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Associations between caregiving status, acculturation, and psychological distress in a diverse sample

Published online by Cambridge University Press:  05 December 2022

Julia P. Nguyen ,
Diane Hoang ,
Kieran Zhou ,
Danielle J. Harvey ,
QuynhAnh Dam  and
Oanh L. Meyer Open the ORCID record for Oanh L. Meyer [Opens in a new window]
Julia P. Nguyen
Affiliation:
Department of Neurology, University of California, Davis, School of Medicine, Sacramento, CA 95817, USA
Diane Hoang
Affiliation:
Foresight Mental Health, Oakland, CA 94612, USA
Kieran Zhou
Affiliation:
Shanghai Unionlab Co., Ltd. Shanghai, CN, USA
Danielle J. Harvey
Affiliation:
Department of Public Health Sciences, University of California, Davis, CA 95616, USA
QuynhAnh Dam
Affiliation:
San Francisco State University, San Francisco, CA 94132, USA
Oanh L. Meyer*
Affiliation:
Department of Neurology, University of California, Davis, School of Medicine, Sacramento, CA 95817, USA
*
Correspondence should be addressed to: Oanh L. Meyer, Alzheimer’s Disease Research Center, Department of Neurology, UC Davis School of Medicine, 4860 Y Street, Sacramento, CA 95817, USA. Tel: +1 916 734 5218; Fax: +1 916703 5290. E-mail: olmeyer@ucdavis.edu.
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Abstract

Objectives:

Increasingly diverse caregiver populations have prompted studies examining culture and caregiver outcomes. Still, little is known about the influence of sociocultural factors and how they interact with caregiving context variables to influence psychological health. We explored the role of caregiving and acculturation factors on psychological distress among a diverse sample of adults.

Design:

Secondary data analysis of the California Health Interview Survey (CHIS).

Participants:

The 2009 CHIS surveyed 47,613 adults representative of the population of California. This study included Latino and Asian American Pacific Islander (AAPI) caregivers and non-caregivers (n = 13,161).

Measurements:

Multivariate weighted regression analyses examined caregiver status and acculturation variables (generational status, language of interview, and English language proficiency) and their associations with psychological distress (Kessler-6 scale). Covariates included caregiving context (e.g., support and neighborhood factors) and demographic variables.

Results:

First generation caregivers had more distress than first-generation non-caregivers (β=0.92, 95% CI: (0.18, 1.65)); the difference in distress between caregivers and non-caregivers was smaller in the third than first generation (β=-1.21, 95% CI: (-2.24, -0.17)). Among those who did not interview in English (β=1.17, 95% CI: (0.13, 2.22)) and with low English proficiency (β=2.60, 95% CI: (1.21, 3.98)), caregivers reported more distress than non-caregivers.

Conclusions:

Non-caregivers exhibited the "healthy immigrant effect," where less acculturated individuals reported less distress. In contrast, caregivers who were less acculturated reported more distress.

Keywords

acculturationmental healthdistresscaregivingsocial determinants

Information

Type
Original Research Article
Information
International Psychogeriatrics , Volume 36 , Special Issue 8: Issue Theme: Social Relationships and Mental Health in Second Half of Life , August 2024 , pp. 666 - 674
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of International Psychogeriatric Association

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References

Abraído-Lanza, A. F., Dohrenwend, B. P., Ng-Mak, D. S. and Turner, J. B. (1999). The Latino mortality paradox: a test of the “salmon bias” and healthy migrant hypotheses. American Journal of Public Health, 89, 1543–1548. DOI 10.2105/ajph.89.10.1543.CrossRefGoogle ScholarPubMed
Abraído-Lanza, A. F., Echeverría, S. E. and Flórez, K. R. (2016). Latino immigrants, acculturation, and health: promising new directions in research. Annual Review of Public Health, 37, 219–236. DOI 10.1146/annurev-publhealth-032315-021545.CrossRefGoogle ScholarPubMed
Acton, G. J. and Kang, J. (2001). Interventions to reduce the burden of caregiving for an adult with dementia: a meta-analysis. Research in Nursing & Health, 24, 349–360. DOI https://doi.org/10.1002/nur.1036.CrossRefGoogle ScholarPubMed
Angel, J. L., Rote, S. M., Brown, D. C., Angel, R. J. and Markides, K. S. (2014). Nativity status and sources of care assistance among elderly Mexican-origin adults. Journal of Cross-Cultural Gerontology, 29, 243–258. DOI 10.1007/s10823-014-9234-9.CrossRefGoogle ScholarPubMed
Bekteshi, V., Xu, Q. and Van Tran, T. (2015). Psychological distress among low-income U.S.- and foreign-born women of Mexican descent: impact of acculturation. Women’s Health Issues, 25, 185–192. DOI 10.1016/j.whi.2014.11.001.CrossRefGoogle ScholarPubMed
Berry, J. W. (1970). Marginality, stress and ethnic identification in an acculturated aboriginal community. Journal of Cross-Cultural Psychology, 1, 239–252. DOI 10.1177/135910457000100303.CrossRefGoogle Scholar
Berry, J. W. (2005). Acculturation: living successfully in two cultures. International Journal of Intercultural Relations, 29, 697–712. DOI https://doi.org/10.1016/j.ijintrel.2005.07.013.CrossRefGoogle Scholar
Booth, J., Ayers, S. and Marsiglia, F. (2014). Perceived neighborhood safety and psychological distress: exploring protective factors. Journal of Sociology and Social Welfare, 39. https://scholarworks.wmich.edu/cgi/viewcontent.cgi?article=3703&context=jssw Google Scholar
California Health Interview Survey (2012). CHIS 2009 Adult Survey. Los Angeles, CA: UCLA Center for Health Policy Research.Google Scholar
Castañeda, H., Holmes, S. M., Madrigal, D. S., Young, M.-E. D., Beyeler, N. and Quesada, J. (2015). Immigration as a social determinant of health. Annual Review of Public Health, 36, 375–392. DOI 10.1146/annurev-publhealth-032013-182419.CrossRefGoogle ScholarPubMed
Cervantes, R. C., Padilla, A. M., Napper, L. E. and Goldbach, J. T. (2013). Acculturation-related stress and mental health outcomes among three generations of Hispanic adolescents. Hispanic Journal of Behavioral Sciences, 35, 451–468. DOI 10.1177/0739986313500924.CrossRefGoogle Scholar
Chang, M. and Moon, A. (2016). Correlates and predictors of psychological distress among older Asian immigrants in California. Journal of Gerontological Social Work, 59, 77–97. DOI 10.1080/01634372.2016.1140694.CrossRefGoogle ScholarPubMed
Dey, A. N. and Lucas, J. W. (2006). Physical and mental health characteristics of U.S.- and foreign-born adults: United States, 1998-2003. Advance Data, 369, 1–19.Google Scholar
Dilworth-Anderson, P., Williams, I. C. and Gibson, B. E. (2002). Issues of race, ethnicity, and culture in caregiving research: a 20-year review (1980-2000. The Gerontologist, 42, 237–272. DOI 10.1093/geront/42.2.237.CrossRefGoogle ScholarPubMed
Frisbie, W. P., Cho, Y. and Hummer, R. A. (2001). Immigration and the health of Asian and Pacific Islander adults in the United States. American Journal of Epidemiology, 153, 372–380. DOI 10.1093/aje/153.4.372.CrossRefGoogle ScholarPubMed
Gomez, S. L., Kelsey, J. L., Glaser, S. L., Lee, M. M. and Sidney, S. (2004). Immigration and acculturation in relation to health and health-related risk factors among specific Asian subgroups in a health maintenance organization. American Journal of Public Health, 94, 1977–1984. DOI 10.2105/ajph.94.11.1977.CrossRefGoogle Scholar
Kennedy, S., Kidd, M. P., McDonald, J. T. and Biddle, N. (2015). The healthy immigrant effect: patterns and evidence from four countries. Journal of International Migration and Integration, 16, 317–332. DOI 10.1007/s12134-014-0340-x.CrossRefGoogle Scholar
Kessler, R. C. et al. (2002). Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychological Medicine, 32, 959–976. DOI 10.1017/S0033291702006074.CrossRefGoogle ScholarPubMed
Kim, G. et al. (2011). Vulnerability of older Latino and Asian immigrants with limited english proficiency. Journal of the American Geriatrics Society, 59, 1246–1252. DOI 10.1111/j.1532-5415.2011.03483.x.CrossRefGoogle ScholarPubMed
Knight, B. G. and Sayegh, P. (2009). Cultural values and caregiving: the updated sociocultural stress and coping model. The Journals of Gerontology: Series B, 65B, 5–13. DOI 10.1093/geronb/gbp096.CrossRefGoogle ScholarPubMed
Lara, M., Gamboa, C., Kahramanian, M. I., Morales, L. S. and Hayes Bautista, D. E. (2005). Acculturation and Latino health in the United States: a review of the literature and its sociopolitical context. Annual Review of Public Health, 26, 367–397. DOI 10.1146/annurev.publhealth.26.021304.144615.CrossRefGoogle ScholarPubMed
Lawton, M. P., Kleban, M. H., Moss, M., Rovine, M. and Glicksman, A. (1989). Measuring caregiving appraisal. Journal of Gerontology, 44, P61–P71. DOI 10.1093/geronj/44.3.P61.CrossRefGoogle ScholarPubMed
Lee, S., Nguyen, H. A. and Tsui, J. (2011). Interview language: a proxy measure for acculturation among Asian Americans in a population-based survey. Journal of Immigrant and Minority Health, 13, 244–252. DOI 10.1007/s10903-009-9278-z.CrossRefGoogle Scholar
Lopez-Class, M., Castro, F. G. and Ramirez, A. G. (2011). Conceptions of acculturation: a review and statement of critical issues. Social Science & Medicine, 72, 1555–1562. DOI 10.1016/j.socscimed.2011.03.011.CrossRefGoogle ScholarPubMed
Mancenido, A., Williams, E. C. and Hajat, A. (2020). Examining psychological distress across intersections of immigrant generational status, race, poverty, and gender. Community Mental Health Journal, 56, 1269–1274. DOI 10.1007/s10597-020-00584-w.CrossRefGoogle ScholarPubMed
Markides, K. S. and Eschbach, K. (2005). Aging, migration, and mortality: current status of research on the Hispanic paradox. The Journals of Gerontology: Series B, 60, S68–S75. DOI 10.1093/geronb/60.Special_Issue_2.S68.CrossRefGoogle ScholarPubMed
Mather, M., Jacobsen, L. A. and Pollard, K. M. (2015). Population bulletin: Aging in the United States. Population Reference Bureau, 70, https://www.prb.org/wp-content/uploads/2019/07/population-bulletin-2015-70-2-aging-us.pdf.Google Scholar
Meyer, O. L., Liu, X., Nguyen, T.-N., Hinton, L. and Tancredi, D. (2018). Psychological distress of ethnically diverse adult caregivers in the California Health Interview Survey. Journal of Immigrant and Minority Health, 20, 784–791. DOI 10.1007/s10903-017-0634-0.CrossRefGoogle ScholarPubMed
Miyawaki, C. E. (2016). Caregiving practice patterns of Asian, Hispanic, and Non-Hispanic White American family caregivers of older adults across generations. Journal of Cross-Cultural Gerontology, 31, 35–55. DOI 10.1007/s10823-016-9281-5.CrossRefGoogle ScholarPubMed
Montenegro, X. (2014). Caregiving among Asian Americans and Pacific Islanders Age 50+. Available at: https://www.aarp.org/research/topics/care/info-2014/caregiving-asian-americans-pacific-islanders.html.Google Scholar
National Alliance for Caregiving, & AARP Public Policy Institute. (2015). Caregivers of older adults: a focused look at those caring for someone age 50+. Reserach Report: Caregiving in the United States 2015. Available at: https://www.aarp.org/content/dam/aarp/ppi/2015/caregivers-of-older-adults-focused-look.pdf.Google Scholar
Novak, M. and Guest, C. (1989). Application of a multidimensional caregiver burden inventory. The Gerontologist, 29, 798–803. DOI 10.1093/geront/29.6.798.CrossRefGoogle ScholarPubMed
Palloni, A. and Arias, E. (2004). Paradox lost: explaining the hispanic adult mortality advantage. Demography, 41, 385–415. DOI 10.1353/dem.2004.0024.CrossRefGoogle ScholarPubMed
Pearlin, L. I., Menaghan, E. G., Lieberman, M. A. and Mullan, J. T. (1981). The stress process. Journal of Health and Social Behavior, 22, 337–356. DOI 10.2307/2136676.CrossRefGoogle ScholarPubMed
Portes, A. (1996). New Second Generation. The Russell Sage Foundation. Available at: http://www.jstor.org/stable/10.7758/9781610444538.Google Scholar
Redfield, R., Linton, R. and Herskovits, M. J. (1936). Memorandum for the study of acculturation. American Anthropologist, 38, 149–152. DOI 10.1525/aa.1936.38.1.02a00330.CrossRefGoogle Scholar
Robinette, J. W., Piazza, J. R. and Stawski, R. S. (2021). Neighborhood safety concerns and daily well-being: a national diary study. Wellbeing, Space, and Society, 2, 100047.CrossRefGoogle ScholarPubMed
Rote, S. M. and Moon, H. (2016). Racial/ethnic differences in caregiving frequency: does immigrant status matter? The Journals of Gerontology: Series B, 73, 1088–1098. DOI 10.1093/geronb/gbw106.Google Scholar
Salant, T. and Lauderdale, D. S. (2003). Measuring culture: a critical review of acculturation and health in Asian immigrant populations. Social Science & Medicine, 57, 71–90. DOI 10.1016/S0277-9536(02)00300-3.CrossRefGoogle ScholarPubMed
SAS version 9.4 (2022, SAS® 9.4 — Today and Tomorrow. Cary, NC: SAS Institute, Inc. Available at: https://support.sas.com/software/94/.Google Scholar
Sörensen, S. and Pinquart, M. (2005). Racial and ethnic differences in the relationship of caregiving stressors, resources, and sociodemographic variables to caregiver depression and perceived physical health. Aging & Mental Health, 9, 482–495. DOI 10.1080/13607860500142796.CrossRefGoogle ScholarPubMed
U.S. Census Bureau. (2020). Selected characteristics of the foreign-born population by period of entry into the United States. Available at: https://data.census.gov/cedsci/table?q=foreign%20born&tid=ACSST5Y2020.S0502&moe=false.Google Scholar
Viruell-Fuentes, E. A. (2007). Beyond acculturation: immigration, discrimination, and health research among Mexicans in the United States. Social Science & Medicine, 65, 1524–1535. DOI 10.1016/j.socscimed.2007.05.010.CrossRefGoogle ScholarPubMed