Part 2 essay
Panahi-Pour
Japanese Immigrant Mental Health and Wellbeing
Yasha Panahi-Pour
UCR
Professor Ayón
February 3, 2021
1
Panahi-Pour
Immigrants encounter significant barriers when it comes to accessing mental health. They
face discrimination, economic problems, and hostile immigration policies preventing them from
accessing better mental health care services (Teruya & Bazargan-Hejazi, 2013). In the United
States, mental health is a significant issue among Japanese immigrants mainly because of racial
discrimination, economic challenges, and health services accessibility challenges. Besides, several
social determinants of health influence how the Japanese immigrants experience mental health in
the U.S. Some of these social determinants of health include economic stability, neighborhood and
physical environment, education, food, community and social context, and health care system
(Cabral & Cuevas, 2020). The immigration status of the Japanese Americans also plays a
substantial role in this group's mental health. The social determinants of health, including
economic stability, neighborhood and physical environment, education, food, community and
social context, and health care system influence the Japanese immigrants' mental health experience
in the United States.
Section 1: Characteristics of Immigrant Group
The immigrant group under consideration in this assignment is the Japanese immigrants.
The Japanese immigrants comprise an ethnic group that falls under the Asian Americans category.
It is regarded as one of the oldest groups of Asian origin to have moved to the United States. The
first Japanese immigrants arrived in the U.S. in the 1880s during the Meiji period (Torimoto,
2017). They first settled in Hawaii islands before moving to the mainland in the late 1890s to early
1900s. Most researchers have pointed out that the home country's challenges and the desire to seek
a better future motivated the early Japanese immigrants to shift to the United States. Although they
initially worked as laborers in the sugar plantations in Hawaii, the Chinese Exclusion Act of 1888
2
Panahi-Pour
paved the way for Japanese immigrants to get other better jobs in mainland America, increasing
their population.
Today, Japanese immigrants reside mostly reside in California, Washington, and Oregon
states. According to the 2010 census, there were 1.3 million Japanese immigrants in the U.S. with
272,528 living in California, 185,502 in Hawaii, 37,780 in New York, and 35,008 in Washington
(Torimoto, 2017). The metropolitan areas occupied by the Japanese immigrants include Honolulu,
Los Angeles, and San Francisco. The median age among Japanese immigrants is 40 years. There
are more women Japanese immigrants than men with 52% and 48%, respectively. The average
household income is $60,000, and only 7% of the Japanese immigrant population does not have
health insurance health cover (Orgera & Tolbert, 2020). Concerning the family structure, Japanese
families are patriarchal, with the father as the breadwinner and must be accorded utmost respect.
However, there have been recent changes in gender roles as women among the Japanese
immigrants receive equal educational and employment opportunities.
Section 2: Brief History of Immigration in the U.S.
As noted in the first section above, the first Japanese immigrants arrived in the United
States in the 1880s. At this time, this group comprised less than 1000 individuals. They first settled
in Hawaii, working mainly as farm laborers in sugar plantations. By 1900, the number of Japanese
immigrants reached 25, 000 and apart from being farm laborers, these individuals also worked in
mining and mills camps (Torimoto, 2017). After a few years, the Japanese immigrants started
forming small communities within small towns and established restaurants, general stores, and
small hotels. By 1925, many Japanese immigrants flocked into the United States, comprising over
100,000 individuals. During this time, the Japanese immigrants established many of its
foundational institutions.
3
Panahi-Pour
Although many newcomers found their employment in migratory labor working in mines,
farms, and railroads, some became active in labor activism. Following constant agitation efforts,
many Japanese immigrants founded their businesses, such as restaurants and shops serving the
community needs. They also established cooperative societies that provided financial support to
farmers and businesses. By 1920, Japanese immigrant farmers owned about 450,000 acres of land
in California and generated about 10% of the total crop revenue (Torimoto, 2017). However,
despite the Japanese immigrant progress in the 19th century, this success story did not come on a
silver plate. The group encountered significant challenges and policy barriers. For instance, they
were excluded from employment, and most of them only worked as laborers regardless of their
qualifications. Several campaigns by the English-language press called for the exclusion of
Japanese immigrants from American life in the early 1990s.
The press labeled the Japanese as the enemies of the American workers and corrupt agents.
This influenced the Alien Land Law's passing in 1913 in California that barred all Asian
Americans from owning land. The policy aimed to discriminate Japanese immigrants from owning
property and competing with the natives. In 1924, the federal government enacted the Immigrant
Act of 1924 that ended Japanese immigration (Torimoto, 2017). Despite these challenges, the
Japanese demonstrated resilience through sticking together and speaking in one voice as a family.
They also learned to manure the restrictive system; for instance, the Japanese immigrants
registered their lands using European names following the Alien Land Law of 1913 enactment.
Section 3: Determinants of Health
Mental health is essential in every stage of individuals' lives beginning from childhood,
adolescence, through adulthood to older adulthood. Healthy People (2021) defined mental health
4
Panahi-Pour
as the emotional, psychological, and social well-being of a person. It often impacts how people
feel, thinks, and behave. A compromised mental health status entails a situation where individuals'
emotions, psychology, and overall social well-being are not good or unstable. In other words, the
person has a poor mental status, feels terrible, and cannot think properly. Mental health problems
can result from genetics, such as a history of mental illness running in the family, chronic medical
conditions, financial/economic situations (lacking money), and death or loss of loved ones.
Examples of mental health concerns include depression, stress, anxiety, sleep disorders, bipolar
disorder, and personality disorder.
In the United States, mental health illness is a massive problem. Current studies show that
about 20.6% of the U.S. adults experienced mental illness in 2019, constituting approximately one
in five adults. More females (49.7%) experienced mental health concerns than males (36.8%).
Apart from mental illness affects virtually everyone in the United States, several factors
impact/influence how immigrants (Japanese immigrants) experience this condition. These factors
are often known as the social determinants of health. Healthy People (2021) defined the social
determinants of health as situations in which individuals are born, live, play, worship, work, or
learn that impact people's and community's health outcomes and quality of life. Such conditions
include economic stability, neighborhood and physical environment, education, food, community
and social context, and health care system.
Economic Stability
According to the Healthy People 2020 campaign, economic stability comprises the pillar of
the social determinants of health. One of the significant indicators in the economic stability domain
5
Panahi-Pour
is employment. Employment is directly linked to an individual’s health outcomes (Teruya &
Bazargan-Hejazi, 2013). For instance, employed individuals can earn income to consume healthy
foods, access better healthcare, and live in better housing. In the case of Japanese immigrants,
employment influences mental health among this group negatively.
Recent statistics show that about 58% of Japanese immigrants are employed, and about
39% are out of the labor force. Although 58% seems like a considerable number, a significant
percentage of Japanese immigrants are still out of the labor force or doing less paying jobs.
Lacking employment makes many of them go through financial difficulties compared to the whites
with similar qualifications, therefore subjected to an array of mental health problems. Assari and
Kumar (2018) stated that most Japanese immigrants have mental illness due to poor or low paying
jobs. Due to a lack of employment, most Japanese immigrants cannot access or afford better
mental health care services, worsening their conditions.
Neighborhood and Physical Environment
The neighborhoods and physical environment where individuals live tend to impact their
health outcomes and overall well-being directly. For instance, people can live in communities with
high violence rates and unsafe water and air, which negatively affects their physical and mental
health. Most Japanese immigrants live in New York and Honolulu, which are among cities with
the highest violence rate, thus harming their mental health. Research by John et al. (2012)
established that immigrants living in places with high crime/violence rates are likely to experience
mental health illness such as stress, anxiety, and depression for fear of being mugged, killed, or
robbed. Another study by Cabral and Cuevas (2020) also indicated that most immigrants live in
areas with high safety and health risks because of their minority status, which harms their mental
health.
6
Panahi-Pour
Education
Education is a major social health determinant because it enables individuals to make
informed decisions about their health and maneuver the healthcare system (John et al., 2012). For
instance, highly educated people can prioritize diagnosis or know which facility to visit before a
health condition worsens. According to recent reports, about 32% of the Japanese immigrants have
attained a bachelor’s degree. This number is still low and means that a considerable percentage of
the population only has basic education. Because of the massive population of individuals without
tertiary education, most do not have the appropriate health literacy to seek mental health treatment.
Alegría et al. (2008) pointed out that most immigrants have low education levels to make informed
decisions about their health. Some even die without knowing their ailments due to a lack of
information for a diagnosis or treatment. The author suggested that improving education and health
literacy among immigrants can help boost health outcomes since these groups will make informed
health decisions, preventing specific health conditions.
Food
Typically, food is linked to economic stability indicators like employment and income
(John et al., 2012). As noted earlier, a significant percentage of Japanese immigrants are
unemployed, thus lack money to access nutritious food, which affects their health outcomes. For
example, due to a lack of healthy and adequate food, most Japanese immigrants are often forced to
starve and subjected to mental illness such as stress and depression. A study by Castañeda et al.
(2012) showed that immigrant parents who cannot provide enough food to their children or family
are likely to suffer from various mental health problems such as depression, panic disorders,
personality disorders, and eating disorders.
Community and Social Context
7
Panahi-Pour
The community and social context domains comprise indicators like social support
networks and resources (Artiga & Hinton, 2019). These domains can influence health outcomes
positively or negatively. Japanese immigrants entail one of the most socially knit ethnic
communities in the United States. Their culture is defined by living together, helping each other,
and visiting one another frequently. Because of this, Japanese immigrants have robust
social/family support networks that release the impacts of mental illness. Those with mental health
concerns receive adequate family support, speeding their recoveries. An article by Butkus et al.
(2020) established that Japanese immigrants have a culture that embraces togetherness, ensuring
that individuals with mental illness, especially among the elderly population, receive sufficient
social support. This influences better health outcomes.
Health Care Systems
Health care systems and policies comprise significant health determinants since they
impact the type and health care available to an individual or community (John et al., 2012).
Generally, the U.S. health care system is expensive compared to other developed nations. In 2019,
the U.S. government spent about $3.8 trillion or 17.7% of the GDP on health care. Because of the
enormous health care costs and the high unemployment rate among Japanese immigrants, most of
them cannot access better health care services, affecting the health outcomes negatively. Teruya
and Bazargan-Hejazi (2013) pointed out that the costly health care system of the United States is a
massive problem to many immigrants’ health since they cannot afford better health care services.
This is why the Healthy People 2020 campaigns suggest reducing care costs and expanding
insurance coverage to ensure health equity in the United States.
Immigration as a Social Determinant of Health
8
Panahi-Pour
Immigration status and policy plays a significant role in the health of Japanese immigrants.
For instance, in states with restrictive immigrant policies such as Arizona, access to employment
and health services for mental health concerns affects immigrants' health outcomes adversely
(Castañeda et al., 2012). In other words, the restrictive regulations prevent Japanese immigrants
from accessing better mental health care services, jeopardizing the health outcomes (Teruya &
Bazargan-Hejazi, 2013). Also, most immigrants encounter discrimination in employment,
education, social support, and health care access, which influences their mental health outcomes
negatively because of the immigration status. For instance, due to constant racial discrimination,
immigrants can experience anxiety, stress, or depressive disorders, reducing the quality of life or
well-being.
Japanese immigrants moved to the United States as early as the 1880s. They have since
settled to become among the powerful communities of Asian origin. The group faced significant
challenges but demonstrated resilience to become what they are today. Besides, mental health is a
massive concern among Japanese immigrants, and this condition is influenced by several social
determinants of health including economic stability, neighborhood and physical environment,
education, food, community and social context, and health care system. The factors have positive
and negative effects on the mental health outcomes of Japanese immigrants. Lastly, the
immigration status and policies also impact the health outcomes of this ethnic group negatively.
References
9
Panahi-Pour
Alegría, M., Canino, G., Shrout, P. E., Woo, M., Duan, N., Vila, D., & Meng, X. L. (2008).
Prevalence of mental illness in immigrant and non-immigrant US Latino groups. American
Journal of psychiatry, 165(3), 359-369.
Artiga, S., & Hinton, E. (2019). Beyond health care: the role of social determinants in promoting
health and health equity. Health, 20(10), 1-13. http://files.kff.org/attachment/issue-brief-
beyond-health-care
Assari, S., & Kumar, A. (2018). Social determinants of physical self-rated health among Asian
Americans; comparison of six ethnic groups. Societies, 8(2), 24.
Butkus, R., Rapp, K., Cooney, T. G., & Engel, L. S. (2020). Envisioning a better US Health Care
System for all: reducing barriers to care and addressing social determinants of
health. Annals of internal medicine, 172(2_Supplement), S50-S59.
Cabral, J., & Cuevas, A. G. (2020). Health inequities among latinos/hispanics: documentation
status as a determinant of health. Journal of racial and ethnic health disparities, 1-6.
Castañeda, H., Holmes, S. M., Madrigal, D. S., Young, M. E. D., Beyeler, N., & Quesada, J.
(2015). Immigration as a social determinant of health. Annual review of public health, 36,
375-392.
Healthy People (2021). Social Determinants of Health.
https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health
John, D. A., De Castro, A. B., Martin, D. P., Duran, B., & Takeuchi, D. T. (2012). Does an
immigrant health paradox exist among Asian Americans? Associations of nativity and
occupational class with self-rated health and mental disorders. Social science &
medicine, 75(12), 2085-2098.
10
Panahi-Pour
Orgera, K., & Tolbert, J. (2020). Key Facts about the Uninsured Population.
https://www.kff.org/uninsured/issue-brief/key-facts-about-the-uninsured-population/
Teruya, S. A., & Bazargan-Hejazi, S. (2013). The immigrant and Hispanic paradoxes: A
systematic review of their predictions and effects. Hispanic journal of behavioral
sciences, 35(4), 486-509.
Torimoto, I. (2017). Okina Kyūin and the Politics of Early Japanese Immigration to the United
States, 1868-1924. McFarland.
11