Immigrants' assimilation and outcomes of health: A multidimensional analysis of self-assessed health among Asians and paramedics of Asian Indian origin in the U.S

Past studies have shown that among immigrant populations of color, greater assimilation into U.S. society leads to poorer health outcomes. In this context of the "immigrant health paradox," a large number of studies have focused on Latinos rather than other immigrants, such as those of Asian ancestry. This dissertation focuses on people of Asian ancestry because increasing racial and ethnic "diversity" in the U.S. demands broader understanding of health by race and ethnicity. Using theories of immigrants' selectivity, classic assimilation, belonging or distance to assimilation and discrimination, and social determinants of health, this study examines the relationship between multiple social dimensions and levels of assimilation and self-assessed health outcomes among populations of Asian ancestry. This study uses data from the National Asian American (NAA) Survey of 2008 (N=5,159), and from oral history interviews with 16 paramedics (12 nurses and 4 physical therapists; 3 men and 13 women) of Asian Indian ancestry. The data was analyzed with a mixed methods approach using Structural Equation Modeling (SEM) and Oral History Narratives within the phenomenological tradition. The SEM results indicate that there is no statistical significance between assimilation, discrimination and health outcomes. The other social determinants, however, show mixed outcomes on health. Overall, the data fits the model significantly. Further, the narratives revealed that despite their experiences with discrimination and related stress with settlement, paramedics of Asian Indian origin express fair to good health outcomes. Based on this evidence, a health paradox can be applied to racial and ethnic minorities of Asian ancestry. The findings from this study will contribute to the understanding of social psychological and structural forces and expansion of knowledge in race and ethnic diversity and health studies, immigration studies, public health scholarship.