Health-Seeking Behaviors of Filipino Migrants in Australia: The Influence of Persisting Acculturative Stress and Depression


This study examined the relationships among the constructs of acculturative stress, depression, English language use, health literacy, and social support and the influence of these factors on health-seeking behaviors of Filipino Australians. Using a self-administered questionnaire, 552 respondents were recruited from November 2010 to June 2011. Structural equation modelling was used to examine relationships. A direct and negative relationship between health-seeking behaviors and depression, and an indirect relationship with acculturative stress, was observed mediated through depression. Social support had an important moderating influence on these effects. Although there was an inverse relationship between age and English language usage and depression, age was positively related to health-seeking behavior. Despite their long duration of stay, Filipino Australian migrants continue to experience acculturative stress and depression leading to lower health-seeking behaviors. This study highlights the importance of screening for acculturative stress and depression in migrants and fostering social support.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2


  1. 1.

    Lassetter JH, Callister LC. The impact of migration on the health of voluntary migrants in Western societies: a review of the literature. J Transcult Nurs. 2009;20:93–104.

    Article  PubMed  Google Scholar 

  2. 2.

    Jatrana S, Pasupuleti SSR, Richardson K. Nativity, duration of residence and chronic health conditions in Australia: do trends converge towards the native-born population? Soc Sci Med. 2014;119:53–63.

    Article  PubMed  Google Scholar 

  3. 3.

    Cunningham S, Ruben JD, Venkat Narayan K. Health of foreign-born people in the United States: a review. Health Place. 2008;14:623–35.

    Article  Google Scholar 

  4. 4.

    Hwang W-C, Ting JY. Disaggregating the effects of acculturation and acculturative stress on the mental health of Asian Americans. Cultur Divers Ethnic Minor Psychol. 2008;14:147.

    Article  PubMed  Google Scholar 

  5. 5.

    MacKian S. A review of health seeking behaviour: problems and prospects. Internal concept paper Health Systems Development Programme, London School of Hygiene and Tropical Medicine London. 2001.

  6. 6.

    Choi JY. Reconstruction of health-seeking behaviors a comparative study of three Asian Pacific immigrant groups. Qual Health Res. 2013;23:517–30.

    Article  PubMed  Google Scholar 

  7. 7.

    Kwok C, Sullivan G. Health seeking behaviours among Chinese-Australian women: implications for health promotion programmes. Health (NY). 2007;11:401–15.

    Google Scholar 

  8. 8.

    Lorant V, Van Oyen H, Thomas I. Contextual factors and immigrants’ health status: double jeopardy. Health Place. 2008;14:678–92.

    Article  PubMed  Google Scholar 

  9. 9.

    Serafica R. Concept analysis of acculturation in Filipino Immigrants within health context. Nurs Forum. 2011;46:128–36.

    Article  PubMed  Google Scholar 

  10. 10.

    David E. A colonial mentality model of depression for Filipino Americans. Cultur Divers Ethnic Minor Psychol. 2008;14:118.

    CAS  Article  PubMed  Google Scholar 

  11. 11.

    Australian Bureau of Statistics. 2004–2005 migration—Australia (3412.0). Canberra: ABS, Commonwealth of Australia; 2007.

  12. 12.

    ABS Census. 2011 QuickStats Country of Birth (Philippines). In: 2011 ABS, ed. Canberra; 2011.

  13. 13.

    Maneze D, Salamonson Y, Attwood N, Davidson PM. Acculturative stress in Filipino migrants with functional English: Implications for health promotion. Int J Cult Mental Health. 2013;7:1–13.

    Article  Google Scholar 

  14. 14.

    Sorkin DH, Nguyen H, Ngo-Metzger Q. Assessing the mental health needs and barriers to care among a diverse sample of Asian American older adults. J Gen Intern Med. 2011;26:595–602.

    Article  PubMed  PubMed Central  Google Scholar 

  15. 15.

    Sanchez F, Gaw A. Mental health care of Filipino Americans. Psychiatr Serv. 2007;58:810–5.

    Article  PubMed  Google Scholar 

  16. 16.

    Gentilucci U, Picardi A, Manfrini S, Khazrai Y, Fioriti E, Altomare M, et al. Westernization of the Filipino population resident in Rome: obesity, diabetes and hypertension. Diabetes Metab Res Rev. 2008;24:364–70.

    CAS  Article  PubMed  Google Scholar 

  17. 17.

    Aukst-Margetić B, Margetić B. Religiosity and health outcomes: review of literature. Coll Antropol. 2005;29:365–71.

    PubMed  Google Scholar 

  18. 18.

    Stokols D. Translating social ecological theory into guidelines for community health promotion. Am J Health Promot. 1996;10:282–98.

    CAS  Article  PubMed  Google Scholar 

  19. 19.

    Estacio EV. Human exploitation Is NOT a joke—so don’t laugh! J Health Psychol. 2009;14:627–37.

    Article  PubMed  Google Scholar 

  20. 20.

    Lueck K, Wilson M. Acculturative stress in Asian immigrants: the impact of social and linguistic factors. Int J Intercult Rel. 2010;34:47–57.

    Article  Google Scholar 

  21. 21.

    Kroenke K, Spitzer RL, Williams JB. The Patient Health Questionnaire-2: validity of a two-item depression screener. Med Care. 2003;41:1284–92.

    Article  PubMed  Google Scholar 

  22. 22.

    Nho CR. Psychological well-being of Korean American and immigrant adolescents. New York: Columbia University; 2000.

  23. 23.

    Hovey JD. Acculturative stress, depression, and suicidal ideation in Mexican immigrants. Cultur Divers Ethnic Minor Psychol. 2000;6:134.

    CAS  Article  PubMed  Google Scholar 

  24. 24.

    David E, Okazaki S. Colonial mentality: a review and recommendation for Filipino American psychology. Cultur Divers Ethnic Minor Psychol. 2006;12:1.

    CAS  Article  PubMed  Google Scholar 

  25. 25.

    Bausell C, Bausell R. The internal structure of health-seeking behavior. Eval Health Prof. 1987;10:460–75.

    Article  Google Scholar 

  26. 26.

    Salamonson Y, Everett B, Koch J, Andrew S, Davidson P. English language acculturation predicts academic performance in nursing students who speak English as a second language. Res Nurs Health. 2008;31:86–94.

    Article  PubMed  Google Scholar 

  27. 27.

    Kang S-M. Measurement of acculturation, scale formats, and language competence: their implications for adjustment. J Cross Cult Psychol. 2006;37:669–93.

    Article  Google Scholar 

  28. 28.

    Chew L, Bradley K, Boyko E. Brief questions to identify patients with inadequate health literacy. Health. 2004;11:12.

    Google Scholar 

  29. 29.

    Powers JR, Goodger B, Byles JE. Assessment of the abbreviated Duke Social Support Index in a cohort of older Australian women. Australas J Ageing. 2004;23:71–6.

    Article  Google Scholar 

  30. 30.

    Tondo J. Popular religiosity and the transnational journey: inscribing Filipino identity in the Santo Niño Fiesta in New Zealand. Asia Pac J Anthropol. 2010;11:219–44.

    Article  Google Scholar 

  31. 31.

    Koenig H, Büssing A. The Duke University Religion Index (DUREL): a five-item measure for use in epidemological studies. Religions. 2010;1:78–85.

    Article  Google Scholar 

  32. 32.

    Tabachnick BG. Using multivariate statistics. Boston: Pearson; 2013.

  33. 33.

    Byrne BM. Structural equation modeling with AMOS: basic concepts, applications, and programming. Boca Raton: CRC Press; 2009.

  34. 34.

    Mossakowski KN. Are immigrants healthier? The case of depression among Filipino Americans. Soc Psychol Quart. 2007;70:290–304.

    Article  Google Scholar 

  35. 35.

    Li HZ, Browne AJ. Defining mental illness and accessing mental health services: Perspectives of Asian Canadians. Can J Commun Ment Health. 2000;19:143–159.

    CAS  Article  PubMed  Google Scholar 

  36. 36.

    Becker CM, Arnold W. Health promoting behaviors of older Americans versus young and middle aged adults. Educ Gerontol. 2004;30:835–44.

    Article  Google Scholar 

  37. 37.

    Mui AC, Kang S-Y. Acculturation stress and depression among Asian immigrant elders. Soc Work. 2006;51:243–55.

    Article  PubMed  Google Scholar 

  38. 38.

    Gill J, Johnson P. Research methods for managers. London: Sage; 2010.

    Google Scholar 

Download references

Author information



Corresponding author

Correspondence to Della Maneze.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Maneze, D., Salamonson, Y., Poudel, C. et al. Health-Seeking Behaviors of Filipino Migrants in Australia: The Influence of Persisting Acculturative Stress and Depression. J Immigrant Minority Health 18, 779–786 (2016).

Download citation


  • Acculturation
  • Health-seeking behavior
  • Filipino
  • Immigrant
  • Social support
  • Culture