Experiences of Cultural Stress Among US Citizen Migrants: A Mixed Method Approach

Background and Purpose: Hurricane Maria was one of the worst hurricanes in United States (U.S.) history, and its devastating effects were similar to those caused by Hurricane Katrina. Although both storms led to mass outmigration, Maria is unique among U.S. hurricanes in that it displaced residents to linguistically/culturally dissimilar areas where they faced manifold challenges in communicating with their new neighbors, prospective employers, and others in their destination communities. Indeed, although Puerto Ricans are U.S. citizens at birth, the island maintains a distinct language and culture from that of the mainland. As a result, Puerto Ricans migrating to the mainland may experience cultural stressors similar to immigrants from Latin American countries. Guided by a cultural stress theory framework, the present mixed method study examined how various cultural stressors manifest in the lives of US citizen migrants and how they relate to participants’ daily interactions and mental health.

Methods: A total of 319 adult Hurricane Maria survivors (71% women; mean age 38.7) residing on the U.S. mainland participated in the study. Most participants arrived on the mainland in 2017 (60.2%) or 2018 (29.6%). A mixed method sequential explanatory design was used. First, we used latent profile analysis (LPA) and multinomial logistic regression to identify the varied cultural stress experiences that participants had. Then we used data from semi-structured interviews to better understand the experiences of participants classified into the profiles identified by LPA.

Results: Four profiles were identified: “Moderate Cultural Stress” (35%); “Overall Low” (29%); “High Cultural Stress” (26%); and “Low Language Stress” (10%). Multinomial regression indicated that members of the “Overall Low” profile reported significantly fewer depressive and anxiety symptoms compared all other profiles. The qualitative excerpts we included serve to confirm and expand upon the profile solution extracted in the quantitative analyses. For example, individuals in the High Cultural Stress profile reported conflictual interactions with monolingual English speakers and perceived that they were not wanted on the U.S. mainland. Respondents in the Overall Low profile were proficient in English and familiar with U.S. culture, and they experienced few or no culturally-related difficulties upon arriving on the mainland. Individuals in the Low Language Stress profile knew some English prior to moving to the U.S. mainland, and described an adjustment process that was less stressful compared other groups in the sample.

Conclusions and Implications: The present results strengthen cultural stress theory by suggesting that participants’ own words and statements exemplify the component stressors included within the theory. Clinicians and providers working with Hurricane Maria survivors should be cognizant and inquire about migration-related cultural stressors including discrimination, feelings of being unwelcomed, and difficulty communicating in the dominant destination cultural language. Further, it is critical for mental health professionals, as well as community leaders, to move beyond the one-to-one clinical relationship and address meso- and macro-level factors that contribute to cultural stress. It would be beneficial for clinicians to develop innovative and wholistic treatment plans when working with migrant populations, to include services that could help address experiences of cultural stress.