Asian American Mental Health Status Varies Widely Down Ethnic Lines

By Kim, Giyeon | Aging Today, January/February 2013 | Go to article overview

Asian American Mental Health Status Varies Widely Down Ethnic Lines


Kim, Giyeon, Aging Today


Dr. Mark Smith is a geriatric psychiatrist practicing in an outpatient clinic in Philadelphia. Several of his older adult Asian patients suffer from depression and anxiety. There is Mr. Chen, a 69-year-old Chinese immigrant who has lived in the United States for 36 years and speaks broken English; Mr. Yamamoto, a 74-year-old American-born Japanese who speaks only English; Mrs. Park, a 76-year-old Korean immigrant who has lived in the United States for 18 years but can't speak English well; and Mrs. Nguyen, a 67-year-old Vietnamese refugee who has lived in the United States for 37 years and is not fluent in English.

Even with his best efforts, Smith finds that his limited knowledge of diverse Asian cultures, plus an inability to communicate with his limited English-proficient patients, curtails how well he can provide culturally competent care.

Asian Americans are one of the fastest growing racial-ethnic minority population groups in the United States. According to the 2010 U.S. Census, the Asian American older adult population has increased by 145 percent between 2000 and 2010, compared with a 59 percent increase among non-Hispanic white elders. Currently, there are more than 20 Asian American subgroups in the United States, with the largest older Asian American subgroups being Chinese, Filipino, Indian, Japanese, Korean and Vietnamese.

Dr. Mark Smith is an invented character, used here to demonstrate the depth of diversity among Asian American patients. But many healthcare practitioners face the complexities of the above scenarioone that is common in clinical practices in modern-day America.

What Do We Know About Asian American Mental Health?

The best available scientific contribution on the mental health of ethnic minorities is the 2012 U.S. Surgeon General's report, Mental Health: Culture, Race, and Ethnicity (www.migrantclinician.org/files/2012 0U31S38S4406.pdf). Although this report addressed Asian American mental health issues, due to a lack of available research, older Asian Americans' mental health issues were not extensively discussed.

A general consensus on older Asian American mental health research has been that Asian American elders tend to have lower prevalence rates of mental disorders compared to other racial-ethnic groups. A 2012 study in the International Journal of Geriatric Psychiatry (onlineli brary.wiley.com/doi/10.1002/gps.2825/abstract; 27(10): 1070-77) reported the lowest prevalence of serious psychological distress in the Asian group compared to other racial-ethnic elderly groups.

Another 2011 study comparing four racial-ethnic groups (non-Hispanic whites, African Americans, Latinos and Asians), published in the American Journal of Geriatric Psychiatry (journals/lww.com/ 'ajgponline/ 'Abstract/ '2011/ '05000/Associations-BetweenSelf-Rated-Mental^Health.and.3.aspx; 19(5): 416-22), also reported Asians' lowest prevalence rates of mood and anxiety disorders from the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV). While comparative studies provide useful information for understanding the current state of older Asian American mental health relative to other racial-ethnic groups, Asian ethnic subgroup differences are not considered.

Deconstructing Asian Subgroup Mental Health Status

There have been some recent efforts to deconstruct the mental health status of older Asian American subgroups. The limited existing studies consistently report significant variations in mental health status by ethnicity, but results are mixed. Using data drawn from the 2010 California Health Interview Survey, a study published in the Journal of the American Geriatrics Society (online library. …

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