230212 Associations of occupational class and immigrant status with the health of Asian Americans in the labor force

Monday, November 8, 2010 : 11:30 AM - 11:45 AM

Dolly A. John, MPH , Dept. of Health Services, University of Washington School of Public Health, Seattle, WA
Diane P. Martin, MA, PhD , Department of Health Services, University of Washington, Seattle, WA
Bonnie Duran, DrPH , Indigenous Wellness Research Institute, Department of Health Services, School of Public Health, Seattle, WA
Arnold (Butch) De Castro, PhD, MSN/MPH, RN , School of Nursing, University of Washington, Seattle, WA
David T. Takeuchi, PhD , School of Social Work, University of Washington, Seattle, WA
Background: A socioeconomic gradient in health (lower socioeconomic status (SES) associated with worse health) is well-documented. However, growing evidence depicts a paradox with some low SES, racial/ethnic minority immigrants having more favorable health than their richer, U.S.-born and more acculturated counterparts.

Objective: We investigated how occupational class (white-collar, blue-collar, service work, unemployed), a SES indicator, and immigrant status (U.S.-born, immigrant) are associated with 5 health outcomes (self-rated fair/poor mental, self-rated fair/poor physical health, DSM-IV defined mental disorders in past 12 months-any mental disorder, anxiety, depression) among Asian Americans in the labor force.

Methods: We conducted weighted, multivariate logistic regression analysis of cross-sectional data from Asian respondents (n=1530) of the National Latino and Asian American Survey controlling for age, gender, ethnicity and English proficiency.

Results: We found no occupational class gradients and a strong health protective effect of being foreign-born for most outcomes. Immigrants had significantly lower odds of self-rated fair/poor physical health [OR=.56 (.33-.96)] and any mental disorder, anxiety and depression [adjusted ORs (95%CI)=.43 (.25-.72), .46 (.26-.82), .49 (.29-.84), respectively] than U.S.-born Asians. However, those reporting speaking fair/poor English had higher odds for all negative outcomes than those speaking excellent/good English (adjusted ORs ranged from 2.81-5.02, p<0.01).

Conclusions: Occupational class and immigration-related factors influence health in complex ways. Being foreign-born was associated with better mental health while limited English proficiency was associated with worse mental health. Disentangling and understanding these relationships can inform more equitable efforts to promote health and provide health services to Asian Americans.

Learning Areas:
Diversity and culture
Occupational health and safety
Public health or related research
Social and behavioral sciences

Learning Objectives:
1) Explain the "SES-health gradient" and "immigrant paradox" 2) Define occupational class and identify 1 way to measure it 3) Describe how socioeconomic status, specifically occupational class, and immigration-related factors are related to the mental health of Asian Americans

Keywords: Social Inequalities, Immigrants

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am conducting this research as part of my PhD dissertation. I have educational training and research experiences that have prepared me to undertake this research.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.