Ethnic Identity and Chronic Disease Among Asian Americans: The Roles of Community Social Cohesion, Social Networks, and Ethnic Subgroup Differences.

objectiveThis study examined associations between identification with one's ethnic group, community social cohesion (CSC), and social networks with chronic disease prevalence among Asian Americans, and whether these relationships differed across East Asian, South Asian, and Southeast Asian subgroups.

designUsing a cross-sectional observational design, we conducted a secondary analysis of the 2016 Asian American Quality of Life survey (n = 1,948). Logistic regression and path analyses were conducted to examine associations among ethnic identification, CSC, social networks, and chronic disease, adjusting for age, gender, educational attainment, subjective financial strain, U.S.-born status, and duration of U.S. residency. Analyses were conducted separately for South Asian, East Asian, and Southeast Asian participants.

resultsOverall, identification with one's ethnic group was not significantly associated with chronic disease (OR = 1.19, 95% CI [0.98, 1.45], p = .079), and we did not observe significant indirect effects through either CSC or social networks. Subgroup analyses revealed distinct patterns. Among South Asian participants, CSC and social networks demonstrated opposing significant indirect effects. Among East Asian participants, CSC was associated with lower odds of chronic disease, whereas social networks were associated with higher odds. Among Southeast Asian participants, identification with one's ethnic group was associated with greater chronic disease odds (OR = 1.78, 95% CI [1.39, 2.29], p < .001), while CSC and social networks were associated with lower odds.

conclusionAssociations between sociocultural factors and chronic disease differed across Asian American subgroups, highlighting the importance of disaggregating Asian American populations and considering sociocultural contexts when examining health disparities.