Associations between caregiving status, acculturation, and psychological distress in a diverse sample

Objectives:Increasingly diverse caregiver populations have prompted studies examining culture and caregiver outcomes. Still, little is known about the influence of sociocultural factors and how they interact with caregiving context variables to influence psychological health. We explored the role of caregiving and acculturation factors on psychological distress among a diverse sample of adults. Design:Secondary data analysis of the California Health Interview Survey (CHIS). Participants:The 2009 CHIS surveyed 47,613 adults representative of the population of California. This study included Latino and Asian American Pacific Islander (AAPI) caregivers and non-caregivers (n = 13,161). Measurements:Multivariate weighted regression analyses examined caregiver status and acculturation variables (generational status, language of interview, and English language proficiency) and their associations with psychological distress (Kessler-6 scale). Covariates included caregiving context (e.g., support and neighborhood factors) and demographic variables. Results:First generation caregivers had more distress than first-generation non-caregivers (beta=0.92, 95% CI: (0.18, 1.65)); the difference in distress between caregivers and non-caregivers was smaller in the third than first generation (beta=-1.21, 95% CI: (-2.24, -0.17)). Among those who did not interview in English (beta=1.17, 95% CI: (0.13, 2.22)) and with low English proficiency (beta=2.60, 95% CI: (1.21, 3.98)), caregivers reported more distress than non-caregivers. Conclusions:Non-caregivers exhibited the "healthy immigrant effect," where less acculturated individuals reported less distress. In contrast, caregivers who were less acculturated reported more distress.