Department of Social Welfare, University of California, 337 Charles E. Young Drive, Los Angeles, CA, United States.
Department of Community Health Sciences, University of California, Los Angeles, CA, United States.
Ethn Health. 2023 Feb;28(2):182-199. doi: 10.1080/13557858.2022.2035691. Epub 2022 Feb 9.
Although prior research suggests Asian Americans experience physical health advantages relative to other racial/ethnic groups, increasing evidence points to health inequalities within Asian American subgroups. Disparities are especially pronounced among middle-aged Asian American women, who remain an understudied population, despite studies showing that midlife corresponds with distinct social stressors and changes in the availability of protective resources, such as social support. Thus, the purpose of the study was to examine racial/ethnic differences in social support and self-rated health (SRH) among middle-aged women.
With data from the Study of Women's Health Across the Nation (SWAN; = 1258), we used modified Poisson regression models to estimate incidence rate ratios (IRR), examining how social support shaped the risk of fair-to-poor SRH by race/ethnicity. We tested interactions between perceived stress, social support and race/ethnicity to determine whether the stress-buffering role of social support varies by group.
Results demonstrate racial/ethnic differences in SRH. Higher levels of social support were linked to higher fair-to-poor SRH among Chinese American women (IRR = 1.24; 95% CI [1.02, 1.52]); while greater social support conferred lower risk among White women. Interaction analyses revealed additional nuances in the stress-buffering effects of social support among Chinese American women, such that the health benefits of social support depended on levels of perceived stress (IRR = 0.75; 95% CI [0.57, 1.00]).
These findings highlight important distinctions in the ways that psychosocial factors shape health across racial/ethnic groups. In particular, this study helps advance our understanding of important subgroup differences in the stress-buffering role of social support for Asian American midlife women. Interventions should focus on identifying sources of social strain among Asian American women that can increase the risk for poor health and identify alternative sources of support that mitigate stressors to improve health.
尽管先前的研究表明,与其他种族/族裔群体相比,亚裔美国人享有身体健康优势,但越来越多的证据表明,亚裔美国人亚群内存在健康不平等现象。在中年亚裔美国女性中,这种差异尤为明显,尽管有研究表明,中年对应着独特的社会压力源和保护资源(如社会支持)的可用性变化,但她们仍然是一个研究不足的群体。因此,本研究旨在探讨中年女性社会支持和自我报告健康(SRH)方面的种族/族裔差异。
利用来自妇女健康全国研究(SWAN;=1258)的数据,我们使用修正后的泊松回归模型来估计发病率比值(IRR),研究社会支持如何通过种族/族裔影响健康状况不佳的风险。我们测试了感知压力、社会支持和种族/族裔之间的相互作用,以确定社会支持的压力缓冲作用是否因群体而异。
结果表明,SRH 存在种族/族裔差异。较高水平的社会支持与华裔美国女性较差的健康状况(IRR=1.24;95%CI[1.02, 1.52])呈正相关;而较高的社会支持则降低了白人女性的风险。交互分析显示,社会支持的压力缓冲作用在华裔美国女性中存在更多细微差别,即社会支持的健康益处取决于感知压力的水平(IRR=0.75;95%CI[0.57, 1.00])。
这些发现强调了心理社会因素在不同种族/族裔群体中塑造健康的方式存在重要差异。特别是,本研究有助于深入了解亚裔美国中年女性社会支持压力缓冲作用的重要亚群差异。干预措施应侧重于确定亚裔美国女性中可能增加健康不良风险的社会压力源,并确定减轻压力源以改善健康的替代支持来源。