Construct vs. measurement: Mixed findings and the limitations of "acculturation" in health research

Objectives: To illustrate the variability of indicators commonly analyzed as proxy measures of acculturation. Methods: Using logistic regression, we systematically examined associations between four indicators (nativity, English proficiency, country of residence during formative years and length of U.S. residence) with three health outcomes (self-rated health, chronic conditions, and behavioral risk) in a population-based cohort of Mexican-origin individuals in Harris County, Texas (n=12,464). Results: Being born in Mexico and reporting low English proficiency were associated with higher odds of reporting fair/poor health (OR=1.3; 95% CI: 1.19-1.43 & OR=1.55; 95% CI: 1.42-1.69), yet residing in the U.S. for 12 years or less was protective (OR=0.90; 95% CI: 0.82-0.99). For chronic conditions and behavioral risk, being born in Mexico was protective (OR=0.80; 95% CI: 0.72-0.89 & OR=0.65; 95% CI: 0.55-0.76). Residing in the US for 12 years or less (OR=0.74; 95% CI: 0.66-0.83) was protective against reporting chronic conditions while spending formative years in Mexico (OR=0.69; 95% CI: 0.51-0.93) was protective against behavioral risks. Conclusions: This methodical evaluation provides evidence of the limitations of the concept of acculturation and suggests a more nuanced, theoretically-grounded use in research.