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Given the paucity of research on differences between older adults representing the many Asian-American subcategories, the present study explored physical and mental health status in five subcategories of Asian Americans aged 60 and older: Chinese, Japanese, Korean, Vietnamese, and Filipino. Data were drawn from the 2007 California Health Interview Survey (CHIS). Background characteristics and physical and mental health conditions were compared, with results showing differences cross the five subcategories of older Asian Americans. Specific patterns were identified in chronic diseases, disease comorbidity, and disability rates. Vietnamese and Filipinos tended to have poorer physical health than Chinese, Japanese, and Koreans. The poorest self-rated health and the highest disability rate were found in the older Vietnamese. Filipinos also exhibited the greatest number of chronic diseases, including the highest rates of asthma, high blood pressure, and heart disease. Although Koreans had the fewest self-reported chronic diseases and the least evidence of disease comorbidity, they also had the highest psychological distress. The lowest psychological distress was found in older Japanese. Findings suggest that generalizing findings from one particular Asian category or from an aggregate Asian category may be problematic and may not reflect an accurate picture of the burden of health in specific Asian categories. Being aware of these differences in background and health characteristics may help providers to better serve older Asian clients.

OBJECTIVES-To examine cultural equivalence in responses to depressive symptom items of three racial or ethnic elderly groups.DESIGN-Cross-sectional analyses of two national data sets. SETTING-The New Haven Established Populations for Epidemiologic Studies of the Elderly (EPESE) and the five-state Hispanic EPESE (H-EPESE).PARTICIPANTS-Whites (n 5 1,876) and blacks (n 5 464) were drawn from the New Haven EPESE and Mexican Americans (n 5 2,623) were drawn from the H-EPESE. MEASUREMENT-The original 20-item version of the Center for Epidemiologic Studies Depression Scale (CES-D).RESULTS-From differential item functioning analyses, a lack of measurement equivalence was found for 16 depressive symptom items. Mexican Americans were predisposed to endorse 12 depressive symptoms. Blacks were more likely than whites to endorse two interpersonal items (unfriendly and disliked). Mexican Americans were more likely than whites to respond to four positive affect items (good, hopeful, happy, and enjoyed) and more likely than blacks to endorse three positive items (good, happy, and enjoyed). CONCLUSION-Resultssuggested response bias to depressive symptom items in racially and ethnically diverse older adults. Mexican Americans were more likely than whites to endorse the large number of depressive symptom items. Blacks were much more likely to respond in patterns similar to those of the whites. Findings from this study provide a foundation for developing culturally appropriate depression measures in health disparities research. Keywords cultural equivalence; depressive symptoms; CESD; measurement equivalence; differential item functioning A growing body of literature documents racial and ethnic disparities in depressive symptoms. 1,2 A number of cross-cultural and cross-national studies on depressive symptoms have found evidence that prevalence rates of probable depression vary dramatically across diverse racial/ and ethnic groups, with rates ranging from 1.5% to 32.0%. 2-5 Because of such cultural variations, it has become a virtual truism in cross-cultural research that racially

Given the increasing evidence that older ethnic minorities underuse mental health services, the present study assessed determinants of attitudes toward mental health services with a sample of older Korean Americans (N = 472). Adapting Andersen's behavioral health model, predisposing factors (age, sex, marital status, education, length of residence in the United States), mental health needs (anxiety, suicidal ideation, depressive symptoms), and enabling factors (personal experiences and beliefs) were considered as potential predictors. Shorter residence in the United States and higher levels of depressive symptoms were associated with more-negative attitudes toward mental health services. Culture-influenced personal beliefs (knowledge about mental illness and stigmatism) were found to play a substantial role in shaping individuals' attitudes toward mental health services. Findings call attention to the need to investigate how culture influences the response to mental health needs and to develop community education and outreach programs to close the gaps between mental health needs and service utilization in older ethnic minority populations.Keywords mental health; service utilization; Korean American; older adults Asian Americans are one of the fastest growing minority groups in the United States. Currently constituting nearly 4% of the total U.S. population, they are projected to reach 10% by 2050, 1 but little is known about this population, especially in the mental health arena. 2,3 Given the heterogeneity of Asian Americans, the present study focuses on one group: older Korean Americans. Korean Americans have been identified as one of the most understudied populations 4 despite the fact that they constitute one of the largest and fastest-growing segments of Asian Americans. 1 Their reportedly high risk for mental health problems also indicates the need for more research on Korean Americans. 4Although service underutilization of Asian Americans is well documented, 3-5 there is little research on their attitude toward mental health services and its correlated factors. Exploring variables associated with the perceptions of mental health service use will help identify facilitators and barriers to service utilization. Because attitudes have been shown to be a critical determinant of help-seeking behaviors, 6,7 this line of research may inform about how to design and implement effective interventions to reduce disparities in mental health services. Need constitutes the second explanatory factor. Just as physical health problems such as illness and chronic conditions represent needs for medical service, mental health problems represent needs for mental health services. In a prospective study based on medical records, level of depression was found to be the most significant predictor of service use. 16 Nevertheless, despite the fact that psychological morbidity and severity of conditions indicate a need for service, there seems to be a wide gap between mental health needs and care.Enabling factors encompass a...