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Understanding the relationships betw...

John, Dolly Ann.

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Understanding the relationships between nativity, occupational class, and the health care and health of Asian Americans: A mixed methods study.

Record Type:	Electronic resources : Monograph/item
Title/Author:	Understanding the relationships between nativity, occupational class, and the health care and health of Asian Americans: A mixed methods study./
Author:	John, Dolly Ann.
Published:	Ann Arbor : ProQuest Dissertations & Theses, : 2010,
Description:	115 p.
Notes:	Source: Dissertations Abstracts International, Volume: 72-08, Section: B.
Contained By:	Dissertations Abstracts International72-08B.
Subject:	Mental health. -
Online resource:	https://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3431614
ISBN:	9781124313405

Understanding the relationships between nativity, occupational class, and the health care and health of Asian Americans: A mixed methods study.
John, Dolly Ann.

Understanding the relationships between nativity, occupational class, and the health care and health of Asian Americans: A mixed methods study. - Ann Arbor : ProQuest Dissertations & Theses, 2010 - 115 p.

Source: Dissertations Abstracts International, Volume: 72-08, Section: B.

Thesis (Ph.D.)--University of Washington, 2010.

This item is not available from ProQuest Dissertations & Theses.

National reports document extensive, persistent, and significant inequities in the healthcare of Asian Americans. Growing evidence also depicts a paradox with some lower SES, minority immigrants having better health than their richer, U.S.-born and more acculturated counterparts. This explanatory mixed methods study aims to disentangle the effects of nativity and occupational class (service, blue-collar, white-collar, unemployed) on the healthcare and health of Asian Americans using cross-sectional data from the 2002-2003 National Latino and Asian American Study (n=2095) followed by qualitative data from focus group discussions. Paper 1 examines the associations of nativity and occupational class with uninsurance, no physical check-ups and no dental/eye exam in past year. The unemployed had higher odds for uninsurance while service workers had higher odds for uninsurance and no physical exams than white-collar workers. Some occupational disparities persisted after adjusting for enabling factors (e.g., income), notably for service workers and uninsurance and no physical check- up. Paper 2 examines the associations with self-rated physical health, self-rated mental health, and DSM-IV assessed any mental disorder, anxiety and depression in the past 12 months. We found no strong occupational class gradients. Instead, we found a strong health protective effect for immigrants for fair/poor self-rated physical health, any mental disorder and anxiety in the last 12 months lending some support for the immigrant paradox. However, speaking fair/poor English, acculturative stress and being uninsured were associated with worse mental health. Paper 3 uses three focus group with 25 Vietnamese women employed in service occupations in Seattle, WA to understand perceptions of work- related stresses and how they affect safety and health, help-seeking and health service use. Participants described numerous inter-related work-stressors which often interact to have cumulative, negative effects. They described somatic manifestations of stress, passive coping and help-seeking barriers in healthcare and beyond. They offered solutions at multiple levels to address structural and social factors to prevent work-stress. Together, our findings explain how nativity and occupational class affect the healthcare and health of Asian Americans in complex ways, which vary by outcome and through important material (e.g., income) and psychosocial (e.g. acculturative stress, work-stress) pathways. Our findings can help inform culturally-centered health promotion, interventions and policies that encourage timely, appropriate use of healthcare.

ISBN: 9781124313405Subjects--Topical Terms:

534751
Mental health.
Subjects--Index Terms:

Asian-Americans

Understanding the relationships between nativity, occupational class, and the health care and health of Asian Americans: A mixed methods study.
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502 $a Thesis (Ph.D.)--University of Washington, 2010.
506 $a This item is not available from ProQuest Dissertations & Theses.
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520 $a National reports document extensive, persistent, and significant inequities in the healthcare of Asian Americans. Growing evidence also depicts a paradox with some lower SES, minority immigrants having better health than their richer, U.S.-born and more acculturated counterparts. This explanatory mixed methods study aims to disentangle the effects of nativity and occupational class (service, blue-collar, white-collar, unemployed) on the healthcare and health of Asian Americans using cross-sectional data from the 2002-2003 National Latino and Asian American Study (n=2095) followed by qualitative data from focus group discussions. Paper 1 examines the associations of nativity and occupational class with uninsurance, no physical check-ups and no dental/eye exam in past year. The unemployed had higher odds for uninsurance while service workers had higher odds for uninsurance and no physical exams than white-collar workers. Some occupational disparities persisted after adjusting for enabling factors (e.g., income), notably for service workers and uninsurance and no physical check- up. Paper 2 examines the associations with self-rated physical health, self-rated mental health, and DSM-IV assessed any mental disorder, anxiety and depression in the past 12 months. We found no strong occupational class gradients. Instead, we found a strong health protective effect for immigrants for fair/poor self-rated physical health, any mental disorder and anxiety in the last 12 months lending some support for the immigrant paradox. However, speaking fair/poor English, acculturative stress and being uninsured were associated with worse mental health. Paper 3 uses three focus group with 25 Vietnamese women employed in service occupations in Seattle, WA to understand perceptions of work- related stresses and how they affect safety and health, help-seeking and health service use. Participants described numerous inter-related work-stressors which often interact to have cumulative, negative effects. They described somatic manifestations of stress, passive coping and help-seeking barriers in healthcare and beyond. They offered solutions at multiple levels to address structural and social factors to prevent work-stress. Together, our findings explain how nativity and occupational class affect the healthcare and health of Asian Americans in complex ways, which vary by outcome and through important material (e.g., income) and psychosocial (e.g. acculturative stress, work-stress) pathways. Our findings can help inform culturally-centered health promotion, interventions and policies that encourage timely, appropriate use of healthcare.
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