Differences in health behaviors and health outcomes among non-Hispanic Whites and Arab Americans in a population-based survey in California

Abstract

Background Few population-based studies of Arab American health behaviors and outcomes exist outside of Michigan. We aimed to provide prevalence estimates of health behaviors and outcomes for Arab Americans and compare them to non-Hispanic Whites in California. Methods We used data from the 2003–2016 California Health Interview Surveys. We determined Arab American ethnicity using an algorithm that considered place of birth of the respondent or parent and use of Arabic language at home. Survey-weighted frequencies, chi-squared statistics, and logistic regression analyses were used to compare Arab Americans and non-Hispanic Whites on socioeconomic indicators, health behaviors and health outcomes. Multivariable models were adjusted for age, education level, and insurance status. Results Arab Americans had higher prevalence of no insurance, living below the federal poverty level, and home ownership than non-Hispanic Whites despite high levels of education and low unemployment prevalence. Arab Americans had reduced odds of alcohol consumption (OR: 0.33, 95% CI: 0.24, 0.45), binge drinking (OR: 0.28, 95% CI: 0.19, 0.40), and suicidal ideation (OR: 0.41, 0.25, 0.66) when compared to non-Hispanic Whites in multivariable models. Arab Americans had decreased odds of hypertension (OR: 0.64, 95% CI: 0.50, 0.83) and increased odds of diabetes (OR: 2.03, 95% CI: 1.23, 3.34) when compared to non-Hispanic Whites in multivariable models. Conclusions Arab Americans in California participate in less risky health behaviors and have better health outcomes than non-Hispanic Whites, except with regards to diabetes. Future work aiming to understand the health of Arab Americans should allow for self-identification and less reliance on country of origin and language use at home for sample selection.

Health Equity During COVID-19: the Case of Arab Americans

“…Preventive behavior among Arab Americans may be poor, especially for reducing infectious disease risk. Arab Americans are less likely to be vaccinated than the average American, and studies have found that they receive the influenza vaccine less frequently in the past year in California than white Americans, 4 which is corroborated by national data for influenza and pneumonia vaccinations. 24 This suggests the need for more targeted education about the risks of infectious diseases for this vulnerable subgroup, with a goal of positively influencing vaccination uptake.…”

“…5 Researchers also found in a study among Arab Americans in California that the proportion of respondents who were overweight or obese was 55.2%. 4 These underlying health conditions are important risk factors for increased severity of COVID-19 and death in other groups and indicate increased risk for severity among Arab Americans.…”

“…A recent study in California showed that Arab immigrants (first generation Arab Americans) had worse health outcomes than second and third generation immigrants, supporting the need for dedicated outreach. 4 Although many organizations and groups have used Arabic language messaging, more work can be done to effectively reach out to these vulnerable subgroups.…”

Disparities in influenza vaccination: Arab Americans in California

“…For this study, we analyzed data from the 2004-2016 CHIS survey cycles. More information on the CHIS can be found in previous work [15,16].…”

“…As previously described, Arab Americans were identified using their responses to three questions on the CHIS Adult Questionnaire related to place of birth, language spoken at home, and parents' place of birth [15,16]. If one of 22 Arab League countries were indicated for participant's or parent's place of birth, then respondents were coded as Arab American.…”