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  • Publication # 14-RA002

Study of Asian Americans identifies subsets of socially disadvantaged workers at risk of poor mental health

Disparities/Minority Health

A well-documented finding is that individuals of the highest socioeconomic status (SES) have better health, particularly mental health, than those at the bottom and all intermediary levels. Yet, there is increasing evidence from studies of racial/ethnic minorities and immigrants in the United States showing more complex links between SES and health. This is sometimes referred to as an "epidemiological paradox" (higher SES not associated with better health) or an "immigrant health paradox" (health-protective effect of being foreign-born despite lower SES than their U.S.-born counterparts). 

In an effort to understand whether such a phenomenon exists in the fast-growing, heterogeneous Asian American population, researchers investigated the associations of nativity and occupational class with subjective health and 12-month mental disorders. They found that occupational class was not strongly associated with subjective health and mental disorder for Asian Americans, including immigrants.

Though they found an overall protective effect of being foreign-born for any mental disorder and anxiety, factors associated with migration and adaptation were independently associated with negative outcomes. For example, limited English proficiency was associated with all five outcomes studied (self-rated physical health, self-rated mental health, any 12-month mental disorder, any 12-month anxiety disorder and any 12-month depressive disorder). Material and psychosocial factors were associated with some outcomes—perceived financial need with self-rated physical and mental health, uninsurance with self-rated mental health and depression, social support, perceived discrimination, and acculturative stress with all or most mental health outcomes. 

The researchers caution against using terms like "immigrant health paradox," which oversimplify complex patterns. They conclude that their findings identify sub-groups of Asians at risk for worse mental health who might be targeted through culturally centered policies and programs to provide language, social, and health services and to promote health. 

The findings were based on analysis of data from 1,530 Asian respondents in the labor force to the National Latino and Asian American Study of 2002–2003. The study was partially supported by AHRQ (T32 HS13853). 

See "Does an immigrant health paradox exist among Asian Americans? Associations of nativity and occupational class with self-rated health and mental disorders," by Dolly A. John, Ph.D., A.B. de Castro, Ph.D., Diane P. Martin, Ph.D., Bonnie Duran, Ph.D., and David T. Takeuchi, Social Science & Medicine 75, pp. 2085-2098, 2012.


Page last reviewed November 2013
Internet Citation: Study of Asian Americans identifies subsets of socially disadvantaged workers at risk of poor mental health: Disparities/Minority Health. November 2013. Agency for Healthcare Research and Quality, Rockville, MD.


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