Depressive Symptoms and Associated Factors in Older Chinese Americans: A Comparison Between Community-Dwelling and Subsidized Housing Residents

Background and Purpose: About 80% of the older Chinese population in the U.S. was foreign-born and one third immigrated to the U.S. after the age of 60.  Their assimilation to American culture might influence their experience of mental health problems including depression. In addition, their socioeconomic status (SES), health status and access to social support may also affect their emotional state. This study compared depressive symptoms in community-dwelling Chinese American elders to their counterparts in subsidized housing facilities in a southwest metropolitan area, and examined risk and protective factors in demographics (e.g., gender, SES),  health (e.g., self-rated health, physical functioning), social support (e.g., family cohesion, family support network size) and cultural aspects (e.g., acculturation).

Method: Survey data among 385 Chinese American adults aged 55 or older living in the Phoenix metropolitan area were collected through face-to-face interviews in 2012. Participants were recruited from four Chinese subsidized housing facilities, the Phoenix Chinese Senior Center, local Chinese churches, and the Chinese community and self-referrals. At the time of interview, 207 (Mage =75.3, SD =7.5) lived in subsidized housing facilities; 178 (Mage = 69, SD=8.7) resided in the community. Depressive symptoms were assessed using the 12-item Center for Epidemiologic Studies Depression Scale.  

Results: Not surprisingly, those living in subsidized housing facilities reported less formal education and lower income, poor self-rated health, lower acculturation scores, and smaller family supportive network than their community-dwelling counterparts. But no significant group differences in depressive symptoms were found. Regression analyses were conducted separately for each group, finding that higher education, better self-rated health, higher levels of family cohesion, and larger friend network size were related to fewer depressive symptoms for both groups. The effect of acculturation was minimal and only significant at the bivariate level for the community-dwelling group, not for the subsidized housing group. Family support network size had an influence on depressive symptoms at .10 level for community-dwelling participants, while family conflict had an effect on depressive symptoms at .10 level for those living in subsidized housing facilities. In addition, older women in subsidized housing facilities reported more depressive symptoms than older men; but that gender difference was not found in the community-dwelling group.

Conclusions and Implications: Despite their disadvantages in SES, acculturation levels, and family support network size, those living in subsidized housing facilities were not necessarily more depressed than their community counterparts. Most factors such as education, perceptions of family cohesion, and the size of friend support network played a consistently positive role for older Chinese Americans regardless of their residency. The limited effect of acculturation on depressive symptoms in this population might warrant future exploration. Caseworkers in the community should not assume the relatively larger family support network size reported by community-welling Chinese American elders is sufficient nor stable therefore ignore the need to  sustain such support. Caseworkers in subsidized housing facilities might focus less on acculturation promotion (e.g., English classes) but more on creative interventions to build friend network for residents, particularly for older women.