Crossroads: The Psychology of Immigration in the New Century

In a study of Korean elders, there was almost no loss of culture
of origin over time, with most remaining strongly acculturated
to their native culture (Jang et al., 2007). However, the few
findings that exist suggest that isolation from American
culture is harmful. For example, older Korean immigrant
adults who were classified as separated, rather than integrated,
experienced more mental health symptoms (Jang et al., 2007).
A. M. Miller, Sorokin, et al. (2006) found that acculturation
to the new culture was associated with less alienation. This
in turn reduced personal and family stress and then reduced
depression. Further, a perceived cultural gap between adults
and children has been found to predict depression in older
adults (Mui & Kang, 2006).
Among immigrant groups, older adults are the most
vulnerable to mental health problems, with the exception
of victims of warfare and torture (Pumariega, Rothe, &
Pumariega, 2005). Studies of older immigrant adults from
several countries of origin, including Korea, China, Mexico,
and Russia/Eastern Europe, show they are at high risk for
depressive symptoms, somatization, and a variety of traditional
culture-bound syndromes (Black, Markides, & Miller, 1998;
Mui, Kang, Chen, & Domanski, 2003; Stokes, Thompson,
Murphy, & Gallagher-Thompson, 2002; T. Tran, Khatutsky,
Aroian, Balsam, & Conway, 2000). For example, in a study of
Soviet immigrant women over age 65, over 80% met criteria
for depression (A. M. Miller, Sorokin et al., 2006).
In a study of older Mexican Americans, the prevalence of
depression was 30.4% among immigrants compared with
20.5% among U.S.-born (H. M. González, Haan, & Hinton,
2001). The rate of depression in an older adult sample of
diverse Asian immigrants was 40% (76% for Japanese, 64%
for Vietnamese, 50% for Indian, 46% for Chinese, 24%
for Koreans, and 15% for Filipino) (Mui & Kang, 2006).
Considering that prevalence of depression in the general
older adult population is reported to be 15% to 20% (Gallo
& Lebowitz, 1999), these statistics are alarming. Notably,
the expression of distress in older immigrant adults is often
more consistent with traditional symptomatic patterns than
with Western-oriented psychiatric disorders (Pang, 2000).
Older immigrant adults, however, access formal services at an
even lower rate than the already low rate seen in immigrant
populations and are more likely to rely on traditional
healers and remedies (Pumariega, Rogers, & Rothe, 2005).
Undocumented immigrants are not eligible for full-benefit
Medicaid coverage, which can also impede access to care
(Siskin & Lunder, 2009). Further, older immigrant adults may
not be eligible for government health care if they have not
been present in the United States for over 5 years (Schlosberg,
2000). When they do access mainstream services, there can be
misdiagnosis related to measurement issues (Mejía, Miguel,
Gutierrez, Villa, & Ostrosky-Solis, 2006).
Aside from the challenges facing immigrant older adults, this
group can be an important resource for immigrant families.
For example, some older adults immigrate later in life to
provide regular care for their grandchildren. These older
adults often play a critical role in fostering a sense of cultural
continuity for younger generations. At the same time, they
may face conflicts related to the discrepancy between their
life in the country of origin and the new culture in the
United States, potentially contributing to intergenerational
strain within the household (C. Suárez-Orozco & Suárez-
Orozco, 2001). For example, stressors identified by older
Asian Indians included loss of authority due to role reversals
within the family, changes in family roles related to household
duties, different sets of cultural values and experiences
among members of the household, limited ability to speak
English, and increased isolation in contrast to more regular
social interactions in India (Kalavar & Van Willigen, 2005).
Additional factors affecting immigrant older adults include
poverty, lack of access to health care, fraud perpetrated on
them, severe isolation in their own ethnic/racial groups, and
potential physical and emotional abuse by family members
and caregivers.
In Conclusion
There is a clear dearth of research on immigrant populations
from a life span, developmental perspective. As the immigrant
population continues to grow, psychological research is
needed in order to understand the complexities of the
immigrant experience across the life span and the reciprocal
interactions with their environments. For example, research
is needed to understand the psychological implications of
familial separation on children, emerging adults who grew
up in the United States but do not have legal status to work,
adults whose work credentials are disqualified and who are
unable to work in their profession in the United States, and
older adults who immigrate to the United States to care for
their grandchildren. In addition, clinical training is needed to
enable psychologists to provide culturally competent services
to these populations and to better understand how to support
and promote resilience.
46 Report of the APA Presidential Task Force on Immigration