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Tran S, Wormley AS, Louie P, Sheehan C. Increasing psychological distress among Californians from 2013 to 2020: Race/ethnic differences. SSM - MENTAL HEALTH 2022; 2:100101. [PMID: 36590986 PMCID: PMC9792130 DOI: 10.1016/j.ssmmh.2022.100101] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 03/24/2022] [Accepted: 04/19/2022] [Indexed: 01/13/2023] Open
Abstract
The influence of the COVID-19 pandemic on mental health is of mounting concern to population-health researchers. While early reports indicated increases in mental health problems, noticeably absent from these studies is how mental health has changed in 2020 compared to previous years (2013-2019) and whether such trends vary by race/ethnicity. The present study used repeated cross-sectional data from the California Health Interview Survey (n = 168,216) to systematically document trends in psychological distress scores (Kessler-6 scale; K6) and severe psychological distress scores (K6; 13+) from 2013 to 2020 and by race/ethnicity over the same period. Among all Californians we find that the reported average psychological distress scores increased by 22% between 2013 and 2020. Reported severe psychological distress scores increased 61% from 2013 to 2020. These increases were largely concentrated in the years 2017-2020. Increases in psychological distress were also especially pronounced among non-Latino/a White Californians (29% increase in K6 from 2013 to 2020), Latino/a Californians (14% increase in K6 from 2013 to 2020), and Asian Californians (35% increase in K6 from 2013 to 2020). Multiple and logistic regression models that accounted for sociodemographic and behavioral health covariates echoed these findings. Future research should continue to investigate secular trends in mental health that coincided with the COVID-19 pandemic and carefully situate the shifts into broader temporal perspective.
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Affiliation(s)
- Sydney Tran
- Department of Psychology, Arizona State University, USA
| | | | | | - Connor Sheehan
- School of Social and Family Dynamics, Arizona State University, USA,Corresponding author. P.O. Box 873701, Tempe, AZ, 85287-3701, USA
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Siddiqui ZA, Sambamoorthi U. Psychological Distress Among Asian Indians and Non-Hispanic Whites in the United States. Health Equity 2022; 6:516-526. [PMID: 36186615 PMCID: PMC9518809 DOI: 10.1089/heq.2021.0159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction: The prevalence of psychological distress (PD) among Asian Indians is unknown. This study estimated and compared moderate–serious PD in Asian Indians and non-Hispanic Whites (NHWs) in the United States. Methods: We used a cross-sectional design using the National Health Interview Survey (2012–2017). Adult (age >18 years) NHWs and Asian Indians (N=2,218) were included. PD was measured using the six-item Kessler (K6) scale. We used multivariable logistic regression to determine the association of Asian Indian ethnicity with PD. Results: In the analysis, 19.9% of NHWs and 11.0% of Asian Indians reported moderate–serious PD. Asian Indians were less likely to report PD in both unadjusted (unadjusted odds ratio=0.50; 95% confidence interval [CI]=0.42–0.58) and fully adjusted (adjusted odds ratio=0.7; 95% CI 0.59–0.82) models. Conclusions: Asian Indians had a lower prevalence of PD than NHWs, likely due to multiple protective factors such as high socioeconomic status and lower multimorbidity.
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Affiliation(s)
- Zasim Azhar Siddiqui
- Department of Pharmaceutical Systems and Policy, West Virginia University School of Pharmacy, Robert C. Byrd Health Sciences Center, Morgantown, West Virginia, USA
| | - Usha Sambamoorthi
- Department of Pharmaceutical Systems and Policy, West Virginia University School of Pharmacy, Robert C. Byrd Health Sciences Center, Morgantown, West Virginia, USA
- Department of Pharmacotherapy, College of Pharmacy, Texas Center for Health Disparities, University of North Texas Health Science Center, Fort Worth, Texas, USA
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Ta Park VM, Park CJ, Kim C, Nguyen NCY, Tran AT, Chiang A, Rho SIJ, Olaisen RH, Vuong Q, Rosas LG, Cho MK. Use of Korean dramas to facilitate precision mental health understanding and discussion for Asian Americans. Health Promot Int 2021; 36:1425-1438. [PMID: 33582752 DOI: 10.1093/heapro/daab012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Precision mental health holds great potential for revolutionizing care and reducing the burden of mental illness. All races and ethnicities such as Asian Americans, the fastest growing racial group in the United States (U.S.), need to be engaged in precision mental health research. Owing to its global popularity, Korean drama ('K-drama') television shows may be an effective educational tool to increase precision mental health knowledge, attitudes and behaviors among Asian Americans. This qualitative study examined the participants' perspectives about and acceptance of using K-dramas to educate and engage Asian Americans about precision mental health. Twelve workshops were conducted in English, Vietnamese and Korean with a convenience sample in the San Francisco Bay Area in the U.S. (n = 122). Discussions were coded for themes. Findings revealed that all language groups reported positive reactions to using K-dramas to learn about precision health, genetics and mental health. Overall, participants shared that they learned about topics that are not generally talked about (e.g. precision health; genetic testing; mental health), from other people's perspectives, and the importance of mental health. Participants expressed how much they enjoyed the workshop, how they felt relieved due to the workshop, thought the workshop was interesting, and had an opportunity for self-reflection/healing. This pilot test demonstrated that K-dramas has promise to be used as a health educational tool in a workshop format focused on mental health among a diverse group of Asian Americans. Given the widespread access to K-dramas, they present a scalable opportunity for increasing awareness about specific health topics.
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Affiliation(s)
- Van My Ta Park
- Department of Community Health Systems, School of Nursing, University of California at San Francisco, San Francisco, CA 94143, USA
| | | | - Charles Kim
- Department of Health Science and Recreation, San Jose State University, San Jose, CA 95192, USA
| | - Nhi Cristina Y Nguyen
- Department of Health Science and Recreation, San Jose State University, San Jose, CA 95192, USA
| | - Anh T Tran
- Department of Health Science and Recreation, San Jose State University, San Jose, CA 95192, USA
- International Children Assistance Network, Milpitas, CA 95035, USA
| | - Anna Chiang
- Department of Health Science and Recreation, San Jose State University, San Jose, CA 95192, USA
| | - Si-Inn J Rho
- Department of Psychology, San Jose State University, San Jose, CA 95192, USA
| | - R Henry Olaisen
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Quyen Vuong
- International Children Assistance Network, Milpitas, CA 95035, USA
| | - Lisa G Rosas
- Department of Health Research and Policy, Stanford University, Stanford, CA 94305, USA
- Department of Primary Care and Population Health, Stanford University, Stanford, CA 94305, USA
| | - Mildred K Cho
- Department of Primary Care and Population Health, Stanford University, Stanford, CA 94305, USA
- Center for Biomedical Ethics, Stanford University, Stanford, CA 94305, USA
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Jiang JJ, Adia AC, Nazareno J, Operario D, Ponce NA, Shireman TI. The Association Between Moderate and Serious Mental Health Distress and General Health Services Utilization Among Chinese, Filipino, Japanese, Korean, and Vietnamese Adults in California. J Racial Ethn Health Disparities 2021; 9:227-235. [PMID: 33452574 DOI: 10.1007/s40615-020-00946-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 12/06/2020] [Accepted: 12/14/2020] [Indexed: 11/25/2022]
Abstract
INTRODUCTION A growing body of literature has indicated that disaggregated analyses using distinct Asian subgroups allow for identification of varying mental health challenges and health services utilization. In this study, we examined the associations between distress and health services utilization among five Asian subgroups: Chinese, Korean, Japanese, Filipino, and Vietnamese adults in California. MATERIALS AND METHODS Using a combined dataset using the 2011-2018 cross-sectional cycles of the California Health Interview survey, we assessed moderate and serious distress and four health services utilization indicators in a set of disaggregated analyses among adults 18 years of age and older in five Asian subgroups. We performed bivariate and multivariable analyses. RESULTS The prevalence of and associations between moderate and serious distress and gaps in health services utilization varied among each Asian subgroup. Koreans had the highest prevalence of moderate and serious distress and the most gaps in health services utilization. Compared to those without moderate distress (p < .05), Japanese adults were more likely to delay care. Compared to those without serious distress (p < .05), Chinese adults who experienced serious distress were more likely to delay both medications and care, whereas Filipino and Vietnamese adults were more likely to delay medications. DISCUSSION Disaggregating health data elucidates the impact of mental distress on healthcare-seeking behaviors among specific Asian subgroups. Identifying these influences can facilitate future tailored interventions, yet fully understanding the mechanism linking mental distress and healthcare usage will necessitate a comprehensive assessment of structural influences and Asian American experiences without otherization.
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Affiliation(s)
- Joy J Jiang
- Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Alexander C Adia
- Philippine Health Initiative for Research, Service, & Training, Brown University School of Public Health, Providence, RI, USA.
| | - Jennifer Nazareno
- Philippine Health Initiative for Research, Service, & Training, Brown University School of Public Health, Providence, RI, USA
| | - Don Operario
- Philippine Health Initiative for Research, Service, & Training, Brown University School of Public Health, Providence, RI, USA
| | - Ninez A Ponce
- UCLA Department of Health Policy and Management, Fielding School of Public Health, Los Angeles, CA, USA
- UCLA Center for Health Policy Research, Los Angeles, CA, USA
| | - Theresa I Shireman
- Center for Gerontology & Healthcare Research, Brown University School of Public Health, Providence, RI, USA
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Park H, Choi E, Wenzel JA. Racial/ethnic differences in correlates of psychological distress among five Asian-American subgroups and non-Hispanic Whites. ETHNICITY & HEALTH 2020; 25:1072-1088. [PMID: 29843534 DOI: 10.1080/13557858.2018.1481495] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 05/03/2018] [Indexed: 06/08/2023]
Abstract
Objective: Despite their vastly different historical backgrounds, unique languages and variable pre- and post-immigration experiences, Asian-Americans are considered to share stressors surrounding immigration, but there is a gap in describing manifestations of possible mental distress. Thus, the purpose of this study was to explore and compare differences in factors associated with psychological distress among Asian subgroups including Chinese, Filipino, Vietnamese, Korean, Japanese, and non-Hispanic Whites. Design: Using a cross-sectional study design, California Health Interview Survey (CHIS) 2011/2012 data were analyzed. The sample consisted of 29,142 participants: 25,645 non-Hispanic Whites, 3497 non-Hispanic Asian-Americans, 1156 Chinese, 471 Filipinos, 864 Vietnamese, 704 Koreans, and 302 Japanese. Sociodemographic characteristics included gender, age group, marital status, education, poverty level, working status, health insurance, level of acculturation, social cohesion, neighborhood safety, and civic engagement. Physical health status included disability and chronic illness. Psychological distress was evaluated using the Kessler 6 (K6) scale. Results: Results showed that psychological distress levels ranged between 1.96 and 4.52 (p < .05) out of 24 and associated factors were significantly different among the five Asian subgroups and non-Hispanic Whites. Conclusions: The current study highlights the differences in characteristics of psychological distress among Asian subgroups. It underscores the significance of understanding individualized cultural and historical background in each Asian subgroup and subsequently developing and applying appropriate interventions for those groups. In addition, different influencing factors should be applied to assess and prioritize the needs of Asian subgroups to improve psychological distress. The study also warrants further investigation and careful description of each Asian subgroups.
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Affiliation(s)
- Hyunjeong Park
- Department of Nursing, Towson University, Towson, MD, USA
| | - Eunsuk Choi
- School of Nursing & Research Institute of Nursing Science, Kyungpook National University, Daegu, South Korea
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Nguyen KH, Trivedi AN. Asian American Access to Care in the Affordable Care Act Era: Findings from a Population-Based Survey in California. J Gen Intern Med 2019; 34:2660-2668. [PMID: 31512183 PMCID: PMC6848322 DOI: 10.1007/s11606-019-05328-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 05/14/2019] [Accepted: 08/16/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Though Asian Americans made gains in coverage following the Affordable Care Act (ACA), substantial variations in access to care remain across different ethnic subgroups. Several states are considering adoption of policies to collect health data for Asian Americans that is disaggregated by ethnic subgroup, which may identify disparities in access to care. OBJECTIVE We examined coverage and access to care between non-Hispanic White and Asian American adults following the ACA in California. We first compared outcomes in non-Hispanic White adults with all Asian Americans in our sample, and then evaluated whether we detect disparities when data is disaggregated into five of the most populous ethnic subgroups (Chinese, Korean, Filipino, Vietnamese, and Japanese). DESIGN Cross-sectional California Health Interview Survey data were collected between January 2014 and December 2016. PARTICIPANTS Our sample included 19,201 non-Hispanic White and 3077 Asian American non-elderly adults age 18 to 64 living in California. MAIN MEASURES Our outcomes were (1) being uninsured, (2) having a usual source of care, (3) delaying necessary medical care, and (4) delaying necessary prescription medications. Using multivariable logistic regression models, we examined our outcomes, adjusting for predisposing, enabling, need, and acculturation factors. KEY RESULTS Compared with non-Hispanic Whites, some subgroups of Asian Americans reported significantly worse access to care: disaggregated, adjusted analyses revealed that Koreans were significantly less likely to report a usual source of care (adjusted odds ratio [AOR] = 0.31, p < 0.01) relative to non-Hispanic Whites. Chinese (AOR = 0.42, p < 0.01) and Vietnamese (AOR = 0.34, p < 0.01) adults were significantly less likely to delay necessary care. CONCLUSIONS Disaggregated analyses identified differences in access to care for Asian American subgroups following the ACA. State policies to collect disaggregated health data for Asian Americans may reveal heterogeneity in experiences of care and inform specific policies to reduce disparities in access to care.
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Affiliation(s)
- Kevin H Nguyen
- Brown University School of Public Health, Providence, RI, USA.
| | - Amal N Trivedi
- Brown University School of Public Health, Providence, RI, USA.,Providence Veterans Affairs Medical Center, Providence, RI, USA
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