Foreign-born Asian Americans Research Articles

Young Elite Asian Americans and the Model Minority Stereotype: The Nativity Effect

While research on the model minority stereotype has focused on white American attitudes, much less research has considered the ways in which Asian Americans understand this concept and its implications. Utilizing frameworks from social psychology and critical race theory we hypothesize that young foreign-born Asian Americans will more likely accept the model minority stereotype than native born Asian Americans due to their likely socialization in a context where their ethnic group was dominant. Further we hypothesize that young Asian Americans who accept the model minority stereotype also accept individualistic explanations for black inequality given that the stereotype implicates non-Asian minorities presumed incompetence and lack of effort on lower socioeconomic outcomes. Third, we hypothesize that US-born Asian Americans’ exposure to the racialized climate of the US will make their belief in the stereotype more salient in predicting individualistic attitudes toward black inequality. We employ OLS regression techniques using survey data from the first wave of the National Longitudinal Survey of Freshmen. We find that the mean level of acceptance to the stereotype does not differ by nativity. However that acceptance, regardless of nativity, is positively associated with individualist explanations for African American inequality. Further, foreign-born status is also linked to anti-black individualist sentiment. When we interact nativity status with belief in the stereotype, we find that foreign-born status is moderated in its effect on individualist beliefs toward African American inequality. Thus, we find that while young foreign-born Asian Americans are more individualistic in their views on racial inequality, native-born acceptance of the stereotype has a more pronounced effect. These findings suggest what we describe as a “choosing sides” logic; acceptance of the model minority stereotype reflects collusion with white dominance at the expense of alienation with other non-white minorities.

The Life Satisfaction of Asian Americans: Evidence from the U.S. General Social Survey, 1972 to 2010

We use the U.S. General Social Survey to investigate the overall life satisfaction of Asian Americans. In contrast to most other racial minority groups in the U.S., Asian Americans are advantaged over whites in regard to education and incomes which are known to be correlated with overall life satisfaction. Despite these socioeconomic advantages, Asian Americans express somewhat lower levels of overall life satisfaction than whites. Foreign-born Asian Americans are more likely than whites to be “not too happy” while native-born Asian Americans are less likely than whites to be “very happy.” This pattern persists even after controlling for educational attainment and the distribution of household income. The implications of these findings are discussed in regard to the social psychology, assimilation, and demographic characteristics of Asian Americans. Asian Americans are often portrayed as the “Model Minority,” but they appear to be somewhat less happy with what they have.

Do spouses matter? Discrimination, social support, and psychological distress among Asian Americans.

Perceived discrimination poses risks for psychological distress among Asian Americans, but the differential impact of general unfair treatment and racial discrimination has not been examined. Although social support from distal sources reduces discrimination-related distress either directly or as a buffer, the unique roles of spousal support have remained understudied. Nativity status was examined as another moderator of these relationships to resolve previous inconsistent findings regarding its relationship to the discrimination-distress link. Data were from 1,626 U.S.- and foreign-born Asian American adults (Mage = 42.17 years; n = 1,142 married/cohabiting) in the nationally representative National Latino and Asian American Study, who reported on experiences of unfair treatment, racial discrimination, social supports from spouses, family, friends, and neighborhood, and psychological distress. Hierarchical multiple regressions showed that both unfair treatment and racial discrimination predicted psychological distress, and spousal support predicted distress above and beyond distal forms of social support in the context of perceived discrimination. Moderation analyses revealed that spousal support buffered against negative psychological consequences of unfair treatment, but not racial discrimination. Spousal support was not differentially protective as a function of nativity; however, U.S.-born respondents reacted with greater distress to unfair treatment than their foreign-born counterparts. Psychological effects of both general and race-based discrimination, and the unique contributions of distinct sources of social support, are important to understanding adjustment and cultural transition among Asian Americans. Nativity differentially influences effects of unfair treatment. Implications for future research are discussed.

Colorectal Cancer Screening among Chinese, Cambodian, and Vietnamese Immigrants in Chicago.

Asian Americans are now the most rapidly growing minority group in the USA. Over 60 % of Asian Americans in the USA are immigrants. Cancer has been the leading cause of death among Asian Americans since 1980. Understanding the barriers to screening is essential to reduce the unnecessary burden of cancer. Little is known about colorectal cancer screening behavior among foreign-born Asian Americans and how socio-demographic factors may influence the behavior. Even less is known about disaggregated Asian subgroups. Using data from the Chicago Asian Community Survey, a local health assessment survey of three Asian subgroups in Chicago, Chinese, Cambodian, and Vietnamese, this study found that the colorectal cancer screening rate were much lower among foreign-born Asian Americans in Chicago (30 %) than the national rate for the general population (59 %). Furthermore, we studied disaggregated data to determine colorectal cancer screening differences between communities. Findings from this study provide a critical evidence base to inform future research and intervention designs.

Association between asthma and obesity among immigrant Asian Americans, California Health Interview Survey, 2001-2011.

Our objective was to study the comorbidity of asthma and obesity among foreign-born Asian Americans, by subgroups. Public data from the California Health Interview Survey, 2001–2011, were analyzed by using independent logistic regressions, yielding the association between asthma and obesity (Asian and standard cutoffs for body mass index [BMIs]) of 19,841 Asian American immigrant respondents. Chinese, Filipino, South Asian, and Japanese immigrants had a positive association between lifetime asthma and obesity, whereas among Korean immigrants, a positive association was found between lifetime asthma and overweight status (standard BMI cutoffs). Routine screening for this comorbidity is warranted among immigrant Asian Americans.

Body Mass Index, Demographic and Socioeconomic Risk, and Protective Factors of Type 2 Diabetes Among Six Groups of Foreign-Born Asian Americans

ABSTRACT. This study examined the association of body mass index (BMI), demographic variables, and self-reported type 2 diabetes among Chinese, Filipino, South Asian, Japanese, Korean, and Vietnamese adults. A sample of 3,204 Asian American respondents born outside of the United States was selected from the 2007 California Health Interview Survey. Logistic regression was used to estimate the relationships between BMI, age, sex, marital status, education, poverty level, years in the United States and self-reported type 2 diabetes. The findings revealed that Koreans had the lowest prevalence for type 2 diabetes and South Asians had the highest. Type 2 diabetes had a statistically significant association with BMI and demographic variables but varied across ethnic groups. Due to sampling variations, no meaningful results were found in the Filipino and Japanese samples. BMI and older age are common risk factors for type 2 diabetes among Asians, but whether sex, marital status, education, and years in the United States are risk factors varies among ethnic groups. Culturally specific prevention programs for type 2 diabetes are important for Asian Americans. Given the diversity of cultures and demographic and socioeconomic factors across the Asian American populations, future research should not combine all ethnic Asian groups into 1 sample.

Effect of a liver cancer education program on hepatitis B screening among Asian Americans in the Baltimore-Washington metropolitan area, 2009-2010.

IntroductionAsian Americans have the highest incidence of hepatocellular carcinoma (HCC), the major form of primary liver cancer, of all ethnic groups in the United States. Chronic hepatitis B virus (HBV) infection is the most common cause of HCC, and as many as 1 in 10 foreign-born Asian Americans are chronically infected with HBV. We tested the effectiveness of a culturally tailored liver cancer education program for increasing screening for HBV among Chinese, Korean, and Vietnamese Americans residing in the Baltimore–Washington metropolitan area, from November 2009 through June 2010.MethodsWe used a cluster randomized controlled trial to recruit volunteer participants from community-based organizations (CBOs) in the Baltimore–Washington metropolitan area. We selected 877 participants by using a pretest survey. People were eligible to participate if they had not attended a hepatitis B–related education program in the past 5 years. The intervention group (n = 441) received a 30-minute educational program, and the control group (n = 436) received an educational brochure. After attending the educational program, the intervention group completed a post-education survey. Six months later, participants in both groups were followed up by telephone. Receipt of HBV screening was the outcome measure.ResultsApproximately 79% (n = 688) of participants completed the 6-month follow-up telephone survey. Among those who had not had HBV screening at baseline (n = 446), the adjusted odds of self-reported receipt of HBV screening at the 6-month follow-up to the educational program were significantly higher for the intervention group than for the control group (odds ratio = 5.13; 95% confidence interval, 3.14–8.39; P < .001). Chinese Americans and Vietnamese Americans had significantly higher odds of having HBV screening in the 6-month period than Korean Americans.ConclusionCulturally tailored education programs that increase liver cancer awareness can be effective in increasing HBV screening among underserved Asian American populations.

Who’s At Risk? Ethnic Drinking Cultures, Foreign Nativity, and Problem Drinking Among Asian American Young Adults

Despite the low overall prevalence of alcohol use among Asian Americans, rates of alcohol use disorder are high among Asian American young adults. The influence of ethnic drinking cultures on immigrants and their descendants has been overlooked in past research. We took an integrative approach to examine the influence of ethnic drinking culture, acculturation, and socioeconomic disparities on problem drinking among Asian American young adults. This study was a nationally representative sample of 854 Asian American young adults extracted from the Wave 4 National Longitudinal Study of Adolescent Health data. About 48% of the sample was female and 52% male. Several multiple logistic regression models were fitted. Controlling for other covariates, two dimensions of ethnic drinking culture were associated with alcohol outcomes only for the foreign born: (a) detrimental drinking pattern with frequent drunkenness and alcohol-abuse symptoms and (b) drinking prevalence with alcohol-dependence symptoms. Financial hardship was a significant predictor of symptoms of alcohol abuse and dependence only for the U.S. born. Asian language use was protective against alcohol-abuse symptoms and alcohol-dependence symptoms for the foreign born. Cultural and socioeconomic factors of problem drinking may be different for U.S.-and foreign-born Asian American young adults. Ethnic drinking cultures may significantly influence problem drinking of foreign-born Asian American young adults, independent of their acculturation into U.S. cultures. To inform effective interventions targeted at immigrants and their descendants, future research might further investigate the cultural and socioeconomic processes in immigrant communities that might significantly influence drinking.

Comparison of major depressive disorder onset among foreign-born Asian Americans: Chinese, Filipino, and Vietnamese ethnic groups

Using a nationally representative sample of 1280 Asian Americans, we examined the extent to which major depressive disorder (MDD) onset differs by ethnicity and its associated factors for each of the three ethnic groups: Vietnamese, Filipino, and Chinese. We employed the Kaplan–Meier method to estimate the survival and hazard functions for MDD onset by ethnicity, and cox proportional hazards models to identify socio-demographic and immigration-related factors associated with MDD onset. Approximately 7% of the entire sample had experienced MDD onset in their lifetime. Filipino immigrants showed the highest survival function, followed by Vietnamese immigrants over time. Those who were never-married or divorced were more likely to experience MDD onset when compared to their married or cohabiting counterparts. Those who immigrated at a younger age were more likely to experience MDD onset than were those who immigrated at an older age. However, there were ethnic variations in terms of the risk factors that were associated with MDD onset across these three ethnic groups. Findings from this study signal the importance of understanding the differing experiences of MDD onset by ethnicity.

An Epidemiological Investigation of Male-Female Differences in Drinking and Drinking-Related Problems between US-Born and Foreign-Born Latino and Asian Americans.

Background. It has been widely documented that males were more likely to drinking alcohol and have alcohol use disorders (AUD). The degrees of the male-female differences in drinking and AUD have varied across countries. The reasons behind these variations have not been fully understood. The current study compared the estimated male-female differences across US-born and foreign-born Latino and Asian Americans with respect to alcohol drinking behavior and AUD. Method. Data come from the National Latino and Asian American Study (NLAAS), a national household survey of adults with Latinos and Asian decent in the United States. Male-female differences were estimated for drinking behavior and AUD among drinkers for US-born and foreign-born individuals, respectively. Zero-inflated Poisson regressions were utilized to estimate male-female differences in the number of AUD clinical features once it occurs. Results. Larger male-female differences were found for foreign-born individuals as compared to US-born individuals, especially the occurrence of AUD among drinkers. Once AUD clinical feature occurs, there was no male-female difference for foreign-born individuals, while there was a males excess in the number of clinical features for US-born individuals. Conclusion. Results from this study supports the importance of sociocultural influence in drinking and AUD. Implications for prevention and intervention programs were discussed.

Health Care Access and Utilization Among US-Born and Foreign-Born Asian Americans

Despite efforts to eliminate inequality in health and health care, disparities in health care access and utilization persist in the United States. The purpose of this study was to compare the access to care and use of health care services of US-born and foreign-born Asian Americans. We used aggregated data from the National Health Interview Survey (NHIS) from 2003 to 2005, including 2,500 participants who identified themselves as Asian. Associations between country of birth and reported access and utilization of care in the previous 12 months were examined. After controlling for covariates, being foreign-born was negatively related to indicators of access to care, including health insurance (OR = 0.29, 95%CI = 0.18-0.48), routine care access (OR = 0.52, 95%CI = 0.36-0.75), and sick care access [OR = 0.67, 95%CI = 0.47-0.96)]. Being foreign-born was also negatively related to all indicators of health care utilization (office visit: OR = 0.58, 95%CI = 0.41-0.81; seen/talked to a general doctor: OR = 0.69, 95%CI = 0.52-0.90; seen/talked to a specialist: OR = 0.42, 95%CI = 0.28-0.63) but ER visit (OR = 0.84, 95%CI = 0.59-1.20). There are substantial differences by country of birth in health care access and utilization among Asian Americans. Our findings emphasize the need for developing culturally sensitive health services and intervention programs for Asian communities.

A longitudinal experimental study comparing the effectiveness of happiness-enhancing strategies in Anglo Americans and Asian Americans

Growing evidence suggests that well-being interventions can be effective. However, it is unclear whether happiness-increasing practices are equally effective for individuals from different cultural backgrounds. To investigate this question, Anglo Americans and predominantly foreign-born Asian Americans were randomly assigned to express optimism, convey gratitude, or list their past experiences (control group). Multilevel analyses indicated that participants in the optimism and gratitude conditions reported enhanced life satisfaction relative to those in the control condition. However, Anglo Americans in the treatment conditions demonstrated larger increases in life satisfaction relative to Asian Americans, while both cultural groups in the control condition showed the least improvement. These results are consistent with the idea that the value individualist cultures place on self-improvement and personal agency bolsters the efforts of Anglo Americans to become more satisfied, whereas collectivist cultures’ de-emphasis of self-focus and individual goals interferes with the efforts of Asian Americans to pursue enhanced well-being.

Asian Americans and Obesity in California: A Protective Effect of Biculturalism

Prior studies comparing US-born and foreign-born Asian Americans have shown that birth in the US conveys greater risk of obesity. Our study investigates whether retention of Asian culture might be protective for obesity despite acculturation to US lifestyle. We classified self-identified Asian American respondents of the California Health Interview Survey as traditional, bicultural, and acculturated using nativity and language proficiency in English and Asian language. We then examined the association of acculturation with overweight/obesity (BMI ≥ 25 kg/m2) in a multivariate regression model. Acculturated respondents had higher adjusted odds of being overweight/obese than bicultural respondents (2.13 [1.40–3.23] for men, 3.28 [2.14–5.04] for women), but bicultural respondents had similar odds of being overweight/obese as traditional respondents (.98 [.69–1.41] for men, .72 [.50–1.05] for women). Among the bicultural, second and first generation respondents were equally likely to be overweight/obese. Biculturalism in Asian Americans as measured by Asian language retention appears protective against obesity. Further research is needed to understand the mechanisms underlying this association.

The Clinical Presentation of Chronic Hepatitis B Virus Infection in Asian Americans

The clinical course of chronic hepatitis B virus (HBV) infection varies with ethnicity. Little is known about the clinical presentation of chronic HBV infection in Asian Americans. To define the clinical presentation of chronic HBV infection in Asian Americans. This is a retrospective study that used systematic chart review and statistical analysis to investigate 213 Asian-American patients with chronic HBV infection who presented to a university medical center. This cohort included 55.8% male patients, 97.9% were born outside the US, and 52.3% reported a family history of HBV infection. Of the 56 patients with liver biopsy, 34.0% had stage 3 to 4 fibrosis. In patients with available data, 21.5% were hepatitis B e antigen positive [HBeAg (+)] and 31.1% had HBV DNA levels >1 x 10(6) copies/mL. Patients with HBeAg (+) HBV infection were diagnosed at a younger age (P=0.002) and with higher alanine aminotransferase (P=0.001) and HBV DNA (P=0.001) levels. Although only 3.3% presented with obesity (ie, body mass index >or=30 kg/m2), 43.4% had evidence of hepatic steatosis. Presentation of hepatocellular carcinoma was associated with an older age at diagnosis (P<0.001), male sex (P<0.001), tobacco use (P<0.001), a greater degree of fibrosis on liver biopsy (P=0.01), and higher alanine aminotransferase, aspartate aminotransferase (P<0.001), and a fetoprotein (P<0.001) levels. Chronic HBV infection in foreign-born Asian Americans was characterized by a low rate of HBeAg (+) and male predominance as well as high rates of family history of HBV infection, hepatic fibrosis, and hepatic steatosis.

Use of specialty mental health services by Asian Americans with psychiatric disorders.

Research suggests that Asian Americans underutilize mental health services but an understanding of the multiple factors involved in utilization has not been examined in a nationally representative sample. The current study analyzed data from the National Latino and Asian American Study (NLAAS) and examined 368 individuals with disorders to understand utilization and what factors were related to the utilization of specialty mental health services. Significant underutilization was found for Asian Americans; moreover, underutilization was especially acute among Asian American immigrants. For U.S.-born Asian Americans, use of primary care services was significantly associated with use of mental health services, but for foreign-born Asian Americans, use of primary care services was unrelated to mental health services use. For both U.S.-born and foreign-born Asian Americans, use of alternative services appeared to significantly affect whether Asian Americans with disorders utilize mental health services, but the nature of the influence varied depending on the individual's level of English-language proficiency. These findings revealed that a major mental health disparity, the underutilization of mental health services by Asian Americans, was nuanced by use of other health-related services and immigration-related factors.

Self-Rated Health among Foreign- and U.S.-Born Asian Americans

We investigated differences between foreign- and U.S.-born Asian Americans in self-rating their physical and mental health. In particular, we tested whether the foreign-born respondents underreport the extreme categories of the scale as compared with U.S.-born respondents. We analyzed data from the National Latino and Asian American Study to examine whether immigrants are less likely to use the extreme ends of the 5-category self-rated health scales than their U.S.-born counterparts. We used propensity score matching to derive groups of U.S.- and foreign-born Asian Americans who share similar demographic and health characteristics. We defined propensity scores as predicted probabilities of being U.S. born, given individual background characteristics. The propensity score framework allowed us to make descriptive comparisons of self-rated health responses controlling for background characteristics. We used log-linear symmetry models to examine cross-tabulations of self-rated physical and mental health reports in matched pairs by the 2 (extreme and nonextreme) and 5 ("excellent," "very good," "good," "fair," and "poor") categories. Controlling for background characteristics, we found no evidence that foreign-born Asian Americans are less likely to endorse extreme categories in self-rated physical or mental health than U.S.-born Asian Americans, as well as no evidence of imbalances in endorsement of any particular self-rated health category between the 2 groups. Controlling for demographic and health characteristics, we find no systematic differences between foreign- and U.S.-born Asian Americans in reporting self-rated physical and mental health on the 5-category scales from "excellent" to "poor."

Psychiatric disorders among foreign-born and US-born Asian-Americans in a US national survey.

Among Hispanics, Non-Hispanic Whites and Non-Hispanic Blacks studies have found lower risk for psychiatric disorders among the foreign-born than among the US-born. We examine the association of nativity and risk for psychiatric disorder in a national sample of the Asian-American (AA) population. Data on 1,236 AAs from the National Epidemiological Survey of Alcohol and Related Conditions (NESARC) are analyzed using logistic regression and discrete time survival models to specify differences between the foreign-born and US-born in the lifetime occurrence of mood, anxiety and substance use disorders. Foreign-born AAs had significantly lower risk for all classes of disorder compared with US-born AAs (OR = 0.16-0.59). Risk for all classes of disorder was lowest for those foreign-born AAs who arrived in the US as adults. Among foreign-born AAs risk of first onset was lowest relative to the US-born in years prior to their arrival in the US and tended to rise to levels equal to that of the US-born with longer duration of residence in the US. Among AAs, risk for psychiatric disorders is lower among the foreign-born than among the US-born. The pattern of change in risk over time suggests that both the developmental timing and the duration of experience in the US contribute to increases in risk.

Older asian americans and pacific islanders dying of cancer use hospice less frequently than older white patients

Purpose Cancer is the leading cause of death among Asian Americans, yet little is known about their use of hospice care. We examined hospice use by Asian patients compared with white patients, and assessed whether utilization differs among those born in the United States or abroad. Methods We studied Asian and white Medicare beneficiaries registered in the Surveillance, Epidemiology, and End Results (SEER) Program who died of primary lung, colorectal, prostate, breast, gastric, or liver cancer between 1988 and 1998. We used logistic regression to determine the effects of race/ethnicity and birthplace on hospice use, adjusting for demographic characteristics, managed care insurance, year of diagnosis, tumor stage at diagnosis, and tumor registry. Results Of the 184,081 patients, 5% (n = 8614) were Asian Americans, of whom 45% (n = 3847) were foreign born. Compared with whites, Asian Americans were more likely to be male, married, and enrolled in managed care. Compared with U.S.-born Asian Americans, foreign-born Asian Americans were more likely to reside in low-income areas. After adjustment, patients who were Asian American (odds ratio [OR] = 0.67; 95% confidence interval [CI]: 0.62 to 0.73) and born abroad (OR = 0.90; 95% CI: 0.86 to 0.94) were less likely to use hospice care than were white patients. These results were consistent across the six cancer diagnoses that were examined. Conclusion Older Asian Americans dying of cancer, especially those who are born abroad, are less likely than white patients to use hospice care at the end of life. Additional research is needed to understand the reasons for these differences and to eliminate potential barriers to hospice care.

Body mass index in a US national sample of Asian Americans: effects of nativity, years since immigration and socioeconomic status

To examine body mass index (BMI) and the proportion overweight and obese among adults age 18-59 in the six largest Asian American ethnic groups (Chinese, Filipino, Asian Indian, Japanese, Korean, Vietnamese), and investigate whether BMI varies by nativity (foreign-vs native-born), years in US, or socioeconomic status. Cross-sectional interview data were pooled from the 1992-1995 National Health Interview Survey (NHIS). 254,153 persons aged 18-59 included in the 1992-1995 NHIS. Sample sizes range from 816 to 1940 for each of six Asian American ethnic groups. Self-reported height and weight used to calculate BMI and classify individuals as overweight (BMI > or = 25 kg/m2) or obese (BMI > or = 30 kg/m2), age, sex, years in the US, household income and household size. For men, the percentage overweight ranges from 17% of Vietnamese to 42% of Japanese, while the total male population is 57% overweight. For women, the percentage overweight ranges from 9% of Vietnamese and Chinese to 25% of Asian Indians, while the total female population is 38% overweight. The percentage of Asian Americans classified as obese is very low. Adjusted for age and ethnicity, the odds ratio for obese is 3.5 for women and 4.0 for men for US-vs foreign-born. Among the foreign-born, more years in the US is associated with higher risk of being overweight or obese. The association between household income for women is similar for US-born Asian Americans and Whites and Blacks, but is much weaker for foreign-born Asian Americans. While these data find low proportions of Asian Americans overweight at present, they also imply the proportion will increase with more US-born Asian Americans and longer duration in the US.

Interpersonal Discrimination Against Hmong Americans: Parallels and Variation in Microlevel Racial inequality

Different racial and ethnic minorities are commonly compared across various measures of macrolevel inequality but have thus far not been compared with respect to microlevel inequality. Using data from interviews with forty-eight Hmong Americans, this article systematically extends Feagin's (1991) analysis of interpersonal discrimination against African Americans to the experiences of everyday racism among a group of foreignborn Asian Americans. Hmong Americans report all of the forms of interpersonal discrimination that Feagin documents for African Americans, suggesting that minorities face a common inequality structure in public face-to-face encounters. Nativism and limited English proficiency, two factors that Feagin did not identify as affecting African Americans, are also important components of interpersonal discrimination against Hmong Americans. These additional dimensions of interpersonal discrimination against suggest that macrolevel patterns of racial and ethnic inequality can lead to variation in microlevel inequality.