From Awareness to Action: Health Choices and Challenges Among First-Generation Indian Immigrants in the Bay Area Público

Kothari, Anusha (Spring 2025)

Permanent URL: https://etd.library.emory.edu/concern/etds/2r36tz981?locale=es
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Abstract

Cardiovascular disease (CVD) disproportionately affects South Asians compared to other ethnic or racial groups in the U.S., due to a combination of physiological and social factors. While research on the sociocultural and psychosocial risk factors contributing to CVD among South Asians is growing, much of the existing literature assesses this population broadly and does not capture more detailed lived realities and personal reflections of individual South Asian communities regarding their health practices, an understanding that is essential for better tailoring public health interventions. To address this gap, this ethnographic study seeks to understand the patterns of perception, awareness, adoption, and rejection of health-related lifestyle habits and attitudes within a specific, localized South Asian diasporic community: first-generation Indian immigrants in the Bay Area. Specifically, 12 semi-structured interviews were conducted with 6 men and 6 women, all first-generation Indian immigrants in the San Francisco Bay Area, aged 45-65. Interviews focused on participants’ demographic and social background as well their attitudes and habits regarding exercise, diet, sleep, and stress management. Using a grounded theory approach, interviews were analyzed inductively to identify recurring themes. The results indicated that participants' health behaviors and attitudes were most influenced by expert sources, personal experiences and feelings, family dynamics, social networks, cultural background, residency in the U.S., and profession. To apply these themes to the identification, adoption, and sustenance of lifestyle habits, this research drew on Arthur Kleinman's cultural construction of clinical reality as well as William Dressler's stress process, cultural consonance, and personal agency. This study found that the decision to pursue lifestyle adjustments is influenced by attention from both popular and professional domains. Additionally, the adoption of lifestyle modifications often depends on the extent to which the change aligns with values deemed important in any culture or society to which the individual belongs. Furthermore, resistance resources like mindset shifts can facilitate sustained commitment to a habit and can help individuals manage stressors that may hinder adherence. The outcomes of this study suggest areas of future research that can inform further enhancement of public health interventions to better resonate with individual immigrant communities.

Table of Contents

CHAPTER ONE: Introduction - 1

CHAPTER 2: Methods - 23

CHAPTER THREE: Results - 30

CHAPTER FOUR: Discussion - 48

CHAPTER FIVE: Conclusion - 64

APPENDIX A: Recruitment Form - 69

APPENDIX B: Oral Consent Form - 71

APPENDIX C: Interview Guide - 74

REFERENCES - 78

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