Generational continuity and change in British Asian health and health behaviour

Abstract

Objectives-To trace patterns of health and health behaviour in those with ancestry in the Indian subcontinent (British Asians) compared with the general population of their age (1) in the younger generation age 14-15 mainly born in the UK and (2) in the older mainly migrant generation. Design-Cross sectional random sample surveys of two age groups in Glasgow. (J Epidemiol Community Health 1998;52:558-563) The health behaviour of British Asians (those with ancestry in the Indian subcontinent) is generally thought to be advantageous for health. Even allowing for variations within heterogeneous British Asian communities, the general picture is favourable whether in regard to smoking, drinking or diet, 1 2 and only exercise levels seem to be unfavourable. Samples-334 3However, the health of these communities does not seem to have benefited as much as it should from their generally exemplary behaviour. Low levels of lung cancer are not matched by low levels of heart disease, and respiratory health too does not seem to show the advantages that might be expected from such low smoking levels, particularly among women. It is true that while migrant women of South Asian descent show a number of health disadvantages, migrant men show a number of advantages in relation to the majority of population, and this is evident both in studies of mortality, 4 5 and morbidity. 6 The male advantage, however, tends to be put down to positive selection for health at the time of migration, though this has been assumed rather than tested.It would be tempting, in this situation, for the younger generation of British Asians to conclude that good behaviour does not pay; and certainly the health record does not provide much counterweight to the powerful pressures drawing them towards conformity with the norms of their peers in the majority population. Although earlier studies have shown health behaviour in young British Asians that continues to diVer from the patterns of the majority population in broadly similar ways to that of their parents, 7 it has not been possible without more accurate comparisons to assess how far these diVerences are eroding. Meanwhile little is known of the general health of young British Asians, or, consequently, of whether their health is as unrelated to their health behaviour as it is in the migrant generation.An opportunity to explore these issues is provided by a school-based study of 14-15 year olds from the British Asian and general populations, nearly all born in the UK, which asked similar questions on health and health behaviour to a community survey of migrant South Asians and the general population aged 30-40, both studies taking place in the same city. This report considers the following questions:(1) What pattern of health advantages and disadvantages do young British Asians show compared with the majority population?(2) What patterns of health behaviour do they show compared with the majority population, at the age when addictive behaviours tend to be tried out?

Generational differences in the physical activity of UK South Asians: a systematic review

“… [ 24 ] Pollard et al 2008 Cross sectional British Pakistani (60) European (25) Female 20 to 40 North East England Self-report, validated questionnaire -International Physical Activity Questionnaire [ 25 ] Pollard et al 2012 Cross sectional British Pakistani (67) White British (70) Female 9 to 11 North East England Accelerometer worn for 2 school days [ 26 ]Pomerleau et al 1999 Cross sectional South Asian (291) European (559), Afro-Caribbean (303) Female 40 to 69 London Self-report questionnaire [ 27 ] Riste et al 2001 Cross sectional Pakistani (132) European (471), African-Caribbean (316) Male and Female 35 to 79 Manchester Self-report validated questionnaire [ 28 ] Smith et al 2012 Cross sectional Indian, Pakistani, Bangladeshi White Male and Female 16 to 55 England Self-report questionnaire based on Allied Dunbar National Fitness Survey [ 29 ] Williams et al 1994 Cross sectional South Asian (173) General population (344) Male and Female 30 to 40 Glasgow Self-report questionnaire. [ 30 ] Williams et al 1998 Cross sectional British Asian (334) Other origin (490) Male and Female 14 to 15 in South Asians Age 35 in General population Glasgow Self-report questionnaire. [ 35 ] Williams et al 2010 Cross sectional South Asian Sikhs (571), Muslims (179), Hindus (315) Whites (818) Ma...…”

“…Of the papers reporting on children, only one reported a power calculation for the sample size [ 30 ]. The other 11 papers provided no justification for their sample size; the majority only reported the number of people they had recruited, implying that their aim was to recruit as many children as possible into their studies.…”

“…There were also issues with the quality of measurement, both for ethnicity and physical activity. For the studies on children, ethnicity was measured through self-identification to pre-defined categories [ 9 , 13 , 14 , 18 , 21 , 23 , 25 ] (often through the parents) or through school records, where ethnicity is reported by the parents [ 7 , 8 , 10 , 11 , 30 ]. While self-identifying ethnicity is regarded as the best measure, assigning people to pre-defined categories or asking them to choose from a pre-defined list restricts the process of self-identification, and therefore the meaning of ethnicity.…”

Differences between 9–11 year old British Pakistani and White British girls in physical activity and behavior during school recess

“…Low levels of physical activity have been reported in adults and children of South Asian origin living in the UK, Canada and the US [1-8] and are thought to contribute to the high risk of type 2 diabetes and cardiovascular disease in this group [9-11]. Activity levels are particularly low in people with origins in Bangladesh or Pakistan, and in women and girls [2,3,5].…”

MECHANISMS IN ENDOCRINOLOGY: Pathogenesis of type 2 diabetes in South Asians

“…The 2004 Health Survey for England data reported lower levels of physical activity in South Asian groups compared with the general UK population and other ethnic minority groups (77), and other studies showed similar results in migrant and urban South Asians (6,15,82,83,84,85,86,87). This low level of physical activity is already present in children and adolescents (77,85,88,89,90,91).…”