The Relationships among Social Discrimination, Subjective Health, and Personal Satisfaction of Immigrants

Transcription

1 ORIGINAL ARTICLE J Korea Acad Commuity Health Nurs ( 지역사회간호학회지 ) ISSN (Prit) / ISSN (Olie) Vol. 28 No. 4, , December The Relatioships amog Social Discrimiatio, Subjective Health, ad Persoal Satisfactio of Immigrats Chu, Jiyoug 1 Lee, Isook 2 1 Graduate School, Seoul Natioal Uiversity, Seoul 2 College of Nursig, Seoul Natioal Uiversity, Seoul, Korea Purpose: This study aims to examie the relatioships amog social discrimiatio, subjective health, ad persoal satisfactio based o the coutry of origi. Methods: The aalysis was based o 16,958 immigrats who participated i the Natioal Survey of Multicultural Family 2015 i Korea. This study coducted stratified cross-aalysis of social discrimiatio for the differeces i subjective health ad persoal satisfactio. Multivariate-adjusted odds ratios ad 95% cofidece itervals for the relatioships amog social discrimiatio, subjective health, ad persoal satisfactio were examied with multivariable logistic regressio. Results: There were differeces i experiece of social discrimiatio, subjective health status, ad persoal satisfactio accordig to the coutry of origi. Groups without the experiece of social discrimiatio had better subjective health ad persoal satisfactio tha the other groups. Coclusio: This study demostrates that a discrimiatio prevetio program eeds to be developed based o a cultural approach Key Words: Immigrats, Discrimiatio, Subjective health, Persoal satisfactio INTRODUCTION 1. Backgroud of the Study Korea is a multicultural society i which the umber of multicultural populatio is cotiuously icreasig. The umber of foreigers stayig i Korea has icreased by 8.6% per year for the last five years [1]. I particular, the umber of the members of multicultural families is estimated to be 278,036 persos i 2015, ad the average family umber of them is 3.16 persos, which is higher tha the average family umber of Korea atioals of 2.8 persos [2]. I additio, 79.9% are i the 20~40 age group, ad the employmet rate is 10% higher tha that of the total populatio i Korea, ad 84% has bee residig i Korea for more tha 5 years [2]. This meas that the multicultural populatio forms a large family through marriage ad childbirth ad evetually they are likely to permaetly reside i Korea as members of this society. With the icreasig multicultural populatio ad the resultig expasio of multicultural society [1], immigrats ot oly form a group but have a multicultural idetity expectig their cultural beliefs, values ad lifestyles to be respected [3]. Giger ad Davidhizar [4] set up meta-paradigms i the Trascultural Assessmet Model with cocepts such as culturally uique idividuals, culturally sesitive eviromets, culturally diverse ursig, ad culturally competet ursig. Madelie Leiiger also claimed that if the diversity ad uiversality of care i trascultural ursig are recogized ad people with differet or similar cultures are provided with care i a way that is appropriate to their idetity ad culture, it would be helpful for them to recover ad maitai their health ad die i a reveret ad digified maer [3]. Leiiger's trascultural ursig was elaborated through the Surise Care Eabler. Accordig to this theory, culturally appropriate care for their health, well-beig, ad death ca be achieved by providig trascultural ursig for decisios ad actios for the idividual, family, ad commuity by cosiderig cultural ad social structural dimesios icludig techology, religio, philosophy, kiship, social beliefs, lifeway, eviromets, politics, ecoomy, ad ed- Correspodig author: Lee, Isook College of Nursig, Seoul Natioal Uiversity, 103 Daehak-ro, Jogo-gu, Seoul 03080, Korea. Tel: , Fax: , lisook@su.ac.kr Received: Jul 13, 2017 / Revised: Oct 1, 2017 / Accepted: Oct 2, 2017 This is a ope access article distributed uder the terms of the Creative Commos Attributio No-Commercial Licese ( by-c/3.0), which permits urestricted o-commercial use, distributio, ad reproductio i ay medium, provided the origial work is properly cited. c 2017 Korea Academy of Commuity Health Nursig

2 Chu, Jiyoug Lee, Isook ucatio [3]. The coutry of origi is the aggregate of the cultural ad social structural dimesios. Sice the coutry of origi reflects the cultural ad social structure of the idividual as a importat compoet that determies the idetity of immigrats [4], ursig accordig to the coutry of origi ca be applied by performig culturally appropriate care by ehacig the sesitivity to the perso requirig care. As Korea etered the 2000s, the umber of migrat workers ad marriage immigrats icreased, ad racial ad ethic miority groups emerged. As a result, social coflicts ad iequalities occurred ad racial discrimiatio became a social issue. Because race is a ideology that regards a huma group as iheretly superior to others based o outward characteristics or geographical origi [5], the issue of discrimiatio agaist foreigers i Korea society is based o a ideological hierarchy of races or atios [6]. I other words, discrimiatio agaist immigrats by Koreas ca be attributed to differeces i race, coutry, laguage, lifestyle, customs, ad orms, ad the cultural characteristics of the coutries of origi of immigrats ifluece their experieces of discrimiatio ad health status [5,7]. Discrimiatio agaist immigrats is a serious problem i itself as a egative factor for adaptatio ad social itegratio of immigrats [8]. I additio, as a cause of stress, it is associated with health risk behaviors such as smokig ad drikig, leadig to the developmet of disease, so the experiece of discrimiatio i the early life has a egative impact o health throughout the lifetime [3,9,10]. As a result, the experiece of discrimiatio of multicultural families are liked to the health status of the atio as a whole ad may lead to health risks ad racial ad hierarchical health iequalities i Korea society. Nevertheless, 40.7% of married immigrats ad aturalized persos livig i Korea ad 9.4% of childre of multicultural families were reported to have experieced discrimiatio ad slights [2]. I Korea, studies o discrimiatio experiece ad health have mostly ivestigated the relatioship betwee discrimiatio experieces ad health status of marriage migrat wome or childre of multicultural families [11], ad experieces of discrimiatio have bee reported to have a egative impact o persoal satisfactio ad metal health [12,13]. I the Uited States, experieces of discrimiatio were reported to be differet depedig o the ski color, ad they were foud to have a egative impact o health status [9,10,14,15]. Meawhile, i Korea, the subjective health status of subjects was reported to vary accordig to the places where they experieced discrimiatio [7]. These studies have revealed a egative correlatio betwee experiece of discrimiatio ad objective ad subjective health status, but they have examied discrimiatio based o the ski color such as black, white, ad Asia, or the place of origi such as the West ad Asia. Cosiderig the fact that the cocept of culture icludes the race ad place of origi, it is ecessary to coduct research by further subdividig the coutry of origi. I particular, immigrats livig i Korea form the commuities of familiar places ad people based o the gatherigs of people from their ative coutries who share the same religio ad coutry of origi to maitai their culture [16], ad also adapt to other cultures by usig the cyber commuities of ethic groups, which are a relatioal medium of 'commuicatio, friedship ad exchage' [17]. The social etwork theory claimed that immigrats icrease their chaces of relocatio through the persoal coectios ad etworks of their ative coutries after they settled i Korea [18], ad previous research suggested that there is a great possibility that marriage immigrats will brig about chages i our society by passig dow their cultural elemets to their childre [19]. Take together, previous studies suggest that commuities of immigrats based o their ative coutries ca be see as a importat factor that ca affect their residece i Korea, their cultural adaptatio ad the future Korea society. To date, Korea's policies to support immigrats have ot bee sufficiet as support policies for multiculturalism because they have bee based o a atioal itegratio model focused o the coveiece support for adaptatio to the life i Korea icludig Korea laguage educatio [20]. Therefore, commuity policies for the coexistece of immigrats ad existig residets ad exchage amog them are ow required [20], ad educatio programs for discrimiatio prevetio are expected to positively ifluece the formatio of the relatioship amog the residets. Therefore, this study aimed to examie the relatioship betwee social discrimiatio experiece, subjective health, ad persoal satisfactio based o the coutry of origi of immigrats, ad provide basic data to establish policies for prevetio of discrimiatio agaist immigrats based o the coutry of origi. 2. Purpose of the Study The purpose of this study is to uderstad the relatioships of the experiece of social discrimiatio with subjective health status ad persoal satisfactio of immigrats i Korea. First, we ited to ivestigate the social discrimiatio 376 Joural of Korea Academy of Commuity Health Nursig

3 The Relatioships amog Social Discrimiatio, Subjective Health, ad Persoal Satisfactio of Immigrats experiece, subjective health status, ad persoal satisfactio accordig to the geeral characteristics of the subjects. Secod, we aim to examie the relatioship betwee the subjective health status ad persoal satisfactio depedig o the presece of experiece of social discrimiatio by coutry of origi. 1. Study Desig METHODS This study is a secodary data aalysis study to ivestigate the relatioship betwee subjective health ad persoal satisfactio accordig to the experiece of social discrimiatio of residet immigrats i Korea by usig the Natioal Survey of Multicultural Families (2015). 2. Subjects This study used the data of 'Natioal Survey of Multicultural Families 2015' coducted amog multicultural families i Korea by the Miistry of Geder Equality ad Family. Based o the Multicultural Family Support Act (eacted o Jauary 18, 2010), the Natioal Survey of Multicultural Families was commissioed to the Statistics Korea by the Multicultural Family Policy Divisio of the Miistry of Geder Equality ad Family i order to establish basic statistical data ad policies. Ivestigators were selected i advace, ad through the educatio of the guidelie book, they were well iformed about the compositio ad order of cotets of the questioaire, guidelies for each item, ad overall survey-related items, such as attitudes ad greetigs whe visitig each household member [21]. The subjects of the survey were marriage immigrats, aturalized persos, ad household members of 'multicultural households residig i Korea durig the survey period.' The survey was coducted usig the double samplig of clusterig systematic samplig ad stratified systematic samplig. I order to carry out the survey, 850 districts icludig admiistrative uits of Eups, Myeos, ad Dogs, 25% of a total of 3,470 admiistrative districts i Korea, were sampled. Amog 26,098 households visited i the 850 districts, a total of 16,000 households agreed to participate i the survey, ad iterviews ad self-admiistered questioaires were coducted [22]. The subjects of this study were 16,958 persos without missig data cocerig mai variables amog a total of 17,109 persos who cosisted of marriage immigrats ad aturalized persos. 3. Istrumets The Natioal Survey of Multi-Cultural Families 2015 was carried out amog multicultural family households, icludig marriage immigrats, aturalized persos, their spouses, ad their childre aged 9~24, ad it ivestigated geeral items such as atioality, geder, ad etry ito Korea, ad other items such as the status of employmet ad occupatio of the spouse, occupatio i their ative coutry, curret status of employmet ad occupatio, marital status ad family compositio, child-rearig, health status ad health care, social life, ad welfare eeds. The subjects of this study were marriage immigrats ad aturalized persos. The purpose of this study was to ivestigate the relatioship of the experiece of discrimiatio with subjective health ad persoal satisfactio of immigrats by coutry of origi. A previous study o the discrimiatio agaist immigrats i Korea reported that o-westerers icludig Asias have a social sese of distace compared to Westerers composed of white people, ad claimed that Koreas' discrimiatio agaist immigrats has a racist tedecy, ad that this racist propesity implies the possibility of discrimiatio based o geder [7]. I the previous studies o the subjective health of immigrats, as the immigrat's age ad the immigrat's period of residece i Korea were icreased, subjective health status became worse [23]. O the other had, as the level of educatio ad icome was elevated, subjective health status became better [23,24]. Moreover, immigrats who lived with the spouse showed better subjective health tha those who did ot [25]. The subjective health status of immigrats has bee reported to be related to the coutry of origi ad persoal satisfactio [23], ad subjective health has bee used as a idex to measure the relatioship betwee discrimiatio experieced by immigrats ad health status [7]. Based o these prior studies, we icluded demographic ad socioecoomic characteristics of geder, age, educatio level, marital status, residece period, ad icome i the study. 1) Demographic ad Socio-Ecoomic Characteristics Geder was divided ito male ad female, ad the America ages i the origial data were classified by the uit of 10 years from 10~19 years to 60 years or over. I the origial data, the educatio level was divided ito seve categories, such as o schoolig, elemetary school graduate, juior high school graduate, high school graduate, 2~3 year college graduate, 4 year uiversity graduate, ad a master's degree or higher, but i this study, it was classified ito o schoolig, elemetary school graduate, juior Vol. 28 No. 4,

4 Chu, Jiyoug Lee, Isook high school graduate, high school graduate, ad college graduate or higher. Marital status was classified ito umarried, livig with the spouse, bereaved, divorced, ad separated i the origial data. I this study, marital status was divided ito umarried, livig with the spouse ad others, with bereaved, divorced, ad separated classified as others. The residece period was based o the data of the atioality at birth ad the first year of etry. Based o the survey time of 2015, the researcher calculated the residece period ad classified it ito 1 year or less, 2~5 years, 6~10 years, ad 11 years or more. I the origial data, icome was classified by the uit of 1 millio wo ito 8 categories of mothly average icome from less tha 1 millio wo to more tha 7 millio wo. I this study, icome was classified by the uit of 1 millio wo ad the mothly icome raged from '1 millio wo or less' to 'more tha 5 millio wo.' 2) Coutry of Origi Oe questio askig the coutry of origi icluded 94 atioalities icludig statelessess. Accordig to the data from the Miistry of Govermet Admiistratio ad Home Affairs i 2016, i the atioality of marriage immigrats ad aturalized persos, the umber of Korea- Chiese were the largest, followed by Chia, Vietam, Philippies, Japa, the Americas, Europe ad Oceaia, other Southeast Asia coutries, Cetral Asia, Taiwa, Hog Kog, South Asia ad other coutries i descedig order. I this study, the classificatio of the coutry of origi was the same as that of the Miistry of Govermet Admiistratio ad Home Affairs. For other coutries, the coutry from which oly oe immigrat came was excluded from the aalysis. 3) Experiece of Social Discrimiatio For the questio 'Have you experieced discrimiatio or disrespect because you are a foreiger while livig i Korea, respodets were required to respod either 'I have experieced discrimiatio.' or 'I have ot experieced discrimiatio.' The places where discrimiatio was experieced were divided ito four categories: 'streets, eighborhoods, shops, restaurats, or baks,' 'public istitutios, 'workplaces,' 'schools or child care ceters.' I terms of the degree of discrimiatio, respodets were asked to choose a respose amog 'I experieced a lot of discrimiatio,' 'I was slightly discrimiated,' ad 'I did ot experiece ay discrimiatio.' I this study, the distictio betwee the presece ad absece of discrimiatio was used for the aalysis. 4) Subjective Health For the questio 'How is your overall health status?,' respodets were asked to choose a respose amog 'very good,' 'geerally good,' 'modest,' 'geerally poor,' ad 'poor.' To perform logistic sessio aalysis, 'very good' ad 'geerally good' were classified as 'good' ad the other resposes were classified as 'poor.' 5) Persoal Satisfactio Respodets were asked to choose a respose amog 'very satisfied,' 'somewhat satisfied,' 'geerally satisfied,' 'ot very satisfied,' ad 'ot satisfied at all' for the questio askig how satisfied they were with their preset life cosiderig their overall life. I order to perform logistic regressio aalysis, 'very satisfied' ad 'somewhat satisfied' were classified as 'satisfied' ad the other resposes were classified as 'ot satisfied.' 4. Data Collectio ad Aalysis This study used the data of 'Natioal Survey of Multicultural Families i 2015' coducted by the Miistry of Geder Equality ad Family for Korea multicultural families. The data is provided by the Natioal Statistical Microdata ad ca be accessed by ayoe who accesses the site ad register as a member ( do). As the data aalysis framework of this study, the idepedet variable was the experiece of discrimiatio of immigrats by coutry of origi, ad the depedet variables were the subjective health ad persoal satisfactio of immigrats. The cofoudig variables based o previous studies were demographic ad socioecoomic variables, such as geder, age, educatioal level, marital status, residece period, ad icome, ad the specific data aalysis process was as follows. First, the geeral characteristics of the subjects cocerig social discrimiatio experiece, subjective health, ad persoal satisfactio were described ad aalyzed. Secod, we coducted a chi-squared test, usig stratificatio accordig to the presece of social discrimiatio experiece by coutry of origi, ad ivestigated whether there is a differece i subjective health ad persoal satisfactio depedig o the presece of social discrimiatio experiece. Third, logistic regressio aalysis was performed through the stadardizatio of demographic ad socioecoomic characteristics of subjects i order to examie the relatioship of social discrimiatio experiece with subjective health ad persoal satisfactio by coutry of origi. The results were expressed as the odds ratio ad 95% cofidece iterval, ad the 378 Joural of Korea Academy of Commuity Health Nursig

5 The Relatioships amog Social Discrimiatio, Subjective Health, ad Persoal Satisfactio of Immigrats Hosmer ad Lemeshow test was used to verify the goodess of fit of the model. This study was approved by Seoul Natioal Uiversity Istitutioal Review Board for exemptio from review (IRB No. E1707/ ) RESULTS 1. The Geeral Characteristics of Participats for Social Discrimiatio Experiece, Subjective Health ad Persoal Satisfactio Of a total of 16,958 respodets, 84.9% were female ad 84.8% were i their forties. I terms of the coutry of origi, the largest umber of respodets came from Chia with 22.4%, followed by Vietam with 16.1%, Korea- Chiese with 15.8%, Southeast Asia with 9.3%, Japa with 8.8%, Philippies with 8.5%, Mogolia, Russia, ad Cetral Asia with 7.3%, Americas, Europe, ad Oceaia with 5.6%, Taiwa ad Hog Kog with 3.2%, ad Souther Asia with 3.0%. There were statistically sigificat differeces i social discrimiatio experiece accordig to geder, age, marital status, residece period, icome, ad coutry of origi, but there was o differece depedig o the educatio level (p<.05). O the other had, there were sigificat differeces i subjective health ad persoal satisfactio accordig to geder, age, educatio level, residece period, icome, ad coutry of origi (p<.05)(table 1). 2. Differeces i Subjective Health ad Persoal Satisfactio accordig to Social Discrimiatio Experiece by Coutry of Origi The experiece of social discrimiatio varied accordig to the coutry of origi (x 2 =76.47, p<.001). As a result of examiig social discrimiatio experiece by coutry of origi through the stratificatio of the presece of social discrimiatio experiece, as for Chia, it was foud that 53.9% of immigrats with discrimiatio experiece ad 65.5% of immigrats with o discrimiatio experiece assessed their health as good, while 46.1% of those with discrimiatio experiece ad 34.5% of those without discrimiatio experiece assessed their health as poor. I the case of the Korea-Chiese, 44.6% of immigrats with discrimiatio experiece ad 55.3% of those with o discrimiatio experiece assessed their health as good, while 55.4% of those with discrimiatio experiece ad 44.7% of those without discrimiatio experiece rated their health as poor. For the immigrats from Japa, 47.3% of those with discrimiatio experiece ad 56.4% of those without discrimiatio experiece showed good subjective health, while 52.7% of those with discrimiatio experiece ad 43.6% of those without discrimiatio experiece exhibited a low level of subjective health (Table 2). Regardig persoal satisfactio, for Chia, 47.5% of the immigrats with discrimiatio experiece ad 57.5% of those without discrimiatio experiece aswered that they were satisfied. For Vietam, 47.5% of the immigrats with discrimiatio experiece ad 57.5% of those with o discrimiatio experiece said that they were satisfied. Similarly, i the case of the US, Europe ad Oceaia, 71.8% of the immigrats with discrimiatio experiece ad 82.2 % of those without discrimiatio experiece said that they were satisfied (Table 2). As described above, groups with o experiece of social discrimiatio i all coutries had better subjective health ad persoal satisfactio at higher populatio ratios tha groups with experiece of discrimiatio. There were differeces i subjective health ad persoal satisfactio accordig to the presece of social discrimiatio experiece amog the coutries of origi (p<.001)(table 2). 3. Relatioship amog Social Discrimiatio, Subjective Health ad Persoal Satisfactio by Coutry of Origi Whe the demographic ad socioecoomic variables were cotrolled statistically, the immigrats from Japa exhibited 1.90 times higher subjective health tha those from wester coutries (95% CI: 1.53, 2.36) ad amog them, the group with o discrimiatio experiece showed 2.29 times higher subjective health (95% CI: 1.70, 3.07). Korea- Chiese immigrats showed 1.64 times better subjective health (95% CI: 1.33, 2.02) compared to those from Wester coutries, ad amog them, the group with o discrimiatio experiece showed 1.77 times better subjective health (95% CI: 1.33, 2.36). immigrats from Vietam showed 1.53 times better subjective health (95% CI: 1.22, 1.91) compared to those from Wester coutries, ad the group with o discrimiatio experiece showed 1.85 times better subjective health (95% CI: 1.35, 2.53). The immigrats from Chia showed 1.37 times higher subjective health (95% CI: 1.12, 1.69) whe compared to immigrats from Wester coutries, ad whe oly the group with o discrimiatio experiece was cosidered, they showed 1.46 times better subjective health (95% CI: 1.10, 1.94). The immigrats from other Southeast Asia coutries showed 1.33 times higher subjective health (95% CI: 1.06, 1.67) whe compared to those from the wester coutries, ad Vol. 28 No. 4,

6 Chu, Jiyoug Lee, Isook Table 1. The Geeral Characteristics of Participats for Social Discrimiatio Experiece, Subjective Health ad Persoal Satisfactio (N=16,958) Total Discrimiatio Subjective health Persoal satisfactio Variables Categories x 2 (p) x 2 (p) x 2 (p) Total 16,958 (100.0) 10,200 (100.0) 10,931 (100.0) 9,619 (100.0) Geder 2,561 (15.1) 14,397 (84.9) 1,451 (56.7) 8,749 (60.8) ,702 (66.5) 9,229 (64.1) ,498 (58.5) 8,121 (56.4) Age (year) 10~19 20~29 30~39 40~49 50~59 60~69 92 (0.5) 4,584 (27.0) 5,816 (34.3) 3,989 (23.5) 1,701 (10.0) 776 (4.6) 69 (75.0) 2,787 (60.8) 3,408 (58.6) 2,262 (56.7) 1,058 (62.2) 616 (79.4) 5.26 (.022) 71 (77.2) 3,506 (76.5) 4,157 (71.5) 2,205 (55.3) 786 (46.2) 206 (26.5) (68.5) 2,934 (64.0) 3,493 (60.1) 2,013 (50.5) 780 (45.9) 336 (43.3) (.026) Educatio No Elemetary school Middle school High school College 196 (1.2) 1,168 (6.9) 3,067 (18.1) 6,871 (40.5) 5,656 (33.4) 121 (61.7) 746 (63.9) 1,870 (61.0) 4,170 (60.7) 3,293 (58.2) 3.85 (.050) 95 (48.5) 621 (53.2) 1,848 (60.3) 4,293 (62.5) 4,074 (72.0) (45.4) 559 (47.9) 1,597 (52.1) 3,719 (54.1) 3,655 (64.6) Marital status Sigle Married Others 237 (1.4) 15,415 (90.9) 1,306 (7.7) 155 (65.4) 9,309 (60.4) 736 (56.4) (79.3) 10,204 (66.2) 539 (41.3) (48.9) 9,125 (59.2) 378 (28.9) Residece period (year) 1 2~5 6~ (2.5) 3,786 (22.3) 6,122 (36.1) 6,632 (39.1) 318 (77.6) 2,394 (63.2) 3,457 (56.5) 4,031 (60.8) 1, (77.8) 2,844 (75.1) 4,091 (66.8) 3,677 (55.4) (73.7) 2,526 (66.7) 3,452 (56.4) 3,339 (50.3) Icome (10,000 wo/ moth) ~ ~ ~ ~ ,357 (8.0) 3,885 (22.9) 5,238 (30.9) 3,507 (20.7) 1,630 (9.6) 1,341 (7.9) 864 (63.7) 2,355 (60.6) 3,156 (60.3) 2,068 (59.0) 945 (58.0) 812 (60.6) (37.5) 2,303 (59.3) 3,505 (66.9) 2,422 (69.1) 1,156 (70.9) 1,036 (77.3) (34.9) 1,755 (45.2) 3,010 (57.5) 2,231 (63.6) 1,132 (69.4) 1,017 (75.8) Coutry of origi Chia Korea-Chiese Japa Taiwa, Hogkog Vietam Philippies The Rese of Southeast Asia South Asia Mogolia, Russia, Cetral Asia America, Europe, Oceaia 3,793 (22.4) 2,678 (15.8) 1,485 (8.8) 550 (3.2) 2,736 (16.1) 1,446 (8.5) 1,569 (9.3) 510 (3.0) 1,240 (7.3) 951 (5.6) 2,292 (60.5) 1,577 (58.9) 973 (65.5) 374 (68.0) 1,628 (59.6) 867 (60.0) 945 (60.3) 236 (46.3) 751 (60.6) 557 (58.6) (.002) 2,311 (61.0) 1,363 (50.9) 791 (53.3) 382 (69.5) 1,915 (70.1) 1,097 (75.9) 1,107 (70.6) 366 (71.8) 839 (67.7) 760 (79.9) No discrimiatio; Good subjective health; Good persoal satisfactio; Icludig divorced, separated ad widows. 2,032 (53.6) 1,205 (45.0) 790 (53.2) 344 (62.5) 1,628 (59.6) 904 (62.5) 907 (57.8) 306 (60.0) 762 (61.5) 741 (77.9) the group with o discrimiatio experiece showed 1.82 times better subjective health (95% CI: 1.32, 2.50). The immigrats from Mogolia, Russia, ad Cetral Asia showed 1.30 times better subjective health tha those from Wester coutries, ad the group with o discrimiatio experiece showed 1.53 times better subjective health (95% CI: 1.12, 2.10)(Table 3). I persoal satisfactio as well, Korea-Chiese immigrats showed a 2.13 times higher level of persoal satisfactio (95% CI: 1.75, 2.60) tha those from Wester coutries, ad amog them, the group with o discrimiatio experiece showed a 2.21 times higher level of persoal satisfactio (95% CI: 1.69, 2.90). The immigrats from Japa showed a 2.09 times higher level of persoal satisfactio (95% CI: 1.70, 2.57) tha those from Wester coutries, ad the group of immigrats with o discrimiatio experieces showed a 2.31 times higher level of persoal satisfactio (95% CI: 1.75, 3.05). The immigrats from Chia showed a 1.83 times higher level of persoal satisfactio (95% CI: 1.51, 2.22) tha those from Wester coutries, ad the group of immigrats with o discrimiatio experieces showed a 1.86 times higher level of persoal satisfactio (95% CI: 1.42, 2.42). The immigrats from Mogolia, Russia, ad Cetral Asia showed a Joural of Korea Academy of Commuity Health Nursig

7 The Relatioships amog Social Discrimiatio, Subjective Health, ad Persoal Satisfactio of Immigrats Table 2. Differeces i Subjective Health ad Persoal Satisfactio accordig to Social Discrimiatio Experiece by Coutry of Origi (N=16,958) Coutry of origi Total Discrimiatio No discrimiatio Subjective health Persoal satisfactio Subjective health Persoal satisfactio Good Poor χ²(p) Good Poor χ²(p) Good Poor χ²(p) Good Poor χ²(p) 3,997 (59.1) 2,761 (40.9) ,416 (50.5) 3,342 (49.5) ,934 (68.0) 3,266 (32.0) ,203 (60.8) 3,997 (39.2) Chia 809 (53.9) 692 (46.1) 713 (47.5) 788 (52.5) 1,502 (65.5) 790 (34.5) 1,319 (57.5) 973 (42.5) Korea-Chiese 491 (44.6) 610 (55.4) 435 (39.5) 666 (60.5) 872 (55.3) 705 (44.7) 770 (48.8) 870 (55.2) Japa 242 (47.3) 270 (52.7) 244 (47.7) 268 (52.3) 549 (56.4) 424 (43.6) 546 (56.1) 427 (43.9) Taiwa, Hogkog 111 (63.1) 65 (36.9) 104 (59.1) 72 (40.9) 271 (72.5) 103 (27.5) 240 (64.2) 134 (35.8) Vietam 710 (64.1) 398 (35.9) 566 (51.1) 542 (48.9) 1,205 (74.0) 423 (26.0) 1,062 (65.2) 566 (34.8) Philippies 419 (72.4) 160 (27.6) 341 (58.9) 238 (41.1) 678 (78.2) 189 (21.8) 563 (64.9) 304 (35.1) The Rese of Southeast Asia 420 (67.3) 204 (32.7) 312 (50.0) 312 (50.0) 687 (72.7) 258 (27.3) 595 (63.0) 350 (37.0) South Asia 187 (68.2) 87 (31.8) 142 (51.8) 132 (48.2) 179 (75.8) 57 (24.2) 164 (69.5) 72 (30.5) Mogolia, Russia, Cetral Asia 313 (64.0) 176 (36.0) 276 (56.4) 213 (43.6) 526 (70.0) 225 (30.0) 486 (64.7) 265 (35.3) America, Europe, Oceaia 295 (74.9) 99 (25.1) 283 (71.8) 111 (28.2) 465 (83.5) 92 (16.5) 458 (82.2) 99 (17.8) Differeces i discrimiatio by coutry of origi (χ²=76.47, p<.001). times higher level of persoal satisfactio (95% CI: 1.28, 1.96) tha those from Wester coutries, ad the group of immigrats with o discrimiatio experieces showed a 1.68 times higher level of persoal satisfactio (95% CI: 1.26, 2.25). For the immigrats from the Philippies, they showed a 1.50 times higher level of persoal satisfactio (95% CI: 1.28, 1.96) tha those from Wester coutries, ad the group of immigrats without discrimiatio experieces showed a 1.68 times higher level of persoal satisfactio (95% CI: 1.26, 2.24). The immigrats from Taiwa ad Hog Kog, they showed a 1.44 times higher level of persoal satisfactio (95% CI: 1.28, 1.96) tha those from Wester coutries, ad the group of immigrats without discrimiatio experieces showed a 1.71 times higher level of persoal satisfactio (95% CI: 1.24, 2.35). As a result of examiig subjective health status ad persoal satisfactio by coutry of origi, the group of immigrats with o discrimiatio experieces was likely to have better subjective health ad persoal satisfactio tha all the immigrats. DISCUSSION The purpose of this study was to ivestigate the relatioship of variatios i subjective health status ad persoal satisfactio with the social discrimiatio experiece of immigrats livig i Korea. I particular, sice the discrimiatio problem i Korea was reported to deped o the hierarchy amog races ad coutries [5,6], we examied social discrimiatio experieces, subjective health status, ad persoal satisfactio based o the coutry of origi. As a result, there were differeces i social discrimiatio experiece, subjective health status, ad persoal satisfactio accordig to the coutry of origi. Especially, the subjects with o social discrimiatio experiece showed a high level of subjective health ad persoal satisfactio. It is thought that sice they may actually experiece dis- Vol. 28 No. 4,

8 Chu, Jiyoug Lee, Isook Table 3. Relatioship 1) amog Social Discrimiatio, Subjective Health ad Persoal Satisfactio by Coutry of Origi Model I (N=16,958) Model II (N=10,200) Variables Subjective health Persoal satisfactio Subjective health Persoal satisfactio OR 2) 95% CI OR 3) 95% CI OR 4) 95% CI OR 5) 95% CI Chia Korea-Chiese Japa Taiwa, Hogkog Vietam Philippies The Rest of Southeast Asia South Asia Mogolia, Russia, Cetral Asia America, Europe, Oceaia Ref Ref Ref Ref Total group; No discrimiatio group; Good subjective health; Good persoal satisfactio. 1) Obtaied from multivariable logistic regressio model icludig variables i Table 1; 2) p-value=0.059 by Hosmer ad Lemeshow Goodess-of-fit-test; 3) p-value=0.364 by Hosmer ad Lemeshow Goodess-of-fit-test; 4) p-value=0.271 by Hosmer ad Lemeshow Goodess-of-fit-test; 5) p-value=0.463 by Hosmer ad Lemeshow Goodess-of-fit-test. crimiatio or their perceptio of discrimiatio may be differet depedig o the coutry of origi, there may be differeces i subjective health status ad persoal satisfactio accordigly. I the case of Westerers, the expressio of emotio is direct, liguistic, ad explicit, ad thus they are sesitive to social discrimiatio. However, sice Asias' expressios of emotios are o-verbal ad idirect, it is possible that they did ot express social discrimiatio by perseverig without revealig bad feeligs [26]. Therefore, the results of this study, which idicated that Asia coutries were more likely to have o experiece of social discrimiatio tha those from Americas, Europe, ad Oceaia, may be attributed to the fact that immigrats from Asia coutries who are racially similar to Koreas have little experiece of discrimiatio or that they do ot feel much social discrimiatio by perseverig ad iteralizig their experieces of discrimiatio due to the characteristics of Asias. However, i the case of immigrats from the Americas, Europe, ad Oceaia, they may experiece a great deal of discrimiatio due to their appearace characteristics differet from those of Koreas. I additio, it is likely that because there is higher awareess of discrimiatio i the US, the UK, ad the Europea Uio, which have ati-discrimiatio laws such as laws prohibitig racial discrimiatio, the immigrats from these coutries showed a higher level of social discrimiatio experiece tha those from Asia coutries i this study. The differece i the perceptio of social discrimiatio accordig to the coutry has ot bee reported yet. Therefore, the hypothesis of this study that the social discrimiatio experiece egatively affects the subjective health status ad persoal satisfactio is thought to be cosistet with the results of the previous study which suggested that social discrimiatio as a cause of stress has a egatively effect both physically ad metally [9,10]. I relatio to culture, there may ot be ay correlatio betwee subjective health status ad persoal satisfactio. It is thought to be due to the differece i the perspective o health betwee Wester ad Asia society. Asia coutries are likely to show better subjective health status tha Wester coutries, which may be attributed to differet views about health ad illess betwee the East ad West [3]. I other words, i the West, health is thought to be the coditio without diseases ad illess is thought to be the collapse of the ormal state. Cosequetly, it is thought that i order for a perso to be healthy, diseases should be treated ad elimiated. O the other had, i the East, it is thought that disease is a atural part of the process of balacig life, ad disease ad health costitute a cotiuum, so it is thought that adaptig to a give eviromet is ul- 382 Joural of Korea Academy of Commuity Health Nursig

9 The Relatioships amog Social Discrimiatio, Subjective Health, ad Persoal Satisfactio of Immigrats timately a life seekig for health [3]. I short, this cotrast i the viewpoit about health is thought to explai higher subjective health of Asia coutries. Social discrimiatio experiece, subjective health status ad persoal satisfactio were foud to be differet accordig to the coutry of origi. These results are believed to be related to the propesity of each atio, which is the aggregate of culture. I this study, subjective health ad persoal satisfactio of immigrats from Japa were foud to be the best, ad it is thought to be associated with Japaese beliefs about health ad emotioal self-cotrol. The Japaese respect the authority of the state through the ifluece of the Meiji period (after 1968) ad Cofuciaism, ad rarely express their ager ad sufferig through perseverace that emphasize emotioal cotrol ad self-disciplie stemmig from the 'ordiary mid' of Ze Buddhism [4]. Also, sice idividuals are cosidered subordiate to their family, they do ot express persoal difficulties ad refrai from expressig emotios [27]. Therefore, it is thought that sice they accept social discrimiatio experieces through emotioal self-cotrol ad obediece to orms [28], ad they thik diseases are caused by the icogruity ad imbalace of the society or family [4], they self-assessed their subjective health ad persoal satisfactio as good. Nevertheless, it should be oted that the group with o experiece of social discrimiatio exhibited a higher level of subjective health ad persoal satisfactio. The Chiese place great emphasis o self-cotrol ad face-savig due to the ifluece of Cofucia thought, ad are willig to abado idividual iterests or edure icoveieces for family members i a collectivist culture to maitai strog family cohesio [4,29]. Moreover, sice they cosider emotios as persoal, they rarely talk about emotioal issues or worries [4,29]. These characteristics of the Chiese are thought to explai the fact that they ted to be less sesitive to social discrimiatio i order to maitai their families, ad ted ot to let others kow eve if they have difficulties. Korea- Chiese immigrats seem to have self-assessed subjective health ad persoal satisfactio better tha immigrats from Chia because they feel more comfortable i their life i Korea tha immigrats from other coutries due to their collectivist culture. As for immigrats from Vietam, i their family-orieted culture, if the idividual' feeligs do ot help the family, they chage their mids for the family. Thus, rather tha acceptig social discrimiatio egatively, they try to cotrol their emotios for the family ad leave it to the flow of time to harmoize with society [4]. Because of this tedecy, they seem to have rated their subjective health status as good. This result is cosistet with a previous study that reported that the Vietamese are less stressed tha Westerers ad ted to be optimistic about the disease [4]. Give the previous study which reported that Koreas feel ucomfortable about livig with foreigers [30], immigrats' experiece of discrimiatio seems to reflect the tedecy of Koreas. People from Asia coutries ted to focus o their families ad cotrol their emotios, ad thus they try to solve their problems by edurig social discrimiatio. Moreover, they accept illesses as part of their lives, ad thik that a harmoious life is a healthy life. Due to these icliatios, they seem to have rated their subjective health higher tha immigrats from the West. Nevertheless, the lack of experiece of social discrimiatio positively affects their subjective health status ad persoal satisfactio. Therefore, it is ecessary to provide policy support for social discrimiatio through a cultural approach, takig ito accout cultural factors icludig the coutry of origi. I particular, sice beliefs about race ad cultural homogeeity are perceived as the most challegig task i the developmet of Korea's multicultural society [8], Koreas eed to chage their attitudes toward prejudice, stereotypes ad discrimiatio agaist race ad ethicity, such as beliefs about laguage ad race homogeeity. CONCLUSION The purpose of this study was to ivestigate the effect of the experiece of social discrimiatio o subjective health status ad persoal satisfactio. The major results of this study were that there were differeces i the experiece of social discrimiatio by coutry of origi, ad subjective health status ad persoal satisfactio were statistically sigificatly higher i the subjects with o experiece of social discrimiatio. The results of this study, which revealed that there were differeces i social discrimiatio experiece, subjective health status, ad persoal satisfactio accordig to immigrats' coutry of origi, are sigificat i that they showed the eed for a social discrimiatio prevetio program through a cultural approach. Eve amog Asia coutries, various factors such as history, religio, lifestyle, etc. vary from coutry to coutry, ad the health status of immigrats ca vary depedig o ative Koreas' attitudes towards immigrats as well as their culture. Therefore, it is cosidered ecessary to expad ad implemet the educatio for prevetio of discrimiatio agaist multicultural families to ative Koreas livig with them as well as immigrats livig i Korea. Specifically, the followig Vol. 28 No. 4,

10 Chu, Jiyoug Lee, Isook measures are required. First, we eed to examie the discrimiatio experieces of immigrats ad the factors that affect them, ad develop a prevetive educatio program to meet the eeds of immigrats. Secod, it is ecessary to idetify reasos for social discrimiatio agaist immigrats, improve the perceptio about related factors, ad develop ad apply discrimiatio prevetio programs. Because this study was based o secodary data, we could ot clearly distiguish the experiece of social discrimiatio from the perceptio of social discrimiatio. Therefore, it is ecessary to examie the relatioships of social discrimiatio educatio, perceived discrimiatio, ad actual experiece of discrimiatio with the health status of immigrats residig i Korea by coutry of origi, cosiderig the aspect of culture. I additio, it is ecessary to develop a social discrimiatio prevetio program that ca be applied i practice through further research. REFERENCES 1. Korea Immigratio Service. Korea immigratio service statistics Gwacheo: Miistry of Justice; p. 2. Jeog HS, Kim IS, Lee TM, Ma KH, Choi YJ, Park GP, et al. Miistry of the geder equality ad family. A aalysis o the atioal survey of multicultural families Statistics Report. Seoul: Miistry of the Geder Equality ad Family; 2016 Jauary. Report No.: Adrews MM, Boyle JS. Trascultural cocepts i ursig care. 6th ed. Philadelphia: Lippicott Williams & Wilkis; p. 4. Giger, JN, Davidhizar RE. Trascultural ursig: Assessmet ad itervetio. 6th ed. Marylad Heights, Missouri: Mosby; p. 5. Williams DR, Lavizzo-Mourey R, Warre RC. The cocept of race ad health status i America. Public Health Reports. 1994; 109(1): Kim JK. Yellow over black: History of race i Korea ad the ew study of race ad empire. Critical Sociology. 2015;41(2): Kim YG, So IS, Kim SS. Associatio betwee discrimiatio ad self-rated health amog marriage migrats i South Korea: Focusig o regio of origi ad geder differeces. Health ad Social Welfare Review. 2015;35(3): Ah SS, Mi MS, Kim IS, Lee MJ, Kim KM. Natioal multicultural acceptability. Research Report. Seoul: Miistry of the Geder Equality ad Family; 2012 Jauary. Report No.: Gee GC, Walsema KM, Brodolo E. A life course perspective o how racism may be related to health iequities. America Joural of Public Health. 2012;102(5): Krieger N. Discrimiatio ad health iequities. Iteratioal Joural of Health Services. 2014;44(4): So IS, Kim SS. A systemic review of research o perceived discrimiatio ad health i South Korea. Health ad Social Welfare Review. 2015;35(1): Kim SJ, Hog CH. The effect of discrimiatio experiece ad laguage problems o psychosocial adjustmet i childre with multi-cultural family: The moderatig effect of ego-resiliece ad family stregths. Korea Joural of Youth Studies. 2017;24(1): Ryu HS. Effects of the marriage immigrat wome's discrimiatory experiece o the physical ad metal health. The Joural of the Korea Cotets Associatio. 2016;16(8): Lee C, Ayers SL, Kroefeld JJ. The associatio betwee perceived provider discrimiatio, health care utilizatio, ad health status i racial ad ethic miorities. Ethicity & Disease. 2009;19(3): Fich BK, Hummer RA, Kol B, Vega WA. The role of discrimiatio ad acculturative stress i the physical health of Mexica-origi adults. Hispaic Joural of Behavioral Scieces. 2001;23(4): Hur CS. Uderstadig the multi-cultural map for Idoesia migrats i South Korea. The Joural of Athropology of Educatio. 2009;12(2): Lee JH, Kim YK. The study o the cyber commuities of migrat workers i Korea. Joural of the Korea Associatio of Regioal Geographers. 2013;19(2): Sul DH. Foreig workers i Korea society. Seoul: Seoul Natioal Uiversity; p. 19. Lee HY, Kim WJ. A aalysis of the growth ad settlemet patter of marriage migratio of wome from developig coutries. Joural of the Korea Urba Geographical Society. 2007; 10(2): Lee EK, Hwag HS. The report of multicultural policy. Policy Report. Seoul: The Hope Istitute; 2016 October. Report No.: Korea Natioal Statistical Office. Statistical iformatio report of atioal survey of multicultural families [Iteret]. Daejeo: Korea Natioal Statistical Office [cited 2017 July 1]. Available from: Joural of Korea Academy of Commuity Health Nursig

11 The Relatioships amog Social Discrimiatio, Subjective Health, ad Persoal Satisfactio of Immigrats mode=read&aseq=351157&pageno=14&rownum=10&ams eq=&starget=title&stxt= 22. Cho SJ, Lee KS, Kwo YB. Periodic statistics quality diagosis of 2015 atioal multicultural family survey. Statistics Report. Daejeo: Korea Natioal Statistical Office; Report No.: Yu JW, Kag HS. Factors ifluecig married immigrat wome's perceived health status: The atioal survey of multicultural families Korea Joural of Wome Health Nursig. 2015;21(1): Lee SM, Kim DS. Acculturatio ad self-rated health amog foreig wome i Korea. Health ad Social Welfare Review. 2014;34(2): Cho JE, Cho GJ. A study o chages of the effect of factors to married immigrat wome's health: Multicultural families survey (2009, 2012). The Joural of Migratio & Society. 2014;7(2): Nilchaikovit T, Hill JM, Hollad JC. The effects of culture o illess behavior ad medical care: Asia ad America differeces. Geeral Hospital Psychiatry. 1993;15(1): Hoolulu JA. People ad cultures of Hawaii: A psychocultural profile. Burs School of Medicie: Uiversity Press of Hawaii; p. 28. Kim BSK, Yag PH, Atkiso DR, Wolfe MM, Hog SH. Cultural value similarities ad differeces amog Asia America ethic groups. Cultural Diversity ad Ethic Miority Psychology. 2001; 7(4): Cheug R, Nelso W, Advidula L, Cureto VY, Caham DL. Uderstadig the culture of chiese childre ad families. Joural of School Nursig. 2005;21(1): Park JH, Lee UB. Compariso of 20 geeratios i five global coutries [Iteret]. Seoul: L.G Busiess Isight [cited 2017 March 30]. Available from: &orderby=register_dt%20desc&startpage=1&datasid=25307 Vol. 28 No. 4,