Asian Americans and Mental Health Services

Abstract

Research in the 1970s and 1980s revealed that Asian Americans, compared with other ethnic groups, tended to under-utilize mental health services. This article is aimed at adding new information to the literature by examining data from the 1990s. The raw data comprised 97,212 total admissions representing 45,774 total individuals utilizing mental health services during a four-year period in San Diego County, California. By comparing our findings with previous research cases on utilization patterns of mental health services, new evidence is found about Asian Americans in terms of their (1) underrepresentation in mental health services, (2) presentation of more severe symptoms than those of other racial/ethnic groups when first seen at clinics, (3) lower dropout rates and higher average lengths of stay than other racial/ethnic groups, and (4) higher percentages of using day treatment and outpatient programs but lower percentage of using inpatient programs.     

Child Welfare and Juvenile Justice: Examining the Unique Mental Health Needs of Girls

This study investigated the prevalence of mental health problems among girls who are involved in child welfare or juvenile justice systems. The sample consisted of 1,193 girls ranging in age from 4 to 18, the majority (82.3%, n = 982) of which were older than age 12. Differences based on race/ethnicity and developmental age groups were examined. Consistent with other research, this study found that the mental health needs of girls involved in the child welfare or juvenile justice systems are several times higher than in the general population. Intervention approaches must be developed that take into consideration differences in gender, age, and racial and ethnic group.     

Lay Understandings of Health among Dai Lue in Xishuangbanna,China

This study analyses lay understandings of health among Dai Lue, an ethnic minority in China, and how they are played out in help-seeking practices. Interviews and focus groups with sixty-three rural villagers in Xishuangbanna, southwest China revealed that health was largely interpreted as a social experience embedded in Dai Lue culture and ethnicity. Salient to this interpretation was family, community connectedness and Dai Lue ceremonies and festivals, as well as connections with a socio-political context. Ethnicity and ‘othering’ was an important thread running through their lay health beliefs, especially distinctions between Dai and Han. The health research, policy and practice implications of the findings are also discussed, and are likely to be applicable to other ethnic minorities in China.     

Racial and Ethnic Differences in Family Caregiving in California

Abstract

Family caregivers are the main source of long-term care for older persons in the United States. At the same time, cultural values and beliefs shape decisions surrounding who provides care and whether families use formal support interventions to assist the caregiver. The current article examines how the family caregiving experience differs among racial and ethnic groups in terms of caregiver characteristics, service utilization, caregiver strain, and coping mechanisms. Telephone interviews were conducted in English and Spanish with a random sample of 1,643 respondents in California who provide care to someone age 50 or over. Bivariate analyses showed evidence of ethnic differences in the demographic characteristics of caregivers, intensity of care provided, caregiver health, level of financial strain, religious service attendance, formal service utilization and barriers to formal services. Odds ratios showed that White and African American caregivers were about two times as likely to use formal caregiver services as were Asian/Native Hawaiian/Pacific Islander and Latina American caregivers. Implied by these findings is the need for further understanding of caregiver service needs among diverse racial and ethnic groups.     

Gambling and the Older Chinese in Canada

In Canada, there is a lack of research on gambling among the older adults from ethnic minority groups, especially the older Chinese. In this study, two research questions were used to examine gambling among the older Chinese: (1) What is the pattern of gambling among the older Chinese in Canada? (2) What are the predictors associated with gambling among the older Chinese in Canada? The data for this study were collected as part of a multi-site study on health and well-being of 2272 older Chinese in Canada. Four main questions related to gambling were used in this study. Among the 2257 participants who answered the questions on gambling, 26.6% of them reported that they gambled. Results of the hierarchical logistic regression analysis showed that being male, having lived in Canada longer, having a higher level of social support, having more service barriers, and having a stronger level of Chinese ethnic identity would increase the probability for an older Chinese to participate in gambling. Conversely, having a post-secondary and above level of education and having a higher level of life satisfaction would reduce one’s probability of gambling. Although city of residency was also significant in predicting gambling, further analysis showed that its effect was actually caused by other factors including services barriers, social support, life satisfaction, Chinese ethnic identity, and education.     

If you look like me,I'll talk to you: a preliminary study of ethnic identity and inter‐ethnic interaction among women in Singapore

In Singapore, government policy is for equal but separate development of the four major ethnic groups—Chinese, Malay, Indian and other. In this study, I attempt to gain some preliminary views of how strongly women identify with their own ethnic group and how freely they are prepared to interact with people from other ethnic groups in non‐work‐related situations. I confine my study to females for two reasons. One is that traditional ethnic dress is common among females in Singapore but much rarer among men, and this makes a strong non‐verbal statement of identity. The second reason is to avoid differences between males and females, which I did not wish to pursue within the limits of this exploratory study. The findings of my pilot investigation indicate that intra‐ethnic spontaneous interaction is more likely to occur among women who display a strong national identity. Moreover, younger women, who were exposed during their school years to the government's recent drive to nurture ethnic and cultural differences, are less open to inter‐ethnic interaction than are women in their 30s and older, who grew up when the government drive was towards creating one common national identity for the people of Singapore.     

Health outcomes for adults in family foster care as children: An analysis by ethnicity

Studies have linked the experience of child abuse or adversity to health problems in adulthood, and researchers have long documented health problems affecting children in foster care. Yet, the adult health outcomes of maltreated children placed in foster care have not been sufficiently isolated. Although information on transitioning youth and young adults is now beginning to emerge, the impact of ethnicity on adult health outcomes has been largely ignored. Given the overrepresentation of ethnic minority children in foster care and the national disparities in the health of ethnic minorities, this study examined the relationship between ethnicity and physical health outcomes for African American, Hispanic, and White adults who experienced family foster care as children. Logistic regression models indicated that ethnicity was not a significant predictor of physical health (p > .05). However, gender and age were associated significantly with their physical health outcomes.     

Conveying a sense of community along Bolsa Avenue: Little Saigon as a model of ethnic commercial belts

In the past, ethnic enclaves have functioned as homogeneous residential areas providing support and comfort to newly arrived immigrants. A new form of urban village is increasingly serving commuting immigrants who live in integrated residential neighbourhoods.
Little Saigon, a Vietnamese commercial belt in Southern California, serves as a model of this emerging form. Participant observation and interviews with users of Little Saigon and other ethnic commercial belts in Southern California reveal that these areas provide users with places where they can experience the sense of community previously provided by ethnic ghettos.
Little Saigon demonstrates that ethnic, commercial enclaves benefit diverse groups of individuals: in these places immigrants with limited English gain employment, older immigrants find solace, and "Americanized" immigrants and their children connect with their ancestral culture.
Concomitant with the cultural advantages are the perpetuation of stereotypes, erosion of ethnic boundaries and persistent forms of specialized crime that threaten these areas' success and yield negative perceptions of the areas' ethnic groups.     

Environmental Health and Safety Philosophy

Abstract

Objective: This study examines ethnic identity and body image in black and white college females. Participants: Researchers surveyed 118 students at 2 universities, 1 traditionally white and 1 historically black. Methods: Correlations and multivariate analysis of variance (MANOVA) were used to investigate the relationship between race, ethnic identity, and body dissatisfaction. Results: There was no relationship between a woman's ethnic identity and her body dissatisfaction. Although white women scored higher on body dissatisfaction measures, women in both groups who had higher body dissatisfaction scores also choose smaller ideal body types. Results suggest that identification with an ethnic group may not shield women from being dissatisfied with their bodies. Conclusion: Colleges and universities should be aware that many women could experience body dissatisfaction and develop diverse programs that target women from different ethnic groups.     

Evidence from the Chernobyl Nuclear Accident: The Effect on Health,Education, and Labor Market Outcomes in Belarus

The Chernobyl nuclear accident of 1986 had deleterious health consequences for the population of Belarus, especially for those who were children at the time of the disaster. Using the 2003–2008 waves of the Belarusian Household Survey of Income and Expenditure (BHSIE), we estimate the effect of radiation exposure on the health, education, and labor market outcomes among cohorts and areas affected by the accident, utilizing the nuclear accident as a natural experiment. We find that young individuals who came from the most contaminated areas had worse health, were less likely to hold university degrees, were less likely to be employed, and had lower wages compared to those who were older at the time of the accident and who came from less contaminated areas.     

Specifying Long-Term Care Provider Responsiveness to LGBT Older Adults

In-depth interviews and focus groups with lesbian, gay, and transgender older adults addressed the question “What does it mean for long-term care providers to be responsive to lesbian, gay, bisexual, and transgender (LGBT) older adults?” Sixteen domains of long-term care provider responsiveness to LGBT older adults were identified, including awareness of centrality of partners, knowledge of importance of preferred gender expression, openness to welcoming LGBT older adults, and ability to create LGBT-safe environments. Future research should include LGBT elders who belong to ethnic minority groups, bisexual elders, and LGBT older adults who do not identify with LGBT labels.     

Promoting the mental well-being of older people from black and minority ethnic communities in United Kingdom rural areas: Findings from an interview study

Drawing from 81 interviews with practitioners in social care and housing with care services in the United Kingdom, this paper explores practice issues in rural areas when supporting the mental health and well-being of older people from Black and minority ethnic groups. The paper begins with a review of the literature which provides evidence that BME older people are likely to be increasingly part of the populations of rural areas. Next it presents interview data revealing that while practitioners are aware of such demographic changes in general terms; some feel that they lack training and skills in adapting their professional practice to support all older people. Others express feelings of professional isolation in seeking to support older people from minority groups and are concerned that older people from minority groups may be at risk of isolation and loneliness. The paper concludes with a discussion of the study's implications for rural practice, policy and research.     

Sensitivity to “Bad Genes” and the Anomalous Face Overgeneralization Effect: Cue Validity, Cue Utilization, and Accuracy in Judging Intelligence and Health

The bad genes and anomalous face overgeneralization accounts of facial preferences were tested by examining cue validity, cue utilization, and accuracy in judging health and intelligence from faces in the upper and lower halves of the distributions of attractiveness and its components: averageness, symmetry, and masculinity. Consistent with the bad genes hypothesis, facial attractiveness, averageness, symmetry, and male face masculinity each provided valid cues to intelligence and/or health for faces in the lower but not the upper halves of the distributions of these facial qualities. Consistent with the anomalous face overgeneralization hypothesis, attractiveness and its components were utilized as cues not only for faces in the lower halves of the distributions, but also for those in the upper halves. Intelligence and health were judged accurately for faces in the lower but not the upper half of the attractiveness distribution, and attractiveness mediated this accuracy at all ages except adolescence. Since adolescence is the prime mating age, the latter finding raises questions about the utility of attractiveness as an evolved mechanism to ensure the selection of high quality mates.     

The College Health Advisor and the College Age Adoptee

Abstract

Eating disorders are among the most common psychopathologies on college campuses. Research on ethnic differences in eating disorder symptoms and prevalence has resulted in conflicting conclusions. Some studies find that particular ethnic groups have a higher prevalence of a symptom; others find that members of that ethnic group have a lower prevalence of the same symptom. The authors explored the role of body mass index (BMI), one potential confound. They used a reliable measure of eating disorder symptoms to assess differences between Hispanic, Asian, and non-Hispanic White college women from two separate samples. After controlling for BMI, ethnic differences in eating disorder symptoms of concern about weight and shape disappeared, but differences in restrained eating remained. Inconsistent findings in the ethnic-difference literature on eating disorders may result from systematic group differences in BMI. Implications for college health programs, counseling, and case finding are discussed.     

Use of Various Health Care Services by Students in Helsinki

Abstract

Review of the working of various health care schemes has revealed predominant use by a certain group of “large-scale consumers.” The concomitant use of various services (health, dental, and mental health care) was studied within the Helsinki Health Center of the Finnish Student Health Service from January 1, 1980 to August 31, 1980. The group consisted of 16,174 students. The characteristics of the groups of patients who used only the mental health care service and of those who used all three services were also studied. Within each sector, there were fewer patients than expected who did not use the services of other sectors. The number of patients visiting dental and health care services, mental health and health care services, and all three services were greater than expected. The groups of patients who used only the mental health care service and those who used all three services were surprisingly similar. The greatest difference between the groups probably lay in their need for somatic and dental care. The organization, which incorporates mental health, dental, and health care services in the same building offers improved possibilities for care of the patient as a whole. On the basis of this study, there is no reason to think that such an organization leads to misuse of the various services.     

Inconsistencies in reporting the occurence and timing of first intercourse among adolescents

Two types of reporting inconsistency for sexual initiation were analyzed--event occurrence and its timing--using data from two waves of the National Longitudinal Study of Adolescent Health (Add Health). Overall, 11.1% of those who reported they were sexually active at the time of first interview denied this at the subsequent one. Males of each race/ethnic group had higher percentages of inconsistency than their female counterparts. Being older, not living with parents, or having a highly educated mother was negatively associated with rescinding. Among those reporting sexual experience at both interviews, only 22.2% reported the same date of first sex. On average, teens revised their age at first sex to older ages, and boys, especially African American boys, had large variability in reporting dates, as did teens with lower verbal ability. Seven strategies for resolving inconsistent reports are presented and implications for substantive findings are discussed.     

Ethnic and class factors affecting mental health clinic service

Service delivery by a mental health clinic to clients from an older suburban catchment area containing both lower and middle class blacks and whites was studied. The epidemiologic method was employed, relating service delivery to the characteristics of the various population groups within the catchment. The findings indicate that low service rates for blacks were not related to ethnicity alone, but to the combination of black ethnicity and low social status; however, middle class blacks and middle class whites who entered treatment received similar service. Poor blacks had higher admission rates than poor whites with similar need indicators. In continued treatment, poor blacks received lowest service rates while minority status poor whites living in a predominantly black area received highest service rates. Social class mediated black service utilization. Severity of illness, interacting with social class and minority status mediated white service utilization. Outreach is suggested not only for poor blacks but also for poor whites, especially those living in areas in which they represent an ethnic minority.     

The Development of a Black and Ethnic minority health policy at the department of health

Britain is a truly multiracial and multicultural society. Immigration into Britain in 1960s and 1970s was mainly fiom South East Asia, Africa and the West Indies. A large number of immigrants have now become residents of Britain and we have a second generation of Black and ethnic minority groups in this country who were bom in Britain. More recently we have been joined by a number of refugee groups and asylum seekers. In the last 10 years, there have been a number of initiatives which have been taken to develop appropriate policies to improve access to health services by ethnic groups and to understand their health and disease patterns. The main issues are: (1) What policies have been developed? (2) The main areas of concern. (3) The differing health and disease patterns among ethnic minority groups. (4) How the policies are being implemented at the health service level and the lessons learned. (5) How the health professionals are being trained to deliver appropriate services to these groups. (6) How volunteer groups are invoked in planning services. (7) The national health services have recently been reformed and have introduced the idea of separating the delivery of health care from its planning and of the purchasing of services by health authorities. It is important to examine whether these have an impact in changing health services to make them more accessible to ethnic minority groups. (8) What the future plans in this area of work are.