Psychological and physical health of Chinese immigrants in the Howard County, Maryland: A community survey

Abstract

Background: Immigrants are the fastest growing fraction of the United States (USA) population. One in every ten people in USA is foreign born. Migration is a stressful event. Immigrants are vulnerable to psychological distress symptoms which increase their risk of heart disease, stroke and diabetes. Chinese are the third largest immigrant group in USA. From 1980 to 2006, the numbers of Chinese immigrants has increased by five-fold. However, little is known about their psychological health. Study of Chinese immigrants increases our understanding of their psychological health condition and the relationship to physical health and can inform the development of culturally sensitive community programs to improve psychological health in Chinese immigrants. Purpose: The purpose of this study was to identify risk factors for psychological distress of Chinese immigrants using a biopsychosocial model. The intention was to identify modifiable factors for psychological distress in Chinese immigrants. Methods: A cross-sectional design was used to conduct a descriptive-correlation survey study. A total of 247 Chinese speaking immigrants in Howard County were recruited. All instruments used in the study were written in Chinese including the Chinese Cultural Orientation Scale, Chinese Bicultural Identity Integration Scale, Chinese Riverside Acculturation Stress Inventory and Chinese Kessler Psychological Distress Scale. Data were analyzed using descriptive statistics, Chi squares, t-tests, Pearson's correlations and hierarchical linear multiple regressions. Results: The psychological distress rate among Chinese immigrants in the study was 22.3%. Biological and social factors explained 17.8% of the variability in psychological distress scores, adjusted R2 = .155 (p<.001). Adding acculturation factors into the regression model increased R2 by .104 (p<.001). The interaction effect of acculturation stress and English proficiency was the strongest predictor of psychological distress scores in Chinese immigrants. Other predictors in the model included age, self-reported health status and financial strain. The final model explained 26.1% of the variability in psychological distress scores. Conclusion: Howard County is the third richest county by per capita income in the nation. Yet, financial uncertainty remains a strong predictor of psychological distress for Chinese immigrants. Interventions of social services could be developed to meet Chinese immigrants' needs. English proficiency is important for psychological health in Chinese immigrants, especially when facing acculturation stress. Participants with low Englishproficiency are more susceptible to acculturation stress to develop psychological distress symptoms. Culturally sensitive strategies are recommended to improve English proficiency in Chinese immigrants. In this sample, there was a fairly low rate of chronic disease. However self-reported health remained a significant risk factor in the model. Further study is needed to examine what factors contribute to an individuals' perception of health and how that perception of health influences psychological health.