Date Presented 03/26/20
Three national surveys in the United States, China, and Korea were used to examine the social, contextual, and behavioral factors that influence health status across three Asian populations.
Primary Author and Speaker: Ickpyo Hong
Additional Authors and Speakers: Loree Pryor, Riqiea Kitchens
PURPOSE: Although cross-national comparisons for patterns of aging populations are feasible due to the existing national micro-data, few studies have attempted to examine different social, cultural, and policy contexts that influence aging across countries in Asian populations. This study aims to examine the social, contextual, and behavioral factors that influence functional status across the three Asian populations.
DESIGN: A secondary data analysis was performed on three national surveys: the 2012 Health and Retirement Study, the 2012 China Health and Retirement Longitudinal Study, and the 2012 Korean Longitudinal Study of Aging.
METHOD: We retrieved a representative sample of 211 American Asian adults, 13,649 Chinese adults, and 7,486 Korean adults from the national aging surveys. Survey participants were population-based national samples of individuals over 50 years old and lived in community settings. Hierarchical regression models were utilized to compare health status and examine the influence of social-contextual factors on health status across the American Asian, Chinese, and Korean adults. The self-rated health question (1-very good to 5-very bad) was the dependent variable and was identified in all three surveys as a common metric for health status (Cieza et al., 2015; Hong et al., 2018). Social-contextual factors were used as independent variables, including: age, sex, living arrangement, employment status, self-rated health, body mass index (kg/m2), cognitive status (CESD depression score, orientation, and serial 7’s test score), chronic conditions (stroke, arthritis, diabetes, hypertension, cancer, heart problem), number of people in house, number of living parents, children, siblings, children living in the same city, weekly contact with children, weekly religious participation, and financial transfer from/to children. The regression coefficients ( β) on the study variables in regression model were examined to compare the effects of family and environmental factors on health status across countries.
RESULTS: The mean age of the sample was 63.8 years (SD=9.5). The majority of the sample lived with a spouse/partner (81.6%), female (52.8%), and employed (53.8%). The unadjusted self-rated health status scores revealed that American Asian had significantly better health status (Mean=2.5, SD=0.06) than Korean (Mean=3.7, SD=0.01) and Chinese adults (Mean=3.9, SD=0.01). Health status orders did not change even after accounting for the social-contextual factors. Age, depression scores, chronic conditions, and receipt of financial assistance from children were significantly associated with poor health status (p<0.05). Factors significantly associated with good health (p<0.05) are: higher education attainment, current employment, active lifestyle, higher cognitive function, social participation, and giving financial support to their children.
CONCLUSION: Study findings that the American Asian adults are healthier than the Korean and Chinese adults. We speculate that the majority of the differences across the three countries may be due to differences in the rate of the aging populations or different cultural aspects for the aging populations. Policy makers and clinicians would need to investigate the negative driving factors on health status in China and Korea or adapt the US health policies to improve healthy aging among the adults in the two countries.
IMPACT STATEMENT: The proposed research methods successfully compared the health status across three Asian populations. Modifiable negative social-contextual factors on health status can inform clinicians and researchers to promote healthy aging for community dwelling Asian populations and contribute to future research directions in global aging studies.
References
Cieza, A., Oberhauser, C., Bickenbach, J., Jones, R. N., Üstün, T. B., Kostanjsek, N., . . . Chatterji, S. (2015). The English are healthier than the Americans: really? International Journal of Epidemiology, 44(1), 229-238.
Hong, I., Reistetter, T. A., Díaz-Venegas, C., Michaels-Obregon, A., & Wong, R. (2018). Cross-national health comparisons using the Rasch model: findings from the 2012 US Health and Retirement Study and the 2012 Mexican Health and Aging Study. Quality of Life Research, 27(9), 2431-2441. doi:10.1007/s11136-018-1878-4
