Risk Factors of Depressive Symptoms Among Korean Immigrant Elders: A Comparison Between Canada and the U.S

Background and Purpose: Current literature indicates that immigrant elders experience acculturative stress and are at risk for depression. However, acculturative stressors may not affect depression of immigrant elders of the same ethnic group uniformly. Immigrant elders develop depression in response to different migration environments. The purpose of this study was to examine and compare factors that influence the level of depressive symptoms among Korean immigrant elders who migrated to two distinct sociocultural environments, i.e., Maricopa and Pima Counties in Arizona, U.S., where the Korean population is small and dispersed, and Toronto, Canada, where the Korean ethnic community is well-developed and the population is large in numbers. Also, two countries have different welfare service systems.

Methods: A total of 245 participants ages 65 or older (mean age: 73.5, SD=6.67) from Arizona (n=117) and Toronto (n=128) was used for this analysis. Before the two datasets were merged for comparison, both authors, who are fluent in the Korean language, independently examined all questions for linguistic equivalence in Korean and created a combined list of variables and attributes. We compared the effects of sociocultural factors on Korean elderly respondents living in Arizona and Canada. Regression analyses on the Geriatric Depression Scale Short Form (GDS-SF) were performed. The outcome variable was depression as measured by the Geriatric Depression Scale – Short Form (GDS-SF) (Almeida & Almeida, 1999). Predictor variables were age, gender, marital status, education level, years since immigration, English language proficiency, number of visits to doctors, exercise, self-rated health status, and number of health conditions.

Results: The two groups were similar in demographic characteristics, including gender composition, marital status, educational level, and the level of depression. Regression analyses revealed that years of immigration (b=.270, p < .05) and English proficiency (b=-.344, p < .01) were associated with depression among Korean immigrant elders in Arizona, but were not significant among those in Toronto. The number of health concerns was positively associated with depression in Arizona (b=.317, p <. 01) but not significant in Toronto.

Conclusions and Implications: The results highlight the importance of the sociocultural environmental context of immigration in depression among Korean immigrant elders. The different capacity level of ethnic communities may have played a role in the differential development of depression. In Arizona, acculturation is a necessary condition for a less stressful life for Korean immigrant elders, whereas Korean immigrant elders in Toronto may not need good language skills because services are provided in their language and accessible through public transportation. Also, discrepancies in service conditions for immigrants may have influenced the differential effect of health conditions on depression, such as availability of culturally responsive services. In general, social workers should be aware of diversity within an ethnic group, taking into account the critical role of the sociocultural environment in which immigrant elders are living. At the policy level, we need to create culturally responsive services by actively recruiting and retaining bilingual/bicultural social workers and clinicians from diverse backgrounds to help immigrant elders who have low levels of linguistic acculturation.