Emily S. Ihara

Change in Self-Reported Health Status among Immigrants in the United States: Associations with Measures of Acculturation

Although acculturation may have positive effects for immigrants, including better socioeconomic profiles and increased occupational opportunities, their health profiles deteriorate with longer duration in the U.S. Prior research indicates that increasing acculturation is associated with some poorer health outcomes among immigrants in the U.S. However, most of these studies have used length of stay or English language proficiency as proxies for acculturation, and have mainly examined self-reported “current” health outcomes. This study advances knowledge on associations between acculturation and health among immigrants by explicitly examining self-reported “change” in health since immigration, in relation to acculturation-related variables. We use data from the New Immigrant Survey (NIS; 2003-2004), a cross-sectional study of legal immigrants to the U.S. In addition to testing more conventionally examined proxies of acculturation (length of stay and English proficiency), we also examine English language use and self-reported change in diet. Multivariable logistic regression analyses on 5,982 participants generally supported previous literature indicating a deleterious impact of acculturation, with increasing duration of stay and greater self-reported change in diet being associated with a poorer change in health since moving to the U.S. Although English language proficiency and use were associated with greater odds of reporting a worse change in health when examined individually, they were non-significant in multivariable models including all acculturation measures. Findings from this study suggest that when taking into account multiple measures of acculturation, language may not necessarily indicate unhealthy assimilation and dietary change may be a pathway leading to declines in immigrant health. Increasing duration in the U.S. may also reflect the adoption of unhealthy behaviors, as well as greater exposure to harmful sources of psychosocial stress including racial and anti-immigrant discrimination. Our study suggests that multiple indicators of acculturation may be useful in examining the effect of acculturation on changes in health among immigrants.

“They Treat us Like Pests:” Undocumented Immigrant Experiences Obtaining Health Care in the Wake of a “Crackdown” Ordinance

This article presents findings from a qualitative study of Latino immigrant experiences seeking health care services in the wake of an anti-immigrant “crackdown” ordinance similar to Arizonas SB 1070. Prince William County, Virginias 2007 “Rule of Law” ordinance escalated law enforcement efforts that targeted this population for deportation and ordered staff to ensure that no one receive social services other than those required by federal law. This article sought to answer the questions: (1) Were undocumented immigrants able to obtain health care? (2) How do immigrants characterize their experiences with health providers? Data were gathered via semi-structured interviews (n = 57) with Latinos in a low-income neighborhood. Analysis of Spanish-language narratives found that many were dissuaded from seeking care because of high costs as well as lack of familiarity with the health care system. Others perceived that they were treated with insensitivity or outright hostility—and believed this treatment was a deliberate effort to discourage them from seeking help.

“Maintaining Connections but Wanting More”: The Continuity of Familial Relationships Among Assisted-Living Residents

Social support is a key component of well-being for older adults, particularly for those who have moved from independent living to assisted living involving a transformation of roles, relationships, and responsibilities. Twenty-nine assisted-living facility residents were interviewed to understand the perceived continuity of relationships with family and friends. An inductive approach to thematic analysis revealed 1 main theme and 3 subthemes. The main theme that emerged was: maintaining connections but wanting more. Residents appreciated maintaining connections with family and friends, but often expressed feelings of discontentment with the continuity of former relationships. The subthemes included: appreciating family and friends, waiting for more, and losing control. Implications for research and practice are discussed.

Correlates of Mental Health Service Use and Type Among Asian Americans

This study uses data from the National Latino and Asian American Study to investigate correlates of mental health service use among Asian Americans with mental health needs. Our study contributes to the extant literature by: (1) differentiating between mental health service use types; and (2) examining a broader swatch of Asian Americans with mental health needs, ranging from mild to severe cases. Multinomial logistic regression analyses revealed heterogeneity in service use patterns by ethnicity, age, marital status, English proficiency, and generation status. Unmet mental health needs continue to be a problem despite treatments that could improve the quality of life of Asian Americans. Our study provides a more nuanced understanding of mental health service utilization patterns in this understudied population.

Research With Indigenous Cultures: A Case Study Analysis of Tongan Grandparents (Research Note)

This article discusses lessons learned about designing culturally informed and respectful research with indigenous peoples through the analysis of a case example, Tongan grandparents. These lessons have implications for educating ethical social work students and better informing the work of educators, researchers, and practitioners. Research issues with indigenous peoples include the need for inclusion of research team members from the culture in study and an understanding of cultural protocols and expectations. Framing this article is the work of Linda Tuhiwai Smith and guidelines from prominent research and assessment organizations that address multicultural issues in relation to research with indigenous cultures, ethical responsibilities to marginalized populations, and protection of basic human rights. Exploration, analysis, discussion, and generation of implications for education, future research, and practice are shared.

Culture and Familism: An Exploratory Case Study of a Grandparent-Headed Household

Increasingly, grandparents provide primary care for their grandchildren, but minimal research exists focusing on Asian and Pacific American grandparent caregivers. Using the conceptual framework of familism, this case study explores the context of a Korean American, interracial, two-grandparent household (age 72 and 73) raising their 12-year-old grandson. The interview of this family was analyzed using coding, memoing, and comparative analysis techniques often used in case study analysis. Three themes related to familism emerged: staying connected, maintaining cultures, and clashing cultures. Inclusion of these concepts may be appropriate for service providers in assessing grandparent-headed families and identifying cultural strengths and appropriate interventions.

Exploring the Socioeconomic and Immigration Health Contexts of Asian Americans

Despite an overall picture of good health for Asian Americans in the aggregate, growing evidence shows that specific subgroups—particularly those with high proportions of immigrants—have diverse patterns relative to socioeconomic position and health. Using data from the largest U.S. state health survey, this study explores the contributions of socioeconomic and immigration factors to health status among Asian American subgroups. Results indicate that level of education, income, and English language ability were significant predictors of health status for the Chinese, Korean, and Vietnamese subgroups. Varying patterns in the results by subgroup are discussed in the context of immigration policy.

Grandchildren Caring for Grandparents: Modeling the Complexity of Family Caregiving

ABSTRACT This study focuses on grandchildren (Generation 3 or G3) caring for grandparents (Generation 1 or G1) and uses agent-based modeling to conceptualize and test a model of two factors—capability and motivation—that may affect a G3s decision to provide care for a G1. We tested our conceptual model and found that the simulated proportion of G3 caregivers has concurrent validity with existing empirical data. In experiments conducted with the validated model, we investigated universal- and targeted-policy changes (tax credit for caregivers) and found that although the universal-policy change increased G3 caregiving overall, a policy change targeting low- and middle-income caregivers was even more successful.

Social Work Faculty Interest in Aging: Impact of Education, Knowledge, Comfort, and Experience

As the need for gerontological social workers increases, it is important to assess faculty interest in strengthening and bolstering this area in the classroom and curriculum. This study sought to compare training and experience of social work faculty that identified aging as a teaching or research interest with faculty who did not, and to identify predictors of aging interest among faculty. A national sample of social work faculty members was recruited, and a total of 609 individuals participated in the study. The findings reveal that faculty with an interest in aging differed from nonaging faculty in the areas of knowledge of older adults, personal and paid experience, and graduate and continuing education. In addition, predictors of interest in aging included taking a graduate course, continuing education units, having paid and volunteer experience, level of knowledge of older adults, and comfort level of covering content on aging in the classroom. The connection between social work faculty and student interest in aging are discussed as implications for further social work research and education.

Quality of life and life skill baseline measures of urban adolescents with disabilities.

Many gaps exist in the understanding of how adolescents with disabilities successfully transition to adulthood and the services contributing to this success. This study attempts to fill one gap by establishing quality of life baseline measures for low-income urban adolescents. We compared baseline data for a representative sample of adolescents with disabilities in the District of Columbia to national norms using three instruments—the Pediatric Quality of Life Inventory 4.0, the Ansell-Casey Life Skills Assessment, and the Career Maturity Inventory-Attitude Scale. The sample for this study was primarily African American and had a higher level of disability as measured by receipt of Supplemental Security Income (SSI). The baseline scores of the adolescents in DC may be lower than the normed scores of their peers with disabilities in the U.S. because of socioeconomic and racial inequities and because the population has to contend with greater levels of disabilities.