Race, Ethnicity, and Birth Place As Predictors of Well-Being Among Older Adults

Background and Purpose

Despite the projected increase in the diversity and number of foreign-born older adults, from 4.6 million in 2010 to more than 16 million by 2050 , research on foreign-born older adults has been limited. In particular, less is known about how stressors are associated with both physical and psychological well being among foreign-born older adults. Simultaneously, more than a quarter of the older adult population in the U.S. is projected to be of ethnic or racial minority status by the year 2030. However, little is known about the ways in which immigrant status and race/ethnicity are associated with well being among foreign-born older adults.  Guided by the Transactional Model of Stress and Coping framework, our aims in this study were to investigate: 1) similarities and differences in demographic characteristics, stressors, resources, and outcomes among older adults foreign-born older adults compared to U.S.-born older adults; 2) whether birth place, race/ethnicity, and interactions between them influence psychological well-being and self-rated health; and, 3) whether stressors (functional ability, dementia classification), internal resources (self-efficacy/mastery, self-determination, sense of community), external resources(financial support from family, number of people in social network) explains any observed differences in psychological well-being and self-rated health. We hypothesized that birthplace and minority race/ethnicity (Black and Hispanic) will moderate the associations among stressors, resources, and outcomes. 

Methods

We used the wave one (2011) of the National Health and Aging Trends Study (NHATS). , a nationally representative study of 8245 Medicare beneficiaries 65 years and older.  We excluded nursing home residents and those who did not complete data on birth place (foreign born or U.S. born). Finally, we included 5411 older adults in our analyses (U.S.-born= 4799, foreign-born=612). We used two-tailed independent t-tests and chi-square tests to assess whether U.S.-born and foreign-born older adults reported different results with respect to sociodemographic and other variables (Aim 1). We used ordinal regression analyses to investigate the roles of birthplace and race/ethnicity and other factors associated with psychological well being and self-rated health (Aim 2 and Aim 3). 

Results

Our results indicate that compared to their U.S.-born counterparts, foreign-born older adults reported higher level of functional abilities and better self-rated physical health but a lower levels of self-efficacy, sense of community, and psychosocial well-being. The results also show that minority foreign-born elders, especially Hispanic older adults, were more likely to report more psychological distress and physical health than US born Hispanics.

Conclusion and Implications

Foreign-born older adults may have better physical conditions, but possible stress caused by adjusting to a new culture and new system, together with fewer resources, may reduce their psychosocial well-being. Given the interrelationship between physical health and psychological well-being, practitioners, community and government should take this into consideration and pay attention to the emotional concerns of foreign-born older adults to prevent any deterioration in overall quality of life.