Journal of Immigrant and Minority Health

, Volume 15, Issue 5, pp 986–992 | Cite as

“Every disease…man can get can start in this cab”: Focus Groups to Identify South Asian Taxi Drivers’ Knowledge, Attitudes and Beliefs About Cardiovascular Disease and Its Risks

  • Francesca M. Gany
  • Pavan P. Gill
  • Ayaz Ahmed
  • Sudha Acharya
  • Jennifer Leng
Original Paper


South Asian (SA) taxi drivers potentially possess a double epidemiologic risk for cardiovascular disease (CVD) due to their ethnicity and occupation. This study investigates SA taxi drivers’ knowledge, attitudes, beliefs about general health, CVD and approaches to reduce CVD risk. Five focus groups were conducted with 31 SA taxi drivers in the participants’ primary language (Bengali, Hindi, Urdu or Punjabi). Audio-recordings of the sessions were transcribed, translated and entered into ATLAS.ti 6.2 for coding and analysis. SA drivers in an urban setting perceive themselves to be at high risk for CVD because of high work-related stress, physical inactivity, poor diet and poor health care access. Participants attributed their occupation to increasing risk for heart disease; none believed that being SA increased their risk. Interventions to lower CVD risk among SA taxi drivers should be multi-level and involve the individual drivers and the taxi industry.


Cardiovascular disease Taxi driver South Asian Immigrant Perceived barriers 



Funding for this project was provided by the New York State Department of Health Empire Clinical Research Investigator Program (ECRIP). Thank you to M. Ahmed and A. Suri who helped conduct the Bengali and Urdu focus groups and D. Massie, A. Singh, N. Rastogi, and Z. Siddiqui who assisted with the analysis of data. Thank you to the South Asian Health Initiative for its insights and input.

Conflict of interest

None of the authors have a conflict of interest.


  1. 1.
    Bureau of Labor Statistics USDoL Taxi Drivers and Chauffeurs. Bureau of Labor Statistics, U.S. Department of Labor, Available at: Accessed 3 March 2011.
  2. 2.
    Kobayashi F, Watanabe T, Watanabe M, et al. Blood pressure and heart rate variability in taxi drivers on long duty schedules. J Occup Health. 2002;44:214–20.CrossRefGoogle Scholar
  3. 3.
    Kurosaka K, Daida H, Muto T, et al. Characteristics of coronary heart disease in Japanese taxi drivers as determined by coronary angiographic analyses. Ind Health. 2000;38:15–23.PubMedCrossRefGoogle Scholar
  4. 4.
    Wu S, Deng F, Niu J, et al. Association of heart rate variability in taxi drivers with marked changes in particulate air pollution in Beijing in 2008. Environ Health Perspect. 2010;118:87–91.PubMedCrossRefGoogle Scholar
  5. 5.
    Blasi G, Leavitt J. Driving Poor: taxi drivers and the regulation of the taxi industry in Los Angeles. Los Angeles: UCLA Institute of Industrial Relations; 2006.Google Scholar
  6. 6.
    Project CD. UNFARE taxi drivers and the cost of moving the city. New York, NY: Urban Justice Center; 2003.Google Scholar
  7. 7.
    Katzmarzyk PT, Church TS, Craig CL, Bouchard C. Sitting time and mortality from all causes, cardiovascular disease, and cancer. Med Sci Sports Exerc. 2009;41(5):998–1005.PubMedCrossRefGoogle Scholar
  8. 8.
    Healy GN, Matthews CE, Dunstan DW, Winkler EA, Owen N. Sedentary time and cardio-metabolic biomarkers in US adults: NHANES 2003–06. Eur Heart J. 2011;32(5):590–7.PubMedCrossRefGoogle Scholar
  9. 9.
    Consulting S. The changing face of taxi and limousine drivers, U.S., large states and metro areas and New York City. Schaller Consult Brooklyn. Available at: Accessed Dec 2010.
  10. 10.
    Center AAFoNYCI census profile: New York City’s Asian American Population. Available at: Accessed 8 Dec 2010.
  11. 11.
    Anand SS, Yusuf S, Vuksan V, et al. Differences in risk factors, atherosclerosis, and cardiovascular disease between ethnic groups in Canada: the Study of Health Assessment and Risk in Ethnic groups (SHARE). Lancet. 2000;356:279–84.PubMedCrossRefGoogle Scholar
  12. 12.
    Cappuccio FP. Ethnicity and cardiovascular risk: variations in people of African ancestry and South Asian origin. J Hum Hypertens. 1997;11:571–6.PubMedCrossRefGoogle Scholar
  13. 13.
    Enas EA, Senthilkumar A. Coronary Artery Disease In Asian Indians: An Update And Review. Internet J Cardiol. 2001;1(2). doi: 10.5580/5ba.
  14. 14.
    Enas EA, Garg A, Davidson MA, et al. Coronary heart disease and its risk factors in first-generation immigrant Asian Indians to the United States of America. Indian Heart J. 1996;48:343–53.PubMedGoogle Scholar
  15. 15.
    Holland AT, Wong EC, Lauderdale DS, et al. Spectrum of cardiovascular diseases in Asian–American racial/ethnic subgroups. Ann Epidemiol. 2011;21:608–14.PubMedCrossRefGoogle Scholar
  16. 16.
    Palaniappan LP, Wong EC, Shin JJ, et al. Asian Americans have greater prevalence of metabolic syndrome despite lower body mass index. Int J Obes (Lond). 2011;35:393–400.CrossRefGoogle Scholar
  17. 17.
    Rao GH, White JG. Coronary artery disease: an overview of risk factors. Indian Heart J. 1993;45(3):143–53.PubMedGoogle Scholar
  18. 18.
    Jeemon P, Reddy KS. Social determinants of cardiovascular disease outcomes in Indians. Indian J Med Res. 2010;132(5):617–22.PubMedGoogle Scholar
  19. 19.
    Glasgow R. Perceived barriers to self-management and preventive behaviors. health behavior constructs: theory, measurement and research. Available at: Accessed 4 Sept 2011.
  20. 20.
    Federation AA. New 2010 census data show increasing diversity in New York City’s Asian Community, 2011. Available at: Accessed 20 Sept 2011.
  21. 21.
    mbH SSD. ATLAS.ti version 6.2 In: Development SS (ed): Berlin, Germany; 2011.Google Scholar
  22. 22.
    Farooqi A, Nagra D, Edgar T, et al. Attitudes to lifestyle risk factors for coronary heart disease amongst South Asians in Leicester: a focus group study. Fam Pract. 2000;17:293–7.PubMedCrossRefGoogle Scholar
  23. 23.
    Tirodkar MA, Baker DW, Khurana N, et al. Explanatory models of coronary heart disease among South Asian immigrants. Patient Educ Couns. 2010;85(2):230–6.PubMedCrossRefGoogle Scholar
  24. 24.
    Changrani J, Pandya S, Mukherjee-Ratnam BR, et al. Hypertension beliefs and practices among South Asian immigrants: afocus group study. J Immigr Refug Stud. 2011;9(1):98–103.CrossRefGoogle Scholar
  25. 25.
    Patel M, Phillips-Caesar E, Boutin-Foster C. Barriers to lifestyle behavioral change in migrant South Asian populations. J Immig Minority Health/Center for Minority Public Health. 2011. Epub 2011/12/20. doi: 10.1007/s10903-011-9550-x. PubMed PMID: 22180198.
  26. 26.
    Lawton J, Ahmad N, Hanna L, et al. ‘I can’t do any serious exercise’: barriers to physical activity amongst people of Pakistani and Indian origin with Type 2 diabetes. Health Educ Res. 2006;21(1):43–54.PubMedCrossRefGoogle Scholar
  27. 27.
    Darr A, Astin F, Atkin K. Causal attributions, lifestyle change, and coronary heart disease: illness beliefs of patients of South Asian and European origin living in the United Kingdom. Heart Lung. 2008;37(2):91–104.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Francesca M. Gany
    • 1
  • Pavan P. Gill
    • 1
  • Ayaz Ahmed
    • 2
  • Sudha Acharya
    • 2
  • Jennifer Leng
    • 1
  1. 1.Immigrant Health and Cancer Disparities Service (IH&CDS), Memorial Sloan-Kettering Cancer CenterNew YorkUSA
  2. 2.South Asian Council for Social Services (SACSS)New YorkUSA

Personalised recommendations