Health Beliefs Related to Heart Disease Prevention among Chinese Americans
Liou, Doreen, Contento, Isobel R., Journal of Family and Consumer Sciences
This study describes health beliefs pertaining to heart disease prevention among a sample of first-generation Chinese Americans. Six hundred Chinese adults living in New York City completed a survey questionnaire that measured demographic information, 13 psychosocial variables derived from Western-based theory, and Chinese food-related beliefs. Statistical analyses showed that Western beliefs predominated. Traditional Chinese health beliefs incorporating yin and yang principles tended to be supported by females, older adults, and less educated respondents. Thus, both biomedical and Chinese traditional beliefs are important in preventing heart disease among Chinese Americans.
Coronary heart disease is the number one national health problem and a leading cause of death in the U.S. (American Heart Association, 1998). Various epidemiological and cross-sectional studies point to this statistical trend for Asian Americans as well, and studies of this population during the past few decades show increases in cardiovascular risk factors (Gerber & Madhaven, 1980; Klatsky & Armstrong, 1991; Pinnelas, Torre, Pugh, Strand, & Horowitz, 1992). Considering the rapid growth in the Asian American population projected for the 21st century, this health concern deserves more attention among health professionals.
Chinese Americans account for approximately 2.4 million of the estimated 10.2 million Asian Americans (U.S. Bureau of the Census, 2000). A rise in the Chinese American population in large U.S. cities, especially New York City, also has been noted. Although little applied research on health and food beliefs in relation to heart disease risk factors among Chinese Americans has been done, healthcare providers need this information to provide effective medical care to increasing numbers of Chinese Americans with elevated risk of heart disease.
Health beliefs are culturally determined and shaped by the ideas, knowledge, and experiences of the past and present. Traditional Chinese beliefs about health and illness reflect the concept of a dichotomy between "hot" and "cold" that is related to the Eastern philosophy of yin and yang (Koo, 1976). Health is viewed as a condition of bodily equilibrium at a point in between the two extremes of hot and cold. This equilibrium is not seen as a single fixed point but as a continuum of acceptable states, dependent on individual variation. Traditionally, the vital force of life is chi, which is equated with energy and breath. In order to maintain health, chi must flow freely along defined meridians in the body and blood must be strengthened through nourishment.
Disease occurs when there is an imbalance between hot and cold states, and hence the flow of chi is impeded. Factors such as food intake can aid in restoring this imbalance. Hot, or yang, conditions (e.g., cold sores, hypertension) can be treated by consuming foods with a cold, or yin, quality. Examples of yin foods include bland and boiled foods and most types of vegetables. Similarly, illnesses caused by an excess of yin are treated by consuming hot, or yang, foods. Foods exhibiting hot properties include fried foods and fatty meats.
A number of psychosocial theories have been developed in the West in an attempt to comprehend people's beliefs and motivations for adopting health behaviors. The health belief model has played a major role in predicting and explaining an individual's acceptance of healthcare recommendations (Rosenstock, 1990). The model postulates that an individual is likely to take action to prevent or cure a given disease when one (a) perceives the disease has some degree of severity; (b) perceives oneself personally susceptible to the disease; (c) believes there are specific benefits in taking action that would prevent or cure the dis ease; and (d) perceives no major barriers impeding that action.
The theory of planned behavior posits that behavioral intention is highly predictive of an individual's behavior (Ajzen, 1985, 1991; Ajzen & Madden, 1986; Fishbein & Ajzen, 1980). …