Associations of Asian Ethnicity and Parental Education with Overweight in Asian American Children and Adolescents: An An
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Associations of Asian Ethnicity and Parental Education with Overweight in Asian American Children and Adolescents: An Analysis of 2011–2016 National Health and Nutrition Examination Surveys Won Kim Cook1 · Winston Tseng2
© Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract Objectives Asian Americans are highly diverse in cultural, socioeconomic, and health conditions. We aimed to identify socioeconomic and cultural profiles of subgroups of Asian American children at high risk of obesity or overweight to inform targeted interventions. Methods A sample of 841 Asian American children and adolescents ages 6–19 from the 2011–2016 National Health and Nutrition Examination Survey was used. Multivariable logistic regression modeling was conducted. Analyses were also stratified by age (6–11 vs. 12–19). Key variables of interest were Asian ethnicity (Chinese, Korean/Japanese, Filipino, South Asian, and Southeast Asian) and parental educational level. Models adjusted for age, gender, nativity status, parental nativity status, and health insurance coverage. Results Filipino (AOR 2.79; 95% CI 1.30–6.00), Japanese/ Korean (AOR 2.55; 95% CI 1.21–5.38), Southeast Asian (AOR 2.54; 95% CI 1.63–3.94), and South Asian (AOR 2.10; 95% CI 1.01–4.36) children ages 6–19 had higher odds of being obese/overweight than Chinese. Filipino (AOR 3.24; 95% CI 1.11–9.49) and Southeast Asian (AOR 2.47; 95% CI 1.22–5.01) ethnicities were associated with higher risk of obesity/ overweight in adolescents ages 12–19. Having a parent with a 4-year college or advanced degree was inversely associated with obesity/overweight in US-born Asian adolescents (AOR 0.34; 95% CI 0.14–0.78). Conclusions for Practice Asian American children and adolescents in some Asian ethnic subgroups may be at higher risk of obesity/overweight than in others. Higher parental education level appears to protect US-born Asian American adolescents from being obese/overweight. Multi-sectoral efforts are needed to better understand and address sociocultural processes that increase childhood obesity/ overweight in high-risk Asian subgroups. Keywords Pediatric obesity · Pediatric overweight · Asian American health · Immigrant status · Social determinants of health
Significance This is the first study using a nationally-representative sample of Asian American children and adolescents with diverse ages and ethnic backgrounds to investigate key * Won Kim Cook [email protected] Winston Tseng [email protected] 1
Alcohol Research Group, Public Health Institute, 6001 Shellmound St. Suite 450, Emeryville, CA 94608, USA
School of Public Health, University of California, 50 University Hall #7360, Berkeley, CA 94720, USA
2
demographic and socioeconomic factors associated with obesity/overweight. In addition to identifying Asian ethnicities associated with overweight in adolescents, this study also found moderation by nativity status of the association between parental educational level and obesity/overweight in Asian American adolescents. Given the wide diversit
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