This study examines the association between acculturation stress and depressive symptoms in a regional probability sample (n = 407) of six groups of Asian immigrant elders (Chinese, Korean, Indian, Filipino,Vietnamese, and Japanese). Findings suggest that about 40 percent of the sample were depressed, indicating higher depression rates than found in other studies of older American or Asian elderly samples in the United States and Asia. Multiple regression analyses indicated that acculturation stress caused by elders' perception of a cultural gap between themselves and their adult children was associated with high depression levels. Other predictors of depression were poor perceived health, stressful life events, religiosity, proximity of children, assistance received from adult children, and longer residence in the United States. Data suggest that depression is prevalent among urban Asian immigrant elders and that there is great heterogeneity among Asian ethnic subgroups. Implications for social work practice are discussed.

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This study examined the association between English language proficiency and health outcomes in a regional probability sample (n = 205) of elderly Chinese and Korean immigrants. Data support that these two Asian ethnic subgroups differ in English proficiency and health-related quality of life. Chinese and Korean elders had poorer health than the national norms, and poor English proficiency was associated with poorer outcomes for six of eight health outcomes measures. Implications for health care delivery and social work are discussed.

The study examined racial/ethnic differences in the association between symptoms of depression and self-rated mental health among older adults. Data came from the first wave of the National Social Life, Health, and Aging Project, a population-based study of non-institutionalized older adults aged 57 to 85. The sample consisted of non-Hispanic Whites (n = 2,110), Blacks (n = 509), and Hispanics (n = 304). The association between symptoms of depression and self-rated mental health was weaker among minority groups than that among non-Hispanic Whites. Tests of interaction effects showed that the predictability of depressive symptoms to self-rated mental health was substantially weakened among Blacks of advanced ages and Hispanics with multiple chronic conditions. The study explored potential sources of racial/ethnic differences in subjective reports of mental health and called attention to older minorities with advanced ages and cormorbid conditions in mental health services and interventions.

This study used data from the 1999 National Long Term Care Survey to examine predictors of emotional strain between spouse and adult child caregivers using the frameworks of role theory and the stress process model. Secondary data analysis examined if and how emotional strain differed between the groups and what the predictors of emotional strain were for each group. Common group predictors of emotional strain were elder's disruptive behaviors, caregiver's perceived overload, family disagreement, limitations on the caregiver's life, and utilization of personal coping strategies by the caregiver. There were predictors unique to spouse's emotional strain but elders' race and respite availability were unique predictors of adult child caregiver's emotional strain. Ways in which predictors of emotional strain can be used to design effective and efficient social work interventions are discussed.

The public health implications for behavioral health include the need to educate health-care providers working with Asian Americans regarding the benefits derived from seeking services and making interpreter services available in a culturally sensitive environment.

The increasing numbers of Asian and other immigrants in the United States have resulted in greater demands for research methodology sensitive to crosscultural issues. A regional probability sample (n = 407) of Asian elderly immigrants of different nationalities (Chinese, Korean, Indian, Filipino, Vietnamese, or Japanese) residing in New York City was used to examine the reliability of the Geriatric Depression Scale (GDS). Using the 30-item GDS, about 40% of this representative sample of Asian elderly immigrants was considered to be depressed, indicating higher depression rates than in the previous studies of other Asian elderly samples in the US and in Asia. Results also showed that the 30-item GDS and 15-item GDS Short Forms were reliable measures to assess depression in communitydwelling Asian immigrant elders. Data strongly suggest that Asian elderly immigrants in the US are at risk of depression, indicating a need for the design of culturally sensitive mental health programs.The United States is facing two dramatic demographic changes: the aging and the increasing ethnic and racial diversification of its population. The population segment that is age 65 and over (35.0 million) now constitutes about 12.4% of the total US. population (Hetzel & Smith, 2001). It is expected to remain near its current level over the next 10 years. Between 2010 and 2030, the baby boomers will join this older population, and by 2030, about 20% of the total population (69.4 million) is projected to be over 65. The non-Hispanic, White share of the population is projected to fall steadily from 74% in 1995 to 72% in 2000, to 64% in 2020, and to 53% in 2050. By the middle of the 21st century the Black population is expected to nearly double its 1995 size to 61 million. The racial/ethnic groups with the highest rates of increase, however,

Nonmedical needs are intricately linked to health. Unaddressed nonmedical needs often result in poorer health and increased healthcare costs. Although social workers are well positioned to address nonmedical needs, their role in healthcare environments to address nonmedical needs is limited. The limited role relates to a lack of reimbursement streams, which stems from poor articulation about their unique contributions. An analysis of a case study in which a social worker using AIMS, a protocolized care coordination model, was undertaken to highlight specific activities performed by social workers. Implications for patient health outcomes and healthcare costs are discussed.