Original articleAcculturative stress in Korean Americans
Introduction
Acculturation is a process of cultural change and adaptation that occurs when foreign-born individuals interact with people from a new country (Lopez-Class et al., 2011, Schwartz et al., 2010). During the process of acculturation to a new environment, some immigrants may have a successful experience through which they modify their life to adjust to the host culture, while others may face ongoing challenges and difficulties that can result in continued stress (Al-Omari and Pallikkathayil, 2008, Berry, 2008, D'Alonzo et al., 2012). The stress associated with acculturation is referred as acculturative stress which can adversely affect an individuals' health, including the development of cardiovascular disease (D'Alonzo et al., 2012, DeVylder et al., 2013, Lee et al., 2015). An understanding of the factors that contribute to acculturative stress is crucial in helping to mitigate and lessen health problems that may be associated with this type of stress.
As of 2014, more than 42.4 million foreign-born individuals (13.3% of U.S. population) reside in the United States (U.S. Census Bureau, 2016). Immigrants are the fastest growing segment of the U.S. population with a 350% increase in number from a total of 9.6 million in 1970 to 42.4 million in 2014 (Camarota & Zeigler, 2015). Despite a relatively short history of immigration to the United States by Koreans, their numbers have rapidly grown by 39% from 1.2 million in 2000 to 1.7 million in 2010 (Pew Research Center, 2013, U.S. Census Bureau, 2014). In 2013, it was found that 1.8 million Koreans (U.S. born and foreign born) resided in the United States (U.S. Census Bureau, 2016). Among them, foreign-born (first generation) Koreans accounted for nearly four out of five Korean Americans (Pew Research Center, 2013). This first generation Korean residing in the United States is predominantly a monolingual speaker in Korean with limited English proficiency.
The degree of acculturative stress that is experienced by an immigrant would seem to vary depending on the degree of similarity or dissimilarity between the heritage culture and new culture (Rudmin, 2003, Schwartz et al., 2010). For example, White, English-speaking individuals (e.g., Canadian or Australian) may experience less stress immigrating to the United States due to similarities in language spoken than Asian immigrants who are not proficient in English. White, English-speaking immigrants may also adapt somewhat easier to American mainstream with less racial discrimination if the culture is closer to their own heritage culture. In contrast, Asian immigrants to the United States may experience a higher level of acculturative stress because they may have to learn a new language (i.e., English), live in a society with different cultural values and social norms (e.g., collectivism over individualism), and sometimes deal with racial discrimination (Schwartz et al., 2010).
A variety of personal factors have been found to impact the degree of acculturative stress that is experienced by immigrants. For example, Korean Americans who were men, younger, had high levels of English proficiency, who arrived to the United States at a younger age, or stayed more years in the United States experienced lower levels of acculturative stress than did their counterparts who were women, older, had low levels of English proficiency, who arrived to the United States at an older age, or stayed less years in the United States (Ji and Duan, 2006, Logan et al., 2012, Moon, 2011). In a study of immigrants from the former Soviet Union, women and older immigrants to the United States experienced higher levels of acculturative stress than did men and younger immigrants (Miller et al., 2006).
In contrast, Asian Indian immigrant men in the United States experienced higher levels of acculturative stress than did women (Conrad & Pacquiao, 2005), while older Latinos residing in the United States experienced lower levels of acculturative stress than did younger Latinos (Bekteshi & van Hook, 2015). Length of residency was not associated with acculturative stress in studies of Latinos and Nigerian immigrants to the United States (Caplan, 2007, Daramola and Scisney-Matlock, 2014).
Asian Americans and Latinos with low levels of English proficiency and who stayed less years in the United States experienced high levels of acculturative stress (Bekteshi and van Hook, 2015, Lueck and Wilson, 2010, Lueck and Wilson, 2011). First-generation Latinos with limited English proficiency were found to experience 13% more acculturative stress than second generation Latinos (Lueck & Wilson, 2011). This is because linguistic integration for immigrants in the United States is a social requirement that enforces the acquisition of English proficiency (Lueck & Wilson, 2011).
Acculturative stress has been associated with physiological changes occurring within the individual, including hypertension and diabetes in Latinos and Chinese immigrants to the United States (D'Alonzo et al., 2012, Lee et al., 2015). In contrast, acculturative stress was not associated with blood pressure (BP) levels in Korean and Nigerian immigrants to the United States (Daramola and Scisney-Matlock, 2014, Logan et al., 2012). Acculturative stress has also been linked to elevated systolic BP among Latino immigrant men, but not among Latino immigrant women in the United States (McClure et al., 2010).
Due to the increased numbers of individuals who are immigrating to a new culture and the observed disparities in health reported outcomes, researchers are focusing to a greater degree on acculturation, acculturative stress, and factor which may impact this process and the ensuing stress that may result. Contributing factors to acculturative stress have been explored; however, the associations between those factors and acculturative stress are inconsistent across a limited number of studies. In particular, little information is available as to whether acculturative stress is associated with physiological factors in Korean Americans. Given that the fast growing numbers of Korean Americans, it is important to understand what factors contribute to acculturative stress and if acculturative stress is associated with physiological factors for this ethnic group. Therefore, we conducted an exploratory study to describe the level of acculturative stress in Korean Americans and to examine if correlations existed with level of acculturative stress and personal (e.g., age, gender) and physiological factors (e.g., BP).
Section snippets
Study design and sample
This study was a secondary analysis of data that were collected for an exploratory, cross-sectional, descriptive study in a large Southwestern city in the United States which examined cardiometabolic risk factors in Korean Americans. We recruited a convenience sample of Korean American adults who self-identified as Korean, aged 18 and above, and able to read, write, and speak either in Korean or the English language from a locally identified Korean community (e.g., restaurants, groceries,
Sample characteristics
All 107 participants were first-generation Koreans, and they all chose to read and sign the consent form in Korean and complete all the study measures in Korean. Participants had a mean age of 53.9 ± 10.7 (range 30–79), a majority were women, married, and educated at a college level or above (Table 1). Slightly more than half (51.9%) of the participants were found to have arrived in the United States at age of 30 or older, 83% had been in the United States for a minimum of 10 years, 51.4% had
Discussion
The level of acculturative stress in this sample (the mean ASI score = 50.4) was higher than the levels (the mean ASI score = 34–40) found in Korean Americans living in cities of Ohio, Kentucky, and Indiana (Ji and Duan, 2006, Rhee, 2013), but lower than the levels (the mean ASI score = 55–66) found in Korean immigrants residing in Canada and Korean Americans in Chicago (Lee and Holm, 2012, Noh and Avison, 1996). This variation in acculturative stress might be related to differences in the personal
Conclusion
Despite the lack of significant associations between acculturative stress and physiological factors (i.e., BMI, BP), the findings of this study provide researchers and healthcare professionals with greater insight related to acculturative stress in Korean Americans in the southwestern United States. A number of personal factors demonstrated significant associations with acculturative stress, BMI, and BP. These linkages support prior research into the importance of considering many factors that
Conflicts of interest
None.
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