DiagnosticsWesternization Associated With Potentially Harmful Sun Habits Among Asian Americans
Asian Americans who have adopted more aspects of Western culture may be more likely to engage in behaviors that increase sun exposure, thereby endangering their skin health, according to a report in the May issue of Archives of Dermatology, one of the JAMA/Archives journals.
Skin cancer typically affects individuals of Asian descent at a lower rate than white individuals, but recent data indicates the disease may be increasing in Asian populations, according to background information in the article. "In the medical literature, numerous published studies among Asians report an association between acculturation to a Western diet and increased risk of cardiovascular disease, type 2 diabetes mellitus and breast cancer. The health consequences of adopting a Western lifestyle are not likely to be limited to dietary changes alone," the authors write. "Although it is difficult to directly compare dietary changes and consequent disease with sun exposure patterns and subsequent skin disease, we mention this as an intriguing potential parallel because both involve westernization."
Emily Gorell, B.A., and colleagues at the Stanford University School of Medicine, Stanford, Calif., conducted an online survey of Asian Americans living in California from November 2007 to January 2008. Participants provided information regarding the degree to which they had acculturated along with details on sun exposure, protection and skin cancer-related habits.
Of the 546 individuals (average age 34) who completed the survey, 57.3 percent identified themselves as being of Chinese or Taiwanese descent, 8.2 percent as Korean, 6 percent as Japanese and 12 percent as mixed Asian descent. Those who were more westernized-defined as those whose families had been in the United States for at least a generation, who were raised mostly or only in the United States rather than in Asia or who rated themselves as more acculturated-more often had attitudes and behaviors promoting sun exposure. For instance, these individuals were more likely to report believing a tan is attractive, having a negative attitude toward sunscreen and getting more sun exposure on the weekends.
"Among more westernized Asian Americans, the practice of deliberate sunbathing was widespread," the authors write. A history of laying out in the sun was reported by 60 percent of second-generation or greater Asian Americans (vs. 47 percent of first-generation), 59.1 percent among those raised mostly or exclusively in the United States (vs. 33.7 percent for those raised mostly or exclusively in Asia) and 58 percent of those who rated themselves as bicultural or more westernized (vs. 43.6 percent of those who self-identified as more Asian).
"Although it has generally been accepted as conventional wisdom that Asian cultures prize lighter skin tones and that Western cultures value a "healthy" tanned appearance, to our knowledge, our study is the first to explore what happens to attitudes and practices of sun exposure when Asians adopt Western culture. Specifically, the adoption of Western culture seems to increase sun exposure, implying negative consequences to skin health," the authors conclude.
"In light of recent evidence pointing to the increasing incidence of skin cancers among Asian populations, as well as delays in diagnosis of skin cancer in part because of a lowered index of suspicion by health care providers and by Asian Americans, dermatologists and other health care providers in the United States should increase their education efforts about sun exposure, sun protection and skin cancer targeted at this growing minority group."
Arch Dermatol. 2009;145[5]:552-556.
Archives of Dermatology