Acculturation and Self-rated Health Among Chinese and Korean Immigrants Aged 49 to 75

Overview

Journal Front Public Health

Specialty Public Health

Date 2024 Jan 5

PMID 38179574

Authors

Soomin Ryu

Brittany N Morey

Yuxi Shi

Sunmin Lee

Affiliations

Soon will be listed here.

Abstract

Background: Given the rapidly growing Asian populations in the U.S. due to immigration, and the aging demographic of Asian immigrants, it is crucial to understand how acculturation shapes health among older adult Asian immigrants. We study the relationship between acculturation and self-rated health (SRH) and moderating roles of age and Asian subgroup.

Methods: Our cross-sectional study consisted of 200 Chinese and 200 Korean immigrants aged 49-75 living in Baltimore-Washington DC metropolitan area, who were recruited from primary care physicians' clinics in Maryland and Northern Virginia. The participants completed the survey either in-person or by phone in their preferred language. Multidimensional proxies were used to measure acculturation: years living in the U.S. (≥23 years, <23 years), English proficiency (fluently/well, so-so, poorly/not at all), and ethnic identity (very Asian, mostly Asian, bicultural/westernized). SRH was measured using the question "How would you rate your general health?" (excellent/very good/good, fair/poor). Poisson regression models with robust error variance examined associations between acculturation and SRH, accounting for socioeconomic and health insurance factors.

Results: Speaking English so-so and fluently/well had 0.73 (95% confidence intervals (CI): 0.55-0.97) and 0.51 (95% CI: 0.30-0.87) times the prevalence of having fair or poor SRH compared to speaking English poorly/not at all, respectively. The magnitudes and statistical significance of these associations were stronger among Chinese participants than Korean participants. Moreover, individuals who self-identified as bicultural/westernized had 0.63 times the prevalence of having fair or poor SRH (95% CI: 0.43-0.92) as those who self-identified as very Asian. The association was more pronounced among older participants (58) compared to younger participants (<58).

Conclusion: Further research should identify the possible mechanisms linking acculturation with health to find effective strategies to enhance health among aging Asian immigrant populations.

References

Salant T, Lauderdale D . Measuring culture: a critical review of acculturation and health in Asian immigrant populations. Soc Sci Med. 2003; 57(1):71-90. DOI: 10.1016/s0277-9536(02)00300-3. View

Huh J, Prause J, Dooley C . The impact of nativity on chronic diseases, self-rated health and comorbidity status of Asian and Hispanic immigrants. J Immigr Minor Health. 2007; 10(2):103-18. DOI: 10.1007/s10903-007-9065-7. View

Ohtani A, Suzuki T, Takeuchi H, Uchida H . Language Barriers and Access to Psychiatric Care: A Systematic Review. Psychiatr Serv. 2015; 66(8):798-805. DOI: 10.1176/appi.ps.201400351. View

Min J, Rhee S, Lee S, Rhee J, Tran T . Comparative analysis on determinants of self-rated health among non-Hispanic White, Hispanic, and Asian American older adults. J Immigr Minor Health. 2013; 16(3):365-72. DOI: 10.1007/s10903-013-9852-2. View

Richardson D, Kinlaw A, MacLehose R, Cole S . Standardized binomial models for risk or prevalence ratios and differences. Int J Epidemiol. 2015; 44(5):1660-72. PMC: 6372130. DOI: 10.1093/ije/dyv137. View

Balidemaj A, Small M . The effects of ethnic identity and acculturation in mental health of immigrants: A literature review. Int J Soc Psychiatry. 2019; 65(7-8):643-655. DOI: 10.1177/0020764019867994. View

Dong X, Chang E, Wong E, Simon M . Perception and negative effect of loneliness in a Chicago Chinese population of older adults. Arch Gerontol Geriatr. 2011; 54(1):151-9. PMC: 3173589. DOI: 10.1016/j.archger.2011.04.022. View

Lommel L, Thompson L, Chen J, Waters C, Carrico A . Acculturation, Inflammation, and Self-rated Health in Mexican American Immigrants. J Immigr Minor Health. 2018; 21(5):1052-1060. DOI: 10.1007/s10903-018-0805-7. View

Frisbie W, Cho Y, Hummer R . Immigration and the health of Asian and Pacific Islander adults in the United States. Am J Epidemiol. 2001; 153(4):372-80. DOI: 10.1093/aje/153.4.372. View

10.

Goel M, McCarthy E, Phillips R, Wee C . Obesity among US immigrant subgroups by duration of residence. JAMA. 2004; 292(23):2860-7. DOI: 10.1001/jama.292.23.2860. View

11.

Lauderdale D, Rathouz P . Body mass index in a US national sample of Asian Americans: effects of nativity, years since immigration and socioeconomic status. Int J Obes Relat Metab Disord. 2000; 24(9):1188-94. DOI: 10.1038/sj.ijo.0801365. View

12.

Acevedo-Garcia D, Bates L, Osypuk T, McArdle N . The effect of immigrant generation and duration on self-rated health among US adults 2003-2007. Soc Sci Med. 2010; 71(6):1161-72. DOI: 10.1016/j.socscimed.2010.05.034. View

13.

Morey B, Ryu S, Shi Y, Park H, Lee S . Acculturation and Cardiometabolic Abnormalities Among Chinese and Korean Americans. J Racial Ethn Health Disparities. 2022; 10(4):1605-1615. PMC: 9200372. DOI: 10.1007/s40615-022-01347-x. View

14.

Wu S, Wang R, Zhao Y, Ma X, Wu M, Yan X . The relationship between self-rated health and objective health status: a population-based study. BMC Public Health. 2013; 13:320. PMC: 3637052. DOI: 10.1186/1471-2458-13-320. View

15.

Chou C, Johnson P, Blewett L . Immigration and selected indicators of health status and healthcare utilization among the Chinese. J Immigr Minor Health. 2009; 12(4):470-9. PMC: 5525973. DOI: 10.1007/s10903-009-9240-0. View

16.

Tsoh J, Sentell T, Gildengorin G, Le G, Chan E, Fung L . Healthcare Communication Barriers and Self-Rated Health in Older Chinese American Immigrants. J Community Health. 2016; 41(4):741-52. PMC: 4930414. DOI: 10.1007/s10900-015-0148-4. View

17.

Idler E, Leventhal H, McLaughlin J, Leventhal E . In sickness but not in health: self-ratings, identity, and mortality. J Health Soc Behav. 2004; 45(3):336-56. DOI: 10.1177/002214650404500307. View

18.

Gomez S, Kelsey J, Glaser S, Lee M, Sidney S . Immigration and acculturation in relation to health and health-related risk factors among specific Asian subgroups in a health maintenance organization. Am J Public Health. 2004; 94(11):1977-84. PMC: 1448572. DOI: 10.2105/ajph.94.11.1977. View

19.

Lee S, Sobal J, Frongillo Jr E . Acculturation and health in Korean Americans. Soc Sci Med. 2000; 51(2):159-73. DOI: 10.1016/s0277-9536(99)00446-3. View

20.

Morey B, Valencia C, Park H, Lee S . The central role of social support in the health of Chinese and Korean American immigrants. Soc Sci Med. 2021; 284:114229. PMC: 8638775. DOI: 10.1016/j.socscimed.2021.114229. View