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Community, Family, and Support: Depression among Older Asian Immigrants in the COVID-19 Pandemic
Lu, Wenyue
Lu, Wenyue
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Thesis/Dissertation
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2025-08
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Sociology
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https://doi.org/10.34944/8gvj-1147
Abstract
This dissertation examines the complex interplay of structural, psychosocial, and cultural determinants shaping depression risk among older Asian American ethnic subgroups during the Coronavirus disease 2019 (COVID-19 pandemic). Addressing critical gaps in mental health research on this rapidly growing yet understudied population, this mixed-method investigation disaggregates the often-homogenized “Asian American” racial category to study significant heterogeneity in mental health outcomes and their determinants across Chinese, Filipino, Korean, and Vietnamese American immigrant communities in the greater Philadelphia (PA-NJ) and the New York City (NYC) areas.The first study analyzes depression prevalence and severity among older Asian Americans (n=482, aged 65 and above) across PA-NJ and NYC areas using quantitative survey data that were collected during the pandemic. To address missing data and preserve statistical power, I employed multiple imputation using chained equations (MICE) to impute missing values in key variables. Multivariate progressive logistic regression models reveal pronounced depression disparities between community contexts and ethnic subgroups. Chinese Americans in NYC exhibited remarkably elevated depression risk (OR=4.76, p<0.001) compared to their PA-NJ counterparts, while Korean and Filipino Americans demonstrated comparatively lower depression rates. Socioeconomic factors, acculturation levels, and cardiometabolic conditions emerged as significant predictors of depression outcomes. Oaxaca-Blinder decomposition analysis further illuminates that while observable factors largely explain the Filipino- Chinese depression gap, unobserved factors primarily drive differences between other community subgroups. These findings, interpreted through weathering and cumulative disadvantage theoretical frameworks, suggest that differential exposure to pandemic stressors, particularly in high-density urban environments, exacerbated pre-existing vulnerabilities in specific Asian American communities.
The second study delves deeper into the mechanisms underlying these disparities by examining how structural and psychosocial determinants operate differently across community contexts. Through exploratory factor analysis, I identified two latent constructs: Cumulative Human Capital Advantage and Aging-Related Family Strain. Multivariate logistic regression models with interaction terms present that while cumulative human capital advantage generally provides protection against depression, its protective effects are unevenly distributed. Chinese immigrants in NYC maintain elevated depression risks despite higher socioeconomic resources, suggesting the presence of community context-specific stressors that overwhelm traditional protective factors. Aging-related family strain has particularly strong detrimental effects among Chinese NYC and Vietnamese older immigrants. In contrast, Korean Americans show notable resilience to these stressors, suggesting more culturally specific mechanisms of vulnerability and protection.
The third study employs participant-driven photo elicitation interviews among 20 older Chinese Americans residing in PA-NJ and NYC to examine how collectivist cultural values specifically shape the mental health experiences and support-seeking behaviors of this population during the pandemic. This qualitative study reveals that collectivism has paradoxical impacts on mental health outcomes. Specifically, although collectivist values discourage mental-health-related help-seeking through concerns about burdening others, they simultaneously facilitate support exchange through principles of mutual responsibility that are rooted in collectivist cultures. The findings demonstrate how collectivism constructs perceived social support into a multi-layered ecosystem in which family and friends, community organizations, and government assistance are interpreted through a distinguishing cultural lens and perception. Notably, within collectivist contexts, providing support becomes a pathway to mental wellness itself, as this act offers meaning and purpose during crisis under a collectivist context.
In conclusion, this dissertation makes significant contributions to a better understanding of depression disparities among older Asian Americans during the COVID-19 pandemic. The research shows how mental health risks develop from the interplay of structural inequalities, psychosocial stressors, community contexts, and cultural frameworks by employing the mixed-method approach and drawing on theoretical frameworks such as the weathering hypothesis, cumulative disadvantage theory, and social support theory. Although with some limitations, the findings underscore the critical importance of disaggregated approaches to mental health research among Asian American immigrants and suggest that effective interventions must be tailored not only to address structural inequalities but also to leverage culturally specific resources and family dynamics that shape vulnerability and resilience differently across Asian American subgroups. This research has important implications for developing culturally responsive mental health services and interventions that can better address the diverse needs of the rapidly growing and aging Asian American population in the United States.
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