Identity and health in the narratives of older mixed ancestry Asian Americans.

Abstract: The United States has experienced rapid growth of the Asian American population in the last decade. People of mixed ancestry are a significant proportion of Asian America. Little is known about the health beliefs and health practices of this extremely diverse population. Thirteen older racially mixed Asian Americans, ranging in age from 48-94, were interviewed in a qualitative study that included questions about identity, health beliefs, and health practices. Narrative analysis revealed a relationship between identity, health practices, and interpretation of experiences with health care providers. Key Words: Asian Americans, Mixed Ancestry Asian Americans, Identity and Health The United States has experienced recent rapid growth of the Asian American population, which grew by 48% between 1990 and 2000 (Barnes & Bennett, 2002). Although in-depth knowledge of Asian American health practices has lagged that of other racial/ethnic minorities (Bagley, Angel, Dilworth-Anderson, Liu, & Schinke, 1995), there has been exponential growth in research about Asian American health beliefs and practices in the past decade. This article will extend the dialogue on these topics a step further by examining the health beliefs and practices of a group that has heretofore been invisible in health-related studies of Asian Americans; namely, mixed ancestry Asian Americans. People of mixed ancestry1 are a significant proportion of Asian America, with almost 14% of Asian Americans identifying themselves as multiracial in the 2000 census (Jones & Smith, 2001). Asian Americans have reported rates of marrying outside their ethnic group as high as 25% (Lee & Yamanaka, 1990), although there is some evidence that out-marriage may be declining with the increase in Asian immigration since the 1980's (Lee & Fernandez, 1998). As with Asian Americans in general, there is tremendous diversity within the mixed population. Number of generations in the United States, socioeconomic status, race/ethnicity of the non-Asian parent, ethnicity of the Asian parent, and age are but some of the factors making this an extremely heterogeneous group (Hall & Turner, 2001). There has been very little health research on people of mixed race. Most studies have focused on infants, no doubt because of the availability of parent race on birth certificates. Studies of birth weight in mixed Black/White infants have generally found an association between the race of the mother (Black) and lower birth weights for mixed race infants than for infants with White mothers and Black fathers or two White parents (Collins & David, 1993), with some regional variations (Polednak & King, 1998). A study of rates of neonatal jaundice in mixed Asian/White infants found their bilirubin levels to be intermediate between those of Asian and White infants (Setia, Villaveces, Dhillon & Mueller, 2002). A study comparing the health status of Asian, Caucasian, and multiracial college students found that the multiracial group had more reported health problems (Vandervoort, Divers, & Acojido, 2000). However, in this study, the multiracial group included an unknown number of Hawaiians identifying as multiracial, which may have confounded the study results, since Hawaiians have worse health in general than Asian Americans and Caucasians (Vandervoort et al., 2000). A study comparing the health and social risks of mixed vs. non-mixed adolescents found the mixed adolescents to be at higher risk (Udry, Li, & HendricksonSmith, 2003). None of these studies included older subjects, who would be more likely to experience health problems. No studies examining what role, if any, mixed ancestry might play with regards to health beliefs and practices were found in a review of the literature. This article is based on an exploratory study that included 13 older people of mixed Asian American/White ancestry who were interviewed as part of a larger qualitative study of mixed race identity (Tashiro, 2002). …