Impact of Multiple Behavioral Risk Factors on Health Status Among Chinese Americans

Smoking, risky drinking, physical inactivity, and obesity are leading causes of preventable death and disability, yet little is known about these highly related risks or their cumulative impact on health status particularly among minority populations. This study contributes to the understanding of health indicators among a rapidly growing but understudied minority group in the U.S. We used cross-sectional data from a representative probability sample of Chinese Americans to assess prevalence of behavioral risk factors and health status as measured by the SF-12. These indicators were compared with data from the general U.S. population. Multivariate regression analyses were used to estimate associations between health status and multiple risk factors. Prevalence of smoking and physical inactivity among Chinese Americans surpassed estimates among the general U.S. population (p<0.001). These behaviors were also negatively associated with health status after controlling for related chronic conditions (p<0.05). One, two, three, and four co-occurring risks were progressively associated with 1.83, 2.86, 4.87, and 8.74 point decreases in physical health status, compared to zero risks (p<0.001). Similar trends were observed in mental health status scores, up to two co-occurring risk factors (p<0.01). Relative to other health issues, efforts to encourage smoking cessation and physical activity may be particularly important in promoting health and well-being among Chinese Americans. In addition, addressing multiple risk behaviors through an integrated rather than a singular approach may be a more effective way to improve health.