Asian-American elders’ health and physician use: An examination of social determinants and lifespan influences


While the Asian American population is growing rapidly, relatively little research has focused on intergroup health comparisons. The application of the life course perspective sheds new light on the inter-section of the ageing process and social determinants of health. This study compares physician use and health equity among Asian ethnic groups and non-Hispanic Whites. Data on Asian American and non-Hispanic White immigrants over 65 were extracted from the California Health Interview Survey. Weighted logistic regression models were tested applying the Commission on Social Determinants of Health model. Intergroup differences in physician use and health equity were observed. Furthermore, physician use and health varied among the groups by age. The diverse background of older Asian Americans and the differential effects of the ageing process point to the need for novel interventions to promote health among this population.

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Nguyen, D. , Bernstein, L. and Goel, M. (2012) Asian-American elders’ health and physician use: An examination of social determinants and lifespan influences. Health, 4, 1106-1115. doi: 10.4236/health.2012.411168.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] US Census Bureau (2008) Table 17. Projections of the Asian alone population by age and sex for the United States: 2010 to 2050 (NP2008-T17), DC: Population Division, US Census Bureau.
[2] Ghosh, C. (2003) Healthy people 2010 and Asian Americans/Pacific Islanders: Defining a baseline of information. American Journal of Public Health, 93, 2093-2098. doi:10.2105/AJPH.93.12.2093
[3] Tanjasiri, S., Wallace, S. and Shibata, K. (1995) Picture imperfect: Hidden problems among Asian Pacific Islander elderly. Gerontologist, 35, 753-760. doi:10.1093/geront/35.6.753
[4] Solar O. and Irwin A. (2007) A conceptual framework for action on the social determinants of health. Discussion paper for the commission on social determinants of health. World Health Organization, Geneva.
[5] Hummer, R.A., Benjamins, M.R. and Rogers, R.G. (2004) Racial and ethnic disparities in health and mortality among the US elderly population. In: Anderson, N.B., Bulatao, R.A. and Cohen, B., Eds., Critical Perspectives on Racial and Ethnic Differences in Health in Late Life. National Academies Press, Washington DC.
[6] Nguyen, D., Ho, K. and Williams, J. (2011) Older Asian Americans’ primary care use: Examining the effect of perceived mental health need. Social Work in Health Care, 10, 89-103.
[7] Jang, Y., Kim, G., Hansen, L and Chiriboga, D.A. (2007) Attitudes of older Korean Americans toward mental health services. Journal of the American Geriatrics Society, 55, 616-620. doi:10.1111/j.1532-5415.2007.01125.x
[8] Jang, M., Lee, E. and Woo, K. (1998) Income, language, and citizenship status: Factors affecting the health care access and utilization of Chinese Americans. Health and Social Work, 23, 136-145. doi:10.1093/hsw/23.2.136
[9] Ma, G.X. (2000) Barriers to the use of health services by Chinese Americans. Journal of Allied Health, 29, 64-70.
[10] Zahran, H.S., Kobau, R., Moriarty, D.G., Zack, M.M., Holt, J. and Donehoo, R. (2005) Health-related quality of life surveillance—United States, 1993-2002. MMWR Surveillance Summary, 54, 1-35.
[11] Misra, R., Patel, T., Kotha, P., Raji, A., Ganda, O. and Banerji, M.A., et al. (2010) Prevalence of diabetes, metabolic syndrome, and cardiovascular risk factors in US Asian Indians: Results from a national study. Journal of Diabetes and Its Complications, 24, 145-153. doi:10.1016/j.jdiacomp.2009.01.003
[12] Oza-Frank, R., Ali, M.K., Vaccarino, V., and Narayan, K. (2009) Asian Americans: Diabetes prevalence across US and world health organization weight classifications. Diabetes Care, 32, 1644-1646. doi:10.2337/dc09-0573
[13] McNeely, M.J. and Boyko, E.J. (2005). Diabetes-related comorbidities in Asian Americans: Results of a national health survey. Journal of Diabetes and Its Complications, 19, 101-106. doi:10.1016/j.jdiacomp.2004.08.003
[14] Mui, A.C. and Shi-busawa T. (2008) Asian American elders in the twenty-first century: Key indicators of well-being. Columbia University Press, New York.
[15] Kim, G., Chiriboga, D.A., Jang, Y., Lee, S., Huang, C.H. and Parmelee, P. (2010) Health status of older Asian Americans in California. Journal of the American Geriatrics Society, 58, 2003-2008. doi:10.1111/j.1532-5415.2010.03034.x
[16] Tran, T.V., Ngu-yen, D., Chan, K., & Nguyen, T.N. (2007) The association of self-rated health and life-style behaviors and among foreign-born Chinese, Korean, and Vietnamese American. Quality of Life Research.
[17] Dhooper, S.S. (2003) Health care needs of foreign-born Asian Americans: An overview. Health and Social Work, 28, 63-73. doi:10.1093/hsw/28.1.63
[18] Sohn, L. (2004) The health and health status of older Korean Americans at the 100-year anniversary of Korean immigration. Journal of Cross-Cultural Gerontology, 19, 203-219. doi:10.1023/B:JCCG.0000034219.97686.69
[19] Mitchell, J., Mathews, H.F. and Griffin, L.W. (1997) Health and community-based service use: Differences between elderly African Americans and Whites. Res Aging, 19, 199-222. doi:10.1177/0164027597192003
[20] Settersten, R.A. (2006) Aging and the life course. In: Binstock, R.H., George, L.K., Cutler, S.J., Hendricks, J., Schulz, J.H., Eds., Handbook of Aging and the Social Sciences. 6th Edition, Elsevier Academic Press, Burlington, 3-19. doi:10.1016/B978-012088388-2/50004-3
[21] Stoller, E.P. and Gibson, R.C. (1999) Worlds of difference: Inequality in the aging experience. Pine Forge Press, Newbury Park.
[22] Jackson, J.S., Antonucci, T.C. and Gibson, R.C. (1995) Ethnic and cultural factors in research on aging and mental health: A life-course perspective. In: Padgett, D., Ed., Handbook on Ethnicity, Aging, and Mental Health, Greenwood Press, Westport, 22-46.
[23] California Health Interview Survey (2005) UCLA Center for Health Policy and Research, Los Angeles.
[24] California Health Interview Survey (2008) UCLA Center for Health Policy and Research, Los Angeles.
[25] SAS Institute (2008) Design and analysis of probability surveys course notes. SAS Education, Cary.
[26] Kleinman, A. (1978) Concepts and a model for the comparison of medical systems as cultural systems. Social Science & Medicine. Part B: Medical Anthropology, 12, 85-93.
[27] Lai, D.W.L. and Surood, S. (2009) Chinese health beliefs of older Chinese in Canada. Journal of Aging and Health, 21, 38-62.
[28] Chung, R.C.-Y. and Lin, K.M. (1994) Help-seeking behavior among Southeast Asian refugees. Journal of Community Psychology, 22, 109-120. doi:10.1002/1520-6629(199404)22:2<109::AID-JCOP2290220207>3.0.CO;2-V
[29] Brush, B.L., Sochalski, J. and Berger, A.M. (2004) Imported care: Recruiting foreign nurses to US health care facilities. Health Affairs, 23, 78-87. doi:10.1377/hlthaff.23.3.78

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