Social capital and self-rated health among older Korean immigrants.

448528 im and HarrisJournal of Applied Gerontology

JAG32810.1177/0733464812448528K

Article

Social Capital and Self-Rated Health Among Older Korean Immigrants

Journal of Applied Gerontology 32(8) 997–1014 © The Author(s) 2012 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/0733464812448528 jag.sagepub.com

Bum Jung Kim1 and Lesley Maradik Harris2

Abstract Purpose of the Study: The objective of this article is to investigate determinants of self-rated health and describe their association with social capital and socioeconomic characteristics among older Korean immigrants. Method: A cross-sectional study of 205 older Korean immigrants (aged 60 years and older) was conducted in Los Angeles county. Independent variables included age, gender, marital status, income of the older Koreans, and social capital included social norms, trust, partnership with the community, information sharing, and political participation. Self-rated health was the dependent variable. Results: Descriptive analyses were done to show group differences in selfrated health and logistic regression analyses to identify determinants of selfrated health. Gender (male), high income, and high levels of information sharing were significant determinants of high self-rated health status among older Korean immigrants. Implications: This population-based study provides empirical evidence that gender, income, and information sharing are directly associated with the selfrated health status of older Korean immigrants. Keywords

socioeconomic status, social capital, self-rated health status, older Korean immigrants Manuscript received: November 9, 2011; final revision received: April 8, 2012; accepted: April 23, 2012. 1

University of Hawaii at Manoa, Honolulu, HI, USA UCLA, Los Angeles, CA, USA

2

Corresponding Author: Bum Jung Kim, University of Hawaii, 1800 East-West Rd, Honolulu, HI 96822, USA. Email: [email protected] Downloaded from jag.sagepub.com at UNIV CALGARY LIBRARY on April 13, 2015

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Journal of Applied Gerontology 32(8)

Introduction The U.S.’ population of individuals aged 65 and above is becoming more diverse, due in part to the increasing number of immigrants from different regions of the world. In 1990, about 4.2 million persons or 13% of the population were aged 65 and above and were non-White. In 2007, about 12.5 million or 25% of the older population were minorities. By 2035, 35% of the population is likely to be non-White (Angel & Angel, 2006; U.S. Census Bureau, 2008). As the older population in the United States becomes increasingly ethnically diverse, the need for research to address issues affecting the various older ethnic groups living in the United States also increases (Kim & Torres-Gil, 2011). One important ethnic group is Korean Americans, the second fastest growing group among older Asian/Pacific Islanders next to Chinese Americans. The population grew steadily from 34,350 persons in 1990 to 72,150 in 2000, a 110% increase. Currently, the population is around 170,000 individuals, a 500% increase from 1990 (Song, 1992; U.S. Census Bureau, 2010). Older Korean immigrants often face economic insecurity and poor health (Kim & Lauderdale, 2002). The immigration experience of many older Koreans living in the United States creates a risk with regard to economic vulnerability and diminished health. More than 20% of older Korean immigrants live below the poverty line, a figure twice that of the general older population. In addition, Korean older immigrants who experience economic vulnerability are more likely to suffer from disparities in terms of health, resources, and acculturation. In the United States, newly arrived Asian immigrants have higher incidences of Hepatitis B and Tuberculosis (Yee, 1992). Within the Asian American and Pacific Islander (AAPI) population, higher percentages of Korean and Vietnamese persons reported fair or poor health status (12.8%-17.2%) compared with persons of Chinese, Filipino, and Japanese descent (6.1%-7.4 %; Kuo & Porter, 1998). Among the older Korean American population, tuberculosis rates are 12 times greater than those of the White population (Kitano & Daniels, 1988). Additional health risks include diabetes, liver cirrhosis, and hepatitis B infections, all more prevalent among older Korean Americans than among other older adults (KagawaSinger, Hikoyeda, & Tanjasiri, 1997). Many older Korean immigrants live alone or with their spouses, creating a unique immigrant experience compared with other immigrant groups that practice extended family care through their living situations (Korean American Centennial Commemoration Curriculum Guide, 2003; Song, 1992). This rapidly growing older Korean population, plagued by low income and health disparities, creates a risk for diminished community engagement and social capital. Extending social networks and building social capital can be challenging for older adults

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adhering to Korean cultural norms, because of language barriers and filial piety, or the notion that it is the family’s responsibility to provide financial and emotional support for older relatives (Kauh, 1999; Kim & Lauderdale, 2002). The purpose of this article is to determine the factors that influence self-rated health among Korean immigrants and to examine the associations of social capital measures with self-rated health. Self-rated health reflects how people view and rate their own health. It has been documented as a reliable and valid measure of actual health (Idler & Benyamini, 1997), and as a predictor of mobility and mortality (Idler & Benyamini, 1997; Mansson & Rastam, 2001). Also, self-rated health and other health indictors among older adults have been linked with social capital (Pollack & VonDem Knesebeck, 2004). Social capital is a topic of recent concern, and spans across several disciplines, including social sciences and public health. Social capital is defined as the accessibility and availability of public resources through participation in the community, which can be gathered to benefit the individual and improve well-being. It also can be described as the web of cooperative relationships among citizens which facilitates resolution and collective action taken against problems. This involves various aspects of social structure, such as levels of interpersonal trust and norms of reciprocity and mutual aid, which act as resources for collective action. Important aspects of social capital are civic engagement in the community and transactions with community members (Bourdieu, 1991; Coleman, 1988; Putnam, 2000). A requirement of social capital is that the individual’s relationship with the community must span over a long period of time, be subconscious, or internalized within the connected individuals, and have consequences such as trust or loss of trust based on several relationships (Paxton, 2002). Within the experience of immigration, obtaining social capital can vary based on one’s community and location. Cultural, economic, and psychological needs can often be met when there is adequate and available social support and social capital for older immigrants (Kang, Domanski, & Moon, 2009), but not met when there is an absence of such support in the community. A key factor related to the well-being and community support of immigrants is the degree to which they can integrate into the communities where they have resettled (Mui, Kang, Kang, & Domanski, 2007). Social capital is an important concept in the fields of social work and public health. It has been associated with successful aging with subjective evaluations of health and well-being among older adults (Helliwell & Putnam, 2004), and with health-related behaviors and access to services and amenities (Kawachi & Berkman, 2000). Social capital has been linked to health and well-being in communities, by encouraging behaviors of healthy living and disapproving of unhealthy lifestyles


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(Kawachi, Kennedy, & Glass, 1999), by increasing availability of services related to health care and lifestyles, and by increasing emotional support through trust in one’s community (Kawachi & Berkman, 2000). Thus, the link between good health and strong social networks in communities is well documented, along with the strong social networks often present in immigrant groups in the United States. However, many new immigrants experience weakened social networks and lower income stability, which can lead to decreased social capital and overall poorer health of a community,. The location of a community also has been linked to social capital and perceived health status. For instance, living in a state that has low-rated social capital can cause an increased risk of self-rated poor health (Kawachi & Berkman, 2000). Although studies have found relationships between self-rated health and social capital (Knesebeck, Dragno, & Siegrist, 2005), few studies have focused on immigrant populations such as older Korean immigrants. Several studies have found that immigrants from Korea and China are high achieving in education, business, and entrepreneurship because of their high accrual of family as social and human capital (Sanders & Nee, 1996; Zhou & Kim, 2006). However, few studies have focused on the connection between sociodemographic characteristics, social capital, and health among immigrant populations. Some studies have focused on how social capital influences quality of life and perceived health status among elderly people in other countries (Nilsson, Rana, & Kabir, 2006). However, the research gap still exists in connecting social capital and self-rated health in the U.S. Korean immigrant population. This study contributes to the body of knowledge in the areas of social capital and immigrant health by examining the understudied population of older Korean immigrants. Despite the rapid population growth of older Korean immigrants, few studies have examined their self-rated health status and relevant factors including social capital. By identifying significant factors related to self-rated health status, health care professionals and community leaders can develop useful tools to enhance health and minimize health disparities among this population. This study aims to examine the relationships between social capital, socioeconomic characteristics and self-rated health using cross-sectional data from a survey conducted in Los Angeles, California. The research will serve as another step toward uncovering the complexities of the relationship between social capital and self-rated health among older Korean immigrants. First, it explores the relationship between socioeconomic status and self-rated health status among gender and age groups. Second, it investigates relationships between some aspects or subsets of social capital (social norms, trust, partnership with the community, information sharing, and political participation) and self-rated health status before and after controlling for sociodemographic effects.


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Method Sampling and Data-Collection Procedures Data for this study were collected from a survey of a convenience sample of 205 community-dwelling, cognitively competent older Korean immigrants (age 62-90). The study sample was recruited from adult day health care centers, senior centers, and churches in Los Angeles county. The screening process involved the administration of the Short Portable Mental Status Questionnaire (SPMSQ) and only participants with intact cognitive functioning (scoring 8 or more) were included in the survey. Participants were informed of the purpose of the study, their rights as interviewees, and confidentiality issues. Three social workers trained in interviewing used a written questionnaire to conduct face-to-face interviews that each lasted 30 to 40 min. From 228 questionnaires, 23 were discarded due to respondents’ minor cognitive impairments; the final sample of 205 represented an acceptance rate of 90%. Institutional Review Board (IRB) was approved by University of California Los Angeles’s (UCLA) Office of the Human Research Protection Program (G10-04-013-01).

Measures Social Capital. Social capital was measured by five indices defined as social norms, trust, partnership with the community, information sharing, and political participation. The value for each index was derived from the sum of responses to a selected group of questionnaire items, with each item having a 5-point (1-5) Likert-type scale response—never, seldom, about half the time, usually, and always. Social norms. This index was based on items in the survey that address social norms, or, the rules that a group uses for appropriate and inappropriate values, beliefs, attitudes, and behaviors. Examples are, “People in my neighborhood obey the law,” “There are a lot of inconsistencies in our laws,” “Social morals are well established in my nation,” “Various organizations in my community cooperate together to increase community development,” “Residents in my community regard volunteering and philanthropy as an honor,” and “Residents in my community settle conflicts or issues by themselves.” The mean of the interitem correlations for this scale was .24 and Cronbach’s alpha was .71. Trust. This index used items such as, “I trust my neighborhood community,” “I trust my relatives and friends,” “I trust the federal government,” and “I trust local governments and organizations.” The trust index mean for interitem correlations was .38 and Cronbach’s alpha was .75.


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Partnership with community. Items in this index are, “I don’t discriminate against people, depending on where there are from,” “I try to respect and reflect various opinions from different groups,” and “I try to resolve conflicts in the community and try to cooperate with others.” The partnership index mean for interitem correlations was .31 and Cronbach’s alpha was .72. Information sharing. This index includes items such as, “I have sufficient amounts of information about my neighborhood community,” “Local governments or organizations provide information about what I need to know,” “There are many organizations that provide information on what I need to know,” “Various organizations in my community are taking active roles to provide sufficient community resources about what I need to know,” and “Mass media in my community are taking roles to resolve social issues.” For this index, the mean of the interitem correlations was .63 and Cronbach’s alpha was .89. Political participation. This index uses the items, “I participate in political meetings during political elections,” “I actively participate in discussions about politics, the economy, and social issues,” “I write for newspapers or publications and subscribe to petitions,” “I am a member of a political party,” “I am participating in political work,” “I take part in presidential elections,” “I take part in elections for members of the national assembly,” “I take part in local elections,” and “I participate in civic groups.” The political participation index interitem correlation’s mean was .25 and Cronbach’s alpha was .77. Self-Rated Health. Self-rated health, as personally perceived physical health, is the main dependent variable in this study. This was assessed by a global question, “How is your health?” The four possible responses to this question were very poor, poor, good, and very good. For logistic regression analysis, the variable was dichotomized as poor health status and good health status. Background Information. Background information included age, gender, marital status, and income. Age in years was grouped into three age brackets: 60 to 64, 65 to 74, and 75 and older. Marital status was indicated as being married or single. Income was divided into two categories: low (below average) and high (above average).

Analysis Descriptive statistics were analyzed to understand how self-rated health varied by the background variables (i.e., demographic and socioeconomic variables) as well as by social capital. χ2 statistics were used to test for significance. An independent samples t-test was done to compare means. Logistic regression analyses using Stata 10 software were conducted to identify predictors of self-rated health and odds ratios (OR) and 95% confidence intervals (CI) were also calculated.


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Table 1. Demographic and Socioeconomic Profile of the Sample (in Percentages). 62-90

Age

Range

73.8

Mean

Women (N = 140) Men (N = 65) Significance

60-64 years 65-74 years 75 years and above Mean age (years) Marital status Single Married Monthly income Low High

7.1 38.6 54.3

9.2 47.7 43.1

n.s. n.s.

74.1 55.7 44.3 87.1 12.9

73.1 23.1 76.9 58.5 41.5

p < .001 p < .001

Results Demographic and socioeconomic profiles of the sample The demographic and socioeconomic profiles of the sample are presented in Table 1. The sample consisted of more women (68.3%) than men (31.7%). The mean age of the sample was 73.8 years and was similar between genders (74.1 years for women and 73.1 years for men). Of the men, 76.9% were married compared with 44.3% of the women. Only 12.9% of the women were considered high income compared with 41.5% of the men.

Distribution of Social Capital Indicators Table 2 indicates that more older Korean women (45%) reported maintaining high social norms compared with older Korean men (29%). Almost half of both men (50.8%) and women (52.1%) reported having high trust in people, community, and governments. Interestingly, a significantly higher proportion of men (73.9%) compared with women (50%) reported having high levels of partnership with their community. In addition, whereas most men (89.2%) reported high levels of sharing information with their community, organizations and government, only half of the women (50.7%) reported high levels of sharing. Similarly, most men (86.1%) were more likely to have high levels of political participation compared with women (50.7%).


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Table 2. Distribution of Social Capital Indicators by Gender (in Percentages). Social capital

Women (N = 140)

Men (N = 65)

55.0 45.0

71.0 29.0

47.9 52.1

49.2 50.8

50.0 50.0

26.1 73.9

49.3 50.7

10.8 89.2

49.3 50.7

13.9 86.1

Norms Low High Trust Low High Partnership Low High Information sharing Low High Political participation Low High

Significance p < .05 n.s. p < .001 p < .001 P < .001

Self-Rated Health Status Table 3 shows that nearly two-thirds (62.4%) of those reporting poor self-rated health status belonged to the oldest age group (75 years and older). The women in the sample (75.8%) were more likely to report poor self-rated health status than the men (24.2%). Married adults (68.7%) were twice as likely to report good self-rated health as the single group (31.3%). A significant difference was found between socioeconomic groups in reporting self-rated health status. Almost two-thirds (62.5%) of those reporting good self-rated health status had high monthly incomes, whereas only 9.5% in the poor health status group had high monthly incomes. When examining the social capital variables, older adults with high levels of social capital (high social norms, high levels of trust, high levels of partnership with their community, high levels of sharing information, and high levels of political participation) were more likely to report having good self-rated health status. All associations were significant with the exception of political participation.

Determinants of Self-Rated Health Status Results from logistic regression analyses are presented in Table 4. Gender, monthly income, and information sharing emerged as significant determinants of


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Kim and Harris Table 3. Distribution of the Sample by Their Health Status (in Percentages). Characteristics All Socioeconomic status Age 60-64 years 65-74 years 75 years and above Gender Women Men Marital status Single Married Monthly income Low High Social capital Norms Low High Trust Low High Partnership Low High Information sharing Low High Political participation Low High

Poor health status (N = 157)

Good health status (N = 48)

76.6

23.4

5.1 32.5 62.4

16.7 70.8 12.5

75.8 24.2

43.8 56.2

49.7 50.3

31.3 68.7

90.5 9.5

37.5 62.5

Significance p < .001

p < .001

p < .05

p < .001

p < .001 66.2 33.8

39.6 60.4

53.5 46.5

31.2 68.8

51.6 48.4

12.5 87.5

46.5 53.5

6.3 93.7

38.2 61.8

37.5 62.5

p < .01

p < .001 p < .001 n.s.

self-rated health status. Older Korean men had almost triple (OR: 2.9, 95% CI: 1.0-8.5) the probability of reporting good self-rated health compared with older Korean women. Those with high monthly incomes were 4.7 times more likely


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Table 4. Odds of Reporting Good Health Status by Socioeconomic and Social Capital Characteristics of Older Korean Immigrants (in Percentages). Characteristics

95% Confidence interval (N = 205)

Odds ratio

Socioeconomic status Age 60-64 years 65-74 years 75 years and above Gender Women Men Marital status Single Married Monthly income Low High Social capital Norms Low High Trust Low High Partnership Low High Information sharing Low High Political participation Low High

1 1.3 0.3 1 2.9 1 1.3 1 4.7

1 1.4 1 1.4 1 1.4 1 7.1 1 0.4

0.3-5.7 0.0-1.9 1.0-8.5* 0.5-3.3 1.5-14.2** 0.4-4.8 0.4-4.6 0.4-4.8 1.4-35.9* 0.1-1.4

*p < .05. **p < .01.

(95% CI: 1.5-14.2) to report good self-rated health status than those with low monthly incomes. Age and marital status were not found to be associated with self-rated health status.


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Information sharing was the only significant determinant of good self-rated health status among all social capital variables. The odds of reporting good selfrated health status were significantly higher (OR: 7.1, 95% CI: 1.4-35.9) among older people with high levels of information sharing with their community, organizations, and government compared with those reporting low levels of information sharing. For other social capital variables, the study yielded no significant associations with self-rated health status.

Discussion Our study investigated the impacts of socioeconomic status and social capital on self-rated health status among older Korean immigrants, one of the fastest growing segments in the older U.S. population. The present study found that, when controlling for other variables, self-rated health status was influenced by gender, monthly income, and information sharing. Men were three times as likely to report having good self-rated health status than women. High income older Koreans were almost five times more likely to report good self-rated health than their low income counterparts. Among the social capital variables, information sharing was the only determinant of good self-rated health among older Korean immigrants.

Determinants of Self-Rated Health In the study, gender was found to be significantly associated with self-rated health among older Korean immigrants, with males more likely to report good self-rated health than females. Our study findings are similar to those of other studies linked self-rated health and self-rated mental health with human capital measures (Jang et al., 2012; Mawani & Gilmour, 2010; Zuvekas & Fleishman, 2008). In a study evaluating the associations between self-rated mental health and a range of mental-health measures, the authors found that women were more likely than men to rate their mental health as fair or poor and to be classified with mental-health morbidity (Mawani & Gilmor, 2010). Overall, women have a tendency to report poorer self-rated health than men (Sadana, Mathers, Lopez, Murray, & Iburg, 2002). To understand the differences in gender among this population, it is important to consider the unique structure of many older Korean couples. Earlier studies have found that older Korean males expressed more independence than females because they participated in more social activities. In addition, older Korean males had greater financial and social resources which aided them in accessing


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health and social services (Kim & Lauderdale, 2002; Song, 1992). With social activities and resources to maintain and improve their health, older Korean males tend to maintain better health than older Korean females. Supporting our findings on income, Mawani and Gilmor (2010) showed that individuals with low level of income and education are the most likely to report fair or poor mental health and general health. Other studies across the United States, Europe, and Canada also have shown that the majority of people with low economic status consider themselves to be in fair or poor health (Dowd & Zajacova, 2007; Humphries & van Doorslaer, 2000; Mackenback, Martikainen, & Looman, 2005; Singh-Mahoux, Dugauot, & Shipley, 2007). Research in the field of self-rated mental health among older Koreans has been consistent with our findings, ascribing gender differences to a person being influenced and exposed to gendered experiences in social situations (Simon, 1995). An individual can understand and internalize gender differences based on various socioeconomic conditions in the workplace, levels of financial independence, and the division of labor in the household (Mirowsky, 1996; Mirowsky & Ross, 1995; Turner & Turner, 1999), and health-related behaviors such as diet, exercise, smoking, and drinking. Results have been consistent in studies examining associations of self-rated mental health with measures of depressive symptoms in a sample of Korean American older adults. Forty percent of Korean American older adults rated their mental health as fair or poor (Jang, Amber, & Chiriboga, 2011; Jang et al., 2012), a percentage two to four times greater than older adults of other racial or ethnic groups in the United States (Kim et al., 2011). We believe that genderrelated differences may go beyond mental health and can also be found in the realm of rating physical health in older Korean immigrants. Our finding that health disparities exist among older Korean immigrants is similar to the findings of several other studies. A study titled the Korean American Health Survey, found that among Koreans aged 65 and older, 69% reported fair or poor health status (Sohn, 2004). Compared with the young–old group in this study, the survey indicated that the oldest-old have relatively poor health status. Our finding that higher income older Koreans were almost five times more likely to report good health may be related to access to health insurance. Those with lower incomes may not have the same access to health care, leading to poor health status. One-third of all Korean Americans are uninsured, which is a rate much higher than the entire AAPI population (21% uninsured) and White Americans (14% uninsured). In California, where our study was conducted, the percentage of uninsured Koreans is even higher at 50% (Brown, Ponce, & Rice, 2001). This kind of disparity is in direct contrast to the “model minority myth” that Asian American groups do not experience obstacles to health care, and are flourishing (Chen & Hawks, 1995) and shows that income levels are involved in


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successful outcomes and health status. In fact, a study looking at access to health services among all AAPI’s noted that Korean Americans comprised one of the most understudied populations (Andersen, Harada, Chiu, & Makinodan, 1995). Other studies found that mental-health service use is lower for minorities than for Whites. This pattern of service usage is believed to be associated with racial and ethnic disparities in terms of underuse by minorities with mental-health problems (Zuvekas & Fleishman, 2008).

Social Capital and Self-Rated Health Our finding on social capital and self-rated health status is consistent with other research examining the connection between social capital and self-rated health status among other populations (Harpham, Grant, & Thomas, 2002; Kawachi & Berkman, 2000; Kawachi, Kennedy, & Glass, 1999; Pollack & von dem Knesebeck, 2004; Tang, 2006; Veenstra, 2000). Other studies found, as did ours, that individuals living in areas with low social capital rate themselves poorly when assessing their own health (Kawachi, Kennedy, & Glass, 1999). When examining social capital at personal and neighborhood levels, it has been shown that social capital can predict self-rated health status, and quality of life among older populations (Bowling, Banister, Sutton, Evans, & Windsor, 2002). Our results indicate that information sharing was another significant factor that influences self-rated health status. Contrary to some research that indicates information sharing may not be correlated with self-rated health status (Taylor, Jones, & Boles, 2004), the present findings are supported by other studies which indicate that information sharing greatly affects the self-rated health status of older Korean immigrants (Min, Moon, & Lubben, 2005). Therefore, it is important to understand the role of information sharing in the context of Asian culture, particularly Korean culture. There are several possible reasons why self-rated health status of older Korean immigrants correlates with the availability of information concerning their community and its various social organizations and news. The vast majority of older Korean immigrants came to the United States during the 1960’s and 1970’s. Because of the immediate pressure to generate income and settle, they did not have enough time and resources to understand American society, culture, and politics. They also were not able to have rich social lives, the lack of which caused difficulties acquiring necessary information concerning their communities (Sohn, 2004). Older Korean immigrants can enrich their lives by actively gathering necessary information and then sharing it with other members of their community. However to do so, there must be access to education in basic English and


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communication skills. Older Korean Americans can also benefit immensely by actively using various kinds of social media. To ensure that older Korean immigrants are exchanging information, there should be effective education programs that can teach the use of modern technology, the Internet and other forms of social media. These programs can create an atmosphere in which older adults can actively exchange information and avoid feeling left out of the mainstream. They should become not only consumers of vital information but also providers of new information. Active information sharing among older Korean immigrants may lead to a renewed sense of ownership of their community. Familiarity with the news in their community and the larger society may increase their sense of belonging. The mental and social stimulation that comes with keeping in touch with their surrounding world can also benefit their health status. Some limitations to the present study should be noted. As the study is based on a cross-sectional survey design, the findings cannot confirm the causal relationship between socioeconomic status, social capital, and self-rated health status. Also, the use of convenience sampling may introduce selection bias by oversampling upper middle class and healthy individuals. Given the nature of the sample and study design, the findings should be viewed with caution and await further investigation in future studies with other samples or with longitudinal assessments. In addition, the study used only some aspects of social capital (norms, information sharing, community participation, and political participation). Thus, there is unexplained variance of social capital which should be examined further. Future studies must include other aspects of social capital for a more comprehensive examination of the association between social capital and self-rated health status. The present study contributes to the literature in two main ways. First, we were able to study older Korean immigrants, a group in which studies are needed to gain valuable information about the health status of this population, to educate health care providers as an effort to remove the health disparities that exist in immigrant populations (Sohn, 2004). Second, by determining that high income is related to good self-reported health and low income is related to poor selfreported health, we now understand that there are disparities within this group, based on income and potential access to healthcare.

Declaration of Conflicting Interests The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding The author(s) received no financial support for the research, authorship, and/or publication of this article.


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Author Biographies Bum Jung Kim is an assistant professor of School of Social Work at University of Hawaii at Manoa. He was the former associate director of Center for Policy Research on Aging at the University of California Los Angeles (UCLA). His research focuses quality of life and mental health among elderly Korean immigrants. Also, he is conducting cross-national studies on aging policies, public long-term care insurance, caregiving issues, and nexus of aging and immigration. Lesley Maradik Harris is a doctoral candidate in Department of Social Welfare, School of Public Affairs at University of California at Los Angeles. Currently, she is working on her dissertation research in partnership with Save the Children’s human immunodeficiency virus (HIV) sector to improve the care and support of orphaned grandchildren affected by HIV/ acquired immune deficiency syndrome (AIDS) who are living with older caregivers in Vietnam. Her areas of interests are skippedgeneration caregiving in Vietnam and health status among older immigrants in the United States.


Understanding employment barriers among older Korean immigrants.

Social capital and health: evidence that ancestral trust promotes health among children of immigrants.

Gender differences in hypertension control among older korean adults: Korean social life, health, and aging project.

Social capital, socioeconomic status, and health-related quality of life among older adults in Bogotá (Colombia).

Social capital and oral health.

Social capital, social participation and life satisfaction among Chilean older adults.

Social capital, health, and care home residence among older adults: a secondary analysis of the Health Survey for England 2000.

Does social capital protect mental health among migrants in Sweden?

spirituality in relation to perceived health, depression, and life satisfaction among older Korean immigrants.

Stressors, coping resources, functioning, and role limitations among older korean immigrants: gender differences.

Social capital and self-rated health among middle-aged and older adults in China: a multilevel analysis.

Structural social capital and health in Italy.

Social capital, health, and elderly driver status.

Health Vulnerability of Immigrants with Limited English Proficiency: A Study of Older Korean Americans.

Social Capital and Sexual Risk-Taking Behaviors Among Older Adults in the United States.

The Role of Relevancy and Social Suffering in "Generativity" Among Older Post-Soviet Women Immigrants.

Development of an instrument for community-level health related social capital among Japanese older people: The JAGES Project.

Neighborhood social capital and achieved mobility of older adults.

Is Social Capital a Determinant of Oral Health among Older Adults? Findings from the English Longitudinal Study of Ageing.

Multilevel, cross-sectional study on social capital with psychogeriatric health among older Japanese people dwelling in rural areas.

Serious engagement in sport and health benefits among Korean immigrants in the USA.

A Longitudinal Study of Social Capital and Acculturation-Related Stress Among Recent Latino Immigrants in South Florida.

Serious engagement in sport and health benefits among Korean immigrants in the USA.

Social relationships and health related behaviors among older US adults.