Health Examination Is Not a Priority for Less Acculturated Asian Americans

Abstract

This study examines the associations between acculturation and three health examination behaviors (physical, dental, and eye exams) among 846 Chinese, Korean, and Vietnamese Americans. The study was part of a randomized, community-based trial on liver cancer prevention that targeted Asian Americans in Washington DC metropolitan area. Acculturation was assessed using Suinn-Lew Asian Self-Identity Acculturation (SL-ASIA) scale, acculturation clusters, and length of stay. Health examination behaviors in the last 2 years were self-reported. Potential confounders such as age, gender, ethnicity, income, marital status, self-rated health status, health insurance, and having a regular physician were adjusted. Increased acculturation was associated with greater receipt of preventive services when acculturation was measured by SL-ASIA and acculturation clusters. Compared to those in the "Asian" cluster, those in the "American" cluster and "bicultural" clusters were more likely to have physical exams (American odds ratio (OR) = 1.83, 95 % confidence interval (CI) 0.99, 3.88; bicultural OR = 1.11; 95 % CI 0.72, 1.70), dental exams (American OR = 1.99, 95 % CI 1.09, 3.65; bicultural OR = 1.83, 95 % CI 1.21, 2.78), and eye exams (American OR = 4.48, 95 % CI 2.67, 7.66; bicultural OR = 1.92, 95 % CI 1.31, 2.81). A gradient was observed in these associations with the American cluster having stronger associations than the bicultural cluster. Interaction was found between acculturation and gender for receipt of a physical exam. Future studies are needed to further explicate how access to health care impacts the association between acculturation and health examinations among Asian Americans.

Keywords: Acculturation; Asian Americans; Ophthalmology; Physical examination; Preventive health services.