title: The longer you stay, the worse your health? A critical review of the negative acculturation theory among Asian immigrants.
abstract: Researchers have become increasingly interested in the health patterns of immigrants with longer residence in the United States, as this reveals the health consequences of integration processes. The negative acculturation effect has been the dominant interpretation of duration patterns, despite empirical and theoretical uncertainties about this assumption. This theory assumes that immigrant health declines with longer residence in the United States because of poorer health behaviors and health risks that reflect Americanized lifestyles. This paper reviews the empirical support for the negative acculturation theory among Asian immigrants to determine if and when it is an appropriate interpretation for duration patterns. I conclude that empirical inconsistencies and methodological issues limit the negative acculturation theory as the primary interpretation for duration patterns. First, there is no consistent evidence that health behaviors decline with time. There is also substantial group heterogeneity in duration patterns as well as heterogeneity across health outcomes. The literature has not adequately addressed methodological shortcomings, such as confounding by cohort effects or non-linear duration patterns. Length of residence in the United States is still an important aspect of Asian immigrant health, but the mechanisms of this relationship are still understudied. I propose alternative frameworks between duration and health that consider environmental influences and end with future research directions to explore research gaps.
authors.affiliation: Program in Public Health, University of California, Irvine, 653 E. Peltason Dr., CA 92697, USA. annie.ro@uci.edu.
authors.forename: Annie
authors.initials: A
authors.lastname: Ro
mesh_terms: D000069:Acculturation; D001213:Asian; D054242:Emigrants and Immigrants; D004641:Emigration and Immigration; D006304:Health Status; D006801:Humans; D014481:United States
references.citation: Am J Epidemiol. 2001 Feb 15;153(4):372-80
references.pmid: 11207155
references.citation: Soc Sci Med. 2009 Jul;69(1):110-20
references.pmid: 19427731
references.citation: Soc Sci Med. 2004 Sep;59(5):973-86
references.pmid: 15186898
references.citation: Health Soc Work. 2007 May;32(2):119-27
references.pmid: 17571645
references.citation: Obesity (Silver Spring). 2013 Aug;21(8):1695-703
references.pmid: 23716458
references.citation: J Gen Intern Med. 2005 Sep;20(9):800-6
references.pmid: 16117746
references.citation: Soc Sci Med. 2009 Oct;69(7):983-91
references.pmid: 19525050
references.citation: Annu Rev Public Health. 2005;26:367-97
references.pmid: 15760294
references.citation: J Immigr Minor Health. 2008 Dec;10(6):551-8
references.pmid: 18373275
references.citation: Demography. 2001 Nov;38(4):551-61
references.pmid: 11723951
references.citation: Am J Public Health. 2003 Feb;93(2):232-8
references.pmid: 12554575
references.citation: JAMA. 2004 Dec 15;292(23):2860-7
references.pmid: 15598917
references.citation: Ethn Dis. 2001 Winter;11(1):107-14
references.pmid: 11289230
references.citation: Int J Obes Relat Metab Disord. 2000 Sep;24(9):1188-94
references.pmid: 11033989
references.citation: Soc Sci Med. 2003 Jul;57(1):71-90
references.pmid: 12753817
references.citation: Med Care Res Rev. 2009 Aug;66(4):355-408
references.pmid: 19179539
references.citation: Am J Public Health. 2010 Apr;100(4):661-8
references.pmid: 19608956
references.citation: Soc Sci Med. 2010 Sep;71(6):1161-72
references.pmid: 20624666
references.citation: Soc Biol. 2001 Fall-Winter;48(3-4):171-95
references.pmid: 12516223
references.citation: Adv Data. 2006 Mar 1;(369):1-19
references.pmid: 16541709
references.citation: Soc Sci Med. 2007 Oct;65(7):1524-35
references.pmid: 17602812
references.citation: J Immigr Minor Health. 2010 Aug;12(4):470-9
references.pmid: 19326215
references.citation: Demography. 2007 May;44(2):251-63
references.pmid: 17583304
references.citation: Nicotine Tob Res. 2008 Apr;10(4):579-87
references.pmid: 18418780
references.citation: Obesity (Silver Spring). 2008 Dec;16(12):2669-75
references.pmid: 18846044
references.citation: Health Econ. 2009 Mar;18(3):291-303
references.pmid: 18464286
references.citation: Am J Public Health. 2013 Sep;103(9):1619-27
references.pmid: 23865667
references.citation: Soc Sci Med. 2001 Jul;53(1):41-53
references.pmid: 11386307
references.citation: Am J Public Health. 2010 Mar;100(3):563-9
references.pmid: 19696376
references.citation: Soc Sci Med. 2009 Jun;68(12):2104-12
references.pmid: 19427087
references.citation: J Behav Med. 2012 Aug;35(4):407-19
references.pmid: 21720827
references.citation: J Gen Intern Med. 2006 Jul;21(7):786-91
references.pmid: 16808783
references.citation: Arch Pediatr Adolesc Med. 2009 Nov;163(11):1022-8
references.pmid: 19884593
references.citation: Res Hum Dev. 2007 Jun 1;4(1 &AMP):49
references.pmid: 20150976
references.citation: Soc Sci Med. 2012 Aug;75(3):459-68
references.pmid: 22580075
references.citation: Nutr Rev. 1997 Feb;55(2):31-43
references.pmid: 9155216
references.citation: Soc Sci Med. 2005 Mar;60(6):1359-70
references.pmid: 15626530
references.citation: J Community Health. 2007 Oct;32(5):299-310
references.pmid: 17922202
references.citation: Am J Prev Med. 2004 Nov;27(4):323-6
references.pmid: 15488363
references.citation: Int J Epidemiol. 1995 Apr;24(2):389-98
references.pmid: 7635601
references.citation: Am J Prev Med. 1999 Oct;17(3):211-29
references.pmid: 10987638
references.citation: Soc Sci Med. 2012 Dec;75(12):2060-8
references.pmid: 22721965
references.citation: Ann Epidemiol. 2005 Apr;15(4):257-65
references.pmid: 15780772
references.citation: J Immigr Minor Health. 2009 Oct;11(5):422-7
references.pmid: 18085438
references.citation: Prev Chronic Dis. 2006 Jul;3(3):A79
references.pmid: 16776880
references.citation: Biodemography Soc Biol. 2015;61(1):65-80
references.pmid: 25879262
references.citation: Soc Sci Med. 2008 Oct;67(8):1300-10
references.pmid: 18657344
references.citation: Am J Clin Nutr. 2002 Oct;76(4):766-73
references.pmid: 12324289
references.citation: J Health Soc Behav. 2007 Dec;48(4):404-17
references.pmid: 18198687
references.citation: Am J Public Health. 2006 Aug;96(8):1342-6
references.pmid: 16809597
references.citation: J Health Soc Behav. 2009 Dec;50(4):427-42
references.pmid: 20099449
references.citation: Epidemiol Rev. 2009;31:130-51
references.pmid: 19805401
references.citation: Soc Sci Med. 2012 Dec;75(12):2085-98
references.pmid: 22503561
references.citation: Nutr Rev. 1994 Sep;52(9):285-98
references.pmid: 7984344
references.citation: Can J Public Health. 2004 May-Jun;95(3):I14-21
references.pmid: 15191127
references.citation: Prev Med. 2005 Aug;41(2):693-9
references.pmid: 15917070