A Systematic Review of Acculturative Stress Among Latino Immigrants: Risk and Protectors

Purpose:By 2050 Latinos are estimated to comprise 29% of the total U.S. population. Research on immigrant Latinos has reflected this increase, with most studies focusing on the impact of acculturation, the process of change in cultural attitudes and behaviors as a result of the encounter between two cultures. Research shows an inconsistent relationship between acculturation and mental health. An attempt to explain this inconsistency has led to the consideration of the acculturative stress - the stress related to the struggle to reconcile native and host cultures. Despite the evidence that acculturative stress mediates the relationship between acculturation and mental health, and that in most cases it significantly predicts poor mental health, acculturative stress-related literature is scarce and scattered across disciplines. With this systematic review of the literature, we enhance the evidence base for social work practice and inform social workers of (a) the relationship between acculturation, acculturative stress and mental health, and (b) risks for and protectors from acculturative stress among Latino immigrants.

Methods:Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), this review synthesizes the results of 31 quantitative articles. Published from 2004 to 2014, these studies investigated the relationship between acculturative stress and mental health, and identified contextual factors influencing acculturative stress among Latino immigrants. We searched MEDLINE, PyscINFO, Social Service Abstracts, Annual Review of Psychology, Social Work Abstracts, SocINDEX, JSTOR and Proquest, using keywords such as acculturation/acculturative stress, Latino and existing acculturative stress measures. Two authors reviewed the resulting 1,174 abstracts. Initially we excluded 1,066irrelevant articles targeting Latino students, physical health, and Latinos outside of U.S. Upon full review, we further excluded 17 qualitative studies, 1 Meta-analysis, 3 conceptual papers, 1 conceptual conference poster and 51 articles on U.S. born Latinos, adolescents, incarcerated population, refugees and seasonal immigrants.

Results: Protectors from acculturative stress included social support (identified by 12.9% of articles reviewed), family support (identified by 19.4%), religious participation (identified by 9.7%), English skills (identified by 12.9%), having a choice in decision to migrate (identified by 3.2%), and self-esteem (identified by 3.4%). The risks for acculturative stress included increase in age (identified by 12.9% of articles reviewed), discrimination (identified by 9.7%), low income (identified by 9.7%) and fear of deportation (identified by 3.2%). The relationship between U.S. length of time, income, and gender with acculturative stress was contingent on the type of Latino subgroup studied. Moreover, when significantly predicting mental health, acculturative stress demonstrated a weaker coefficient compared to discrimination, low income, and fear of deportation.

Implications: The results emphasize a contextual approach to effective, culturally sensitive interventions with Latino immigrants in the U.S. To support Latino immigrant clients in achieving a less stressful integration experience, social workers should acknowledge discrimination experience and highlight social support and family dynamics in service plans, especially when working with elderly Latinos. Advocacy efforts endorsing anti-discrimination laws and policies and skill enhancement should be supported. Future research should acknowledge socio-economic and cultural heterogeneity among Latinos by investigating risks for and protectors from acculturative stress among Latino subgroups.