Conceptual models of health and disease among South Asian immigrants

Context: Asian Indians and Pakistanis (South Asians) are among the most rapidly growing immigrant groups in the United States (US). Few studies focus on concepts of health and disease among South Asians in the US.

Objectives: To identify concepts of health and disease as part of a study on designing culturally-targeted heart disease prevention messages for South Asians.

Design, Setting, Participants: We conducted qualitative, semi-structured interviews in English, Hindi and Urdu with 75 respondents from a federally qualified health center and at a community center for South Asian immigrants in Chicago, Illinois. Age ranged from 20-70 years; 60% were women; 60% held advanced degrees; 70% migrated to the US in the last 10 years; and 60% of the interviews were in Hindi or Urdu.

Results: Concepts of health and disease fell into four major domains: behavioral physical psychological and spiritual. Urdu-speakers more than others consistently evoked spiritual factors such as faith and prayer. Women more frequently included weight maintenance, performing home duties and positive affect in their concept of health. Men more frequently cited behavioral factors such as smoking and drinking as the cause of disease.

Conclusion: In contrast to the bio-psychosocial model (which emphasizes physical and psychological concepts), South Asians have a more holistic conceptualization of health and disease, incorporating spiritual, physical and psychological factors. Health promotion strategies aimed at South Asians in the US should take into account this holistic model of health and disease, while also recognizing that variations exist within South Asians, by gender and language.