Prevalence of health seeking behaviors and health outcomes among south Asian sikh immigrants in New York City

Background: Research has demonstrated that the United States immigrant population has higher rates of chronic diseases as compared to the rest of the population. Health-seeking behaviors and their relation to acculturation has rarely been examined in understudied populations such as South Asian Sikh immigrants.

Methods: In 2010, surveys were completed with 171 New York City South Asian Sikhs in order to inform the development of a community health worker program to prevent diabetes and promote healthy living. Questions were included on socio-demographics, acculturation, and health-seeking behaviors, and clinical measures included blood pressure, weight and BMI. Hypertension was determined by a systolic reading of >140 mm Hg or a diastolic reading of >90 mm Hg. BMI was measured using WHO Asian guidelines, with an obesity cutoff point of 27.5 kg/m2.

Results: Approximately 50% of respondents had seen a doctor in the past year and 30% had some form of medical insurance. Thirty-eight percent of individuals had hypertension, and 44% were obese. Among those who had seen a doctor in the past year, 28% had hypertension, compared to 59% of those who had not seen a doctor in the past year (p<0.05). Conversely, obese individuals reported more doctor visits. Among those who had seen a doctor in the past year, 59% were obese as compared to 41% of those who had not seen the doctor in the past year (p<0.05). Stratified by gender, 60% of females were obese compared to 38% of males. Additionally, individuals living in the US for 10 years or less were more likely to have not seen a doctor in the past year and be uninsured compared to individuals living in the US for 10 or more years (p<0.01). Further analyses will use logistic regression to predict a recent visit to the doctor, adjusting for demographics, health variables, and past diagnoses of illnesses.

Discussion: Results show this population to have low rates of insurance coverage and access to care. Additionally, a high proportion of hypertensive individuals are not visiting the doctor. The high number of obese individuals visiting the doctor could be due to the fact that obesity is a more visible disease as compared to hypertension. Lower rates of access to care were further compounded by low levels of acculturation and certain health related outcomes. Our findings indicate that there is an association between acculturation and health-seeking behaviors leading to health inequalities in the Sikh immigrant population.