Self-rated health among foreign- and U.S.-born Asian Americans: a test of comparability.

OBJECTIVES We investigated differences between foreign- and U.S.-born Asian Americans in self-rating their physical and mental health. In particular, we tested whether the foreign-born respondents underreport the extreme categories of the scale as compared with U.S.-born respondents. METHODS We analyzed data from the National Latino and Asian American Study to examine whether immigrants are less likely to use the extreme ends of the 5-category self-rated health scales than their U.S.-born counterparts. We used propensity score matching to derive groups of U.S.- and foreign-born Asian Americans who share similar demographic and health characteristics. We defined propensity scores as predicted probabilities of being U.S. born, given individual background characteristics. The propensity score framework allowed us to make descriptive comparisons of self-rated health responses controlling for background characteristics. We used log-linear symmetry models to examine cross-tabulations of self-rated physical and mental health reports in matched pairs by the 2 (extreme and nonextreme) and 5 ("excellent," "very good," "good," "fair," and "poor") categories. RESULTS Controlling for background characteristics, we found no evidence that foreign-born Asian Americans are less likely to endorse extreme categories in self-rated physical or mental health than U.S.-born Asian Americans, as well as no evidence of imbalances in endorsement of any particular self-rated health category between the 2 groups. CONCLUSIONS Controlling for demographic and health characteristics, we find no systematic differences between foreign- and U.S.-born Asian Americans in reporting self-rated physical and mental health on the 5-category scales from "excellent" to "poor."