%0 Journal Article %J Soc Sci Med %D 2012 %T Does an immigrant health paradox exist among Asian Americans? Associations of nativity and occupational class with self-rated health and mental disorders. %A John, Dolly A %A de Castro, A B %A Martin, Diane P %A Duran, Bonnie %A Takeuchi, David T %K Adult %K Asian Americans %K Confidence Intervals %K Emigrants and Immigrants %K Employment %K Female %K Health Status %K Humans %K Logistic Models %K Male %K Mental Disorders %K Odds Ratio %K Population Surveillance %K Self Report %K Sex Distribution %K United States %X

A robust socioeconomic gradient in health is well-documented, with higher socioeconomic status (SES) associated with better health across the SES spectrum. However, recent studies of U.S. racial/ethnic minorities and immigrants show complex SES-health patterns (e.g., flat gradients), with individuals of low SES having similar or better health than their richer, U.S.-born and more acculturated counterparts, a so-called "epidemiological paradox" or "immigrant health paradox". To examine whether this exists among Asian Americans, we investigate how nativity and occupational class (white-collar, blue-collar, service, unemployed) are associated with subjective health (self-rated physical health, self-rated mental health) and 12-month DSM-IV mental disorders (any mental disorder, anxiety, depression). We analyzed data from 1530 Asian respondents to the 2002-2003 National Latino and Asian American Study in the labor force using hierarchical multivariate logistic regression models controlling for confounders, subjective social status (SSS), material and psychosocial factors theorized to explain health inequalities. Compared to U.S.-born Asians, immigrants had worse socioeconomic profiles, and controlling for age and gender, increased odds for reporting fair/poor mental health and decreased odds for any DSM-IV mental disorder and anxiety. No strong occupational class-health gradients were found. The foreign-born health-protective effect persisted after controlling for SSS but became nonsignificant after controlling for material and psychosocial factors. Speaking fair/poor English was strongly associated with all outcomes. Material and psychosocial factors were associated with some outcomes--perceived financial need with subjective health, uninsurance with self-rated mental health and depression, social support, discrimination and acculturative stress with all or most DSM-IV outcomes. Our findings caution against using terms like "immigrant health paradox" which oversimplify complex patterns and mask negative outcomes among underserved sub-groups (e.g., speaking fair/poor English, experiencing acculturative stress). We discuss implications for better measurement of SES and health given the absence of a gradient and seemingly contradictory finding of nativity-related differences in self-rated health and DSM-IV mental disorders.

%B Soc Sci Med %V 75 %P 2085-98 %8 2012 Dec %G eng %N 12 %R 10.1016/j.socscimed.2012.01.035 %0 Journal Article %J Public Health Nurs %D 2010 %T Associations of employment frustration with self-rated physical and mental health among Asian American immigrants in the U.S. Labor force. %A de Castro, A B %A Rue, Tessa %A Takeuchi, David T %K Adaptation, Psychological %K Adult %K Asian Americans %K Cross-Sectional Studies %K Diagnostic Self Evaluation %K Emigrants and Immigrants %K Employment %K Female %K Health Status %K Health Status Indicators %K Humans %K Logistic Models %K Longitudinal Studies %K Male %K Mental Health %K Multivariate Analysis %K Occupational Health %K Psychometrics %K Sex Factors %K Socioeconomic Factors %K Stress, Psychological %K United States %X

OBJECTIVE: This study examined the associations between employment frustration and both self-rated physical health (SRPH) and self-rated mental health (SRMH) among Asian American immigrants.

DESIGN AND SAMPLE: A cross-sectional quantitative analysis was conducted utilizing data from 1,181 Asian immigrants participating in the National Latino and Asian American Study.

MEASURES: Employment frustration was measured by self-report of having difficulty finding the work one wants because of being of Asian descent. SRPH and SRMH were each assessed using a global one-item measure, with responses ranging from poor to excellent. Control variables included gender, age, ethnicity, education, occupation, income, whether immigrated for employment, years in the United States, English proficiency, and a general measure for everyday discrimination.

RESULTS: Ordered logistic regression showed that employment frustration was negatively associated with SRPH. This relationship, however, was no longer significant in multivariate models including English proficiency. The negative association between employment frustration and SRMH persisted even when including all control variables.

CONCLUSIONS: The findings suggest that Asian immigrants in the United States who experience employment frustration report lower levels of both physical and mental health. However, English proficiency may attenuate the relationship of employment frustration with physical health.

%B Public Health Nurs %V 27 %P 492-503 %8 2010 Nov-Dec %G eng %N 6 %R 10.1111/j.1525-1446.2010.00891.x %0 Journal Article %J J Immigr Minor Health %D 2010 %T Examining alternative measures of social disadvantage among Asian Americans: the relevance of economic opportunity, subjective social status, and financial strain for health. %A de Castro, A B %A Gee, Gilbert C %A Takeuchi, David T %K Adolescent %K Adult %K Aged %K Asian Americans %K Body Mass Index %K Data Collection %K Educational Status %K Employment %K Female %K Health Status %K Humans %K Income %K Male %K Middle Aged %K Obesity %K Smoking %K Social Class %K United States %K Young Adult %X

Socioeconomic position is often operationalized as education, occupation, and income. However, these measures may not fully capture the process of socioeconomic disadvantage that may be related to morbidity. Economic opportunity, subjective social status, and financial strain may also place individuals at risk for poor health outcomes. Data come from the Asian subsample of the 2003 National Latino and Asian American Study (n = 2095). Regression models were used to examine the associations between economic opportunity, subjective social status, and financial strain and the outcomes of self-rated health, body mass index, and smoking status. Education, occupation, and income were also investigated as correlates of these outcomes. Low correlations were observed between all measures of socioeconomic status. Economic opportunity was robustly negatively associated with poor self-rated health, higher body mass index, and smoking, followed by financial strain, then subjective social status. Findings show that markers of socioeconomic position beyond education, occupation, and income are related to morbidity among Asian Americans. This suggests that potential contributions of social disadvantage to poor health may be understated if only conventional measures are considered among immigrant and minority populations.

%B J Immigr Minor Health %V 12 %P 659-71 %8 2010 Oct %G eng %N 5 %R 10.1007/s10903-009-9258-3 %0 Journal Article %J Am J Ind Med %D 2010 %T Smoking and the Asian American workforce in the National Latino and Asian American Study. %A de Castro, A B %A Garcia, Gabriel %A Gee, Gilbert C %A Tsai, Jenny Hsin-Chun %A Rue, Tessa %A Takeuchi, David T %K Adolescent %K Adult %K Aged %K Asian Americans %K Cross-Sectional Studies %K Employment %K Female %K Hispanic Americans %K Humans %K Interviews as Topic %K Male %K Middle Aged %K Occupations %K Prevalence %K Smoking %K United States %K Young Adult %X

BACKGROUND: Smoking among the Asian American workforce has not been extensively researched. This study examines smoking prevalence among a nationally representative sample of Asian Americans with an emphasis on occupational classification.

METHODS: Cross-sectional data come from the National Latino and Asian American Study. Multivariate logistic regression analyses were used to determine smoking prevalence by occupation, gender, and nativity, among 1,528 participants self-identifying as in the labor force.

RESULTS: Blue collar workers reported the highest smoking prevalence (32%) followed by unemployed (19%), other (17%), service (14%), and white collar (10%). Among both employed males and females, blue collar workers had the highest prevalence (45% and 18%, respectively). By nativity, smoking was highest among blue collar workers for immigrants (25%) and highest among the unemployed for U.S. born (16%). Blue collar employment was significantly associated with being a current smoker (OR = 2.52; 95% CI: 1.23-5.16; P < 0.05) controlling for demographics (e.g., age, gender, ethnic group, nativity, etc.).

CONCLUSIONS: Findings reveal that smoking differs by occupation among Asian Americans. Future research should examine factors explaining differences while considering gender and nativity.

%B Am J Ind Med %V 53 %P 171-8 %8 2010 Feb %G eng %N 2 %R 10.1002/ajim.20697