Faculty Bibliography

We examined the association between years living in the United States and overweight risk among a community sample of Filipino adult immigrants living in the New York metropolitan area. We found a significant and adverse association between years living in the United States and overweight risk. Compared with Filipinos who lived in the United States less than 5 years, those who lived in the United States 10 years or longer had a higher overweight risk; this association was present only among Filipinos who migrated to New York metropolitan area at 30 years of age or younger. Studies on causal mechanisms explaining this pattern are needed.

Health information can potentially mitigate adverse health outcomes among ethnic minority populations, but little research has examined how minorities access health information. The aim of this study was to examine variations in the use of health information sources among Asian American (AA) subgroups and to identify differences in characteristics associated with the use of these sources. We analyzed data from a foreign-born community sample of 219 Asian Indians, 216 Bangladeshis, 484 Chinese, and 464 Koreans living in New York City. Results found that use of health information sources varied by AA subgroup. Print media source use, which included newspapers, magazines, and/or journals, was highest among Chinese (84%), Koreans (75%), and Bangladeshis (80%), while radio was most utilized by Chinese (48%) and Koreans (38%). Television utilization was highest among Bangladeshis (74%) and Koreans (64%). Koreans (52%) and Chinese (40%) were most likely to use the Internet to access health information. Radio use was best explained by older age and longer time lived in the United States, while print media were more utilized by older individuals. Results also highlighted differences in native-language versus non-native-language media sources for health information by subgroup. Media sources can be used as a vehicle to disseminate health information among AAs.

Asian Americans, Native Hawaiians, and Pacific Islanders (AANHPIs) experience a large burden from certain chronic disease-related risk factors. The STRIVE Program funded four AANHPI community-based organizations (CBOs) to implement culturally adapted community gardens and farmers' markets to increase access to healthy foods. Key CBO informant interviews were conducted to understand processes and lessons learned.

PURPOSE: Physical activity (PA) levels in Asian-American adults may be lower than other racial or ethnic groups. This analysis tested the hypothesis that Asian-Americans are less likely to meet PA guidelines than other racial or ethnic groups regardless of location of residence. METHODS: The New York City (NYC) Community Health Survey (2010, 2012) and Los Angeles County (LAC) Health Survey (2011) are cross-sectional surveys conducted with similar sampling strategies (NYC: n = 17,462; LAC: n = 8036). Meeting PA guidelines was calculated using self-reported moderate or vigorous minutes per week; multivariable regression models adjusted for demographics, insurance, nativity and language spoken at home. Data were weighted to be representative of their respective geographies. RESULTS: In both areas, Asian-Americans had a low prevalence of meeting PA guidelines (NYC: 42.7 [39.2-46.3]; LAC: 55.8 [51.2-60.2]). Other racial or ethnic groups were more likely to meet PA guidelines versus Asian-Americans after adjustment for covariates in NYC (white odds ratio [OR]: 1.35 [1.09-1.68]; black OR: 1.61 [1.28-2.02]; Hispanic OR: 2.14 [1.74-2.62]) and in LAC (white OR: 1.45 [1.13-1.86]; Hispanic OR: 1.71 [1.32-2.22]). CONCLUSIONS: Asian-Americans were less likely to meet PA guidelines compared with other racial or ethnic groups in NYC and LAC. Description of cultural and neighborhood-level factors and of types of PA in specific Asian subgroups is needed.

Eliminating health disparities in racial/ethnic minority and underserved populations requires a paradigm shift from biomedical approaches that are disease-focused to a health equity framework that aims to achieve optimal health for all by targeting social and structural determinants of health. We describe the concepts and parallel approaches that underpin an integrative population health equity framework and present the experience of NYU Center for the Study of Asian American Health (CSAAH) in applying the framework to guide its work. Applying an integrative framework has deepened our community engagement efforts, our understanding of the multi-level contextual factors that influence health, and our capacity to advance health equity for Asian American communities through action-oriented research and policy. This framework and experience is applicable to researchers and community members working with other underserved populations.

Suicide has become an increasing public health challenge, with growing incidence among Asian American, Native Hawaiian, and Pacific Islander (AA and NHPI) youth. Using an ecological framework, the purpose of this systematic review was to explicate risk and protective factors for depression or suicide among AA and NHPI youth from available peer reviewed research. The ecological framework provides a useful blueprint for translating social determinants of health to explain the experience of depression and suicidal behaviors among AA and NHPI youth. Sixty-six studies were extracted from PsychInfo, Ovid Med-line, EMBASE, CINAHL, and Web of Science. Policy and practice recommendations are offered in light of relevant themes that emerged. Further research and data disaggregation is needed to develop and strengthen population health strategies, interventions, and policies that address the underlying social conditions and cultural contexts of mental health disparities associated with depression and suicide among AA and NHPI youth.

Community health workers (CHWs) are frontline health workers who often serve socially and linguistically isolated populations, including Asian American, Native Hawaiian, and Pacific Islander (AA and NHPI) communities in the United States (U.S.) and U.S. territories. We conducted a systematic review of the peer-reviewed literature to assess the characteristics of CHW programs for AA and NHPI communities in the U.S. and U.S. territories, generating a total of 75 articles. Articles were coded using eight domains: ethnic group, health topic, geographic location, funding mechanism, type of analysis reported, prevention/management focus, CHW role, and CHW title. Articles describing results of an intervention or program evaluation, or cost-effectiveness analysis were further coded with seven domains: study design, intervention recruitment and delivery site, mode of intervention delivery, outcomes assessed, key findings, and positive impact. Results revealed gaps in the current literature and point towards recommendations for future CHW research, program, and policy efforts.

Recent initiatives have focused on the dissemination of evidence-based policy, systems, and environmental (EBPSE) strategies to reduce health disparities. Targeted, community-level efforts are needed to supplement these approaches for comparable results among Asian Americans and Native Hawaiians and Pacific Islanders (NHPIs).The STRIVE Project funded 15 Asian American and NHPI community-based organizations (CBOs) to implement culturally adapted strategies. Partners reached more than 1.4 million people at a cost of $2.04 per person. CBOs are well positioned to implement EBPSE strategies to reduce health disparities.

OBJECTIVES: We explored the relationship between health-related quality of life (HRQOL) and adequate physical activity (PA) and fruit and vegetable (F&V) intake among racial/ethnic minority groups aged 60 years or older living in New York City (NYC). METHODS: Survey data from 2009 to 2012 targeted minority groups in NYC ethnic enclaves; we analyzed 3594 individuals (Blacks, Hispanics, and Chinese) aged 60 years or older. Descriptive statistics were run; unadjusted and adjusted logistic regression evaluated the relationship of HRQOL with PA and F&V intake. RESULTS: Hispanics were most likely to engage in sufficient PA and eat recommended F&Vs and had significantly worse HRQOL. After multivariable adjustment, significant associations were found between PA and self-reported health, activity limitation and physical health days for all groups, and PA and mental health days for Hispanics. Significant associations were found between F&V intake and physical health days for Hispanics and F&V intake and self-reported health for Chinese. CONCLUSIONS: Findings indicated variations between HRQOL and PA by racial/ethnic subgroup. Despite being highly insured, recommendations for PA and F&V intake were not met. There is a need to promote healthy living behaviors among aging NYC racial/ethnic populations.