Knowledge, behaviors, and beliefs related to ischemic heart disease : a comparative study of IndoCanadians and EuroCanadians

Background and Purpose: The increased mortality from ischemic heart disease (IHD) observed in East Indians who emigrate to the west is due to genetic susceptibility in combination with lifestyle-related risk factors. Lifestyle factors, ingrained in cultural values, are influenced by environmental factors encountered in the host country. An understanding of the factors that influence health behaviors that predispose to IHD is essential for effective prevention strategies targeted towards this group. The primary purpose of this study was to examine the impact of culture on IHD-related knowledge, behaviors, and beliefs of the immigrant IndoCanadian (IC) and the dominant EuroCanadian (EC) ethnic groups. Design: Descriptive comparative study using a structured self-administered questionnaire. Subjects and Methods: 102 first-generation ICs and 102 ECs, recruited via convenience sampling from community centers across the British Columbia lower mainland, completed and returned the questionnaires which were designed to obtain information about the IHDrelated knowledge, behaviors, and beliefs. Results: ICs had lower knowledge of IHD risk factors, and were less likely to exercise, or have healthful dietary practices compared with ECs. Barriers and motivating factors for health behaviors identified by the two groups reflected their cultural orientations. Duration of residence in Canada (for IC immigrants) had no effect on knowledge scores, physical activity levels, or health beliefs although dietary practices had improved in the long-term immigrants. Discussion and Conclusions: In accordance with cultural theory, these findings describe differences between the East Indian and European Canadian cultures with respect to health behaviors and beliefs. Although the findings support that ICs were less likely to practice positive health behaviors compared with ECs, there is no evidence to suggest deterioration in health practices following immigration to explain the increased IHD mortality in this group. Similar high rates of IHD mortality among urban dwelling East Indians in India compared with migrant ICs suggest the role of the westernized environment in risk factor determination. The present study demonstrates that IC cultural values augment the effect of the Canadian environment in influencing their health behaviors. Recommendations are provided for the design and dissemination of health education and health promotion strategies targeted toward these groups.Medicine, Faculty ofGraduat