Older Vietnamese Americans Suffer Higher Rate of Mental Health Problems

Vietnamese Americans who came to the United States as political refugees are suffering from higher rates of mental health problems than non-Latino whites, an indication that many Vietnamese Americans are experiencing lingering effects from the Vietnam War, according to a UC Irvine Center for Health Care Policy study.

In the first analysis of its kind for Vietnamese Americans in California, researchers found that Vietnamese Americans over 55 were twice as likely as whites to report needing mental health care, but were less likely to discuss such issues with their doctors.

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In general, Vietnamese Americans have assimilated quickly in the United States and have achieved success in business, education and politics. The study offers a contrasting view of the tough adjustments refugees have endured.

Many Vietnamese American refugees are suffering from problems related to traumatic experiences fleeing the Communist government after the 1975 fall of Saigon, Ngo-Metzger said. Along the way, families were separated, fortunes were lost, and many who fled by small fishing boats perished at sea. Former South Vietnamese military officers left behind were sent to Communist “re-education” camps.

When they came to the U.S., many had difficulty adjusting, Ngo-Metzger said.

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Cambodian Americans who fled after the atrocities of the Khmer Rouge regime in the late 1970s experience similar mental health issues, she said.

The UCI study, published in the Journal of the American Geriatrics Society, found that 21% of Vietnamese Americans said they suffered from depression or anxiety, compared with 10% among whites who participated in the 2001 and 2003 California Health Interview Surveys. Only 20% of Vietnamese Americans had a discussion with a medical provider about their mental health, compared with 45% of whites. The sample included 359 Vietnamese and 25,177 white adults, which representing the ethnic proportions of the two groups in California. The surveys were conducted by telephone.

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In Little Saigon, home to the largest population of Vietnamese in the United States, mental health services have increased in size and funding in recent years.

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[Editor’s Note: “Self-Reported Health Status of Vietnamese and Non-Hispanic White Older Adults in California,” by Quyen Ngo-Metzger, et al., can be downloaded or read in HTML or PDF documents here. (There is a charge.)]

From the *Division of General Internal Medicine and Primary Care and Center for Health Policy Research, University of California at Irvine, Irvine, California; and †Division of General Internal Medicine and Health Services Research, University of California at Los Angeles, Los Angeles, California

Address correspondence to Quyen Ngo-Metzger, MD, MPH, UCI Center for Health Policy Research, 111 Academy Way, Ste 220 Irvine, CA 92697. E-mail: Qhngo@uci.edu

Copyright Journal compilation 2008 The American Geriatrics Society/Blackwell Publishing

KEYWORDS

Vietnamese o aging o mental health o chronic diseases o older adults o SF-12 o health

ABSTRACT

Vietnamese Americans are a rapidly growing minority group in the United States, yet little is known about their health status. Chronic medical conditions and self-rated health of older Vietnamese Americans were compared with those of non-Hispanic white adults living in California using the 2001 and 2003 California Health Interview Surveys (CHISs). The CHIS employed a random-digit-dial telephone survey, and its sample is representative of California’s noninstitutionalized population. The sample included 359 Vietnamese and 25,177 non-Hispanic white adults aged 55 and older. Vietnamese and non-Hispanic white adults were compared in terms of limitations in activities of daily living, chronic medical conditions (diabetes mellitus, hypertension, heart disease, asthma), mental health care, and self-reported health, adjusting for age, sex, and education. Vietnamese were more likely than white participants to report needing help for mental health problems (adjusted odds ratio (aOR)=2.1, 95% confidence interval (CI)=1.4—3.1) but less likely to have had their medical providers discuss their mental health problems with them (aOR=0.3, 95% CI=0.1—0.5). In addition, Vietnamese participants reported significantly worse health than white adults on five of eight domains of the Medical Outcomes Survery 12-item Short Form survey (P<.006). Clinicians caring for older Vietnamese individuals should be aware of the high risk for mental health needs in this population and should initiate discussions about mental health with their patients. Further research is needed to better understand why older Vietnamese Americans are at higher risk for worse self-reported health than older white adults.