Rutgers study links depression with chronic health conditions in elderly Chinese-American immigrants

Two recent studies by Rutgers researchers found a link between depression and chronic health conditions in more than 50% of elderly Chinese-American immigrants. 

More than 3,000 elderly Chinese Americans above the age of 60 were examined by the team to investigate the relationship between mental health and both the onset of disabilities and other chronic medical conditions such as cancer and diabetes.

The studies were guided by Dr. XinQi Dong and the Population Study of Chinese Elderly (PINE) study team at the Rutgers Institute for Health, Health Care Policy and Aging Research. Both papers were published in the Journal of the American Geriatrics Society and were authored by Dr. Dexia Kong and her team.

“We found that older Chinese Americans with certain chronic medical conditions, including heart disease, stroke, cancer, diabetes and arthritis, are more likely to experience coexisting depressive symptoms,” Kong said.

This coexistence of both depression and chronic conditions often leads to an increase in hospitalizations and emergency department visits, she said. Knowing that, addressing these depressive symptoms is a major public health need.

The study also addresses a lack of public health data on minority populations, focusing on elderly Chinese Americans.

“Simply put, the data usually doesn’t exist. For Chinese especially, this population is usually lumped in with Indians, Koreans, Vietnamese, etc., all of whom have very different experiences. When we just have data about 'Asian Americans,' we aren't able to have any specificity about the cultural nuances or unique outcomes of Chinese Americans," Kong said.

To conduct field research in a Chinese American metropolitan cluster in the greater Chicago area, Kong and her team had to work with more than 20 community organizations including senior apartments, religious groups and social services. They encountered a number of cultural and linguistic challenges while interviewing the group of 3,100 elderly Chinese Americans.

“We had to ensure our measures are culturally and linguistically sensitive so that the interview could be conducted in English and Chinese dialects. Our team developed a novel software application enabling health data to be collected in English, Chinese traditional and simplified characters," Kong said.

The study will hopefully raise awareness of the health consequences that are often caused by depressive symptoms in older Chinese Americans, Kong said. Minority cultures often have a cultural taboo toward mental health that contribute to the problem, and awareness is the first step to developing solutions.

These solutions will likely be family-based.

“Chinese culture has a preference on family caregiving. In fact, most of our research participants are being cared for at home by their adult children. So, we think future intervention strategies focused on mental health awareness need to take a family-based approach, where adult children caregivers need to actively engage in the process as well,” Kong said.

These adult caregivers of elderly Chinese Americans present another interesting question, she said. A sister project of the PINE study has collected data on this population and is hoping to implement two-pronged analyses that look at how the well-being of older Chinese Americans affects the younger Chinese American population.

The team plans on expanding the study to understand the causes of depressive symptoms in aging Chinese Americans.

“We also know that Asian Americans under-utilize professional mental health services in general. But depression help-seeking patterns and behaviors remain poorly understood in this community, and our team plans to investigate this specific issue as the next step to address the disparities," Kong said.