Stress and Mental Health: Testing Social Support Deterioration Model Using Chinese and Korean Immigrant Elders

Objectives: Asian immigrant elders face unique challenges in reconstituting their social lives after migrating to the United States. The Asian American Federation (2003, February) has reported that Asian immigrant elders in New York City were more likely to be depressed than the elderly population overall. The same report highlighted additional psychosocial stressors closely associated with their worsening mental health status. There are a number of instances where stress may directly affect psychosocial resources. One theory that explicates this relationship is the social support deterioration model (SSDM; Barrera, 2000). The SSDM posits that acute and overwhelming stressors can lead to a reduction in psychosocial resources, which in turn diminishes their supportive influence on mental health outcomes. Using the SSDM, the present study examined the roles of informal psychosocial resources in the relationship between stress and mental health among Asian immigrant elders.

Method: This study tested the SSDM with a convenience sample of Chinese (n=120) and Korean (n=118) immigrant elders living in a Southwestern state. We examined the mediating effects of two psychosocial resources (religious participation and assistance from children) in the relationship between three types of stressors (stressful life events, medical conditions, and limited English proficiency) and mental health outcome, assessed using the Mental Health subscale from the SF-36, version 1 (Ware, 1993). We conducted multiple mediator analyses to examine how psychosocial resources (religious participation and assistance from children) mediated the relationships between three stressors and mental health outcomes. Four control variables (sex, age, length of U.S. residency, and Medicaid eligibility) were included to control for sociodemographic backgrounds.

Results: The multiple mediator analyses partially supported the SSDM. Results showed that two indirect paths were significant for the Korean subgroup: the relationship between medical conditions and mental health status (B = -.044, [-.111, -.008]), and the relationship between limited English proficiency and mental health status (B = -.051, [-.135, -.006]) were both mediated through assistance from children. In other words, assistance from children significantly mediated the relationship between the number of medical conditions and limited English proficiency, and mental health status among older Korean-immigrant adults. For the Chinese subgroup, only one indirect path was significant: the relationship between limited English proficiency and mental health status was mediated through religious participation (B = -.044, [-.125, -.002]). That is, religious participation significantly mediated the relationship between limited English proficiency and mental health outcomes among older Chinese-immigrant adults.

Conclusion: Results highlighted the fact that the level of psychosocial resources is closely related to the levels of various stressors experienced by Asian immigrant elders in this study. In addition to testing the SSDM theory, the results also highlighted the importance of ethnic background in predicting which mediators explain how stress impacts mental health among the older Chinese and Korean immigrants in this study. The differential outcomes based on ethnic differences suggest that family, ethnocultural, and immigration experiences should be considered when health care providers develop intervention plans.