Older Asian American Women:An Overview

Older Asian American Women:An Overview

Gero-435

Andrea Chin

Gero-435

Andrea Chin

Who are Asian Americans?Who are Asian Americans?

People who identify with being Asian Indian, Cambodian, Chinese, Filipino, Japanese, Korean, Vietnamese, Hmong and/or other cultural groups

Speak over 100 languages and dialects Have immigrated to or have been born in or

lived in the US

People who identify with being Asian Indian, Cambodian, Chinese, Filipino, Japanese, Korean, Vietnamese, Hmong and/or other cultural groups

Speak over 100 languages and dialects Have immigrated to or have been born in or

lived in the US

Immigration HistoryImmigration History

Between 1980 and 1990 alone, there was a two-fold increase in the number of AA older adults.

About 455,000 (6.3%) of the AA population are age 65 or over. Of those, about 154,000 (3%) are age 75 or over.

Two main waves of immigration for this group: Migrants who arrived during the turn of the century

and their children; this particularly applies to Japanese and Filipinos

Older migrants, primarily from Southeast Asia, who entered the U.S. in the 1970's with their families.

Between 1980 and 1990 alone, there was a two-fold increase in the number of AA older adults.

About 455,000 (6.3%) of the AA population are age 65 or over. Of those, about 154,000 (3%) are age 75 or over.

Two main waves of immigration for this group: Migrants who arrived during the turn of the century

and their children; this particularly applies to Japanese and Filipinos

Older migrants, primarily from Southeast Asia, who entered the U.S. in the 1970's with their families.

History of Immigration Discrimination

History of Immigration Discrimination

AAs are the only race to have been specifically barred in immigration legislation in the Chinese Exclusion Act of 18

The Immigration Act of 1924 used national origins quotas all but halting the tide of immigration from Asia and elsewhere until it was repealed in 1965

Many of the first wave of Asian female immigrants were forced into prostitution

AAs are the only race to have been specifically barred in immigration legislation in the Chinese Exclusion Act of 18

The Immigration Act of 1924 used national origins quotas all but halting the tide of immigration from Asia and elsewhere until it was repealed in 1965

Many of the first wave of Asian female immigrants were forced into prostitution

Arrival of Asian Immigrant Women

Arrival of Asian Immigrant Women

Most of the 1st wave Asian immigrants were male laborers; high male:female ratio (except for the Japanese community) made it difficult for them to start families and make roots in the US

History of picture brides: received photos from “old country” of eligible brides to bring over to the US

WWII brides brought over many East Asian women ill-equipped to adjust to American life; many were abused by their veteran husbands

Most of the 1st wave Asian immigrants were male laborers; high male:female ratio (except for the Japanese community) made it difficult for them to start families and make roots in the US

History of picture brides: received photos from “old country” of eligible brides to bring over to the US

WWII brides brought over many East Asian women ill-equipped to adjust to American life; many were abused by their veteran husbands

Japanese American Internment Camps

Japanese American Internment Camps

Executive Order 9066: 110,00 JAs were sent to internment camps “for their own good”

Real reason: High-ranking officials believed that they weren’t loyal to the US and might spy for the enemy, despite the fact that there was no evidence and that most of those sent were American-born

Families were given short notice to relocate and lost virtually all of their property

Executive Order 9066: 110,00 JAs were sent to internment camps “for their own good”

Real reason: High-ranking officials believed that they weren’t loyal to the US and might spy for the enemy, despite the fact that there was no evidence and that most of those sent were American-born

Families were given short notice to relocate and lost virtually all of their property

Japanese American Internment Camps

Japanese American Internment Camps

Intern camps such as Manzanar were located in rural areas; interns often ill-equipped to handle the below zero temperatures in these areas

Families were crammed into "tar paper-covered barracks of simple frame construction without plumbing or cooking facilities of any kind” (1943 War Authority Report)

Documented instances of guards shooting internees who reportedly attempted to walk outside the fences

Japanese people tended to comply with the U.S. government to prove themselves loyal citizens

Intern camps such as Manzanar were located in rural areas; interns often ill-equipped to handle the below zero temperatures in these areas

Families were crammed into "tar paper-covered barracks of simple frame construction without plumbing or cooking facilities of any kind” (1943 War Authority Report)

Documented instances of guards shooting internees who reportedly attempted to walk outside the fences

Japanese people tended to comply with the U.S. government to prove themselves loyal citizens

Legacy of InternmentLegacy of Internment

Many internees experienced depression and helplessness and were too ashamed to talk about what happened afterwards

1992: public apology from the government and reparations finally made with $20,000 given to each surviving internee

Many still haven’t received their reparations How can you repay for the loss of all their

property and the shame they suffered?

Many internees experienced depression and helplessness and were too ashamed to talk about what happened afterwards

1992: public apology from the government and reparations finally made with $20,000 given to each surviving internee

Many still haven’t received their reparations How can you repay for the loss of all their

property and the shame they suffered?

California DemographicsCalifornia Demographics

AA women make up 12.4% of women 65 and older in the state of California

Nearly half are still married They have a median personal income of $9,103,

the second lowest of all racial groups 8.6% of them live in poverty. 62.2% of older AA women in California receive

social security.

AA women make up 12.4% of women 65 and older in the state of California

Nearly half are still married They have a median personal income of $9,103,

the second lowest of all racial groups 8.6% of them live in poverty. 62.2% of older AA women in California receive

social security.

National DemographicsNational Demographics

Nationally, older AA women make up 2.9% of the population.

Compared to older women of other races, they are the most likely to still be married; 48.1% of AA women who are 65 and older are.

The sex ratio is higher in the AA population compared to all other racial populations: there are 82 AA men per 100 women 65 and older.

More than 60% are concentrated in California and Hawaii. Most of the rest live either in New York, New Jersey, Illinois, Texas or Washington (state).

Nationally, older AA women make up 2.9% of the population.

Compared to older women of other races, they are the most likely to still be married; 48.1% of AA women who are 65 and older are.

The sex ratio is higher in the AA population compared to all other racial populations: there are 82 AA men per 100 women 65 and older.

More than 60% are concentrated in California and Hawaii. Most of the rest live either in New York, New Jersey, Illinois, Texas or Washington (state).

Religion and SpiritualityReligion and Spirituality

Many East and Southeast Asians practice Buddhism

Taoism is another common East Asian religion Significant population of Hindu Asian Indians Indonesia has the largest population of Muslims in

the world; many other Muslims from India and South Asia

Meditation and tai chi are great forms of mental and physical exercise to reduce stress and develop balance

Many East and Southeast Asians practice Buddhism

Taoism is another common East Asian religion Significant population of Hindu Asian Indians Indonesia has the largest population of Muslims in

the world; many other Muslims from India and South Asia

Meditation and tai chi are great forms of mental and physical exercise to reduce stress and develop balance

The Cultural Roles of Older AA Women

The Cultural Roles of Older AA Women

In Confucian/East Asian societies, filial piety (respect for elders) is a key value

If the eldest male has passed away, the eldest female is the leading authority figure in the family

Traditionally in Asia, households are multigenerational with younger female relatives looking after their elders

What happens if younger generations are unable/unwilling to fulfill the caregiving role?

In Confucian/East Asian societies, filial piety (respect for elders) is a key value

If the eldest male has passed away, the eldest female is the leading authority figure in the family

Traditionally in Asia, households are multigenerational with younger female relatives looking after their elders

What happens if younger generations are unable/unwilling to fulfill the caregiving role?

Health IssuesHealth Issues

Cancer and cardiovascular disease are the two leading causes of death for Asian Americans in the U.S

AA women have much lower rates of heart disease than women of other minority groups, but heart disease is still the second leading cause of death for this group.

AAs are 3 to 13 times more likely to die from liver cancer caused by Hepatitis B than Caucasians.

Cancer and cardiovascular disease are the two leading causes of death for Asian Americans in the U.S

AA women have much lower rates of heart disease than women of other minority groups, but heart disease is still the second leading cause of death for this group.

AAs are 3 to 13 times more likely to die from liver cancer caused by Hepatitis B than Caucasians.

More Health IssuesMore Health Issues

Older AA women have a high risk of osteoporosis. The average calcium intake among them is half that of Westerners. As many as 90% of Asian Americans are lactose intolerant or cannot easily digest dairy products.

AA women have low breast and cervical cancer screening rates compared to other groups of women, and lower cholesterol and blood pressure screening rates than the national average.

They have a higher prevalence of tuberculosis than all other racial and ethnic groups

Older AA women have a high risk of osteoporosis. The average calcium intake among them is half that of Westerners. As many as 90% of Asian Americans are lactose intolerant or cannot easily digest dairy products.

AA women have low breast and cervical cancer screening rates compared to other groups of women, and lower cholesterol and blood pressure screening rates than the national average.

They have a higher prevalence of tuberculosis than all other racial and ethnic groups

Mental Health IssuesMental Health Issues

AA women 65+ have the highest suicide rate of all women aged 65 and older.

Older AA women show a greater prevalence of dementia than the general population

70% of Southeast Asian refugees receiving mental health care met diagnostic criteria for PTSD

Consistently low rates of help-seeking behavior General stigma against mental illness; shame in being

“found out” for treatment More likely to describe somatic symptoms such as

fatigue, headache, poor appetite, indigestion

AA women 65+ have the highest suicide rate of all women aged 65 and older.

Older AA women show a greater prevalence of dementia than the general population

70% of Southeast Asian refugees receiving mental health care met diagnostic criteria for PTSD

Consistently low rates of help-seeking behavior General stigma against mental illness; shame in being

“found out” for treatment More likely to describe somatic symptoms such as

fatigue, headache, poor appetite, indigestion

Cultural Conceptions of Mental Illness

Cultural Conceptions of Mental Illness

Linguistic differences: no real equivalent translation of Western notion of anxiety, depression or guilt in Chinese

Cultural attribution (such as Chinese and Cambodian) of mental illness to supernatural causes; “blame the victim” phenomenon

Fatalistic conception of mental illness as retributive punishment for ancestral sins

Dementia seen as normal aging; fatalistic attitudes about dementia as an untreatable condition

Linguistic differences: no real equivalent translation of Western notion of anxiety, depression or guilt in Chinese

Cultural attribution (such as Chinese and Cambodian) of mental illness to supernatural causes; “blame the victim” phenomenon

Fatalistic conception of mental illness as retributive punishment for ancestral sins

Dementia seen as normal aging; fatalistic attitudes about dementia as an untreatable condition

Mental Health Risk FactorsMental Health Risk Factors

General stresses of immigration Weaker support network Southeast Asian refugees particularly at risk after

experiencing premigration wartime trauma Fear of loss of culture, values, status in acculturation Culturally insensitive/ignorant clinicians viewing AAs

under the model minority stereotype Model minority: assumption that AAs are well-off and so

integrated into American life that they are not in need of services; overlooks many issues within this population

General stresses of immigration Weaker support network Southeast Asian refugees particularly at risk after

experiencing premigration wartime trauma Fear of loss of culture, values, status in acculturation Culturally insensitive/ignorant clinicians viewing AAs

under the model minority stereotype Model minority: assumption that AAs are well-off and so

integrated into American life that they are not in need of services; overlooks many issues within this population

Healthcare BarriersHealthcare Barriers Older AA women less likely to use formal health care

services, such as those reimbursed under Medicare, and report poorer quality of care.

Traditional pathways to care may lead to reliance on folk medicine and alternative healers such as acupuncturists.

Many immigrants are low-income and lack insurance, and most are unaware of the options for affordable care such as sliding-scale fees.

Language barriers can be intimidating; many are unaware of their right to a medical interpreter.

Lack of familiarity with the system and fear of the system further limit access.

Older AA women less likely to use formal health care services, such as those reimbursed under Medicare, and report poorer quality of care.

Traditional pathways to care may lead to reliance on folk medicine and alternative healers such as acupuncturists.

Many immigrants are low-income and lack insurance, and most are unaware of the options for affordable care such as sliding-scale fees.

Language barriers can be intimidating; many are unaware of their right to a medical interpreter.

Lack of familiarity with the system and fear of the system further limit access.

How to Address General Issues Facing Older AA Women

How to Address General Issues Facing Older AA Women

Health: screen for Hepatitis B, heart disease, diabetes, osteoporosis, breast cancer, dementia and depression

Multilingual service delivery: train more multilingual social workers and medical interpreters

Ask the clients how they conceptualize their issues and what resources they draw upon in their communities; integrate alternative therapies/support networks as appropriate

Health: screen for Hepatitis B, heart disease, diabetes, osteoporosis, breast cancer, dementia and depression

Multilingual service delivery: train more multilingual social workers and medical interpreters

Ask the clients how they conceptualize their issues and what resources they draw upon in their communities; integrate alternative therapies/support networks as appropriate

How to Address the Issues, continued

How to Address the Issues, continued

Outreach workshops on how to apply for Social Security and Medicare

If they’re not citizens, work to secure citizenship so that they are eligible for social services

Get younger AAs involved in care Learn more about their immigration experience

and experience living in the US Be respectful!

Outreach workshops on how to apply for Social Security and Medicare

If they’re not citizens, work to secure citizenship so that they are eligible for social services

Get younger AAs involved in care Learn more about their immigration experience

and experience living in the US Be respectful!