Background: The World Health Organization recommends the promotion of positive cardiovascular behaviors (healthy diet and physical activity), while reducing negative ones (tobacco and alcohol abuse) as critical steps in reducing the burden of cardiovascular diseases. Researchers have highlighted the role of acculturation in predicting such behaviors among immigrants, though similar studies among Asian-American subgroups are lacking. This study examines the putative relationship between acculturation and aforementioned cardiovascular behaviors among six Asian-American subgroups.

Methods: A secondary analysis of the California Health Interview Survey 2007, 2009, and 2011 public access data was conducted. Acculturation was assessed utilizing proxy measures of language spoken at home and time in U.S. (generation or years of residency). Diet was measured as number of times respondents ate fast food in past week while physical activity was evaluated as meeting American College of Sports Medicine (ACSM) recommendation of 450 metabolic equivalents per week. Binge drinking was measured as 5+ drinks for men/4+ drinks for women. Finally, smoking was categorized as current versus non-current smokers.

Results: Second generation Koreans reported significantly higher mean intake of fast food as compared to first generation, as did third or more generation South Asians and Japanese. Bilingualism was positively associated with meeting ACSM recommendation for Chinese (OR=1.65, 95% Cl: 1.04, 2.61) and Vietnamese (OR=2.79, 95% Cl: 1.39, 5.61). Odds of being a current smoker were significantly lower with increasing generation among Chinese (first OR=0.37, 95% Cl: 0.19, 0.75; second or more OR=0.11, 95% Cl: 0.03, 0.32) and monolingual (English only) Japanese (OR=0.25, 95% Cl: 0.09, 0.70). Finally, binge drinking was positively associated with being first generation South Asian (OR=3.05, 95% Cl: 1.55, 5.98) and monolingual (English only) Vietnamese (OR=3.00, 95% Cl: 1.58, 5.70).

Conclusion: Acculturation has both positive (increased physical activity and reduced smoking) and negative (increased fast food intake and binge drinking) impact on cardiovascular behaviors among specific Asian-American subgroups. Public health professionals must target specific traditional or acculturated subgroups to improve cardiovascular health. Longitudinal studies addressing the temporal relationship between acculturation and such behaviors are needed.


School of Public Health

First Advisor

Patti Herring

Second Advisor

Helen Hoop Marshak

Third Advisor

Jim Banta

Degree Name

Doctor of Public Health (DrPH)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Asian Americans; Acculturation; Cardiovascular Diseases -- etiology; Cardiovascular Diseases -- ethnology; Health Behavior -- ethnology; Risk Factors; Energy Intake; Motor Activity; Longitudinal Studies.



Page Count

xvi; 185

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


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Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives