Journal of Cross-Cultural Gerontology

, Volume 33, Issue 4, pp 411–425 | Cite as

The Effects of Religious Participation and Familial Assistance on Mental Health among Older Chinese and Korean Immigrants: Multiple Mediator Analyses

  • Isok Kim
  • Suk-Young Kang
  • Wooksoo Kim


Older Asian immigrants are one of the fastest growing segments of the U.S. population and a growing number of them reside in non-traditional destination cities. However, there is a paucity of research on older Asian immigrants living in these non-traditional destination cities, and how this residential choice impacts their stress and mental health. In the current study, we examined how stressors and social support contribute to the overall mental health of older Asian immigrants who lack access to culturally responsive formal social support services. Using a convenience sample of older Chinese (n = 120) and Korean (n = 118) immigrants living in Arizona, we conducted multiple mediator analyses, focusing specifically on how ethnicity would differentially influence mediating effects of religious participation and familial assistance in the relationships between physical/acculturative stressors and mental health outcomes. The results showed that among older Chinese immigrants, religious participation significantly mediated the relationships between both physical/acculturative stressors and mental health, while there was no significant mediation effect detected among older Korean immigrants. Although Asian Americans are often perceived as a monolithic homogeneous group, the multiple mediator models suggest significant differences in the use of cultural/information resources in coping with life stressors and their impact on mental health outcomes between the older Chinese and Korean immigrants in our study. The study findings suggest a need for developing and strengthening formal social services in non-traditional destination cities that are culturally and linguistically responsive to those older Asian immigrants.


Older Chinese and Korean immigrants Mental health Social support Chronic medical conditions Limited English proficiency 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.


  1. Asian American Federation. (2003). Asian American elders in new York City: A study of health, social needs, quality of life and quality of care. New York, NY: Asian American Federation Retrieved from Scholar
  2. Asian American Federation. (2012). Asian Americans in new York City: A decade of dynamic change 2000–2010. New York, NY: Asian American Federation Retrieved from Scholar
  3. Barrera Jr., M. (2000). Social support research in community psychology. In J. Rappaport & E. Seidman (Eds.), Handbook of community psychology (pp. 215–245). New York, NY: Springer.CrossRefGoogle Scholar
  4. Chang, M., & Moon, A. (2016). Correlates and predictors of psychological distress among older Asian immigrants in California. Journal of Gerontological Social Work, 59(2), 77–97. Scholar
  5. Chen, H., Cheal, K., McDonel Herr, E. C., Zubritsky, C., & Levkoff, S. E. (2007). Religious participation as a predictor of mental health status and treatment outcomes in older persons. International Journal of Geriatric Psychiatry, 22(2), 144–153. Scholar
  6. Cheung, C.-K., & Kwan, A. Y.-H. (2009). The erosion of filial piety by modernisation in Chinese cities. Ageing and Society, 29(2), 179–198. Scholar
  7. Cho, S., Park, S.-Y., Bernstein, K. S., Roh, S., & Jeon, G.-S. (2015). Socio-demographic and health behavioral correlates of depressive symptoms among Korean Americans. Community Mental Health Journal, 51(4), 414–423. Scholar
  8. Feng, Z., Fennell, M. L., Tyler, D. A., Clark, M., & Mor, V. (2011). Growth of racial and ethnic minorities in US nursing homes driven by demographics and possible disparities in options. Health Affairs, 30(7), 1358–1365. Scholar
  9. Fiske, A., Gatz, M., & Pedersen, N. L. (2003). Depressive symptoms and aging: The effects of illness and non-health-related events. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 58(6), P320–P328. Scholar
  10. Gerteis, J., Izrael, D., Deitz, D., LeRoy, L., Ricciardi, R., Miller, T., & Basu, J. (2014). Multiple Chronic Conditions Chartbook (AHRQ publications no. Q14–0038). Agency for Healthcare Research and Quality. Retrieved from
  11. Hoeffel, E. M., Rastogi, S., Kim, M. O., & Shahid, H. (2012). The Asian Population: 2010 (C2010BR-11). Washington, D.C.: U.S. Census Bureau Retrieved from Scholar
  12. Huang, B., Appel, H. B., Ai, A. L., & Lin, C. J. (2012). Religious involvement effects on mental health in Chinese Americans. Asian Culture and History, 4(1), 2–12. Scholar
  13. Ikels, C. (Ed.). (2004). Filial piety: Practice and discourse in contemporary East Asia. Stanford, CA: Standford University Press.Google Scholar
  14. Ishii-Kuntz, M. (1997). Intergenerational relationships among Chinese, Japanese, and Korean Americans. Family Relations, 46(1), 23–32. Scholar
  15. Kang, S.-Y., Domanski, M. D., & Moon, S. S. (2009). Ethnic enclave resources and predictors of depression among Arizona's Korean immigrant elders. Journal of Gerontological Social Work, 52(5), 489–502. Scholar
  16. Kang, S.-Y., Boyas, J., & Salehin, M. (2012). Correlates of depression among Chinese immigrant elders in Arizona: The role of acculturative stress and social support. Journal of Human Behavior in the Social Environment, 22(3), 334–350. Scholar
  17. Kang, S.-Y., Kim, I., & Kim, W. (2016). Differential patterns of healthcare service use among Chinese and Korean immigrant elders. Journal of Immigrant and Minority Health, 18(6), 1455–1461. Scholar
  18. Kaniasty, K., & Norris, F. H. (2000). Help-seeking comfort and receiving social support: The role of ethnicity and context of need. American Journal of Community Psychology, 28, 545–581.CrossRefGoogle Scholar
  19. Kaniasty, K., & Norris, F. H. (2004). Social support in the aftermath of disasters, catastrophes, and acts of terrorism: Altruistic, overwhelmed, uncertain, antagonistic, and patriotic communities. In R. J. Ursano, A. E. Norwood, & C. S. Fullerton (Eds.), Bioterrorism: Psychological and public health interventions (pp. 200–229). New York, NY: Cambridge University Press.Google Scholar
  20. Kim, I.-H., & Noh, S. (2016). Racial/ethnic variations in the main and buffering effects of ethnic and nonethnic supports on depressive symptoms among five ethnic immigrant groups in Toronto. Ethnicity & Health, 21(3), 215–232. Scholar
  21. Kim, W., Kang, S.-Y., & Kim, I. (2015). Depression among Korean immigrant elders living in Canada and the U.S.: A comparative study. Journal of Gerontological Social Work, 58(1), 86–103. Scholar
  22. Kim, K. C., Kim, S., & Hurh, W. M. (1991). Filial piety and intergenerational relationship in Korean immigrant families. The International Journal of Aging and Human Development, 33(3), 233–245. Scholar
  23. Kline, R. B. (2016). Principles and practice of structural equation modeling (4th ed.). New York, NY: The Guilford Press.Google Scholar
  24. Kuk, K., & Lichter, D. T. (2011). New Asian destinations: A comparative study of traditional gateways and emerging immigrant destinations. Paper presented at the population Association of America. DC: Washington Scholar
  25. Kuo, B. C. H., Chong, V., & Joseph, J. (2008). Depression and its psychosocial correlates among older Asian immigrants in North America. Journal of Aging and Health, 20(6), 615–652. Scholar
  26. Lai, D. W. L. (2004). Impact of culture on depressive symptoms of elderly Chinese immigrants. Canadian Journal of Psychiatry (Revue Canadienne De Psychiatrie), 49(12), 820–827.CrossRefGoogle Scholar
  27. Lee, E.-K. O. (2007). Religion and spirituality as predictors of well-being among Chinese American and Korean American older adults. Journal of Religion, Spirituality & Aging, 19(3), 77–100. Scholar
  28. Lee, E.-K. O., & Chan, K. (2009). Religious/spiritual and other adaptive coping strategies among Chinese American older immigrants. Journal of Gerontological Social Work, 52(5), 517–533. Scholar
  29. Lee, H. Y., Moon, A., & Knight, B. G. (2005). Depression among elderly Korean immigrants. Journal of Ethnic and Cultural Diversity in Social Work, 13(4), 1–26. Scholar
  30. Lim, S., Yi, S. S., Lundy De La Cruz, N., & Trinh-Shevrin, C. (2017). Defining ethnic enclave and its associations with self-reported health outcomes among Asian American adults in new York City. Journal of Immigrant and Minority Health, 19(1), 138–146. Scholar
  31. Mui, A. C., & Kang, S.-Y. (2006). Acculturation stress and depression among Asian immigrant elders. Social Work, 51, 243–255.CrossRefGoogle Scholar
  32. Mui, A. C., & Lee, E. S. (2014). Correlates of depression among Chinese and Korean immigrant elders in the United States. Ageing International, 39(3), 274–288. Scholar
  33. Mui, A. C., Kang, S.-Y., Kang, D., & Domanski, M. D. (2007). English language proficiency and health-related quality of life among Chinese and Korean immigrant elders. Health & Social Work, 32(2), 119–127. Scholar
  34. Oh, H., Ardelt, M., & Koropeckyj-Cox, T. (2016). Daughters’ generation: The importance of having daughters living nearby for older Korean immigrants mental health. Journal of Family Issues, 38, 1–17. Scholar
  35. Park, K. (1997). The Korean immigrant dream: Immigrant and small business in new York City. Ithaca, NY: Cornell University Press.Google Scholar
  36. Park, S.-Y., & Bernstein, K. (2008). Depression and Korean American immigrants. Archives of Psychiatric Nursing, 22(1), 12–19. Scholar
  37. Pew Research Center. (2012). Asian Americans: A mosaic of faiths. Pew Research Center. Retrieved from
  38. Pew Research Center. (2013). The rise of Asian Americans: Updated Edition. D.C.: Washington Retrieved from Scholar
  39. Preacher, K. J., & Hayes, A. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40(3), 879–891. Scholar
  40. Prelow, H. M., Mosher, C. E., & Bowman, M. A. (2006). Perceived racial discrimination, social support, and psychological adjustment among African American college students. Journal of Black Psychology, 32, 442–454. Scholar
  41. Ramakrishnan, K., & Ahmad, F. Z. (2014). Demographics: Part of the “state of Asian Americans and Pacific islanders” series. In Center for American Progress Retrieved from Scholar
  42. Rhee, S. L. (2016). Acculturative stress and depressive symptoms among Korean immigrant elders residing in non-Korean ethnic enclaves. Journal of Ethnic & Cultural Diversity in Social Work, 26, 1–19. Scholar
  43. Roh, S., Lee, K. H., & Yoon, D. P. (2012). General well-being of Korean immigrant elders: The significance of religiousness/spirituality and social support. Journal of Social Service Research, 39(4), 483–497. Scholar
  44. Ryan, A. S., Mui, A. C., & Cross, P. (2003). Asian American elders in new York City: A study of health, social needs, quality of life and quality of care. New York: The Asian American Federation of New York. Retrieved from.Google Scholar
  45. SAMHSA, Substance Abuse and Mental Health Services Administration. (2011). The Treatment of Depression in Older Adults: Depression and Older Adults: Key Issues (HHS Pub. No. SMA-11–4631). Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services. Retrieved from
  46. Statacorp. (2011). Stata statistical software: Release 12. College Station, TX: StataCorp, LP.Google Scholar
  47. Sun, F., Gao, X., Gao, S., Li, Q., & Hodge, D. R. (2016). Depressive symptoms among older Chinese Americans: Examining the role of acculturation and family dynamics. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences., gbw038.
  48. Sung, K.-T. (1990). A new look at filial piety: Ideals and practices of family-centered parent care in Korea.. The Gerontologist, 30(5), 610–617. CrossRefGoogle Scholar
  49. Taylor, S. E., & Broffman, J. I. (2011). Psychosocial resources: Functions, origins, and links to mental and physical health. In M. O. James & P. Z. Mark (Eds.), Advances in Experimental Social Psychology (Vol. volume 44, pp. 1–57): Academic press.Google Scholar
  50. Taylor, S. E., Sherman, D. K., Kim, H. S., Jarcho, K., Takagi, K., & Dunagan, M. S. (2004). Culture and social support: Who seeks it and why? Journal of Personality and Social Psychology, 87(3), 354–362. Scholar
  51. Tsai, D. T., & Lopez, R. A. (1998). The use of social supports by elderly Chinese immigrants. Journal of Gerontological Social Work, 29(1), 77–94. Scholar
  52. Tsutsui, T., Muramatsu, N., & Higashino, S. (2014). Changes in perceived filial obligation norms among coresident family caregivers in Japan. The Gerontologist, 54(5), 797–807. Scholar
  53. U.S. Census Bureau. (1990a). 1990 census of population. In General population characteristics Retrieved from Scholar
  54. U.S. Census Bureau. (1990b). 1990 Census of Population: Asian and Pacific Islanders in the United States (1990 CP-3-5). Retrieved from
  55. U.S. Census Bureau. (2001). Census 2000 Summary File 2 (SF 2). Retrieved from
  56. Ware, J. E. (1993). SF-36 health survey: Manual and interpretation guide. Boston: Health Institute, New England Medical Center.Google Scholar
  57. Ware, J. E., Kosinski, M., Dewey, J. E., & Gandek, B. (2000). SF-36 health survey: Manual and interpretation guide: Quality metric Inc.Google Scholar
  58. WHO, World Health Organization. (2016). Mental health and older adults. Fact Sheet No. 381. Retrieved from
  59. Wong, S. T., Yoo, G. J., & Stewart, A. L. (2005). Examining the types of social support and the actual sources of support in older Chinese and Korean immigrants. The International Journal of Aging and Human Development, 61(2), 105–121. Scholar
  60. Wong, S. T., Yoo, G. J., & Stewart, A. L. (2006). The changing meaning of family support among older Chinese and Korean immigrants. The Journals of Gerontology: Series B, 61(1), S4–S9. Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.School of Social WorkUniversity at BuffaloBuffaloUSA
  2. 2.Department of Social WorkBinghamton UniversityBinghamtonUSA

Personalised recommendations