title: Is an index of co-occurring unhealthy lifestyles suitable for understanding migrant health?
abstract: OBJECTIVE
  This study investigated variation in unhealthy lifestyles within Australia according to where people were born.
  
  
  METHODS
  Multilevel linear regression models were used to explore variation in co-occurring unhealthy lifestyles (from 0 to 8) constructed from responses to tobacco smoking, alcohol consumption, moderate-to-vigorous physical activity and a range of dietary indicators for 217,498 adults born in 22 different countries now living in Australia. Models were adjusted for socio-economic variables. Data was from the 45 and Up Study (2006-2009). Further analyses involved multilevel logistic regression to examine country-of-birth patterning of each individual unhealthy lifestyle.
  
  
  RESULTS
  Small differences in the co-occurrence of unhealthy lifestyles were observed by country of birth, ranging from 3.1 (Philippines) to 3.8 (Russia). More substantial variation was observed for each individual unhealthy lifestyle. Smoking and alcohol ranged from 7.3% and 4.2% (both China) to 28.5% (Lebanon) and 30.8% (Ireland) respectively. Non-adherence to physical activity guidelines was joint-highest among participants born in Japan and China (both 74.5%), but lowest among those born in Scandinavian countries (52.5%). Substantial variation in meeting national dietary guidelines was also evident between participants born in different countries.
  
  
  CONCLUSIONS
  The growing trend for constructing unhealthy lifestyle indices can hide important variation in individual unhealthy lifestyles by country of birth.
authors.affiliation: School of Health and Society, University of Wollongong, Wollongong, Australia; Menzies Centre for Health Policy, University of Sydney, Sydney, Australia; Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, University of Sydney, Sydney, Australia; School of Science and Health, University of Western Sydney, Sydney, Australia. Electronic address: X.Feng@uws.edu.au.
authors.forename: Xiaoqi
authors.initials: X
authors.lastname: Feng
authors.affiliation: School of Science and Health, University of Western Sydney, Sydney, Australia.
authors.forename: Thomas
authors.initials: T
authors.lastname: Astell-Burt
authors.affiliation: School of Science and Health, University of Western Sydney, Sydney, Australia.
authors.forename: Gregory S
authors.initials: GS
authors.lastname: Kolt
mesh_terms: D000428:Alcohol Drinking / Q000208:ethnology; D001208:Asia / Q000208:ethnology; D001315:Australia / Q000453:epidemiology; D003431:Cross-Cultural Comparison; D005060:Europe / Q000208:ethnology; D015438:Health Behavior / Q000208:ethnology*; D006801:Humans; D008019:Life Style; D016014:Linear Models; D009043:Motor Activity; D055361:Multilevel Analysis; D009520:New Zealand / Q000208:ethnology; D018673:Nutrition Policy; D012907:Smoking / Q000208:ethnology; D014171:Transients and Migrants / Q000706:statistics & numerical data*
keywords: Australia; Migrant health; Unhealthy lifestyles index