School of Public Health
Permanent URI for this communityhttp://hdl.handle.net/1903/1633
The collections in this community comprise faculty research works, as well as graduate theses and dissertations.
Note: Prior to July 1, 2007, the School of Public Health was named the College of Health & Human Performance.
Browse
3 results
Search Results
Item Self-reported discrimination among Asian Americans: An examination of its measurement and relationship with health-related quality of life(2019) Jung, Mary; Lee, Sunmin; Epidemiology and Biostatistics; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Labeled as a “model minority,” Asian Americans have often been excluded from the dialogue on discrimination. Previous studies frequently used discrimination measures that were initially developed for African Americans and lack items related to language and nativity. Although discrimination adversely affects mental and physical health, its relationship to health-related quality of life (HRQOL) has been understudied in this population. This dissertation evaluated self-reported discrimination among Asian Americans by examining its measurement and relationship with HRQOL. Manuscript 1 assessed the psychometric properties of everyday (ERDS) and major racial discrimination scales (MRDS) that were developed for Asian Americans. In a sample of 569 Asian American immigrant adults, reliability was excellent for ERDS but moderate for MRDS (Cronbach’s α=0.94 and 0.60). The latter is likely low given that MRDS is an inventory of events. For construct validity, weak positive linear correlations with perceived stress and depressive symptoms were observed (r=0.22 and 0.28 for ERDS and r=0.11 and 0.14 for MRDS; p<0.001). Factor analysis confirmed the unidimensionality of both measures. Manuscript 2 cross-sectionally examined the association between the racial discrimination measures from Manuscript 1 and HRQOL among 524 foreign-born Asian American adults. Multivariable logistic regression and negative binomial regression were performed to examine self-rated health (poor vs. good) and days of poor physical health, mental health, and activity limitation. ERDS (IRR range: 1.04-1.08) and MRDS scores (IRR range: 1.19-1.61) were significantly and positively associated with worse HRQOL for all measures, except for self-rated health. Manuscript 3 examined discrimination trajectories and assessed their relationship with self-rated health in a longitudinal, multi-ethnic sample of 2,004 middle-aged women in the Study of Women’s Health Across the Nation (SWAN). Group-based trajectory analysis identified three distinct discrimination groups. The “high and decreasing” but not “moderate and decreasing” group was significantly associated with poor self-rated health compared to the “low and decreasing” group (OR=1.61; 95% CI: 1.12-2.31). This dissertation provides insight into discrimination measures and their relationships with HRQOL among Asian Americans. Proper measurement and health impact assessment of discrimination in this population can contribute to better monitoring and provide improved accountability and support for interventions and public policies.Item THE EFFECT OF OWN RACE/ETHNICITY DENSITY ON INSURANCE TAKE-UP BY ASIAN AMERICANS(2019) Choi, Yoon Sun; Roby, Dylan H; Health Services Administration; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Asian Americans are the fastest growing minority population in the U.S. (Lopez et al., 2017). Since the implementation of the Patient Protection and Affordable Care Act (ACA), Asian Americans have benefitted from insurance coverage increases but continue to experience disparities at the subgroup level (Park et al., 2018). This study investigates the association of own race subgroup density on the take-up of insurance by examining the effect of Asian subgroup concentration that may provide social and knowledge support linkages to available insurance coverage options.Item Acculturation and BMI among Chinese, Korean and Vietnamese Adults in Maryland(2011) Chen, Lu; Lee, Sunmin; Carter-Pokras, Olivia D; Epidemiology and Biostatistics; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Objective: To examine the relationship between acculturation and BMI among Asian Americans. Methods: Data of 847 Chinese, Korean and Vietnamese recruited for a health education program in Maryland were included. Acculturation was measured by the short version of Suinn-Lew Asian Self-Identity Acculturation Scale (SL-ASIA) and its individual components. Height and weight were measured by trained staff. Multiple linear regression was used to estimate the parameters of acculturation variables. Results: After adjusting for confounders, SL-ASIA (β=0.71, 95% CI: 0.15, 1.26), having education in the U.S (β=0.56, 95% CI: 0.01, 1.11), younger age of arrival (0-5 years: β=3.32, 95% CI: 1.84, 4.80, 6-10 years: β=1.55, 95% CI: 0.02, 3.07) and equal preference of Asian/American food in restaurants (β=0.92, 95% CI 0.38, 1.46) were associated with BMI. The association between acculturation and BMI was stronger among men than women, and weakest among Vietnamese. Conclusion: Acculturation is moderately associated with BMI among Asian Americans.