In conclusion, the findings suggest that CA patients' racial backgrounds and the language spoken during the encounters may influence how patients and oncologists initiate discussion about patients' emotions. Furthermore, the findings suggest that oncologists remain neutral and turn away from CA and NHW patients' emotions in similar ways. This study provides preliminary data for more comprehensive investigations of Asian American cancer patients' actual communication with their providers regarding emotions and treatment decisions to facilitate patient-provider communication quality.

Developing the Meaning-Centered Program for Chinese Americans with Advanced Cancer: Applying Cultural Adaptation Frameworks.

Asian Americans have surpassed Hispanics as the fastest-growing racial/ethnic group in the United States and Chinese Americans are the largest Asian American subgroup. Cancer is the leading cause of death among Chinese Americans while heart disease remains the leading cause of death in the U.S. overall. Foreign-born immigrants are more likely to be diagnosed with advanced stage cancers than their native-born counterparts. Patients with advanced cancer have specific psychosocial needs, such as end-of-life concerns and existential distress. Meaning-Centered Psychotherapy (MCP), which enhances a sense of meaning in life to increase QOL, is among the most promising psychosocial treatments for advanced cancer patients, having demonstrated efficacy in several randomized controlled trials. Our preliminary qualitative work suggested a meaning-centered intervention was acceptable but required adaptation to ensure ecological validity among Chinese cancer patients. This paper presents the cultural and linguistic adaptation of Meaning-Centered Program for Chinese Americans with advanced cancer (MCP-Ch), which was informed by the Ecological Validity Model (EVM) and Psychotherapy Adaptation and Modification Framework (PAMF) for cultural adaptation of evidence-based interventions. Implementation considerations, which will be assessed in the next phase of the project, are also discussed. MCP-Ch is used as a case example to illustrate how to adapt culturally syntonic and sustainable evidence-based psychosocial interventions for racial/ethnic minority cancer populations.