Research Paper Summaries

Acculturation and Culture: A Critical Factor for Asian Americans’ Health

Authors: Yijie Wang and Su Yeong Kim

Summary:

Yijie Wang and Su Yeong Kim (2013) examined how acculturation and cultural orientation influence the physical and mental health of Asian Americans. Acculturation is defined as adaptation to the mainstream U.S. culture, while retaining one’s heritage culture is termed enculturation. The chapter highlights that these dual processes are crucial to understanding Asian Americans’ health behaviors, service utilization, and well-being.

The authors reviewed both unilinear models (which assume that adopting mainstream culture means losing heritage culture) and bilinear models (which treat acculturation and enculturation as independent processes). They argue the bilinear model provides a more accurate and flexible framework, especially for Asian Americans across different generations. Four acculturation strategies are described: integration, assimilation, separation, and marginalization, with integration being the most adaptive and marginalization the least.

Empirical studies show mixed findings regarding acculturation’s relationship to mental health. Epidemiological research often suggests that higher acculturation increases risks for depression and anxiety, particularly among later generations. In contrast, psychological studies using behavioral and value-based measures find that low acculturation predicts poorer adjustment due to greater acculturative stress. Stress from language barriers, discrimination, and family conflict is identified as a key pathway linking acculturation to negative outcomes. For adolescents, heritage orientation often protects against depressive symptoms, whereas for adults, mainstream orientation is more predictive of well-being.

The chapter also explores culturally shaped health expressions, such as somatization—reporting physical symptoms (e.g., headaches, fatigue) for psychological distress—which is more common among Asians than Westerners. Culture-bound syndromes like hwa-byung in Koreans and shenjing shuairuo in Chinese populations illustrate how mind–body beliefs affect symptom expression and diagnosis.

In terms of physical health, acculturation influences behaviors like smoking and diet. Highly acculturated men are less likely to smoke, while women and adolescents show the opposite trend, reflecting gendered cultural norms. Dietary shifts toward Western foods with higher fat and sugar content among acculturated individuals increase chronic disease risks such as diabetes and heart disease.

Asian Americans also underutilize both mental and physical health services due to stigma, cultural values of self-reliance, language barriers, and lack of culturally competent care. The authors emphasize the need for bilingual services, culturally tailored education, and improved multicultural competence among providers.

In conclusion, Wang and Kim highlight that acculturation and culture critically shape Asian Americans’ health experiences. Future research should adopt bilinear models, examine

subgroups beyond East Asians, and explore mechanisms such as acculturative stress to design more effective health interventions.

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