Using CHIS to understand self –rated health among South Asians residing in California

Background: Few data sources exist that offer robust samples of Asian subgroups in the United States. Prior US studies are limited by their small questionnaires, their volunteer-based population, or lack of a comparison group. There is a consequent paucity of research on Asian subgroups that require multiple health measures and adequate samples, such as ‘self-rated health.'

Objective: Using data from the California Health Interview Survey (CHIS), a biennial random-digit-dial telephone survey (n=50,000+), we pooled data to create a robust and comprehensive sample of an Asian subgroup (South Asians) and a comparison group of non-Hispanic White adults.

Methods: Pooling four cycles of CHIS data (2001, 2003, 2005 and 2007) resulted in a sample of 1645 South Asians and 120,511 White, non-Hispanic adults. Currently, this is largest sample of South Asians in the US. Power was adequate to examine the relationships between 25 preventive health behaviors (including pap smear, mammogram and flu shot) and self rated health as well as to explore changes over time.

Results: South Asians reported fewer preventive health behaviors including ever having a pap smear (78.7% vs. 95.8%, p < 0.001) or mammogram (50.9% vs. 80.6%, p < 0.001) compared to non-Hispanic Whites. However, more South Asians rated their health as excellent, very good, or good compared to non-Hispanic Whites (94% vs. 87%, p < 0.001). These associations were similar for all study years.

Conclusions: CHIS's size and questionnaire consistency enabled us to be the first to demonstrate the need for increasing preventive health behaviors in South Asians.