Abstract
Is the consistently poorer health of Vietnamese refugees relative to whites due largely to differences in socioeconomic status, demographic characteristics, and health risk behaviors or the residual impact of the trauma of war and resettlement? Using data from a population-based household survey we use multinomial logistic regression to assess the self-rated health and activity limitations of Vietnamese refugees aged 55 and older compared to whites, adjusting for demographics, socioeconomic status, and lifestyle characteristics. Vietnamese refugees report poorer health and are more likely to report activity limitations than whites. While substantial differences in characteristics exist between the two groups, they explain little of the health differentials. Demographic and socioeconomic factors do not explain the health differential between older Vietnamese refugees and whites, although their lifestyle exerts a protective effect. The trauma of war and the stressful context of immigration likely contribute to the poorer health of Vietnamese refugees.
Similar content being viewed by others
References
Abdulrahim, S., & El Asmar, K. (2012). Is self-rated health a valid measure to use in social inequities and health research? Evidence from the PAPFAM women’s data in six Arab countries. International Journal of Equity Health, 11(1), 53.
Adams, P. F., Martinez, M. M., & Vickerie, J. L. (2010). Summary health statistics for the US population: National Health Interview Survey 2009. Vital Health Statistics, 10(248). Retrieved February 28, 2018 from http://www.cdc.gov/nchs/data/series/sr_10/sr10_248.pdf.
American Association for Public Opinion Research. (2015). Standard definitions. Retrieved May 30, 2018 from https://www.aapor.org/AAPOR_Main/media/publications/Standard-Definitions2015_8theditionwithchanges_April2015_logo.pdf.
Barnes, P. M., Adams, P. F., & Powell-Griner, E. 2008. Health characteristics of the Asian adult population: United States, 2004–2006. Advance data 394. Retrieved February 28, 2018 from https://www.cdc.gov/nchs/data/ad/ad394.pdf.
Benyamini, Y., Blumstein, T., Lusky, A., & Modan, B. (2003). Gender differences in the self-rated health–mortality association: Is it poor self-rated health that predicts mortality or excellent self-rated health that predicts survival? The Gerontologist, 43(3), 396–405 (discussion 372–375).
Brown, T. H., Richardson, L. J., Hargrove, T. W., & Thomas, C. S. (2016). Using multiple-hierarchy stratification and life course approaches to understand health inequalities. Journal of Health and Social Behavior, 57(2), 200–222.
Centers for Disease Control and Prevention. (2016). Asian Americans and Pacific Islanders and Chronic Hepatitis B. Retrieved February 28, 2018 from https://www.cdc.gov/hepatitis/populations/api.htm.
Conley, D. (2010). Being black living in the red: Race, wealth and social policy in America (2nd ed.). Berkeley: University of California Press.
DeSalvo, K. B., Fan, V. S., McDonell, M. B., & Fihn, S. D. (2005). Predicting mortality and healthcare utilization with a single question. Health Services Research, 40(4), 1234–1246.
Farmer, M. M., & Ferraro, K. F. (2005). Are racial disparities in health conditional on socioeconomic status? Social Science and Medicine, 60(1), 191–204.
Ferraro, K. F., & Shippe, T. P. (2009). Aging and cumulative inequality: How does inequality get under the skin? The Gerontologist, 49(3), 333–343.
French, D. J., Sargent-Cox, K., & Luszcz, M. A. (2012). Correlates of subjective health across the aging lifespan: Understanding self-rated health in the oldest old. Journal of Aging and Health, 24(8), 1449–1469.
Frisbie, W. P., Cho, Y., & Hummer, R. (2001). Immigration and the health of Asian and Pacific Islander adults in the United States. American Journal of Epidemiology, 153, 372–380.
Geronimus, A. T. (2001). Inequality in life expectancy, functional status, and active life expectancy across selected black and white populations in the United States. Demography, 38(2), 227–251.
Hayward, M. D., Crimmins, E. M., Miles, T. P., & Yang, Y. (2000). The significance of socioeconomic status in explaining the racial gap in chronic health conditions. American Sociological Review, 65, 910–930.
Idler, E., Leventhal, H., McLaughlin, J., & Leventhal, E. (2004). In sickness but not in health: Self-ratings, identity, and mortality. Journal of Health and Social Behavior, 45(3), 336–356.
Idler, E. L. (2003). Discussion: Gender differences in self-rated health, in mortality, and in the relationship between the two. Gerontologist, 43(3), 372–375.
Ihara, E. (2009). Ethnicity matters: The socioeconomic gradient in health among Asian Americans. Journal of Sociology and Social Welfare, 36(2), 125–144.
Johnson, R. C., & Schoeni, R. F. (2011). Early-life origins of adult disease: National longitudinal population-based study of the United States. American Journal of Public Health, 101(12), 2317–2324.
Johnson, R. C., Schoeni, R. F., & Rogowski, J. A. (2012). Health disparities in mid-to-late life: The role of earlier life family and neighborhood socioeconomic conditions. Social Science & Medicine, 74(4), 625–636.
Kandula, N. M., Wen, M., Jacobs, E. A., & Lauderdale, D. S. (2009). Association between neighbhorhood context and smoking prevalence among Asian Americans. American Journal of Public Health, 99(5), 885–892.
Kandula, N. R., Lauderdale, D. S., & Baker, D. W. (2007). Differences in self-reported health among Asians, Latinos, and non-Hispanic whites: The role of language and nativity. Annals of Epidemiology, 17(3), 191–198.
Khow, S., & Foo, M. A. (2014). A Community of Contrasts: Asian Americans, and Native Hawaiians and Pacific Islanders in Orange County. Orange County: Asian Americans Advancing Justice—Orange County.
Kimbro, R. T., Bzostek, S., Goldman, N., & Rodriguez, G. (2008). Race, ethnicity, and the education gradient in health. Health Affairs, 27(2), 361–372.
Kimbro, R. T., Gorman, B. K., & Schachter, A. (2012). Acculturation and self-rated health among Latino and Asian immigrants to the United States. Social Problems, 59(3), 341–363.
Macro International. (2007). 2007 Orange County Health Needs Assessment Survey methodology report. Unpublished report.
Maty, S., Leung, H., Lau, C., & Kim, G. (2011). Factors that influence self-reported general health status among different Asian ethnic groups: Evidence from the roadmap to the New Horizon: Linking Asians to improved health and wellness study. Journal of Immigrant & Minority Health, 13(3), 555–567. https://doi.org/10.1007/s10903-010-9349-1.
Miller, B. A., Kolonel, L. N., Bernstein, L., Young, J. L., Jr., Swanson, G. M., West D., et al. (Eds.). (1996). Racial/ethnic patterns of cancer in the United States: 1988–1992 (NIH Pub. No. 96–4104). Bethesda, MD: National Cancer Institute.
Mutchler, J. E., Prakash, A., & Burr, J. A. (2007). The demography of disability and the effects of immigrant history: Older Asians in the United States. Demography, 44(2), 251–263.
Ponce, N. A., et al. (2004). The California Health Interview Survey 2001: Translation of a major survey for California’s multiethnic population. Public Health Reports, 119(4), 388–395. https://doi.org/10.1016/j.phr.2004.05.002.
Read, J. G., & Gorman, B. K. (2010). Gender and health inequality. Annual Review of Sociology, 36, 371–386.
Reed, H. E., & Barbosa, G. Y. (2016). Investigating the refugee health disadvantage among the U.S. immigrant population. Journal of Immigrant and Refugee Studies, 15(1), 53–70.
Rumbaut, R. G. (2006). Vietnamese, Laotian and Cambodian Americans. In P. G. Min (Ed.), Asian Americans Contemporary Trends and Issues (2nd ed., pp. 262–289). Thousand Oaks: Pine Forge Press.
Simon, R. W. (2002). Revisiting the relationships among gender, marital status, and mental health. American Journal of Sociology, 107(4), 1065–1096.
Sorkin, D., et al. (2008). Self-reported health status of Vietnamese and non-Hispanic white older adults in California. Journal of American Geriatric Society, 56, 1543–1548.
Takei, I., & Sakamoto, A. (2011). Poverty among Asian Americans in the 21st century. Sociological Perspectives, 54(2), 251–276.
Taylor, V. M., et al. (2009). Pap smear receipt among Vietnamese immigrants: The importance of health care factors. Ethnicity & Health, 14(6), 575–589.
U.S. Census. (2012). Asian population 2010. Available from http://www.census.gov/prod/cen2010/briefs/c2010br-11.pdf. Accessed 10 Sept 2012.
U.S. Census Bureau. (2016). 2012–2016 American Community Survey, 5 Year Estimates. Retrieved February 28, 2018.
Vo, L. T., & Hom, L. D. (2018). Transforming Orange County: Assets and needs of Asian Americans & Native Hawaiians and Pacific Islanders. Orange County: Asian Americans Advancing Justice – Orange County.
Walsh, E. T., Torr, B. M., & Bui, B. H. (2010a). Inequalities in self-rated health: Untangling ethnicity, social, class, and lifestyle effects on the Vietnamese, Other Asians, Hispanics, and Whites. International Review of Modern Sociology, 36(2), 195–220.
Walsh, J. M., et al. (2010b). Healthy colon, healthy life: A novel colorectal cancer screening intervention. American Journal of Preventive Medicine, 39(1), 1–14.
Yang, M. S., Burr, J. A., & Mutchler, J. E. (2012). The prevalence of sensory deficits, functional limitations, and disability among older southeast Asians in the united states. Journal of Aging and Health, 24(7), 1252–1274.
Yoo, H. C., Gee, G. C., & Takeuchi, D. (2009). Discrimination and health among Asian American immigrants: Disentangling racial from language discrimination. Social Science & Medicine, 68(4), 726–732.
Zhang, W., Hong, S., Takeuchi, D., & Mosakowski, K. (2012). Limited English proficiency and psychological distress among Latinos and Asian-Americans. Social Science & Medicine, 75(6), 1006–1014.
Zhang, W., & Ta, V. M. (2009). Social connections, immigration-related factors, and self-rated physical and mental health among Asian Americans. Social Science & Medicine, 68, 2104–2112.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Rights and permissions
About this article
Cite this article
Torr, B.M., Walsh, E.T. Does the Refugee Experience Overshadow the Effect of SES? An Examination of Self-Reported Health Among Older Vietnamese Refugees. Race Soc Probl 10, 259–271 (2018). https://doi.org/10.1007/s12552-018-9240-6
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12552-018-9240-6