Self-reports of stress in Asian immigrants: effects of ethnicity and acculturation.
BACKGROUND
Although the concept of stress is hard to define or measure, it is a phenomenon associated with a number of health conditions, including hypertension, heart disease, and decreased immunocompetency. Events such as migration are known to create stress; researchers refer to this as acculturative stress. Given that cultural background might influence a patient's recognition, interpretation, and coping mechanisms for stress, we wondered how self-reports of stress by Asian immigrants compare with those of non-Hispanic Whites, and how these self-reports vary with years since immigration, a proxy for acculturation.


METHODS
Data from the National Health Information Survey for 1993 and 1995 were analyzed for six groups of Asian national origin, and were compared with non-Hispanic Whites. Using ordered logistic regression, we examined self-reports of stress over two weeks and twelve months, as well as the changes in these self-reports with years since immigration.


RESULTS
Adjusted for age, income, educational level, marital status, and gender, Asian immigrants were uniformly less likely to report stress over a two-week period than were non-Hispanic Whites (OR ranges: 0.34[Asian Indian]-0.59[Korean], P values<.05). There were no significant differences in reported stress among Asian ethnic groups. Compared with immigrants who have lived in the United States for at least 15 years, recent immigrants (<1 year) were likely to report less stress over two weeks and twelve months, OR = 0.13 and 0.23, respectively, P values<.005.


CONCLUSIONS
Despite their status as immigrants, Asians report less stress than non-Hispanic Whites. These reports of stress increase as years since immigration increase. One potential explanation for these discrepancies is under-reporting, which might reflect underlying cultural differences in the perception or definition of stress, differences that may diminish with "acculturation."
Uppaluri
C R
CR
Robert Wood Johnson Clinical Scholars Program, The University of Chicago, Illinois, USA. cuppaluri@aol.com
Schumm
L P
LP
Lauderdale
D S
DS
D000069:Acculturation; D000328:Adult; D001213:Asian; D002681:China / Q000208:ethnology; D004641:Emigration and Immigration; D005260:Female; D006801:Humans; D007194:India / Q000208:ethnology; D007564:Japan / Q000208:ethnology; D007723:Korea / Q000208:ethnology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010679:Philippines / Q000208:ethnology; D013315:Stress, Psychological / Q000208:ethnology*; D014744:Vietnam / Q000208:ethnology