Receipt of Social Support and Mental Health in Older Vietnamese Immigrants: Results from the Vietnamese Aging and Care Survey (VACS)

Background and Purpose. After Vietnam War, since 1975, waves of Vietnamese immigrants and refugees migrated to the United States (U.S.) accounting for over 1.3 million. Having been exposed to war-time physical and emotional violence, as well as their traumatic escape and relocation to U.S. cities, Vietnamese older adults are vulnerable. Vietnamese are the fourth largest Asian-origin subgroup and one of the fastest-growing immigrant populations in the U.S. Despite this high risk and a large number, however, health research on this population is limited. Those who arrived 45 years ago have aged and need care for their health. They have been subject to significant trauma, but the impact of those experiences on their lives is unknown. To fill this gap, we developed the Vietnamese Aging and Care Survey and collected health data on older Vietnamese immigrants (≥65 years) in Houston, Texas (N=132), where Vietnamese are the largest Asian-origin subgroup. The purpose of this study was to examine the health of this understudied population and how receipt of social support is associated with their mental health (depressive symptoms and loneliness).

Methods. Depressive symptoms and loneliness were measured by the 20-item Center for Epidemiologic Studies Depression Scale and the UCLA 3-item Loneliness Scale, respectively. Receipt of social support was assessed using the 19-item Medical Outcomes Study Social Support Survey. Descriptive statistics were used to summarize the participants’ sociodemographic characteristics. Logistic regression models were used to examine if receipt of social support was associated with depressive symptoms and loneliness after adjusting for covariates.

Results. Older Vietnamese immigrants were on average 75.4 years old with less than a high school education (86%) and belong to low socioeconomic status (≤$25K, 94%). Most self-rated their health as fair or poor (76%). They live with family members, surrounding themselves within tightly-knit ethnic enclaves, and the level of social support was high (21.6 out of 27). Findings suggest that the number of physical disabilities appears to have strong associations with their mental health: the more they have physical disabilities, they felt more depressed (OR=1.30, 95%CI: 1.09, 1.55) or lonely (OR=1.36, 95%CI: 1.07, 1.74). But social support was found to be associated with loneliness only. Increased social support was associated with being less lonely (OR=0.90, 95%CI: 0.84, 0.98).

Conclusions and Implications. Older Vietnamese immigrants try to manage their lives by living in multi-generational households, cared for by family members, and show resilience to their low socioeconomic status. Leveraging their family unit as strength, healthcare professionals can facilitate access to healthcare services to benefit Vietnamese older adults’ physical health so that they can maintain their physical skills that benefit their mental health. Simultaneously, the service providers should consider and meet the expectations of Vietnamese older adults and their families by providing culturally and linguistically appropriate services. The physical and mental benefits of ethnically specific adult day centers have been cited for different ethnic groups across the nation. Utilizing these existing social and health services may result in older Vietnamese immigrants maintaining their physical health while being socially supported by their families.