Is Acculturation Always Adverse to Korean Immigrant Health in the United States?

This study examined the association between individuals’ proportion of life spent in the United States and the health status and health behaviors among Korean immigrants aged 25 and above. The analysis is stratified by level of education to test whether a higher proportion of time spent in the United States is associated with poorer health among both less educated and highly educated Korean immigrants. California health interview survey data from 2005 to 2007 were used to estimate logistic regression models of health and health behaviour among Korean immigrants, stratified by educational attainment. The health and health behaviour of less educated Korean immigrants tended to be worse among those with a higher proportion of residence in the United States. However, more highly educated Korean immigrants tended to exhibit lower odds of being unhealthy and lower odds of poor health behavior with a higher proportion of life spent in the United States. Acculturation is not always associated with poorer immigrant health outcomes. A higher proportion of life spent in the United States tends to be associated with more favorable health and health behavior among highly educated Korean immigrants.     

A trauma-informed examination of the hardships experienced by abortion fund patients in the United States

Researchers describe hardships experienced by abortion patients, examining administrative health cases from 2010 to 2015 in the United States. All patients received financial assistance from an abortion fund to help pay for abortion. Case data were analyzed to assess types and numbers of hardships experienced by age, race, and geographic origin. Hardships ranged from homelessness to parenting multiple children. Patients from the geographic South experienced the most hardships, followed by those from the Midwest. Hardships experienced by abortion fund patients are like those reported in other samples of abortion patients; hardships potentially cause or exacerbate trauma. Results are discussed in the context of a trauma-informed perspective.     

Fatal violence among spouses in the United States, 1976-85.

In this paper we examine patterns and trends in homicides between marriage partners in the United States for 1976 through 1985 using data from the Federal Bureau of Investigation's Supplemental Homicide Reports (FBI-SHR). We identified 16,595 spouse homicides accounting for 8.8 per cent of all homicides reported to the FBI-SHR during this 10-year period. The rate of spouse homicide for this 10-year period was 1.6 per 100,000 married persons. The risk of being killed by one's spouse was 1.3 times greater for wives than for husbands. Black husbands were at greater risk of spouse homicide victimization than Black wives or White spouses of either sex. The risk of victimization was greater for spouses in interracial than in intraracial marriages and increased as age differences between spouses increased. From 1976 through 1985, the risk of spouse homicide declined by more than 45.0 per cent for both Black husbands and wives but remained relatively stable for White husbands and wives. Demographic patterns in the risk of spouse homicide were similar to those reported for nonfatal spouse abuse suggesting that the causes of spouse homicide and nonfatal spouse abuse may be similar.     

Acculturation and cigarette smoking among pregnant Hispanic women residing in the United States

Objectives. We explored whether higher levels of acculturation were associated with higher rates of cigarette smoking among pregnant Hispanic women residing in the United States.Methods. We evaluated data from the Latina Gestational Diabetes Mellitus Study, a prospective study of 1231 Hispanic prenatal care patients conducted from 2000 to 2004 in Massachusetts. Self-reported data on acculturation, cigarette smoking, and covariates were collected by bilingual interviewers using a questionnaire. We conducted logistic regression multivariate analyses to examine the impact of acculturation level on the odds of smoking.Results. Overall, 21% of women reported smoking during pregnancy. Acculturation was associated with elevated smoking rates in pregnant Hispanic women. US-born Hispanic women who preferred English had more than twice the odds of smoking compared with Puerto Rican or foreign-born Hispanic women who preferred Spanish (odds ratio [OR]=2.76, 95% confidence interval [CI] 1.36, 5.63).Conclusions. Our findings suggest that higher-acculturated Hispanic women living in the United States are more likely to smoke cigarettes during pregnancy than are less-acculturated Hispanic women. These results will inform interventions aimed at reducing cigarette smoking during pregnancy among US Hispanic women.Smoking during pregnancy is associated with numerous negative outcomes, including spontaneous abortion, stillbirth, perinatal death, low birthweight, preterm delivery, intrauterine growth retardation, and an increased risk of sudden infant death syndrome.1^–4 Smoking during pregnancy is commonplace in the United States, with an estimated 10.7% of pregnant women acknowledging smoking during pregnancy.5 Cigarette smoking is a particular concern for Hispanics, given that, in 2002, more than 21% of all births in the United States were to Hispanics and Hispanics had the highest fertility rate of any racial or ethnic group.6^,7 Hispanics are the largest minority group in the United States and are growing at the fastest rate of any racial or ethnic group.8Regardless of pregnancy status, Hispanic women in the United States are less likely to smoke than are non-Hispanic Whites and Blacks. Age-adjusted data from the National Health Interview Survey of 2001 found that 10.9% of Hispanic women reported being current smokers compared with 22.7% of non-Hispanic Whites and 18.1% of non-Hispanic Blacks.5 In 2003, birth certificate data from the National Vital Statistics System found that 2.7% of Hispanic women reported smoking during pregnancy compared with 14.3% of non-Hispanic Whites and 8.3% of non-Hispanic Blacks.5 Smoking rates in the United States vary considerably by country of origin; for example, 7.9% of women of Puerto Rican origin report smoking during pregnancy compared with 2.0% of women of Mexican and 2.4% of women of Cuban origin.5Hispanic women living in the United States are more likely to smoke than are Hispanic women living in their countries of origin. For example, only 0.9% of women in Puerto Rico report smoking during pregnancy compared with 7.9% of pregnant Puerto Rican women in the United States.5^,9 In Mexico, 4.5% of women report smoking compared with 9.6% of women of Mexican descent living in the United States.5^,10 These different rates may be explained by the more conservative attitudes toward cigarette smoking in traditional Hispanic cultures compared with US culture and the acculturation of women after arriving in the United States.11^,12 Acculturation is defined as the process of adopting the attitudes, beliefs, and behaviors of a new culture.13 The body of acculturation literature among non-pregnant women indicates that acculturation to the US culture is associated with the adoption of negative health behaviors that are more prevalent in this country.14^,15Prior studies of pregnant Hispanic women suggest that increasing acculturation is associated with higher levels of smoking during pregnancy.16^–18 However, the majority of these studies were limited by small sample size and used only single measures of acculturation. Furthermore, these studies did not take into account parental birthplace. We were able to examine the association between cigarette smoking and parental and individual birthplace, language preference, and age at migration in a cohort of 1231 Hispanic prenatal-care patients. We hypothesized that pregnant Hispanic women in the United States with higher levels of acculturation would have higher rates of cigarette smoking compared with those with lower-acculturation levels.     

Acculturation and Health Care Utilization among Mexican Heritage Women in the United States

With the increasing Latino population in the United States, it is critical to examine the influence of the process of acculturation on health care practices and utilization. The purpose of this study was to evaluate the relationship between acculturation level and post-partum visit (PPV) compliance among Latinas participating in a larger psycho-educational intervention aimed at encouraging women to engage in positive healthcare practices. Acculturation was measured with the Bicultural Involvement Questionnaire which assigned participants to five categories: Assimilated, Separated, Moderate, Bicultural and Alienation. Logistic Regression analyses were conducted to predict post-partum visit attendance. Odds ratios and relative risk of not attending the post-partum visit are presented. Results suggest women in the Separation and Assimilation groups were less likely than bicultural group members to attend the PPV. The only other variable that was significant in this analysis is the group condition, indicating that the intervention group was more likely to attend the PPV than the control group. Women identifying as bicultural seem to participate more actively in their own healthcare as they draw on the cultural assets that have a positive influence on informal health practices, such as healthy eating and refraining from drug use. Bicultural group members can also use formal skills related to language and knowledge of the dominant culture to help effectively navigate the healthcare system. Implications for research, intervention and practice are discussed to improve healthcare practices and increase utilization among Latinas.     

Korean Women Living in the United States as Student Wives

Korean students' wives who travel with their husbands to the United States while they pursue academic degrees often experience the extremes of assimilation into the host culture. The purpose of this study is to address the following questions: (a) What are the processes used by Korean women to adapt to life in the United States, and (b) what are the barriers they encounter, as wives of students and mothers of their children, in adapting to this new life? Fourteen Korean wives were interviewed. All interviews were completed in Korean and transcribed verbatim. The study reveals eight phases to the basic social process of adjusting to life in the United States: preconfronting, confronting, discovering, undergoing crisis, seeking, reorienting, reflecting, and reconfronting. These were observed to be dynamic and recurrent ongoing phases that are likely to repeat themselves. The study findings provide health care practitioners with a better understanding of Korean wives' adjustment to life in the United States and suggest the development of culturally appropriate interventions.     

Korean women living in the United States as student wives

Korean students' wives who travel with their husbands to the United States while they pursue academic degrees often experience the extremes of assimilation into the host culture. The purpose of this study is to address the following questions: (a) What are the processes used by Korean women to adapt to life in the United States, and (b) what are the barriers they encounter, as wives of students and mothers of their children, in adapting to this new life? Fourteen Korean wives were interviewed. All interviews were completed in Korean and transcribed verbatim. The study reveals eight phases to the basic social process of adjusting to life in the United States: preconfronting, confronting, discovering, undergoing crisis, seeking, reorienting, reflecting, and reconfronting. These were observed to be dynamic and recurrent ongoing phases that are likely to repeat themselves. The study findings provide health care practitioners with a better understanding of Korean wives' adjustment to life in the United States and suggest the development of culturally appropriate interventions.     

United States health professionals in international health work

This article reports results of a survey of 1,257 potential employers of US health professionals overseas, interviews with informants in international health, an analysis of career patterns of a small group of international health workers, and a review of numbers of health professionals trained in schools of public health for international health work. There are approximately 9,000 US health professionals in the international health field. Doctors (1,400), nurses (1,500) and administrators (900) are the largest groups. Church-related agencies (2,200 people), private voluntary agencies (1,700 people), and universities (1,000 people) are the largest employers.     

Acculturation and health in Korean Americans

Despite increasing research on the relationships between acculturation and health, it is unclear whether (1) ethnic group variation occurs in acculturation-health relationships, (2) acculturation components vary differently in relationship to health, (3) biculturalism has beneficial effects on health and (4) multidimensional health relationships occur with acculturation. This study examined the Korean American ethnic group, considering how acculturation was related with five dimensions of health: smoking, physical activity, fat intake, body weight, and reported health. Pretested questionnaires were mailed to a national sample with Korean American surnames, and 55% of the deliverable sample responded, producing 356 usable questionnaires. Acculturation was measured using a two-culture matrix model and Gordon's theoretical work, and showed three distinct groups (acculturated, bicultural and traditional) and four components (American structural, American cultural, Korean structural and Korean cultural). Bicultural men were least likely to smoke, while acculturated and bicultural women were more likely to smoke than traditional women. Korean structural and cultural components were related to men's smoking. Higher acculturation was related to light physical activity, but not to vigorous physical activity. Fat intake did not differ by acculturation status. Higher acculturation was associated with higher body weight and better self-reported health only in men. Higher American cultural component scores were associated with better self-reported health in men. Among Korean Americans, acculturation components varied in their relationships with health, beneficial effects of being bicultural on health were not found, and acculturation-health relationships were multidimensional. Overall, ethnic group variation in health occurred, with Korean Americans similar to some ethnic groups but different than others. Future health research and practice can benefit by acknowledging the complexity of acculturation and its multidimensional effects on health.     

Acculturation Matters: Risk Perceptions of Smoking among Bosnian Refugees Living in the United States

The relationship between acculturation and health behavior change is complex. Little research has focused on acculturation and perceptions of health-related risks. This study investigated acculturation and risk perceptions of heart attack and lung cancer among a group of refugees. Questionnaires were distributed to a sample of Bosnian refugees living in the United States (N = 55). Results indicated that smokers thought they were less at risk than other smokers and no more at risk than non-smokers, whereas non-smokers did not think they were less at risk than other non-smokers. Greater acculturation was associated with greater perception of smokers' risk of heart attack and lung cancer. Smoking cessation interventions with refugees should incorporate culturally appropriate risk information.     

Dietary Acculturation Process of Israeli Women Who Immigrated to the United States as Adults

The purpose of this study was to contribute to the knowledge of the dietary acculturation of women who immigrated to the U.S. as adults from Israel. Participants (N = 6) were women of Israeli descent and lived in Massachusetts. Data was collected using interviews constructed of three parts: dietary recall, questions on causes for altering food choices, and participant observation. Qualitative analysis of the data led to identification of changes in consumption of food and beverages, weight and exercise change, food as culture, and the relocation process. We found that predisposing factors are key elements in influencing behavioral change in food consumption.     

Age dependence of cohort phenomena in breast cancer mortality in the United States

Breast cancer mortality has increased in most parts of the world, and many explanations have been postulated. In this paper, the authors examined the evolution of mortality rates for white and nonwhite females in the United States from 1950-1979. Using both graphic techniques and Poisson regression models, they found that there has been strong modification of apparent cohort effects by age. For both white and nonwhite females, they observed an increase in mortality rates limited to the postmenopausal ages.     

Traditional Postpartum Care Among Women of Korean Descent in the United States

Maternal and Child Health Journal - Traditional postpartum care practices in East Asia have been recognized as non-functional by some government public health agencies. This study examined the...     

Factors of Breast Cancer Screening Among Korean Immigrants in the United States

The purpose of this paper is to assess breast cancer screening rates and explore factors related to all three measures of breast cancer screening, mammography, clinical breast examination (CBE), and breast self-examination (BSE), among Korean immigrants in the United States. A telephone survey was conducted with 189 Korean women aged 40 and older in Cook County, Illinois. Of this group, 78% had had a mammogram at some point, and 38.6% had had one within the previous year. Fifty-three percent had had a CBE, while 26.1% had had one within the previous year. Whereas 58.1% had examined their breasts before, 46.3% did monthly BSE. Korean women’s breast cancer screening rates are improving even though the rates are still lower than screening rates in the United States. Having a regular check-up and being married were strongly related to all three measures of cancer screening. Further in-depth research is suggested to understand KA women’s perspectives on having access to care. This work was performed at University of Illinois at Chicago, Chicago, Illinos     

Teaching about international health in United States public schools

This is a decade length study which will involve periodic surveys of curriculum directors and coordinators and review of health, social studies, and selected other curriculum documents. Curriculum directors and coordinators from 43 states responded to the Cissell International Health Curricula Questionnaire. Eighteen sent copies of their health curriculum documents. Ten sent copies of the social studies curriculum documents. Several indicated their curriculum documents could be purchased. Several others indicated their curriculum documents were being revised or reprinted. Solicitation of responses to the questionnaire and of additional copies of the curriculum guides will continue until curriculum directors or coordinators from all 50 states have responded and a copy of each of the published health and social studies curriculum documents has been received and analyzed or June 30, 1988. A second phase will be initiated in 1989 to solicit comparable information. Likewise, a third phase of the study will be initiated in 1994. Phases two and three will produce data that can be compared with the data obtained in phase one. In that way, any changes in school health curricula, as it relates to international health, should be evident.     

Health disparities experienced by Hispanics--United States

In the 2000 census, 35.3 million persons in the United States and 3.8 million persons in the Commonwealth of Puerto Rico identified themselves as Hispanic (i.e., Hispanic, Spanish, or Latino; of all races). Hispanics constituted 12.5% of the U.S. population in the 50 states; by subpopulation, they identified as Mexican (7.3%), Puerto Rican (1.2%), Cuban (0.4%), and other Hispanic (3.6%). For certain health conditions, Hispanics bear a disproportionate burden of disease, injury, death, and disability when compared with non-Hispanic whites, the largest racial/ethnic population in the United States. The leading causes of death among Hispanics vary from those for non-Hispanic whites. This week's MMWR is the second in a series focusing on racial/ethnic health disparities; eliminating these disparities will require culturally appropriate public health initiatives, community support, and equitable access to quality health care.