Date of Award

5-1-2021

Language

English

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

College/School/Department

School of Social Welfare

Content Description

1 online resource (xiii, 203 pages) : color illustrations.

Dissertation/Thesis Chair

Julia Hastings

Committee Members

Barry Loneck, Carmen Morano, Mary Gallant

Keywords

aging, Asian Americans, caregivers, CHIS, culture, health, Caregivers, Adjustment (Psychology), Older people

Subject Categories

Asian American Studies | Public Health | Social Work

Abstract

Background: Asian American family caregivers came from various ethnic groups with different sociodemographic characteristics and culturally specific values. However, cultural practices were often overlooked because researchers often combined all Asian Americans under one umbrella. Objective: The purpose of the study was two-fold. First, the study investigated the study sample of Asian Americans participating in the California Health Interview Survey (CHIS) 2009 comprised of multiple Asian American ethnic groups. By utilizing the study sample, the research aimed to investigate 1) the associations between caregiving and self-rated health (SRH) and hypertension and 2) the associations between heterogeneity of Asian American ethnic groups and SRH and hypertension. Second, the study investigated the subsample of Asian American caregivers in the CHIS 2009 survey. By examining the subsample, the research aimed to observe 1) the relationship between caregiving practice patterns and distress, 2) the effects of physical exercise and familism in mediating the relationship between distress and SRH, 3) the association between citizenship and volunteer work, and 4) the associations between sociodemographic characteristics and Asian American ethnic groups and respite care. Methods: Data from the CHIS 2009 were analyzed for 5,104 Asian American ethnic individuals aged 18 to 85 years as the study sample and 747 Asian American caregivers as the study subsample. Unweighted descriptive analyses, weighted bivariate analyses, and weighted multivariate analyses were performed using STATA 16. Results: The findings included 1) caregiving decreased the odds of better SRH; 2) Japanese Americans and South Asian Americans reported higher odds of better SRH whereas Vietnamese Americans reported lower odds of better SRH than Chinese Americans. From within-group analyses, aging decreased the odds of better SRH while living within 300% FPL increased the odds of better SRH for Chinese Americans. Aging, being naturalized citizens, being non-U.S. citizens, and speaking a language other than English at home decreased the odds of better SRH for Vietnamese Americans; 3) Filipino Americans reported higher odds of hypertension than Chinese Americans. From within-group analyses, Chinese Americans reported employment decreased the odds of hypertension but aging increased the odds of hypertension. Korean Americans reported being female decreased the odds of hypertension; however, being widowed/separated/divorced/living with a partner and aging increased the odds of hypertension. Vietnamese Americans reported being female decreased the odds of hypertension; 4) Living with care recipients and caring for two or more care recipients increased relative risk of serious distress; and 5) Never being married decreased the odds of respite care but speaking English and other languages at home increased the odds of respite care. From within-group analyses, employment increased the odds of respite care for Chinese American caregivers. However, pursuing graduate schools and living within 0-99% FPL increased the odds of respite care for Korean American caregivers. Conclusions: Disaggregation of Asian American data was essential to uncover the needs and obstacles faced by a specific Asian American ethnic group. Caregiving and heterogeneity of Asian American ethnic groups played significant roles in health outcomes and respite care utilization. Culture was also influential in Asian Americans’ lives where sociodemographic differences were found within an ethnic group related to health outcomes and respite care utilization. Recognizing caregiving practices related to cultural norms between Asian American ethnic groups and within an ethnic group helped uncover multifaceted challenges, coping mechanisms, and types of support that affected caregivers’ physical and mental health.

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