Pilots
ABSTRACT YEAR 4
Elucidating resilience during COVID-19 pandemic in older Chinese immigrants living in congregate, low-income housing in the United States.
- PI: Judy Tan, Assistant Professor, University of California - San Francisco
- July 2021 – June 2022
Among Asians in the U.S., COVID-19 case-fatality rates are alarmingly high and testing rates are among the lowest. Older Asian immigrants living in low-income, congregate housing are particularly vulnerable to highly communicable diseases like COVID-19 due to older age, multimorbidity, poorer health, and living in low-income housing where crowded conditions exacerbate transmission risks. There is a paucity of disaggregated data on how health-related information is disseminated through informal social networks, including multigenerational family structures, among older Chinese immigrants. This pilot study will address a critical and urgent knowledge gap regarding low COVID testing rates but high death rates among Chinese immigrant communities as well as inform community-based intervention strategies that leverage informal social networks among older Chinese immigrants with limited English proficiency, the largest Asian ethnic group in the San Francisco Bay Area.
Attitudes toward and experiences of family involvement in end-of-life care among older Southeast Asian Americans and Chinese Americans: How does family relationship matter?
- PI: Kaipeng Wang, Assistant Professor, University of Denver
- July 2021 – June 2022
Asian Americans are one of the fastest growing geriatric populations in the United States, with an estimated 2.3 million older AAs (65 years or older) in 2017. Additionally, older AAs are projected to reach 8 million in 2060 and constitute 8% of the entire U.S. geriatric population. Despite the continuing rapid increase of older AAs, there is a paucity of research on this population’s health and mental health disparities. This is particularly problematic because many older AAs are at high risk for distressful or traumatic experiences due to migration, acculturation, and other challenging life events as they move to the United States. As a result, older AAs are vulnerable to various psychosocial challenges, such as social isolation, depression and anxiety, low self efficacy, and poor health service utilization. In turn, older AAs suffer from significant health disparities across health outcome domains, especially in chronic diseases and psychosocial distress. When faced with a distressing or traumatic life events, older AAs often turn to their social support systems, namely their family support, to cope with psychosocial challenges. This present study focuses on examining the association between family relationship and older Southeast AAs’ experiences and attitudes toward family involvement in EOL care and comparing those associations between older Southeast AA subgroups and Chinese Americans. Qualitatively exploring how resilience is influenced by family relationship will be a secondary aim to deepen the understanding of resilience among older AAs.
Understanding mental health among aging Filipinos: the digital world and COVID-19.
- PI: Melanie D. Sabado-Liwag, Assistant Professor, California State University-Los Angeles
- July 2021 – June 2022
Filipinos represent the third-largest ethnic minority group, and second-largest Asian American Pacific Islander (AAPI) group in the US, comprising of about 3.4 million. Of the 10 million people who reside in Los Angeles County, AAPIs make up approximately 14.5% of the population, with approximately 395,580 Filipinos – 60% of which are foreign born.1,2 Despite being one of the largest and rapidly expanding ethnic groups and the second largest AAPI population in Los Angeles County, the health needs of Filipinos are poorly understood and underestimated.2-5 Aggregated as ‘model minorities’, the social and economic diversity among AAPI sub-ethnic groups are masked, overlooked, and deemed as unproblematic.6 Although Filipinos are federally classified as Asian, historically, their cumulative cultural characteristics are exclusively experienced, which has shaped them to be the most imbibed and largest foreign-born English (as second language) speaking community in the US today.7,8 Colonialized by Western societies for over 400 years and supported by Philippine dependence for foreign work and remittances, Filipinos have built a cultural norm of an outwardly, pococurante demeanor that has kept them fully assimilated and unmasked for decades.6-10 Despite these efforts to be ‘under the radar’, the Filipino community has yet to fully combat intergenerational trauma induced by an acculturated identity which further complicates the identification of singular social determinants that plague poor Filipino health outcomes across the lifespan. Understanding aging Filipino’s mental, physical, and sociocultural resilience is essential in distributing resources to (1) improve mitigation strategies post COVID-19, (2) close digital disparities among elder Filipinos and (3) develop interventions for healthcare teams caring for adult Filipinos with pre-existing health conditions.
The Impact of Immigrant Diversity on Community-Wide Resilience against Age-Related Diseases: The NEIGHBORS Study.
- PI: Robert Huang, Instructor, Stanford University
- July 2021 – June 2022
The number of immigrants in the US is projected to reach over 72 million by 2060, which will make up approximately 1 in 5 people in the US. Currently, nearly 30% of foreign-born Americans are from Asia, and with accelerating rates of Asian immigration this proportion will grow over the coming decade. Previous research (CAUSES Study, R01MD007012) has demonstrated that although immigrants have lower SES than non-immigrants, immigrants demonstrate lower overall mortality and as a whole are healthier than non-immigrants. The “healthy immigrant effect” may be observed for several reasons including 1) lower prevalence of deleterious behaviors such as tobacco smoking, 2) lower rates of obesity, 3) healthier food environments,24 4) higher consumption of fruits and vegetables, and 5) higher levels of physical activity (such as walking and biking) compared to nonimmigrants. Our central hypothesis is that Asian immigrants not only demonstrate better personal health outcomes, but may also positively impact community-level resilience to age-related diseases through mediation of the cultural, dietary, and environmental characteristics of their communities. This study will inform clinicians, policymakers, urban planners, as well as the general public, on how community diversity shapes our collective health behaviors and outcomes.
Exploring the associations between religious coping, resiliency, and social support and the physical and mental health of Bhutanese refugee older adults in Ohio.
- PI: Saruna Ghimire, Assistant Professor, Miami University
- July 2021 – June 2022
Acknowledging that Asians are one of the most understudied racial/ethnic group in the US, with the Bhutanese refugees even further understudied, we believe this study is highly significant to enhance our understanding of diversity within the Asian population. Furthermore, by virtue of their unique history, likely marked by both trauma and resiliency, this population may exemplify the antithesis of the "model minority" stereotype faced by Asians in the U.S. One central theme in successful aging research is that we should aim to understand how adverse exposures and challenges across the life span lead to health disparities in late life; conversely, understanding how resilience can mitigate against adverse effects is also key. Our population likely provides an exemplary case of trauma and subsequent resiliency. From the life-course perspective, understanding the role of midlife exposure to trauma in shaping later life is still poorly understood. However, given the lack of understanding of this population's basic health profile, an exploratory study to assess their health outcomes is necessary as a stepping stone that will lead to the identification of future research directions.
