Acculturation and Self-rated Health Among Asian Immigrants: The Role of Gender and Age

Abstract

Using the 2002–2003 National Latino and Asian American Study (NLAAS), we examine the relationship between acculturation and poor-to-fair self-rated health (SRH) among Asian immigrants (N = 1639). Using latent class analysis, we construct a multidimensional measure of acculturation that considers dimensions of involvement in U.S. culture as well as attachment to Asian ethnic cultures and identify three classes of Asian immigrants: the assimilated, who most strongly adhere to U.S. culture; the integrated, who align with both U.S. and Asian ethnic cultures; and the separated, who are almost exclusively attached to Asian ethnic cultures. Logistic regression results revealed that among the pooled sample of Asian immigrant adults, the separated are significantly more likely to report poor-to-fair SRH than the assimilated. We then tested for gender and age differences in the acculturation–SRH relationship, and found that stratifying by gender yields noticeably different patterns. Among Asian immigrant women, the probability of reporting poor-to-fair SRH increases with age for the separated and the integrated, while it declines with age for the assimilated. Conversely, among Asian immigrant men, the probability of reporting poor-to-fair SRH increases most steeply with age for the assimilated, while it is shallower for the separated and the integrated. Future research should continue to develop a dynamic understanding of acculturation and examine its association with other health outcomes, including how these relationships differ across subsets of immigrant groups.

Acculturation and self-rated health among Chinese and Korean immigrants aged 49 to 75

“…For example, acculturative stress is prominent for less acculturated Asian Americans, which contributes to poor mental health and ultimately worse SRH despite their lower prevalence of major diseases compared to more acculturated populations ( 14 ). Additionally, more acculturated Asian Americans are more likely to receive health screening and healthcare services than less acculturated Asian Americans ( 14 , 32 , 34 , 54 ). In particular, higher English proficiency and more bicultural or western identity—the acculturation factors most associated with better SRH—are likely associated with higher health literacy and better access to health care, as structural barriers to access will be easier for those individuals to overcome ( 55 – 57 ).…”

“…Ro and colleagues also demonstrated that SRH improved with longer duration in the U.S. particularly among older cohorts of Asian immigrants ( 28 ). A recent study reported the moderating role of age in the association between the acculturation and SRH with different patterns by gender: the probability of having poor to fair SRH increased with age among less acculturated or bicultural Asian immigrant women, whereas the probability increased steeply with age among the highly acculturated Asian immigrant men ( 34 ). Older Asian immigrants are more likely to suffer from isolation and limited utilization of health services than their younger counterparts ( 30 , 37 , 38 ) which may result in poor SRH.…”

“…Given the rapidly growing Asian populations in the U.S. particularly due to immigration, and the aging demographic of Asian immigrants, it is crucial to understand how acculturation shapes perceived health among older adult Asian immigrants ( 34 ). Relying on a single measure of acculturation (e.g., duration in the U.S.) may paint an incomplete picture.…”

International medical students’ acculturation and self-rated health status in Hungary: a cross-sectional study

“…This is consistent with the findings of Suleiman et al (2021), who have discovered that greater heritage identity is associated with a lower risk of poor self-rated health [ 36 ]. Meanwhile, research conducted among Asian immigrant groups has found that the separated are significantly more likely than the assimilated to report poor-to-fair SRH [ 37 ].…”

“…Nonetheless, acculturation can increase stress or conflict between two competing cultures [42] or be associated with decreased social support [43]. Not surprisingly, empirical findings have been mixed, with some studies linking higher acculturation to a new culture to poorer SRH [38,39], while others show favorable relationship to mental health [37,44] or no relationship at all [36].…”