Health Service Use Among Chinese American Older Adults: Is There a Somatization Effect?

Abstract

BACKGROUND/OBJECTIVES: Somatization of depressive symptoms among Chinese American older adults remains understudied. This study aimed to identify whether the relationship between depressive symptoms and use of health services (ie, doctor visits, hospital, and emergency department) could be due to pain and whether acculturation played a role in the relations among depressive symptoms, pain, and health service use. DESIGN AND PARTICIPANTS: Secondary data came from the Population Study of Chinese Elderly in Chicago that surveyed 3159 Chinese community-dwelling older adults in the greater Chicago area. The average age was 76.3 years (standard deviation = 8.4); 57.95% were female). Negative binominal models were used to identify the effects of depression and pain on each type of health service use, controlling for sociodemographics and healthrelated factors (eg, chronic illness). MEASUREMENTS: Depressive symptoms were assessed using the Patient Health Questionnaire-9; pain was assessed by self-reported pain severity. Participants were classified into low, moderate, and high acculturation groups based on acculturation scores. RESULTS: Depressive symptoms and pain were positively related to health service use on the bivariate level. For groups with both low and high acculturation levels, depression and pain each independently predicted more health service use, whereas for the group with a moderate acculturation level, the effect of somatization was substantialized. CONCLUSION: Depression largely influenced health service use independently and partially through pain for older Chinese Americans. The somatization tended to be only salient for the moderate acculturation group, calling for more research attention to the complicated effect of acculturation. J Am Geriatr Soc 67:S584-S589, 2019.

Mediation Role of Health Service Use and Depression on Multimorbidity and Self-rated Health in Home-based Long-term Care Residents: a Cross-sectional Study

“…In addition, health service use was also associated with depression in this study, indicating that depression may predict health service use to some extent. In a study on American older adults, depressive symptoms were positively related to health service use [42], which is consistent with our results. A possible reason for this association is that depressive symptoms lead older people to have a negative perception of their health, thereby increasing their use of health services.…”

A comparison of the influencing factors of chronic pain and quality of life between older Koreans and Korean–Americans with chronic pain: a correlational study

“…These findings suggest that acculturation among elderly immigrants may not be a strong variant predicting health outcomes because they tend to have low level of acculturation in general. Nevertheless, assessing cultural effects on health may be important to better understand the Asian elderly immigrants’ health and healthcare use [ 19 ] because low acculturation level may suggest a lower likelihood of adjusting to the new culture.…”

“…Although previous studies have reported an association between acculturation and chronic pain, the results are somewhat sparse by age group; a relatively high level of acculturation was found among young immigrants [ 17 , 18 ], and more acculturated immigrants had a higher prevalence of chronic pain [ 18 ]. Among elderly immigrants, a relatively low level of acculturation was reported [ 19 ], and acculturation did not directly correlate with somatization [ 20 ], which is often associated with pain complaints.…”

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