Yuri Jang

Depressive Symptoms in Four Racial and Ethnic Groups The Survey of Older Floridians (SOF)

Responding to the need for research on the mental health of minority elders, the present study explored determinants of depressive symptoms using a statewide sample of African Americans, Cubans, non-Cuban Hispanics, and Whites from the Survey of Older Floridians. The investigators focused on direct and interactive effects of demographic variables and stressful life conditions (chronic health conditions, functional disability, and negative life events) on depressive symptoms. A hierarchical regression model showed that lower income, more chronic health conditions, greater disability, and more life events were common risk factors for depressive symptoms across all groups. The impacts of age and education were found to be group specific. Significant interactions were also obtained among predictor variables in each group, identifying risk-reducing and risk-enhancing factors within each group. The findings on race-specific risk factors and within-group variability should be taken into consideration when developing and implementing services for diverse older populations.

The Mediating Role of Loneliness in the Relation Between Social Engagement and Depressive Symptoms Among Older Korean Americans: Do Men and Women Differ?

OBJECTIVES This study conceptualized loneliness as a mediator in the relation between social engagement and depressive symptoms and explored gender differences in the mediation model. Various indices of social engagement were considered including living arrangement, social network, and activity participation. METHOD Using data from 674 community-dwelling Korean American older adults, we first examined the mediation effect of loneliness in the relation between each of 3 indices of social engagement (not living alone, social network, and activity participation) and depressive symptoms. Subsequently, gender differences in the mediation model were examined. RESULTS As hypothesized, loneliness was found to mediate the relation between each of the indices of social engagement and depressive symptoms in both men and women. We also observed gender differences in the strength of mediating effects; the effect of living alone was more likely to be mediated by loneliness among men, whereas women showed greater levels of mediation in the models with social network and activity participation. DISCUSSION Our findings suggest that loneliness may explain the mechanism by which deficits in social engagement exerts its effect on depressive symptoms and that gender differences should be considered in interventions targeting social engagement for mental health promotion.

An Empirical Typology of Social Networks and Its Association With Physical and Mental Health: A Study With Older Korean Immigrants

OBJECTIVES In the context of social convoy theory, the purposes of the study were (a) to identify an empirical typology of the social networks evident in older Korean immigrants and (b) to examine its association with self-rated health and depressive symptoms. METHOD The sample consisted of 1,092 community-dwelling older Korean immigrants in Florida and New York. Latent class analyses were conducted to identify the optimal social network typology based on 8 indicators of interpersonal relationships and activities. Bivariate and multivariate analyses were conducted to examine how the identified social network typology was associated with self-rating of health and depressive symptoms. RESULTS Results from the latent class analysis identified 6 clusters as being most optimal, and they were named diverse, unmarried/diverse, married/coresidence, family focused, unmarried/restricted, and restricted. Memberships in the clusters of diverse and married/coresidence were significantly associated with more favorable ratings of health and lower levels of depressive symptoms. DISCUSSION Notably, no distinct network solely composed of friends was identified in the present sample of older immigrants; this may reflect the disruptions in social convoys caused by immigration. The findings of this study promote our understanding of the unique patterns of social connectedness in older immigrants.

Social Activity and Depressive Symptoms in Korean American Older Adults: The Conditioning Role of Acculturation

Objective: This study examined the independent and interactive effects of acculturation and social activity on depressive symptoms. Method: Using a sample of community-dwelling Korean American older adults (N = 675), hierarchical regression models of depressive symptoms were estimated with an array of predictors: (a) demographic variables, (b) health-related variables, (c) acculturation, (d) social activity, and (e) an interaction between acculturation and social activity. Results: After controlling for the effects of demographic and health-related variables, both acculturation and social activity were identified as significant predictors. Moreover, their interaction was significant (β = .09, p < .05). Further analysis showed that the beneficial effect of social activity on mental health was particularly strong among those with lower levels of acculturation. Discussion: Our findings suggest that enhancing opportunities for social engagement may serve to protect and promote the mental health of vulnerable older immigrants, particularly those who are less acculturated.

Acculturation and Its Effect on Depressive Symptom Structure in a Sample of Mexican American Elders.

In this study, we compared the depressive symptoms reported by Mexican American elders who scored higher and lower on a linguistic acculturation scale. Prevalence, equality of covariance matrices, equality of error variances, and factor structures were examined for the 20 items included in the Center for Epidemiologic Studies Depression (CES-D) Scale. The sample consisted of 3,050 community-dwelling Mexican Americans from five states. Significant differences were found on all parameters, indicating that level of acculturation is associated with pervasive differences in the way items are endorsed on the most commonly used inventory of depressive symptoms. Results add to literature suggesting that there may not be a universal structure to symptoms. Higher or lower scores may have different implications for people representing different cultures and/or stages of acculturation, something that both researchers and clinicians should be sensitive to when interpreting results of screening tests.

Bridging the Gap between Common Mental Disorders and Service Use: The Role of Self-Rated Mental Health among African Americans

OBJECTIVE The unmet need for mental health care in racial/ethnic minorities has been a major public health concern. Using a sample of African Americans, this study questioned whether self-rated mental health (SRMH), an individuals subjective assessment of personal mental and emotional status, modifies the link between mental disorders and service use. DESIGN Cross-sectional analyses of the Milwaukee African American oversample of the Midlife Development in the United States (MIDUS II) study, 2005-2006. SETTING In-home personal interviews. PARTICIPANTS Self-identified African American/black participants aged 40 to 85 years (N = 460). MEASUREMENTS Participants were assessed if they met the diagnostic criteria for three common mental disorders (major depression, generalized anxiety disorder, and panic disorder) in the prior 12 months, using the Composite International Diagnostic Interview (CIDI). Response to a single-item SRMH was dichotomized (excellent/very good/good or fair/poor). Service use was indicated by the use of any services in the past year (mental health specialist, general doctor, and clergy). RESULTS Multivariate analyses identified a significant interaction between mental disorder and SRMH in predicting service use. The likelihood of service use increased substantially when individuals with a disorder reported their mental health to be fair/poor. CONCLUSIONS Reflecting its subjective nature, SRMH enhances our understanding of individual variations in self-recognition and help-seeking behaviors. Findings suggest that interventions that enhance an individuals self-awareness of mental health problems may help bridge the gap between mental health care needs and service use in African Americans.

Social Capital in Ethnic Communities and Mental Health: A Study of Older Korean Immigrants

This study examined how social capital in ethnic communities (e.g., social cohesion, community support, community participation, and negative interaction) influences depressive symptoms of older Korean immigrants. Using survey data from 209 participants in Central Texas (Mage = 69.6, SD = 7.50), hierarchical regression models of depressive symptoms were examined with the following sets of predictors: (1) demographics, (2) physical health, (3) sociocultural factors, and (4) ethnic community factors. After controlling for the multiple sets of individual-level variables previously known to be important predictors of mental health, ethnic community factors made a substantial contribution. Higher levels of depressive symptoms were observed among individuals who received lower levels of community support (β = −0.14, p < 0.05), had limited participation in ethnic community events and activities (β = −0.15, p < 0.05), and reported more frequent negative interactions with ethnic community members (β = 0.12, p < 0.05). Findings highlight the importance of social capital in ethnic communities and hold implications for improving older ethnic immigrants’ mental well-being.

The impact of acculturation on depressive symptoms: A comparison of older Korean Americans in two areas.

This study examined how the impact of acculturation on depressive symptoms varied between two samples of older Korean Americans. One sample was from west central Florida (low Korean density area; n = 672), and the other from the New York City metropolitan area (high Korean density area; n = 420). The average level of acculturation was lower among older Korean Americans in New York, compared to those living in Florida. In the hierarchical regression models with the New York sample, acculturation was initially significant in predicting depressive symptoms; however, its impact was gradually attenuated and eventually became nonsignificant with the sequential entry of control variables. On the other hand, in the Florida sample, the impact of acculturation on depressive symptoms remained significant throughout the models. The results suggest that the level and importance of acculturation may differ by geographic locations and invite further contextual research in immigrant populations.

Social engagement in older residents of assisted living facilities

Objectives: As a core component of successful aging, social engagement is widely known to play an important role in promoting the health and well-being of older populations. Given the unique nature of assisted living facility (ALF) settings, the present study made a distinction between social engagement within and outside the facility and explored how these two types of social engagement would interact with functional disability in predicting depressive symptoms of older residents in ALFs. We hypothesized that the positive impact of social engagement within the facility would be greater among residents with higher levels of functional disability.Method: Using data from 150 ALF residents in Florida (Mage = 82.8, SD = 9.41), the direct and moderating effects of functional disability and the two types of social engagement on depressive symptoms were assessed.Results: Supporting the hypothesis, the interaction between functional disability and social engagement within the facility was found to be significant. The finding demonstrates the particular importance of social engagement within the facility for those with reduced physical function. For them, the limited but available opportunities for social activities and interpersonal contacts within the facility seem to bring substantial psychological benefits.Conclusion: The findings call attention to efforts to promote social activities and interpersonal contacts within ALFs.

Dental care utilization and unmet dental needs in older Korean Americans

Objective: The study explored predictors of dental care utilization and unmet dental needs in older Korean Americans, considering predisposing, enabling (dental insurance, acculturation, and family network), and need (self-rated oral health) variables. Method: Multivariate regression models were used to evaluate the data from 209 Korean Americans (aged ≥60) surveyed in Central Texas. Results: Participants with strong family networks and fair/poor self-ratings of oral health reported higher numbers of dental visits in the past year. The likelihood of having an unmet dental need increased when participants had less education, a shorter stay in the United States, no dental insurance coverage, lower levels of acculturation, more limited family networks, fair/poor self-ratings of oral health, and fewer numbers of dental visits. Discussion: Our findings underscore the vulnerability of individuals who are culturally and linguistically isolated and lack family resources, and they highlight the importance of incorporating social and cultural factors in intervention efforts.