Skip to main content

Health Behaviors and Their Risk Factors Among Arab Americans

  • Chapter
  • First Online:
Biopsychosocial Perspectives on Arab Americans

Abstract

We examine tobacco and alcohol use, physical activity and weight, and cancer screening behaviors among Arab American adults through a review of national, statewide, and community-based studies, with the addition of recently collected data from a University of Michigan/Arab Community Center for Economic & Social Services study with Arab and Chaldean Americans. We include findings, a critique of the methodology, and suggestions for future research.

Across these studies, Arab American adults had higher rates of tobacco use and lower rates of alcohol use compared to the majority white population, though there were also significant differences within the Arab American population in these two behaviors. Though little work has been conducted around physical activity and weight for this population, there are indications that overweight and obesity rates may be higher and physical activity lower than in the non-Arab American population. Finally, screening rates were significantly lower among Arab American adults than the majority white population for cervical cancer, breast cancer, and colorectal cancer in national, statewide, and community-based studies. Additional data on all of these health behaviors is critical to better establish prevalence rates and health disparities in this population, as well as to inform interventions to improve health behaviors and outcomes in the Arab American community. These findings over a variety of health behaviors underline the importance of not only including an indicator for Arab American ethnicity in more national and statewide studies but also of disaggregating Arab American data to examine differences within this heterogeneous population.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 179.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Abuelezam, N. N., El-Sayed, A. M., & Galea, S. (2018). The health of Arab Americans in the US: An updated comprehensive literature review. Frontiers in Public Health, 6, 262.

    Article  PubMed  PubMed Central  Google Scholar 

  • Al-Omari, H., & Scheibmeir, M. (2009). Arab Americans’ acculturation and tobacco smoking. Journal of Transcultural Nursing, 20(2), 227–233.

    Article  PubMed  Google Scholar 

  • Alatrash, M. (2020). Prevalence, perceived benefits, and perceived barriers regarding breast cancer screening among three Arab American women subgroups. Journal of Transcultural Nursing, 31(3), 242–249.

    Article  PubMed  Google Scholar 

  • Alzyoud, S., Haddad, L., El Shahawy, O., Ghadban, R., Kheirallah, K., Alhawamdeh, K. A., & Jin, Y. (2014). Patterns of waterpipe use among Arab immigrants in the USA: A pilotstudy. Journal of Advances in Medicine and Medical Research, 816–827.

    Google Scholar 

  • Arfken, C. L., Kubiak, S. P., & Farrag, M. (2009). Acculturation and polysubstance abuse in Arab-American treatment clients. Transcultural Psychiatry, 46(4), 608–622.

    Article  PubMed  Google Scholar 

  • Arfken, C. L., Arnetz, B. B., Fakhouri, M., Ventimiglia, M. J., & Jamil, H. (2011). Alcohol use among Arab Americans: What is the prevalence? Journal of Immigrant and Minority Health, 13(4), 713–718.

    Article  PubMed  PubMed Central  Google Scholar 

  • Arfken, C. L., Owens, D., & Said, M. (2012). Binge drinking among Arab/Chaldeans: An exploratory study. Journal of Ethnicity in Substance Abuse, 11(4), 277–293.

    Article  PubMed  Google Scholar 

  • Arshad, S., Williams, K. P., Mabiso, A., Dey, S., & Soliman, A. S. (2011). Evaluating the knowledge of breast cancer screening and prevention among Arab-American women in Michigan. Journal of Cancer Education, 26(1), 135–138.

    Article  PubMed  PubMed Central  Google Scholar 

  • Athamneh, L., Sansgiry, S. S., Essien, E. J., & Abughosh, S. (2015). Predictors of intention to quit waterpipe smoking: A survey of Arab Americans in Houston, Texas. Journal of Addiction, 2015.

    Google Scholar 

  • Athamneh, L., Essien, E. J., Sansgiry, S. S., & Abughosh, S. (2017). Intention to quit water pipe smoking among Arab Americans: Application of the theory of planned behavior. Journal of Ethnicity in Substance Abuse, 16(1), 80–90.

    Article  PubMed  Google Scholar 

  • Ayash, C., Costas-Muñiz, R., Badreddine, D., Ramirez, J., & Gany, F. (2018). An investigation of unmet socio-economic needs among Arab American breast cancer patients compared with other immigrant and migrant patients. Journal of Community Health, 43(1), 89–95.

    Article  PubMed  PubMed Central  Google Scholar 

  • Ayyash, M., Ayyash, M., Bahroloomi, S., Hamade, H., Makki, M., Hassouneh, S., & Blackwood, R. A. (2019). Knowledge assessment and screening barriers for breast cancer in an Arab American Community in Dearborn, Michigan. Journal of Community Health, 44(5), 988–997.

    Article  PubMed  Google Scholar 

  • Ayash, C., Badreddine, D., Gatarny, R., Wu, M., Alward, Z., Roberts-Eversley, N., et al. (2020). Associations with the receipt of colon cancer screening among a diverse sample of Arab Americans in NYC. Journal of Immigrant and Minority Health, 22(3), 503–511.

    Article  PubMed  PubMed Central  Google Scholar 

  • Commodore-Mensah, Y., Selvin, E., Aboagye, J., Turkson-Ocran, R. A., Li, X., Himmelfarb, C. D., et al. (2018). Hypertension, overweight/obesity, and diabetes among immigrants in the US: An analysis of the 2010–2016 National Health Interview Survey. BMC Public Health, 18(1), 1–10.

    Article  Google Scholar 

  • Dallo, F. J., & Kindratt, T. B. (2015a). Disparities in vaccinations and cancer screening among US-and foreign-born Arab and European American non-Hispanic White women. Women’s Health Issues, 25(1), 56–62.

    Article  PubMed  Google Scholar 

  • Dallo, F. J., & Kindratt, T. B. (2015b). Disparities in preventive health behaviors among non Hispanic White men: Heterogeneity among foreign-born Arab and European Americans. American Journal of Men’s Health, 9(2), 124–131.

    Article  PubMed  Google Scholar 

  • Darwish-Yassine, M., & Wing, D. (2005). Cancer epidemiology in Arab Americans and Arabs outside the Middle East. Ethnicity & Disease, 15(1 Suppl 1), S1–S5.

    Google Scholar 

  • Davis, R. E., Resnicow, K., & Couper, M. P. (2011). Survey response styles, acculturation, and culture among a sample of Mexican American adults. Journal of Cross-Cultural Psychology, 42(7), 1219–1236.

    Article  PubMed  PubMed Central  Google Scholar 

  • Division of Cancer Prevention and Control, Centers for Disease Control and Prevention. (2020, July 20). What should I know about screening? Cancer Prevention and Control. https://www.cdc.gov/cancer/dcpc/prevention/screening.htm

  • Endeshaw, M., Clarke, T., Senkomago, V., & Saraiya, M. (2018). Cervical cancer screening among women by birthplace and percent of lifetime living in the US. Journal of Lower Genital Tract Disease, 22(4), 280.

    Article  PubMed  PubMed Central  Google Scholar 

  • El-Shahawy, O., & Haddad, L. (2015). Correlation between nicotine dependence and barriers to cessation between exclusive cigarette smokers and dual (water pipe) smokers among Arab Americans. Substance Abuse and Rehabilitation, 6, 25.

    Article  PubMed  PubMed Central  Google Scholar 

  • El Hajj, D. G., Cook, P. F., Magilvy, K., Galbraith, M. E., Gilbert, L., & Corwin, M. (2017). Tobacco use among Arab immigrants living in Colorado: Prevalence and cultural predictors. Journal of Transcultural Nursing, 28(2), 179–186.

    Article  PubMed  Google Scholar 

  • Gauss, J. W., Mabiso, A., & Williams, K. P. (2013). Pap screening goals and perceptions of pain among black, Latina, and Arab women: Steps toward breaking down psychological barriers. Journal of Cancer Education, 28(2), 367–374.

    Article  PubMed  PubMed Central  Google Scholar 

  • Ghadban, R., Haddad, L., Thacker, L. R., An, K., Balster, R. L., & Salyer, J. (2019). Smoking behaviors in Arab Americans: Acculturation and health beliefs. Journal of Transcultural Nursing, 30(2), 115–123.

    Article  PubMed  Google Scholar 

  • Haddad, L., El-Shahawy, O., Shishani, K., Madanat, H., & Alzyoud, S. (2012). Cigarette use attitudes and effects of acculturation among Arab immigrants in USA: A preliminary study. Health, 4(10).

    Google Scholar 

  • Haddad, L., & Corcoran, J. (2013). Culturally tailored smoking cessation for Arab American male smokers in community settings: A pilot study. Tobacco Use Insights, 6, TUI S11837.

    Article  Google Scholar 

  • Haddad, L., El-Shahawy, O., & Ghadban, R. (2014). Comparison of barriers to cessation among Arab American smokers of cigarettes and waterpipe. International Journal of Environmental Research and Public Health, 11(9), 9522–9531.

    Article  PubMed  PubMed Central  Google Scholar 

  • Haddad, L. G., Al-Bashaireh, A. M., Ferrell, A. V., & Ghadban, R. (2017). Effectiveness of a culturally-tailored smoking cessation intervention for Arab-American men. International Journal of Environmental Research and Public Health, 14(4), 411.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hatahet, W., Khosla, P., & Fungwe, T. V. (2002). Prevalence of risk factors to coronary heart disease in an Arab-American population in Southeast Michigan. International Journal of Food Sciences and Nutrition, 53(4), 325–335.

    Article  PubMed  Google Scholar 

  • Hekman, K., Weir, S., Fussman, C., & Lyon-Callo, S. (2015). Health risk behaviors among Arab adults within the state of Michigan: 2013 Arab Behavioral risk factor survey. Michigan Department of Health and Human Services, Lifecourse Epidemiology and Genomics Division and Health Disparities Reduction and Minority Health Section.

    Google Scholar 

  • Jadalla, A., & Lee, J. (2012). The relationship between acculturation and general health of Arab Americans. Journal of Transcultural Nursing, 23(2), 159–165.

    Article  PubMed  Google Scholar 

  • Jadalla, A. A., Hattar, M., & Schubert, C. C. (2015). Acculturation as a predictor of health promoting and lifestyle practices of Arab Americans: A descriptive study. Journal of Cultural Diversity, 22(1).

    Google Scholar 

  • Jamil, H., Fakhouri, M., Dallo, F., Templin, T., Khoury, R., & Fakhouri, H. (2008). Disparities in self-reported diabetes mellitus among Arab, Chaldean, and black Americans in Southeast Michigan. Journal of Immigrant and Minority Health, 10(5), 397–405.

    Article  PubMed  Google Scholar 

  • Jamil, H., Templin, T., Fakhouri, M., Rice, V. H., Khouri, R., Fakhouri, H., et al. (2009). Comparison of personal characteristics, tobacco use, and health states in Chaldean, Arab American, and non-Middle Eastern White adults. Journal of Immigrant and Minority Health, 11(4), 310–317.

    Article  PubMed  Google Scholar 

  • Jamil, H., Janisse, J., Elsouhag, D., Fakhouri, M., Arnetz, J. E., & Arnetz, B. B. (2011). Do household smoking behaviors constitute a risk factor for hookah use? Nicotine & Tobacco Research, 13(5), 384–388.

    Article  Google Scholar 

  • Jamil, H., Geeso, S. G., Arnetz, B. B., & Arnetz, J. E. (2014a). Risk factors for hookah smoking among Arabs and Chaldeans. Journal of Immigrant and Minority Health, 16(3), 501–507.

    Article  PubMed  Google Scholar 

  • Jamil, H. J., Rajan, A. K., Grzybowski, M., Fakhouri, M., & Arnetz, B. (2014b). Obesity and overweight in ethnic minorities of the Detroit metropolitan area of Michigan. Journal of Community Health, 39(2), 301–309.

    Article  PubMed  Google Scholar 

  • Jen, K. L. C., Zhou, K., Arnetz, B., & Jamil, H. (2015). Pre-and post-displacement stressors and body weight development in Iraqi refugees in Michigan. Journal of Immigrant and Minority Health, 17(5), 1468–1475.

    Article  PubMed  Google Scholar 

  • Jen, K. C., Jamil, H., Zhou, K., Breejen, K., & Arnetz, B. B. (2018). Sex differences and predictors of changes in body weight and noncommunicable diseases in a random, newly arrived group of refugees followed for two years. Journal of Immigrant and Minority Health, 20(2), 283–294.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kahan, D. (2007). Overweight and its relationship to Middle Eastern American college students’ sociodemographics and physical activity. Research Quarterly for Exercise and Sport, 78(3), 248–256.

    Article  PubMed  Google Scholar 

  • Kahan, D. (2009). Quantity, type, and correlates of physical activity among American Middle Eastern university students. Research Quarterly for Exercise and Sport, 80(3), 412–423.

    Article  PubMed  Google Scholar 

  • Kahan, D. (2011). Arab American college students’ physical activity and body composition: Reconciling Middle East-West differences using the socioecological model. Research Quarterly for Exercise and Sport, 82(1), 118–128.

    Article  PubMed  Google Scholar 

  • Kahan, D., Amini, H., & Osman, M. (2018). Formative evaluation of a pilot study of a university exercise class for female Muslims. Journal of Physical Activity and Health, 3, 35–40.

    Google Scholar 

  • Kassem, N. O., Kassem, N. O., Jackson, S. R., Daffa, R. M., Liles, S., & Hovell, M. F. (2015). Arab-American hookah smokers: Initiation, and pros and cons of hookah use. American Journal of Health Behavior, 39(5), 680–697.

    Article  PubMed  Google Scholar 

  • Kawar, L. N. (2009). Jordanian and Palestinian immigrant women’s knowledge, affect, cultural attitudes, health habits, and participation in breast cancer screening. Health Care for Women International, 30(9), 768–782.

    Article  PubMed  Google Scholar 

  • Kawar, L. N. (2013). Barriers to breast cancer screening participation among Jordanian and Palestinian American women. European Journal of Oncology Nursing, 17(1), 88–94.

    Article  PubMed  Google Scholar 

  • Kindratt, T. B., Dallo, F. J., & Roddy, J. (2018). Cigarette smoking among US-and Foreign-born European and Arab American Non-Hispanic white men and women. Journal of Racial and Ethnic Health Disparities, 5(6), 1284–1292.

    Article  PubMed  Google Scholar 

  • Kulwicki, A., Smiley, K., & Devine, S. (2007). Smoking behavior in pregnant Arab Americans. MCN: The American Journal of Maternal/Child Nursing, 32(6), 363–367.

    PubMed  Google Scholar 

  • Matin, M., & LeBaron, S. (2004). Attitudes toward cervical cancer screening among Muslim women: A pilot study. Women & Health, 39(3), 63–77.

    Article  Google Scholar 

  • McClelland, M. L., Weekes, C. V., Bazzi, H., Warwinsky, J., Abouarabi, W., Snell, F., & Salamey, T. (2016). Perception of obesity in African-American and Arab-American minority groups. Journal of Racial and Ethnic Health Disparities, 3(1), 160–167.

    Article  PubMed  Google Scholar 

  • National Institute on Alcohol Abuse and Alcoholism. (2004). NIAAA council approves definition of binge drinking. NIAAA Newsletter, 3(3).

    Google Scholar 

  • Nelson, D. A., & Barondess, D. A. (1997). Whole body bone, fat and lean mass in children: Comparison of three ethnic groups. American Journal of Physical Anthropology: The Official Publication of the American Association of Physical Anthropologists, 103(2), 157–162.

    Article  Google Scholar 

  • Neumayer, H., Weir, S., Fussman, C., & McKane, P. (2017). Health risk behaviors among Arab adults within the state of Michigan: 2016 Arab behavioral risk factor survey. Michigan Department of Health and Human Services, Lifecourse Epidemiology and Genomics Division and Health Disparities Reduction and Minority Health Section.

    Google Scholar 

  • Padela, A. I., Peek, M., Johnson-Agbakwu, C. E., Hosseinian, Z., & Curlin, F. (2014). Associations between religion-related factors and cervical cancer screening among Muslims in greater Chicago. Journal of Lower Genital Tract Disease, 18(4), 326.

    Article  PubMed  PubMed Central  Google Scholar 

  • Peterson, L., Soliman, A., Ruterbusch, J. J., Smith, N., & Schwartz, K. (2011). Comparison of exposures among Arab American and non-Hispanic White female thyroid cancer cases in metropolitan Detroit. Journal of Immigrant and Minority Health, 13(6), 1033–1040.

    Article  PubMed  PubMed Central  Google Scholar 

  • Read, J., West, J., & Ajrouch, K. (n.d.). Arab Americans: A community portrait. ACCESS Reports. https://insight.livestories.com/s/v2/arab-american-heritage-a-communityportrait/0adb9ffd-937c-4f57-9dca-80b81ee46b9f

  • Resnicow, K., Soler, R. E., Braithwaite, R. L., Selassie, M. B., & Smith, M. (1999). Development of a racial and ethnic identity scale for African American adolescents: The survey of black life. Journal of Black Psychology, 25(2), 171–188.

    Article  Google Scholar 

  • Resnicow, K., Patel, M. R., Green, M., Smith, A., Bacon, E., Goodell, S., et al. (2021). Development of an ethnic identity measure for Americans of Middle Eastern and North African descent: initial psychometric properties, sociodemographic, and health correlates. Journal of Racial and Ethnic Health Disparities, 8, 1067–1078. https://doi.org/10.1007/s40615-020-00863-y

  • Rice, V. H., & Kulwicki, A. (1992). Cigarette use among Arab Americans in the Detroit metropolitan area. Public Health Reports, 107(5), 589.

    PubMed  PubMed Central  Google Scholar 

  • Roman, L., Meghea, C., Ford, S., Penner, L., Hamade, H., Estes, T., & Williams, K. P. (2014). Individual, provider, and system risk factors for breast and cervical cancer screening among underserved Black, Latina, and Arab women. Journal of Women’s Health, 23(1), 57–64.

    Article  PubMed  PubMed Central  Google Scholar 

  • Saadi, A., Bond, B., & Percac-Lima, S. (2012). Perspectives on preventive health care and barriers to breast cancer screening among Iraqi women refugees. Journal of Immigrant and Minority Health, 14(4), 633–639.

    Article  PubMed  Google Scholar 

  • Salman, K. F. (2012). Health beliefs and practices related to cancer screening among Arab Muslim women in an urban community. Health Care for Women International, 33(1), 45–74.

    Article  PubMed  Google Scholar 

  • Schwartz, K., Fakhouri, M., Bartoces, M., Monsur, J., & Younis, A. (2008). Mammography screening among Arab American women in metropolitan Detroit. Journal of Immigrant and Minority Health, 10(6), 541–549.

    Article  PubMed  Google Scholar 

  • Talaat, N., & Harb, W. (2013). Reluctance to screening colonoscopy in Arab Americans: A community based observational study. Journal of Community Health, 38(4), 619–625.

    Article  PubMed  Google Scholar 

  • Talaat, N. (2015). Adherence and barriers to colorectal cancer screening varies among Arab Americans from different countries of origin. Arab Journal of Gastroenterology, 16(3–4), 116–120.

    Article  PubMed  Google Scholar 

  • Talley, C. H., Yang, L., & Williams, K. P. (2017). Breast cancer screening paved with good intentions: Application of the information–motivation–behavioral skills model to racial/ethnic minority women. Journal of Immigrant and Minority Health, 19(6), 1362 1371.

    Article  PubMed  Google Scholar 

  • Williams, K. P., Mabiso, A., Todem, D., Hammad, A., Hill-Ashford, Y., & Hamade, H. (2011). Differences in knowledge of breast cancer screening modalities among African American, Latina and Arab-American Women. Preventing Chronic Disease, 8, 1–8.

    Google Scholar 

  • Williams, K. P., Roman, L., Meghea, C. I., Penner, L., Hammad, A., & Gardiner, J. (2013). Kin KeeperSM: Design and baseline characteristics of a community-based randomized controlled trial promoting cancer screening in Black, Latina, and Arab women. Contemporary Clinical Trials, 34(2), 312–319.

    Article  PubMed  Google Scholar 

  • Zayed, L., Chebli, P., Shalabi, I., Taha, N., & Abboud, S. (2020). Health assessment of the Arab American Community in Southwest Chicago. Journal of Community Health, 1–7.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Molly Green .

Editor information

Editors and Affiliations

Appendix

Appendix

Table 15.2 Relationship between smoking behaviors and ethnic identity
Table 15.3 Relationship between BMI, physical activity, and ethnic identity
Table 15.4 Relationship between drinking behaviors and ethnic identity
Table 15.5 Relationship between screening behaviors and ethnic identity
Table 15.6 Adjusted odds* of MENA-IM scores as a predictor of substance use and self-reported illness

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Green, M., Tariq, M., Resnicow, K. (2023). Health Behaviors and Their Risk Factors Among Arab Americans. In: Nassar, S.C., Ajrouch, K.J., Dallo, F.J., Hakim-Larson, J. (eds) Biopsychosocial Perspectives on Arab Americans. Springer, Cham. https://doi.org/10.1007/978-3-031-28360-4_15

Download citation

Publish with us

Policies and ethics