Immigration-Related Factors and Depression Help-Seeking Behaviors Among Older Chinese Americans

Figures & data

Table 1. Sample characteristics by help-seeking categories.

Variables	Total sample (N = 907)	No help (n = 211)	Informal help only (n = 350)	Formal help only (n = 79)	Informal & formal help (n = 257)	p value
Age, mean (SD)	74.78 (8.30)	76.59 (8.65)	73.20 (7.64)	78.07 (8.42)	75.07 (8.21)	<.0001
Gender, n (%)
Female	655 (66.36)	128 (60.66)	250 (71.43)	46 (58.23)	176 (68.48)
Male	332 (33.64)	83 (39.34)	100 (28.57)	33 (41.77)	81 (31.52)	0.0193
Marital status, n (%)
Married	640 (64.91)	120 (57.14)	243 (69.43)	39 (49.37)	170 (66.15)
Not married	346 (35.09)	90 (42.86)	107 (30.57)	40 (50.63)	87 (33.85)	0.0009
Education, mean (SD)	8.75 (5.27)	8.43 (5.81)	9.80 (5.21)	8.23 (5.57)	7.90 (4.70)	<.0001
Health insurance, n (%)
Yes	867 (87.84)	190 (90.05)	285 (81.43)	76 (96.20)	238 (92.61)
No	120 (12.16)	21 (9.95)	65 (18.57)	3 (3.8)	19 (7.39)	<.0001
Income, mean (SD)	1.90 (0.91)	1.97 (1.04)	1.86 (0.89)	1.95 (1.04)	1.91 (0.79)	0.4997
Overall health status, n (%)
Poor	407 (41.24)	3 (1.42)	7 (2.00)	1 (1.27)	3 (1.17)
Fair	402 (40.73)	39 (18.48)	57 (16.29)	10 (12.66)	32 (12.45)
Good	159 (16.11)	81 (38.39)	147 (42.00)	37 (46.84)	104 (40.47)
Very good	19 (1.93)	88 (41.71)	139 (39.71)	31 (39.24)	118 (45.91)	0.6680
Functional limitations, mean (SD)	2.88 (3.75)	2.93 (3.83)	2.60 (3.85)	3.28 (2.93)	3.14 (3.72)	0.0003
Depressive symptoms, mean (SD)	5.44 (4.57)	5.16 (4.25)	5.94 (4.88)	5.80 (4.66)	5.67 (4.62)	0.2013
Acculturation, mean (SD)	15.38 (4.48)	16.08 (5.76)	15.53 (4.27)	14.30 (2.73)	15.18 (4.11)	0.0085
Length of U.S. residence, mean (SD)	21.47 (12.48)	23.28 (12.85)	19.08 (11.85)	24.09 (11.66)	22.66 (11.97)	<.0001
Chinatown residence, n (%)
Yes	569 (58.24)	119 (57.21)	192 (55.33)	60 (75.95)	153 (60.00)
No	408 (41.76)	89 (42.79)	155 (44.67)	19 (24.05)	102 (40.00)	0.0085
Family reunification, n (%)
Yes	735 (74.47)	161 (76.30)	248 (70.86)	58 (73.42)	202 (78.60)
No	252 (25.53)	50 (23.70)	102 (29.14)	21 (26.58)	55 (21.40)	0.1621

The p value refers to the difference between the 4 help-seeking categories.

Table 2. Frequencies of specific types of help sought among those who sought help.

	Specific sources of help sought^a	Frequencies,^bn (%)
Informal sources of help	Adult children	410 (44.42)
	Partner	354 (38.35)
	Friends, neighbors, colleagues	263 (28.49)
	Other family members	109 (11.83)
	Children-in-law	101 (11.48)
	Grandchildren	47 (5.09)
	Religious workers (from church, temples)	36 (4.01)
	Parent	11 (1.19)
Formal sources of help	Primary care physicians^a	288 (32.11)
	Allied healthcare professionals ^b	44 (4.91)
	Chinese medicine doctors^c	27 (3.01)
	Community social services organizations	16 (1.78)
	Mental health professionals^d	7 (0.78)
Any help	Help sought from any listed sources	714 (76.94)

^aIncluded family doctors, geriatricians, internists.

^bIncluded social workers, nurses, physical therapists.

^cIncluded traditional Chinese medicine practitioners, herbalists, acupuncturists, massage therapists.

^dIncluded psychologist, psychiatrist.

Table 3. Multivariable associations between immigration-related factors and depression help-seeking behaviors (reference group is “no help”).

	Informal help only	Formal help only	Informal & formal help
	OR (95% CI)	OR (95% CI)	OR (95% CI)
Predisposing factors
Immigration-related factors
Acculturation	0.97 (0.93, 1.02)	0.87 (0.79, 0.97)*	0.91 (0.91, 1.01)
Length of U.S. residence	0.99 (0.97, 1.01)	1.00 (0.97, 1.03)	1.01 (0.99, 1.03)
Chinatown residence	1.27 (0.85, 1.98)	2.19 (1.13, 4.28)*	1.11 (0.73, 1.70)
Family reunification	0.66 (0.43, 1.02)	1.06 (0.56, 2.01)	1.05 (0.66, 1.66)
Age	0.96 (0.93, 0.99)**	0.99 (0.95, 1.04)	0.97 (0.94, 1.00)*
Female	2.08 (1.38, 3.14)**	0.96 (0.52, 1.75)	1.52 (0.99, 2.33)
Married	1.49 (0.97, 2.29)	0.85 (0.45, 1.58)	1.62 (1.03, 2.54)*
Education	1.07 (1.03, 1.11)**	1.05 (0.99, 1.12)	1.00 (0.96, 1.04)
Enabling factors
Health insurance	0.72 (0.39, 1.34)	2.31 (0.61, 8.74)	1.66 (0.80, 3.43)
Income	0.94 (0.75, 1.18)	1.11 (0.75,1.64)	1.01 (0.79, 1.28)
Household size	0.93 (0.84, 1.04)	0.90 (0.75, 1.07)	0.96 (0.86, 1.07)
Need factors
Overall health status	1.17 (0.91, 1.50)	1.08 (0.75, 1.56)	0.92 (0.71, 1.20)
Physical function	1.03 (0.97, 1.09)	1.00 (0.92, 1.09)	1.03 (0.97, 1.09)
Depressive symptoms	1.05 (1.01,1.10)*	1.02 (0.96, 1.09)	1.02 (0.98, 1.07)

OR = Odds Ratio. CI = Confidence Interval.

***p < .001, ** p < .01, *p < .05.

Data availability statement

The data that support the findings of this study are available on request from the corresponding author.