Fang Gong

A life course perspective on migration and mental health among Asian immigrants: The role of human agency

The relationship between human agency and health is an important yet under-researched topic. This study uses a life course perspective to examine how human agency (measured by voluntariness, migratory reasons, and planning) and timing (measured by age at immigration) affect mental health outcomes among Asian immigrants in the United States. Data from the National Latino and Asian American Study showed that Asian immigrants (n=1491) with multiple strong reasons to migrate were less likely to suffer from mental health problems (i.e., psychological distress and psychiatric disorders in the past 12 months) than those without clear goals. Moreover, Asian immigrants with adequate migratory planning had lower levels of distress and lower rates of 12-month psychiatric disorders than those with poorly planned migration. Compared with migrants of the youngest age category (six or younger), those who migrated during preteen and adolescent years without clear goals had higher levels of psychological distress, and those who migrated during adulthood (25 years or older) were less likely to suffer from recent depressive disorders (with the exception of those migrating for life-improving goals). Furthermore, we found that well-planned migration lowered acculturative stress, and multiple strong reasons for migration buffered the negative effect of acculturative stress upon mental health. Findings from this study advance research on immigrant health from the life course perspective by highlighting the effects of exercising human agency during the pre-migration stage upon post-migration mental health.

Cultural Expressions of Distress

We test whether acculturation to American society is linked to higher depressive symptoms but lower neurasthenia symptoms. Depression and neurasthenia represent compelling contrasts since the first is a prevalent mental health problem in the United States and the latter is a common diagnostic entity in China. We also examine whether financial stress interacts with acculturation to explain depressive and neurasthenia symptoms. Data come from a community study conducted on Chinese Americans residing in the greater Los Angeles area (N = 1610). Analyses show a main effect between acculturation and depressive symptoms, but an interaction between financial stress and acculturation in explaining neurasthenia. The results argue for the inclusion of multiple indicators of mental health and cultural expressions of distress when investigating racial and ethnic minority groups.

Translating Questionnaire Items for a Multi-Lingual Worker Population: The Iterative Process of Translation and Cognitive Interviews With English-,Spanish-, and Chinese-Speaking Workers

BACKGROUND The increasing ethnic diversity of the US workforce has created a need for research tools that can be used with multi-lingual worker populations. Developing multi-language questionnaire items is a complex process; however, very little has been documented in the literature. METHODS Commonly used English items from the Job Content Questionnaire and Quality of Work Life Questionnaire were translated by two interdisciplinary bilingual teams and cognitively tested in interviews with English-, Spanish-, and Chinese-speaking workers. RESULTS Common problems across languages mainly concerned response format. Language-specific problems required more conceptual than literal translations. Some items were better understood by non-English speakers than by English speakers. De-centering (i.e., modifying the English original to correspond with translation) produced better understanding for one item. CONCLUSIONS Translating questionnaire items and achieving equivalence across languages require various kinds of expertise. Backward translation itself is not sufficient. More research efforts should be concentrated on qualitative approaches to developing useful research tools.

The Role for Community-Based Participatory Research in Formulating Policy Initiatives: Promoting Safety and Health for In-Home Care Workers and Their Consumers

Although community-based participatory research (CBPR) can be effective in influencing policy, the process of formulating policy initiatives through CBPR is understudied. We describe a case study to illustrate how alliances among various community partners could be united to formulate policy directions. In collaboration with partners, the National Institute for Occupational Safety and Health initiated a project aimed at improving health and safety for low-income elderly and disabled persons and their in-home care workers. Community partners and stakeholders participated in focus groups, stakeholder interviews, and meetings; they played multiple roles including identifying organizational policy changes the partners could initiate immediately, as well as broader public policy goals. Results indicated that a strong community partnership, participation, and shared values contributed to successful formulation of policy initiatives.

The NLAAS Story: Some Reflections, Some Insights A commentary prepared for the special issue of the Asian American Journal of Psychology.

The General Social Survey (GSS), a national survey that queries U.S. residents about their behaviors and attitudes on social issues, shows that many Americans do not have as much familiarity with Asian Americans as they do with other racial and ethnic groups (Gee, Ro, Shariff-Marco & Chae, 2009). Thirty-four percent of the GSS sample stated that they had less in common with Asian Americans compared to African Americans, Latinos, Whites, and Jews. African Americans received the next highest percentage (17%). When the question was reversed, “Which group do you have the most in common with?”, a small percentage of the GSS respondents cited Asian Americans (7.5%) and African Americans (7.7%). What accounts for this lack of connection with Asian Americans? There are several likely reasons, including past and current stereotypes of Asian Americans, the geographic and residential distribution of racial groups across the country, and the high proportion of immigrants among Asian Americans that make them seemingly dissimilar to U.S.-born residents. It is also likely that there is relatively limited scientific data available about Asian Americans which make it difficult to adequately inform the general public about Asian American experiences on a wide range of dimensions. It is within this context that the National Latino and Asian American Study (NLAAS) was conceived, designed, implemented, and analyzed. NLAAS is the first national epidemiological study of Asian Americans that used state-of-the-art sampling and survey design strategies, an interview guide that was translated into multiple languages and dialects, and includes data that can be compared across Black American, Latino and White samples see Pennel). Its findings have been disseminated to a broad range of public and scientific audiences and the data are still being analyzed. NLAAS has received special recognition for its contribution to the scientific enterprise and it became one of the most downloaded datasets when it became publically-available. We are gratified and honored that this special issue of the journal has focused on analyses derived from the NLAAS. This paper serves to provide some of the initial thinking behind NLAAS and discuss some of the themes that we find in the papers included in the two special issues.

Using the Associative Imagery Technique in Qualitative Health Research The Experiences of Homecare Workers and Consumers

The associative imagery technique is a qualitative tool with which researchers use carefully selected photographs or images to trigger participants’ responses to explain difficult behavioral and social concepts. In this article, we describe the development and implementation of the associative imagery method in focus groups to understand the complex relationships between homecare workers and their clients as part of a larger health and safety intervention project conducted by the National Institute for Occupational Safety and Health. A total of 116 homecare workers and clients were recruited for the study. We found that participants used images mainly in two ways. First, the images served to remind participants of specific persons, events, and/or objects. Second, the images facilitated recollections and reflections that allowed participants to metaphorically describe their experiences, feelings, and emotions. Both usages of imagery generated comments that answered the research question in a more relevant, descriptive, and vivid way.

The NLAAS story: Some reflections, some insights.

The General Social Survey (GSS), a national survey that queries U.S. residents about their behaviors and attitudes on social issues, shows that many Americans do not have as much familiarity with Asian Americans as they do with other racial and ethnic groups (Gee, Ro, Shariff-Marco & Chae, 2009). Thirty-four percent of the GSS sample stated that they had less in common with Asian Americans compared to African Americans, Latinos, Whites, and Jews. African Americans received the next highest percentage (17%). When the question was reversed, “Which group do you have the most in common with?”, a small percentage of the GSS respondents cited Asian Americans (7.5%) and African Americans (7.7%). What accounts for this lack of connection with Asian Americans? There are several likely reasons, including past and current stereotypes of Asian Americans, the geographic and residential distribution of racial groups across the country, and the high proportion of immigrants among Asian Americans that make them seemingly dissimilar to U.S.-born residents. It is also likely that there is relatively limited scientific data available about Asian Americans which make it difficult to adequately inform the general public about Asian American experiences on a wide range of dimensions. It is within this context that the National Latino and Asian American Study (NLAAS) was conceived, designed, implemented, and analyzed. NLAAS is the first national epidemiological study of Asian Americans that used state-of-the-art sampling and survey design strategies, an interview guide that was translated into multiple languages and dialects, and includes data that can be compared across Black American, Latino and White samples see Pennel). Its findings have been disseminated to a broad range of public and scientific audiences and the data are still being analyzed. NLAAS has received special recognition for its contribution to the scientific enterprise and it became one of the most downloaded datasets when it became publically-available. We are gratified and honored that this special issue of the journal has focused on analyses derived from the NLAAS. This paper serves to provide some of the initial thinking behind NLAAS and discuss some of the themes that we find in the papers included in the two special issues.

Ethnicity and Health

With the rapid growth of the Asian American population and its diverse ethnic composition, it is both surprising and problematic that the quality of health within Asian American communities is not better understood. This chapter reviews existing literature and highlights the relationship between ethnicity and health among Asian Americans. After presenting terms and theoretical perspectives, we review current literature and explore national data to describe patterns of physical and mental health among Asian ethnic groups. Finally, we conclude the chapter with recommendations for future directions on ethnicity and health among Asian Americans.

Racial and Ethnic Differences in Perceptions of Everyday Discrimination

This study examines differences in perceptions of discrimination across multiple racial and ethnic minority groups. We focus on structural factors such as race/ethnicity and socioeconomic status (SES) and psychosocial factors such as racial/ethnic identities as predictors of perceived everyday discrimination. Data come from the Collaborative Psychiatric Epidemiology Surveys (CPES), and analyses reveal several important patterns. First, perceived everyday discrimination is highly prevalent among racial/ethnic minorities in the United States and these perceptions largely reflect existing racial/ethnic hierarchies: African Americans and Afro-Caribbeans report the highest level of discrimination, whereas most Asian and Latino groups report less. Second, education, income, and immigration-related factors such as duration of residence and English language proficiency are positively associated with perceived discrimination. Third, the effects of racial/ethnic identity on perceived discrimination vary across ethnic groups, showing stronger associations among Afro-Caribbeans than among other racial and ethnic minorities. Findings from this study help to advance our theoretical understanding and empirical knowledge of racial/ethnic stratification and perceived discrimination in the United States.