title: A cluster analytic examination of acculturation and health status among Asian Americans in the Washington DC metropolitan area, United States.
abstract: Previous studies reported mixed findings on the relationship between acculturation and health status among Asian Americans due to different types of acculturation measures used or different Asian subgroups involved in various studies. We aim to fill the gap by applying multiple measures of acculturation in a diverse sample of Asian subgroups. A cross sectional study was conducted among Chinese, Korean and Vietnamese Americans in Washington D.C. Metropolitan Area to examine the association between health status and acculturation using multiple measures including the Suinn-Lew Asian Self-Identity Acculturation (SL-ASIA) scale, clusters based on responses to SL-ASIA, language preference, length of stay, age at arrival in the United Sates and self-identity. Three clusters (Asian (31%); Bicultural (47%); and American (22%)) were created by using a two-step hierarchical method and Bayesian Information Criterion values. Across all the measures, more acculturated individuals were significantly more likely to report good health than those who were less acculturated after adjusting for covariates. Specifically, those in the American cluster were 3.8 times (95% Confidence Interval (CI): 2.2, 6.6) more likely and those in the Bicultural cluster were 1.7 times more likely (95% CI: 1.1, 2.4) to report good health as compared to those in the Asian cluster. When the conventional standardized SL-ASIA summary score (range:-1.4 to 1.4) was used, a one point increase was associated with 2.2 times greater odds of reporting good health (95% CI: 1.5, 3.2). However, the interpretation may be challenging due to uncertainty surrounding the meaning of a one point increase in SL-ASIA summary score. Among all the measures used, acculturation clusters better approximated the acculturation process and provided us with a more accurate test of the association in the population. Variables included in this measure were more relevant for our study sample and may have worked together to capture the multifaceted acculturation process.
authors.affiliation: 2234C School of Public Health Building, College Park, MD 20742, USA. Electronic address: sunmin@umd.edu.
authors.forename: Sunmin
authors.initials: S
authors.lastname: Lee
authors.forename: Lu
authors.initials: L
authors.lastname: Chen
authors.forename: Xin
authors.initials: X
authors.lastname: He
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Miller
authors.forename: Hee-Soon
authors.initials: HS
authors.lastname: Juon
mesh_terms: D000069:Acculturation; D000328:Adult; D001213:Asian / Q000706:statistics & numerical data*; D002681:China / Q000208:ethnology; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D004219:District of Columbia; D005260:Female; D006304:Health Status; D006801:Humans; D007723:Korea / Q000208:ethnology; D008113:Liver Neoplasms / Q000208:ethnology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D014744:Vietnam / Q000208:ethnology
keywords: Acculturation; Asian Americans; Clusters; Health status; Measures; United States
references.citation: Am J Epidemiol. 2001 Feb 15;153(4):372-80
references.pmid: 11207155
references.citation: J Immigr Minor Health. 2008 Apr;10(2):103-18
references.pmid: 17546500
references.citation: J Couns Psychol. 2011 Jul;58(3):346-57
references.pmid: 21574693
references.citation: Nicotine Tob Res. 2007 Dec;9(12):1277-86
references.pmid: 18058346
references.citation: Nicotine Tob Res. 2004 Jun;6(3):481-9
references.pmid: 15203782
references.citation: Ann Epidemiol. 2007 Mar;17(3):191-8
references.pmid: 17320786
references.citation: Am J Epidemiol. 1976 Sep;104(3):225-47
references.pmid: 961690
references.citation: Arch Pediatr Adolesc Med. 2008 Aug;162(8):756-63
references.pmid: 18678808
references.citation: J Soc Psychol. 2002 Aug;142(4):511-26
references.pmid: 12153126
references.citation: JAMA. 2004 Dec 15;292(23):2860-7
references.pmid: 15598917
references.citation: Int J Obes Relat Metab Disord. 2000 Sep;24(9):1188-94
references.pmid: 11033989
references.citation: Cultur Divers Ethnic Minor Psychol. 2008 Apr;14(2):147-54
references.pmid: 18426287
references.citation: J Natl Cancer Inst. 1993 Nov 17;85(22):1819-27
references.pmid: 8230262
references.citation: Med Care. 2007 Jul;45(7):610-7
references.pmid: 17571009
references.citation: Am J Orthopsychiatry. 2011 Oct;81(4):489-97
references.pmid: 21977934
references.citation: Adv Data. 2006 Mar 1;(369):1-19
references.pmid: 16541709
references.citation: Am J Public Health. 2004 Nov;94(11):1977-84
references.pmid: 15514240
references.citation: Soc Sci Med. 2000 Jul;51(2):159-73
references.pmid: 10832565
references.citation: Obesity (Silver Spring). 2008 Dec;16(12):2669-75
references.pmid: 18846044
references.citation: Psychosom Med. 2006 May-Jun;68(3):386-97
references.pmid: 16738069
references.citation: J Am Diet Assoc. 2008 Aug;108(8):1330-44
references.pmid: 18656573
references.citation: J Health Soc Behav. 2007 Dec;48(4):404-17
references.pmid: 18198687
references.citation: Cancer Epidemiol Biomarkers Prev. 2005 Dec;14(12):2905-13
references.pmid: 16365008
references.citation: Psychol Assess. 2011 Jun;23(2):300-10
references.pmid: 21381836
references.citation: J Immigr Minor Health. 2007 Apr;9(2):125-36
references.pmid: 17111215
references.citation: J Gerontol B Psychol Sci Soc Sci. 2005 Oct;60 Spec No 2:68-75
references.pmid: 16251594
references.citation: Am Psychol. 1991 Jun;46(6):632-41
references.pmid: 1952422