Background: Health status measures are being used in increasingly diverse populations. However, there are no known studies to date that examine the SF-12 in US Chinese populations. This study reports on the performance and validity of the SF-12 among Chinese immigrants residing in New York City, and evaluates the impact of multiple behavioral risk factors on physical and mental health status. Methods: We used cross-sectional survey data from a multistage probability sample of 2537 Chinese adults. SF-12 scores were examined according to sociodemographic, cultural, and clinical characteristics. Regression analyses were used to examine associations between health status and co-occurring behavioral risk factors of smoking, risky drinking, physical inactivity, and overweight/obesity. Results: SF-12 scores were significantly lower among women, those with less education, lower incomes, and more health problems (P < 0.001). Older adults had worse physical but better mental health (P < 0.05). Individuals with 1, 2, 3, and 4 behavioral risk factors reported decreases of 1.91, 2.92, 4.86, and 9.21 points on the PCS-12, respectively, in comparison with the reference group having zero risk factors (P < 0.01). Similar trends up to 2 co-occurring risks were observed with MCS-12 scores (P < 0.01). Conclusions: The SF-12 exhibited known-groups validity in a US Chinese immigrant population. Co-occurring behavioral risk factors were associated with progressive declines in physical health, independent of sociodemographic and clinical characteristics traditionally associated with impairments in health status. Targeting patients with multiple risks for behavior change may be effective in improving health across diverse populations. Copyright © 2009 by Lippincott Williams & Wilkins.

immigrants Health status SF-12 Risk behaviors/factors Asian health issues

education China immigrant validity lifestyle Chinese Life Style Alcohol Drinking drinking behavior lowest income group regression analysis population demography mental health human Health Behavior middle aged Immobilization Overweight statistics controlled study obesity comparative study health status Aged Health Surveys behavioral risk factor surveillance system ethnology Cross-Sectional Studies United States Young Adult cross-sectional study Humans smoking Adolescent Asian Americans male Emigrants and Immigrants performance Asian American female risk factor Risk Factors questionnaire cultural factor Health Status Indicators Article Questionnaires adult migration New York City Motor Activity probability sample Short Form 12 Reference Values reference value behavior change health survey