The Moderating Effect of Ethnically Dense Neighborhood On Acculturative Stress, Discrimination, and Depressive Symptoms Among Korean Americans

Background/Purpose: Korean Americans (KA) make up one of the largest Asian ethnic groups in US, of which, many are first generation immigrants. KA must adjust to significant changes in various aspects of their lives as they acculturate in a new society. Changes during the acculturation process can affect cultural values, living conditions, language, family structure, and social networks. Mental health issues among certain minorities, especially depression and its connection to discrimination and acculturative stress, are reported to have serious implications. Available literature indicates that KA experience high levels of depression, and yet many refrain from utilizing appropriate mental health services. Furthermore, literature with KA on this topic is limited. Aims of this study are to 1) examine the prevalence of depression; 2) examine predictors of depression; and 3) to explore whether ethnically dense neighborhood (EDN) would moderate the relationship between acculturative stress and depression and the relationship between discrimination and depression. Methods: The cross-sectional survey was conducted with 383 KA who were age 18 and older residing in New York State (NYS). A non-probability of convenience sampling method was used to recruit participants from various community settings including Korean ethnic religious institutions, Korean restaurants and retail stores. Depression was measured using a Korean version of the Center for Epidemiological Studies Depression Scale (CES-D-K). Discrimination and acculturative stress scales were adapted from the National Latino and Asian American Study (NLAAS). Acculturation was measured by the English fluency. EDN was measured using a single item question with four response categories. All scales except CES-D-K were translated into Korean and then back-translated to English. Data analysis included descriptive statistics and hierarchical multiple regression. Results: The prevalence of depression was 15.7% in this sample population. Hierarchical multiple regression analysis revealed that after controlling for socio-demographic and acculturation variables, discrimination (beta=.26, p<.01) and acculturative stress (beta =.26, p<.01) were significantly associated with depression. Also, English proficiency (beta =-.14, p<.05) was significantly and negatively related to depression. The interaction between acculturative stress and EDN were added to the final model, yielded a significant change R2, and was significant (beta=-.28, p<.05). In other words, for those who experienced higher acculturative stress, living in higher EDN was associated with lower depression compared to living in lower EDN. However, the interaction between discrimination and EDN was not significant. Conclusions and Implications: This study confirms that the prevalence of depression among KA is relatively higher than that of the general population (7.06%, Rakesh, Bailey, & Maletic, 2008). The findings highlight the need for an integrated and multilevel approach to prevention and potential interventions that address at the individual, local community, and the larger society in which KA are embedded. At the individual level, interventions can be designed around the development of coping strategies and empowerment to deal with discrimination and acculturative stress. At the macro level, programs that promote public acceptance of ethnic minority to reduce discrimination are needed. Furthermore, social programs that facilitate cultural and language development and help increase personal resources and social network is recommended.