Health Status Among Korean Immigrant Elders: Role of Limited English Proficiency

Purpose:

Many previous studies have identified acculturation and socioeconomic factors influencing the psychological well-being of Korean immigrant elders (Lee & Hwang, 2014; Woo, Lee, & Hong, 2014).  However, little is known about the role of limited English proficiency (LEP) on health status (physical functioning, social functioning, general mental health, and vitality) as well as moderating factors in the relationship between them.  Thus, the purpose of this study was to explore these topics. 

Methods:

This cross-sectional survey used a purposive sampling method to recruit 206 Korean immigrant elders 65 years old or over living in Los Angeles and Orange counties in California.  From June 2008 to June 2009, face-to-face interviews lasting 40 to 50 minutes were conducted in Korean.  To measure health status, the dependent variable,, this study used the Short Form 36 health survey questionnaire (Jenkinson, Coulter, & Wright, 1993).  For independent variables, this study included LEP, education, lack of driving capability, length of residency in the US, living alone, and social support.  To measure social support, this study used the Multidimensional Scale of Perceived Social Support (MSPSS) (Zimet, Davlem, Zimet, & Farley, 1988).  Respondents ranged in age from 65 to 96, with a mean of 76.3 years; more than 71 percent were female and 47.8 percent were married or remarried.    

Results:

Hierarchical regression results showed that a high level of LEP was significantly related to lower levels of social functioning (B = −.159, p ≤ .01), general mental health (B = −.223, p ≤ .01), and vitality (B = −.205, p ≤ .01). High level of education was significantly related to higher levels of social functioning (B = .184, p ≤ .05) and vitality (B = .221, p ≤ .01). Lack of driving capability was significantly related to lower levels of physical functioning (B = −.184, p ≤ .05) and social functioning (B = −.165, p ≤ .05). Longer length of residency in the US was significantly related to lower levels of physical functioning (B = −.132, p ≤ .05), social functioning (B = −.160, p ≤ .05), and vitality (B = −.219, p ≤ .001).  Education changed direction from negative relationship between LEP and physical functioning to positive relationship (B = .126, p ≤ .05).  Length of residency in the US changed directions from both negative relationships between LEP and physical functioning (B = .127, p ≤ .05) and between LEP and general mental health (B = .237, p ≤ .001) to positive relationships.  Living alone significantly moderated the relationship between LEP and general mental health, but did not change direction or strengthen the relationship between LEP and general mental health (B = −.202, p ≤ .01). Social support weakens the relationship between LEP and vitality (B = −.137, p ≤ .05).   

Implications for Policy and Practice:

Many Korean immigrant elders do not have adequate English ability, which severely inhibits the life of older adults.  Community service programs such as senior centers and adult schools need to provide special educational services for immigrant elders to learn English.