Mental Health Status of Japanese American Elders

Principal Investigator: Tazuko Shibusawa, Ph.D. (CUSSW)

Funding: Center for the Study of Social Work Practice and NIMH (application under review)

Asian and Pacific Islanders comprise the fastest growing ethnic group in the United States. Between 1980 and 1990, the population increased by 108 percent (U.S. Bureau of Census, 1991). The growth of the elderly population among this group has equally been dramatic. According to the 1990 census, in a span of ten years, the Asian American elderly population increased by 127 percent in the city of New York. Despite dramatic increases in the population, there has been paucity in the knowledge base of Asian American elders. For example, there have been no epidemiological studies of Asian American elders in the field of mental health. Despite the fact that Japanese-and Chinese American elders have the highest suicide rate among ethnic U.S. elderly (Baker, 1994; Lester, 1994), they have received very little attention from researchers in the field of social work.

Because of the low utilization rate of mental health services among Asian Pacific elders, they are thought to have low incidences of mental illness (Damon-Rodriguez, et. al., 1994, Liu & Yu, 1985). In addition, Asian American elders are thought to be well cared for by their families, and in less need of formal services because of traditional cultural norms of filial obligation (Liu, 1986, Sakauye, 1992). There are, however, no data that substantiates that Asian elders are well cared for by their families. As Sakauye and Chacko (1994) point out, family solidarity may be more strained between the immigrant generation and their children due to acculturative stresses. In addition, although a strong sense of filial responsibility may exist among Asian families, this does not necessarily translate into mutually satisfying close family relationships. The U.S. census shows that 21.4 percent of Asian American elderly live below the poverty level in New York City, and another study indicates that 68 percent of those who live alone live in poverty (Asian American Task Force on the Aging, 1996).

Goal of the Study: The purpose of this study is to build on Professor Muiís studies of mental health and social support among Chinese- and Korean American elders by examining the mental health status of Japanese American elders who reside in New York and Los Angeles (Mui, 1996a, Mui, 1996b). Specifically, this study will examine mental health, social support/isolation, health status, and attitudes towards receiving support among this population. It will also test the cross-cultural validity of the Geriatric Depression Scale (GDS) and MOS 36-Item Short-Form health Survey (SF-36). The long-term objective of this study is to collaborate with community organizations and contribute to the development of a screening instrument that can be used by social service agencies to assess the mental health status of Japanese American elders.

Because of immigration patterns, Japanese American elders have the highest percentage of American-born elders among the Asian American elderly population. At the present time, 63 percent of Japanese American elders are American-born (Elo, 1997). A study of Japanese American elders, therefore, will lend new information on the effects of acculturation on Asian American elders. In addition, Los Angeles and New York City offer two different types of social environments. Because of the large Japanese American population in Los Angeles, a variety of formal services are available for Japanese American elders, while this is not available for elders in New York City. Japanese elders in New York City tend to be socially isolated because of the lack of programs and services. A comparative study will provide information on the differences in mental health status and social support among elders residing in ethnic and non-ethnic urban environments.

The proposed study will be conducted as part of a larger study that investigates the mental health status of Asian and Asian Pacific American elderly in China, Korean, Japan and the United States. The long term goals of the larger study are twofold: 1) to validate screening instruments for depression and social isolation among Asian and Asian American elders, and 2) to build a data base for cross-national research between Asian elders in Asian and the United States to understand the effects of acculturation and adjustments to changes in family and societal conditions.

Sample: The sample for this study will consist of 100 community-dwelling Japanese American elders who reside in Los Angeles and New York. Subjects in Los Angeles and New York will be matched to the extent possible on age, sex, education, and income. Measures will include demographic variables, social support network, functional status, health status, acculturation, mental health status, and knowledge and attitudes towards social services. The Geriatric Depression Scale (Thompson, et. al, 1988) will be used to measure depression, and the Medical Outcome Study SF36 (Ware & Sherbourne, 1992) will be used to measure overall functional status.

External consultants and collaborators of this research project include: Professor Harry H. Kitano, Ph.D., Department of Social Welfare, School of Public Policy and Social Research, University of California, Los Angeles; Professor Daisaku Maeda, Professor, Risshou University; Hisanori Ishikawa, Ph.D., Department of Social Welfare, Japan Lutheran College; and Yasuko Sakamoto, L.C.S.W, Little Tokyo Service Center.

References:

Asian American Task Force on the Aging (1996). Human services for the Asian American elderly in New York City. New York: Asian American Federation of New York.

Baker, FM (1994). Suicide among ethnic minority elderly: A statistical and psychosocial perspective. Journal of Geriatric Psychiatry, 27 (2), 241-264.

Damon-Rodriguez, J., Wallace, S., Kington, R. (1994). Service utilization and minority elderly:Appropriateness, accessibility and acceptability. Gerontology and Geriatrics Education, 15 (1), 45-63.

Elo, I.T. (1997). Adult mortality among Asian Americans and Pacific Islanders: A review of the evidence. In K.S. Markides & M.R. Miranda (Eds.), Minorities, aging and health (pp. 41-78). Thousand Oaks, CA: Sage.

Lester, D. (1994). Differences in epidemiology of suicide in Asian Americans by nation of origin. Omega, 29 (2), 89-93.

Liu, W.T. (1986). Health services for Asian elderly. Research on Aging, 8 (1), 156-157.

Mui, A.C. (1996a). Geriatric depression scale as a community screening instrument for elderly Chinese immigrants. International Psychogeriatrics, 8 (3), 1-10.

Mui, A.C. (1996b). Depression among elderly Chinese immigrants: An exploratory study. Social Work, 41, (6), 633-645.

Mui, A.C. (1997). Mental health and social support among elderly Korean immigrants. Unpublished manuscript. Columbia University School of Social Work.

Mui, A.C. (in press). Living alone and depression among older Chinese immigrants. Journal of Gerontological Social Work.

Sakauye, K. (1992). The elderly Asian patient. Journal of Geriatric Psychiatry, 25 (1): 85-104

Sakauye, K., & Chacko, R.C. (1994). Issues in the psychiatric care of Asian/Pacific American elders. In American Psychiatric Association (Ed.), Ethnic minority elderly: A talk force report of the American Psychiatric Association. Washington, D.C.: Author

Thompson, L.W., Futterman, A., & Gallagher, D. (1988). Assessment of late life depression. Psychopharmacology Bulletin, 24, 577-586.

Ware, J.E., Sherbourne, C.D. (1992). The MOS 36-Item Short-Form Health Survey (SF-36): I. Conceptual framework and item selection. Medical Care, 30 (6), 473-481.