Between 1980 and 1990, the Asian American population in the United States increased by 107.8 percent (from 3,500,439 to 7,273,662), compared with 6 percent for whites, 13 percent for blacks, and 53 percent for Hispanics (U.S. Bureau of the Census, 1991). The Asian American population is composed of more than two dozen ethnic groups from Asia and the Pacific Islands, including Chinese, Koreans, Filipinos, Japanese, Asian Indians, Vietnamese, Thais, Hmong, Laotians, and many others. For Chinese Americans and Chinese immigrants specifically, the growth rate was about 104 percent (from 806,040 to 1,645,472). Data from the 1990 census also show that one-third of Asian American elderly people are Chinese and that over 85 percent of these older Chinese are foreign born (U.S. Bureau of the Census, 1991).
Although there are an increasing number of Asian and other ethnic groups and immigrants in the population, there are substantial knowledge gaps regarding the state of ethnic groups in America, especially the elderly populations, because of a lack of empirical research (LaVeist, 1995). Researchers with the Gerontological Society of America's Minority Task Force noted that numerous medical, psychological, social, and biological research questions remain unanswered because of the unavailability of data on this population (Gibson, 1989; Jackson, 1989).
In a survey of ongoing aging-related data sources supported by U.S. federal agencies, LaVeist (1995) found that for the white elderly population, all available national data sets were large enough to conduct analysis, and a majority of the data sets were large enough for research on the African American elderly population. However, Asian American and other ethnic elderly groups were rarely included in sufficient numbers to enable meaningful statistical analysis. In this study, the author has attempted to fill this gap by conducting an empirical study to understand factors associated with depression among elderly Chinese immigrants in a major U.S. metropolitan region.
Mental Health Status of Elderly Chinese Immigrants
Of all the psychological problems that affect elderly people, depression is the risk factor most frequently associated with suicide (Lapierre, Pronovost, Dube, & Delisle, 1992). One-fifth of all late-life suicides are due to depression (American Psychiatric Association, 1988). There is evidence that Chinese Americans have a higher rate of suicide than white Americans (Yu, 1986). Compared with other groups, the suicide rate for older Chinese women has been much higher than for their white counterparts. In 1980, the suicide rate for elderly Chinese immigrants was almost three times higher than the rate for U.S.-born older Chinese Americans (Yu, 1986). Because suicide attempts and suicide are considered manifestations of mental disorder and because suicide is more likely among people who are depressed, the mental health status of elderly Chinese immigrants deserves careful evaluation and attention so that culturally appropriate intervention programs can be developed.
Depression may occur frequently in elderly immigrants because they have limited resources and yet must deal with physical losses and stressful life events (Gelfand & Yee, 1991). Despite substantial prevalence rates, symptoms of depression often go unrecognized, undiagnosed, and untreated due to patient- and health care-related barriers and problems in the organization and financing of mental health services for older adults (Gottlieb, 1991). Studies also suggest that Chinese immigrants tend to underuse mental health services, even though the prevalence and types of reported psychological disorders are similar to those in the white population (Loo, Tong, & True, 1989; Snowden & Cheung, 1990). Depressive symptoms do not tend to remit spontaneously in older adults (Allen & Blazer, 1991), and undiagnosed and untreated depression in late life causes tremendous distress for older adults, their families, and society. …