@article {10965,
	title = {Impact of Social, Contextual, and Behavioral Factors on Health Status Among Asian Populations Across the United States, China, and Korea...2020 AOTA Annual Conference \& Expo},
	journal = {American Journal of Occupational Therapy},
	volume = {74},
	year = {2020},
	abstract = {PURPOSE: Although cross-national comparisons for patterns of aging populations are feasible due to the existing national micro-data, few studies have attempted to examine different social, cultural, and policy contexts that influence aging across countries in Asian populations. This study aims to examine the social, contextual, and behavioral factors that influence functional status across the three Asian populations.

DESIGN: A secondary data analysis was performed on three national surveys: the 2012 Health and Retirement Study, the 2012 China Health and Retirement Longitudinal Study, and the 2012 Korean Longitudinal Study of Aging.

METHOD: We retrieved a representative sample of 211 American Asian adults, 13,649 Chinese adults, and 7,486 Korean adults from the national aging surveys. Survey participants were population-based national samples of individuals over 50 years old and lived in community settings. Hierarchical regression models were utilized to compare health status and examine the influence of social-contextual factors on health status across the American Asian, Chinese, and Korean adults. The self-rated health question (1-very good to 5-very bad) was the dependent variable and was identified in all three surveys as a common metric for health status (Cieza et al., 2015; Hong et al., 2018). Social-contextual factors were used as independent variables, including: age, sex, living arrangement, employment status, self-rated health, body mass index (kg/m2), cognitive status (CESD depression score, orientation, and serial 7{\textquoteright}s test score), chronic conditions (stroke, arthritis, diabetes, hypertension, cancer, heart problem), number of people in house, number of living parents, children, siblings, children living in the same city, weekly contact with children, weekly religious participation, and financial transfer from/to children. The regression coefficients (β) on the study variables in regression model were examined to compare the effects of family and environmental factors on health status across countries.

RESULTS: The mean age of the sample was 63.8 years (SD=9.5). The majority of the sample lived with a spouse/partner (81.6\%), female (52.8\%), and employed (53.8\%). The unadjusted self-rated health status scores revealed that American Asian had significantly better health status (Mean=2.5, SD=0.06) than Korean (Mean=3.7, SD=0.01) and Chinese adults (Mean=3.9, SD=0.01). Health status orders did not change even after accounting for the social-contextual factors. Age, depression scores, chronic conditions, and receipt of financial assistance from children were significantly associated with poor health status (p<0.05). Factors significantly associated with good health (p<0.05) are: higher education attainment, current employment, active lifestyle, higher cognitive function, social participation, and giving financial support to their children.

CONCLUSION: Study findings that the American Asian adults are healthier than the Korean and Chinese adults. We speculate that the majority of the differences across the three countries may be due to differences in the rate of the aging populations or different cultural aspects for the aging populations. Policy makers and clinicians would need to investigate the negative driving factors on health status in China and Korea or adapt the US health policies to improve healthy aging among the adults in the two countries.},
	keywords = {Asians, CHARLS, Congresses and Conferences, Functional status, KLoSA, Social determinants of health},
	isbn = {0272-9490},
	doi = {https://doi.org/10.5014/ajot.2020.74S1-PO3606},
	author = {Ickpyo Hong and Pryor, Loree and Kitchens, Riqiea}
}
@article {10372,
	title = {Comparisons of the Association of Family and Social Factors With Functional Limitations Across the United States, Mexico, and South Korea: Findings From the HRS Family of Surveys},
	journal = {Journal of Aging and Health},
	year = {2019},
	note = {doi: 10.1177/0898264319878549},
	month = {2019/10/04},
	abstract = {Objective: The association of family and social factors with the level of functional limitations was examined across the United States, Mexico, and Korea. Method: Participants included adults from the 2012 Health and Retirement Study (n = 10,017), Mexican Health and Aging Study (n = 6,367), and Korean Longitudinal Study of Aging (n = 4,134). A common functional limitation scale was created based on Rasch analysis with a higher score indicating better physical function. Results: The American older adults (3.65 logits) had better physical function compared with Mexican (2.81 logits) and Korean older adults (1.92 logits). There were different associations of family and social factors with functional limitations across the three countries. Discussion: The American older adults demonstrated less functional limitation compared with Mexican and Korean older adults at the population level. The findings indicate the need to interpret carefully the individual family and social factors associated with functional limitations within the unique context of each country.},
	keywords = {Cross-Cultural Comparison, cross-national study, Family, KLoSA, MHAS, multiple studies, socialization},
	isbn = {0898-2643},
	doi = {https://doi.org/10.1177/0898264319878549},
	author = {Ickpyo Hong and Pryor, Loree and Rebeca Wong and Ottenbacher, Kenneth J. and Timothy A Reistetter}
}
@article {9629,
	title = {Cross-national health comparisons using the Rasch model: findings from the 2012 US Health and Retirement Study and the 2012 Mexican Health and Aging Study},
	journal = {Quality of Life Research},
	volume = {27},
	year = {2018},
	month = {09/2018},
	pages = {2431-2441},
	abstract = {Purpose

Cross-national comparisons of patterns of population aging have emerged as comparable national micro-data have become available. This study creates a metric using Rasch analysis and determines the health of American and Mexican older adult populations.

Methods

Secondary data analysis using representative samples aged 50 and older from 2012 U.S. Health and Retirement Study (n = 20,554); 2012 Mexican Health and Aging Study (n = 14,448). We developed a function measurement scale using Rasch analysis of 22 daily tasks and physical function questions. We tested psychometrics of the scale including factor analysis, fit statistics, internal consistency, and item difficulty. We investigated differences in function using multiple linear regression controlling for demographics. Lastly, we conducted subgroup analyses for chronic conditions.

Results

The created common metric demonstrated a unidimensional structure with good item fit, an acceptable precision (person reliability = 0.78), and an item difficulty hierarchy. The American adults appeared less functional than adults in Mexico (β = - 0.26, p < 0.0001) and across two chronic conditions (arthritis, β = - 0.36; lung problems, β = - 0.62; all p < 0.05). However, American adults with stroke were more functional than Mexican adults (β = 0.46, p = 0.047).

Conclusions

The Rasch model indicates that Mexican adults were more functional than Americans at the population level and across two chronic conditions (arthritis and lung problems). Future studies would need to elucidate other factors affecting the function differences between the two countries.},
	keywords = {Arthritis, Chronic conditions, Comparisons, Disabilities, MHAS},
	issn = {09629343},
	url = {https://link-springer-com.proxy.lib.umich.edu/article/10.1007\%2Fs11136-018-1878-4},
	author = {Ickpyo Hong and Timothy A Reistetter and D{\'\i}az-Venegas, Carlos and Alejandra Michaels-Obregon and Rebeca Wong}
}
