Education gradients in health behaviors among Hispanic and Asian young adults: The influence of nativity and age at immigration

Background: Although social gradients are evident for most health outcomes, research has increasingly suggested that socioeconomic status (SES) may not have the same effect on health for all US populations. In particular, more modest socioeconomic differentials in health have been found for foreign-born than corresponding US-born populations. We extend this research by testing the hypothesis that the relationship between education and two health behaviors, smoking and physical inactivity, depends not only on place of birth, but also on age at immigration. We examine these associations among Hispanic and Asian young adults. Methods: Data come from the 2000-2008 National Health Interview Survey. The sample included 13345 Hispanics and 2528 Asians aged 18 to 30. Smoking and physical inactivity were based on self reports. We used logistic regression to examine interactions between education, nativity, and age at immigration in each group. Results: The effect of education on smoking and physical inactivity is weaker for foreign- versus US-born Hispanic young adults, but does not vary for Asians. Education gradients for smoking and physical inactivity among Hispanic young adults who immigrated at an early age (at or before age 15) more closely resemble those of US-born Hispanics than do gradients among individuals who immigrated at an older age (after age 15). A similar pattern is evident for Asians for smoking. Conclusion: Both country of birth as well as country of residence in childhood and adolescence may be crucial to understanding differences in the effect of SES on health behaviors in diverse populations.