Health Behaviors of Older Chinese Adults Living in New York City
Health Behaviors of Older Chinese Adults Living in New York City
The dramatic increase in the number of older immigrants living in the U.S. presents new challenges to policy makers concerned with promoting healthy aging. To date, however, strikingly little is known regarding the health and health trajectories of older immigrants. This paper examines the prevalence and predictors of important health behaviors associated with chronic disease prevention, including current smoking status, physical activity, alcohol use, and body mass index (BMI). We analyzed data from the 2003 New York City Chinese Health Survey (NYC CHS), the largest probability-based sample of Chinese immigrants residing in two distinct communities. In-person interviews were conducted with 517 representative men and women aged 55-75. Logistic regression modeling was used to test the influence of demographic, socioeconomic status, acculturation, and health characteristics on selected health behaviors. Results revealed that having more education and better physical health status were associated with greater participation in physical activity. Gender-specific analyses indicated that the effect of selected predictors varied between the sexes. For example, among older Chinese women, acculturation was negatively associated with alcohol use. This study provides some of the first evidence on health behaviors of one of the fastest growing older immigrant groups in the U.S. Study results add to the emerging literature on the complex nature of immigrant health trajectories, and demonstrate that contrary to prior research, living a greater proportion of time in the U.S. can be associated with selected positive health behaviors. Further longitudinal studies are needed to help inform policy initiatives to encourage healthy aging among diverse older immigrant groups.
Over 3.1 million immigrants living in the U.S. are aged 65 and over, an all time high. This startling development coincides with the recent dramatic increase in younger immigrants arriving in the U.S., primarily from Latin America and Asia. The resulting paradox is that while the older immigrant population has remained stable for over 40 years, it has proportionately declined, from 32.6% in 1960 to 11.0% in 2000. As a result, older immigrants, despite their significant numbers, are thus in danger of being overlooked by policy makers. Moreover, this unprecedented population rise will result in a doubling of non-white elderly living in the U.S. by 2050, growing from 16 to 36%. Given the intersection of these two unparalleled demographic shifts -- the significant surge in growth of the older adult population and continued increase in immigration -- there is a compelling need for studies to address the current paucity of information on the health status and health behaviors of older immigrant populations. In this paper, we present some of the first evidence on health status and health risk behaviors among older Chinese adults.
Chinese Americans make up the largest subgroup of Asian and Pacific Islanders (APIs), one of the fastest growing ethnic groups, currently representing 4% of the total U.S. population. Asian subgroups differ vastly in regard to language, culture, socioeconomic characteristics, immigration status, and adaptation to host countries. Yet, with a few notable exceptions, most previous research has aggregated this population as a whole, masking important health disparities that exist among specific Asian subgroups. Considerable empirical evidence suggests immigration-related factors, such as English proficiency, length of time in the U.S., and age of immigration are often associated with health outcomes, yet the relationships found are complex, not always consistent, and poorly understood. In general, much of research over the past decade on the potential effects of immigration-related factors on immigrants' health outcomes reveals a common pattern -- immigrants have significant health advantages over their U.S.-born counterparts, initially, but over time, and with increasing length of residence in the U.S., this relative advantage decreases and converges with the health indicators and outcomes of the native-born population. Yet, depending on the population category (aggregated or not), health outcome of interest, how immigration-related factors are measured, and the effect of demographic characteristics or socioeconomic status (SES), such as age, sex, or education, results are often inconsistent. Emerging literature challenges the proposition of an inevitability of a deterioration of health the longer an immigrant resides in the U.S. Thus, as healthy aging gains momentum as an essential tenet of U.S. aging policy, it is critically important for policy makers to understand how best to encourage, support, and maintain positive health behaviors and health status among our growing diverse populations of older immigrants.
In this paper, we focus on health risks, including diet, physical activity, alcohol consumption, and smoking, responsible for a substantial proportion of morbidity and mortality in the U.S., as well as around the world. Little is known about the protective and risk practices of older foreign-born adults residing in the U.S., despite their growing number. We organize this paper in three sections: (1) description of the prevalence of health behaviors, including current smoking, alcohol consumption, physical activity, and body mass index (BMI) among older Chinese immigrants, (2) analysis of the association of demographic factors, SES, and immigration and acculturation characteristics with selected protective and risk factors, and 3) examination of the correlates of health behaviors by gender.
Abstract and Introduction
Abstract
The dramatic increase in the number of older immigrants living in the U.S. presents new challenges to policy makers concerned with promoting healthy aging. To date, however, strikingly little is known regarding the health and health trajectories of older immigrants. This paper examines the prevalence and predictors of important health behaviors associated with chronic disease prevention, including current smoking status, physical activity, alcohol use, and body mass index (BMI). We analyzed data from the 2003 New York City Chinese Health Survey (NYC CHS), the largest probability-based sample of Chinese immigrants residing in two distinct communities. In-person interviews were conducted with 517 representative men and women aged 55-75. Logistic regression modeling was used to test the influence of demographic, socioeconomic status, acculturation, and health characteristics on selected health behaviors. Results revealed that having more education and better physical health status were associated with greater participation in physical activity. Gender-specific analyses indicated that the effect of selected predictors varied between the sexes. For example, among older Chinese women, acculturation was negatively associated with alcohol use. This study provides some of the first evidence on health behaviors of one of the fastest growing older immigrant groups in the U.S. Study results add to the emerging literature on the complex nature of immigrant health trajectories, and demonstrate that contrary to prior research, living a greater proportion of time in the U.S. can be associated with selected positive health behaviors. Further longitudinal studies are needed to help inform policy initiatives to encourage healthy aging among diverse older immigrant groups.
Introduction
Over 3.1 million immigrants living in the U.S. are aged 65 and over, an all time high. This startling development coincides with the recent dramatic increase in younger immigrants arriving in the U.S., primarily from Latin America and Asia. The resulting paradox is that while the older immigrant population has remained stable for over 40 years, it has proportionately declined, from 32.6% in 1960 to 11.0% in 2000. As a result, older immigrants, despite their significant numbers, are thus in danger of being overlooked by policy makers. Moreover, this unprecedented population rise will result in a doubling of non-white elderly living in the U.S. by 2050, growing from 16 to 36%. Given the intersection of these two unparalleled demographic shifts -- the significant surge in growth of the older adult population and continued increase in immigration -- there is a compelling need for studies to address the current paucity of information on the health status and health behaviors of older immigrant populations. In this paper, we present some of the first evidence on health status and health risk behaviors among older Chinese adults.
Chinese Americans make up the largest subgroup of Asian and Pacific Islanders (APIs), one of the fastest growing ethnic groups, currently representing 4% of the total U.S. population. Asian subgroups differ vastly in regard to language, culture, socioeconomic characteristics, immigration status, and adaptation to host countries. Yet, with a few notable exceptions, most previous research has aggregated this population as a whole, masking important health disparities that exist among specific Asian subgroups. Considerable empirical evidence suggests immigration-related factors, such as English proficiency, length of time in the U.S., and age of immigration are often associated with health outcomes, yet the relationships found are complex, not always consistent, and poorly understood. In general, much of research over the past decade on the potential effects of immigration-related factors on immigrants' health outcomes reveals a common pattern -- immigrants have significant health advantages over their U.S.-born counterparts, initially, but over time, and with increasing length of residence in the U.S., this relative advantage decreases and converges with the health indicators and outcomes of the native-born population. Yet, depending on the population category (aggregated or not), health outcome of interest, how immigration-related factors are measured, and the effect of demographic characteristics or socioeconomic status (SES), such as age, sex, or education, results are often inconsistent. Emerging literature challenges the proposition of an inevitability of a deterioration of health the longer an immigrant resides in the U.S. Thus, as healthy aging gains momentum as an essential tenet of U.S. aging policy, it is critically important for policy makers to understand how best to encourage, support, and maintain positive health behaviors and health status among our growing diverse populations of older immigrants.
In this paper, we focus on health risks, including diet, physical activity, alcohol consumption, and smoking, responsible for a substantial proportion of morbidity and mortality in the U.S., as well as around the world. Little is known about the protective and risk practices of older foreign-born adults residing in the U.S., despite their growing number. We organize this paper in three sections: (1) description of the prevalence of health behaviors, including current smoking, alcohol consumption, physical activity, and body mass index (BMI) among older Chinese immigrants, (2) analysis of the association of demographic factors, SES, and immigration and acculturation characteristics with selected protective and risk factors, and 3) examination of the correlates of health behaviors by gender.
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