Background: Asian populations have lower rates of obesity based on standard body mass index (BMI) thresholds but higher rates of obesity-related diseases. Self-employment has been negatively linked with obesity and cardiovascular disease (CVD) risk factors among women across different racial and ethnic groups. However, no studies have examined this relationship among Asian women. 

Objective: This study aims to explore the relationship between self-employment and CVD risk factors among Asian women.

Methods: Linear regression models and Behavioral Risk Factor Surveillance System (1993–2022) data were used to conduct weighted cross-sectional analyses exploring the relationship between self-employment and CVD risk factors (obesity, diabetes, hypertension, binge drinking, smoking, and exercise) among working Asian women aged 20–64. An indicator variable was coded as “1” for women who were self-employed and “0” for women who worked for salary or wages. Obesity was classified using standard BMI (≥30 kg/m2) and Asian-specific BMI (≥27.5 kg/m2) thresholds. Models were adjusted for demographics, socioeconomic status, family structure, and insurance, as well as state and year fixed effects.

Results: Self-employment was negatively associated with obesity with a statistically significant (p < 0.05) decline of 4.9 and 6.8 percentage points in the probability of obesity using standard and Asian-specific BMI thresholds, respectively. Self-employment was also associated with a 4-percentage-point decline in the probability of reporting binge drinking. None of the other outcome measures had a statistically significant relationship with self-employment.

Conclusions: This study suggests that self-employment is negatively associated with obesity and binge drinking, important risk factors for CVD. Furthermore, the relationship between self-employment and obesity is underestimated by nearly 30% using standard BMI thresholds. Future studies should explore the mechanism underlying these relationships.

Keywords: Asian women; cardiovascular disease risk factors; self-employment