Acculturative stress, disability, and health treatment utilization among Asian and Latin American immigrants in the United States

Soc Psychiatry Psychiatr Epidemiol. 2019 Oct;54(10):1275-1284. doi: 10.1007/s00127-019-01691-0. Epub 2019 Mar 20.

Abstract

Purpose: Empirical research has largely ignored the potential links between immigration-related stress and disability as well as immigration-related stress and health service utilization despite increasing scholarship on the association between acculturative stress and health. This study examined the associations between acculturative stress, disability, and health treatment utilization among Asian and Latin American immigrants in the United States.

Methods: Data were from the National Latino and Asian American Study (NLAAS), a nationally representative survey of Asians and Latinos living in the United States. The analytic sample contained 2653 immigrants. We utilized multivariable logistic regression and negative binomial regression analyses to examine the associations between acculturative stress and disability domains. We also examined the association between acculturative stress and treatment utilization, as this may have implications for how to best intervene to address any functional disability related to acculturative stress.

Results: Acculturative stress was significantly associated with self-reported disability across five domains: self-care, cognition, mobility, time out of role, and social interaction. Additionally, acculturative stress was significantly associated with a greater frequency of disability domains. Acculturative stress was not significantly associated with utilization of services from mental health or general health sectors, but was significantly and positively associated with utilization of non-health care services. The findings were robust regarding the inclusion of everyday discrimination as well as demographic and socioeconomic covariates.

Conclusions: Acculturative stress may be an important yet overlooked correlate of disability among immigrants in the United States. Non-health care services may provide an effective pathway for intervening for these individuals.

Keywords: Acculturative stress; Disability; Discrimination; Migration; Treatment.

MeSH terms

  • Acculturation
  • Adult
  • Asian Americans / psychology*
  • Disabled Persons / psychology
  • Disabled Persons / statistics & numerical data*
  • Emigrants and Immigrants / psychology*
  • Female
  • Hispanic Americans / psychology*
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care / ethnology*
  • Self Report
  • Stress, Psychological / epidemiology
  • Stress, Psychological / ethnology*
  • Stress, Psychological / psychology
  • United States / epidemiology
  • Young Adult