Title: The Effects of Husband s SES on International Marriage Migrant Partner s Health and Life Satisfaction in South Korea

Title: The Effects of Husband s SES on International Marriage Migrant Partner s Health and Life Satisfaction in South Korea Daesung Choi a, Myungsoon Yoo b, Youngtae Cho b, Sanglim Lee c, Gabriela Sanchez-Soto a a Department of Demography, University of Texas at San Antonio b The Graduate School of Public Health at Seoul National University c The Korea Institute for Health and Social Affairs Abstract. The present study examines the effects of Korean husband s socioeconomic status (SES) on international migrant wife s self-reported health (SRH) and life satisfaction in South Korea. Earlier studies show that spouse s SES is an important factor for the respondent s health-related outcomes. Due to their low SES and the commercialized international marriage process, migrant female spouses are presumed to have a high dependence on their Korean husbands and therefore suffer a resultantly unequal relationship within the marriage. Thus, we expect that the SES of the husband plays a significant role in determining marriage migrant s health and life satisfaction. The data to be used is drawn from the National Survey on Multicultural Families 2009, conducted in Korea. This study analyzes Chinese, Vietnamese, Filipino, Japanese and Korean Chinese female marriage migrants aged 14 and over, living in Korea in 2009 (n=49,087). To address the independent effects of Korean husband s SES, we include three dimensions of covariates: foreign wife s characteristics, Korean husband s characteristics and couple s characteristics. The results from logistic regression models suggest that there are significant disparities of SRH among female migrant partners in relation to the Korean husband s educational attainment even after adjusting for all other covariates, and this effect is greater than that of the migrant women s own educational attainment; suggesting the Husband s education and employment status have a positive effect on the foreign wife s life satisfaction, but the migrant wife s own education was negatively associated with their life satisfaction. There is significant interaction effect between duration of marriage and educational difference between the couple; when migrant women have a lower educational attainment they are more likely to show worse SRH and life satisfaction. Therefore future research on health intervention policies aimed at international marriage migrants, should take into account the husband s characteristics. Background During the last few decades, countries in East and South East Asia have experienced dramatic increases in international marriage migration, and it has become a highly significant type of migration

flow within the region (Jones and Shen 2008; Wang 2007). In particular, South Korea (referred to below as Korea ), Taiwan, Japan and Singapore have been the major immigrant-receiving countries, accepting a steady increase in migrants from such international marriages since 1980 (Jones and Shen 2008). Among these countries, the rate of increasing migration into Korea from international marriage is considerable. According to the Korean survey of 2011, 11,605 marriages were registered as international marriages in 2000, a figure representing about three percent of all marriages in the country, but by 2010 this figure had increased to 34,235, or almost 11% of total number of marriages for that year (Statistic Korea, 2011). With the growing influx of marriage migrants into Korea, several characteristic marriage migration trends emerged between Korea and other major sending countries in East and South East Asia. First, the largest share of international marriages is between Korean males and foreign females, showing the feminization of international migration. Until the 1990s most international marriages in Korea were Korean brides being married to foreign males. However after the 1990s, for various reasons including changes in Korea s population structure and diplomatic relations, cross-border marriages in recent years have been dominated by female migrants coming into Korea; the proportion of marriages between Korean men and foreign women constituting about 77% of the total number of international marriages in 2010 (Kim 2008c; Lee, Seol and Cho 2006). The second characteristic aspect is that the majority of migrating women who marry Korean males come from less developed countries in South East Asia, such as Vietnam, the Philippines and rural China (Jones and Shen 2008; Kim 2008c; Lee 2008; Lee, Seol and Cho 2006). As the number of international marriages between Korean men and foreign women increased, the health implications and issues connected to migration that are specific to women have received growing attention from both Korean policy makers and scholars. Of particular interest has been the fact that foreign women who marry Korean spouses are likely to migrate at young ages (they were, on average, 24 years at the time of marriage in 2009) and that these brides frequently begin childbearing shortly after migration (Jeong et al. 2009; Korea 2011). Since Korean society has experienced an ongoing period of low fertility and a resulting decrease in its labor force population, the increased influx of international

migrant women, and their subsequent offspring, will inevitably affect the population structure of Korea in new and dynamic ways (Yang 2010). However recent statistics and literature consistently demonstrates that female marriage migrants in Korea are likely to suffer from various health-related problems, such as poor access to health care services due to severe poverty (Korea Ministry of Health, 2008), acculturative stress (Kim et al. 2010) and low life satisfaction (Park, Park and Kim 2007). Given that maternal health is highly associated with fetal health and later child health outcomes, the problems of health and stress among marriage migrant women become a crucial issue to consider (Lee, Lee and Kim 2012b). Health of marriage migrant women and husband s SES As immigrants, marriage migrants face many barriers to healthcare in Korea which native-born women would not experience, including a poor understanding of the healthcare systems and a lack of social support and thus, the social determinants affecting the health of the female marriage migrant group as a whole may be more complex than for the native population (Lee, Lee and Kim 2012b). Unlike migrants with only a temporary legal status, marriage migrants, voluntarily or not, gradually integrate into both the larger Korean society and its household culture while forming their new family units. Naturally among health predictors for migrant wives, those specifically related to their own background characteristics, and others related to the characteristics of their husbands, or the families they join in Korea might be important. In this paper, we explore the role that the husband s characteristics play in regard to their wives health outcomes. In fact, many empirical and theoretical studies in Western countries have explored the influence of partner s socioeconomic status (SES) on own health and health behaviors. Despite a few differences in the results based on research contexts, these studies document consistent findings that a person s socioeconomic characteristics are significantly and independently associated with the spouse s health outcomes (Martikainen 1995; Monden et al. 2003; Moser, Pugh and Goldblatt 1988; Van Berkel and De Graaf 1995). For instance, Moser and colleagues (1988) investigated inequality in the mortality of women in England using Census data and reported that those women whose

husbands have non-manual jobs show a decreased mortality in comparison to those marrying husbands in manual jobs. Despite past studies contributions to the subject of health and partner relationships, there is a limitation in postulating similar such relationships between couples in contemporary contexts. This is because much of the research examining the influence of spouses and health was conducted during the 1980s and 1990s, when female labor force participation was much less common, and so the husbands SES provided a more reliable measure of the wives SES and health than that of themselves (Martikainen 1995). Also, in Korea, as with other industrialized countries, gender equality and women s social participation has increased. For instance; in 2011 the proportion of the dual-earner couples reached about 44% of all households, and this figure was almost 60% for households headed by individuals 15 to 40 years old (Statistics Korea, 2011). Therefore in present day Korean society, the husbands SES may no longer be an accurate indication of the wives SES and wives health outcomes in the case of native-born couples. But, in the case of multicultural families with foreign brides, relationships are more likely to follow a patriarchal family structure in which the foreign wives are highly dependent on their husbands, both economically and psychologically. Therefore, even if the framework from earlier studies may no longer explain the reality of Korean-Korean partner relationships, it may still have some relevance in the case of multicultural families with foreign brides. The high dependence of foreign wives on their native-born husbands is facilitated in part by each marital partner s motivation to enter into an international marriage. Regarding the purpose of marriage, prior quantitative and qualitative studies show that whether women migrated to Korea for the purpose of marriage or seeking job opportunities, foreign women are largely motivated to marry Korean males out of economic necessity (Kim et al. 2006; Lee, Seol and Cho 2006). As mentioned, foreign women who were involved in the international marriage migration are likely to come from low income countries and these women are motivated by economic reasons, for instance, to escape poverty in their home countries, improve their quality of life, and obtain financial support from their husbands to send to family members in their country of origin (Lee, Lee and Kim 2012b; Lu 2005). For women who immigrate to Korea as

labor migrants a large proportion of which are ethnic Korean Chinese - marriage is regarded as a means to maintain their residency and, therefore, continue their employment in Korea (Seol et al. 2005). Results from two different large sample surveys show evidence of this phenomenon. For example, findings from a survey in 2007 revealed that 70% of female migrant partners entered Korea for the purpose of marriage, and among all female Vietnamese and Filipino immigrants who entered Korea that same year, 90% immigrated in order to marry Korean men (Jung 2007). Another survey conducted by Ministry of Health and Welfare (2005) reports that when asked why they married their Korean husbands, almost half of foreign brides responded they did so for economic reasons (41%), in contrast 35% of them responded they married because they love their husbands (Seol et al. 2005). Some migrant wives try to seek a new job to contribute to the household economy and/or to send remittance to their remaining family in their home country. These women are generally marginalized in the labor market or occupy lower paid jobs irrespective of their particular nationality and ethnicity, because they lack the language and work skills demanded in higher paid industries (Seol, Lee and Cho 2006a). Therefore, not surprisingly, marriage migrants tend to depend heavily or even completely on their husbands financial support (Lee, Lee and Kim 2012a). Prior studies have pointed out that this imbalance in economic power and social status within the married-couple is the critical reason for the difference in household decisionmaking power between husbands and wives and gender inequality, resulting in the higher dependence of women on their husbands, as well as increased domestic abuse (Kalmuss and Straus 1982; Lee 2008; Lim 1997; Warner, Lee and Lee 1986). Besides the individual economic motivations of migrant brides, the context of international marriage in Korea helps explain the strong dependence of migrant women on their husbands and the inequity within their relationships. With the rapid urbanization of Korean society since the 1950s, Korean women have attained a higher level of education and increased their participation in the labor market. In order to pursue their educational and occupational goals, women marry at later ages, or sometimes they forgo marriage altogether (Kim 2008a). This demographic shift in marital formation is combined with a

traditional preference for male offspring and a subsequent fertility rate below replacement levels, reducing the number of marriageable women in the country (Kim 2004). The resulting deficit of domestic female partners is a phenomenon referred to as marriage squeeze. Under these circumstances, Korean males, particularly those of lower socioeconomic status such as unmarried males living in rural farming communities, or low-income divorced males living in urban areas, find it difficult to attract women of marriageable age in the domestic marriage market (Kim 2008c; Seol, Lee and Cho 2006b). Korean males are then forced to find prospective wives in other countries, especially in low income countries in Asia because these countries have cultures of marriage similar to South Korea, and Korean males can take advantage of Korea s higher economic position to attract spouses. Although a portion of international marriages are mediated through personal networks, or through the Unification Church, a large share of marriages are arranged by profit oriented agencies or commercialized brokers, which have played an important role in increasing the cross-border marriage market in Asia (Kim 2008c; Wang 2007). These international marriage agencies arrange meetings between local women in less developed countries and marginalized men in Korea. This process takes only a few weeks and men pay a sizable fee to meet their potential wives (Park, Park and Kim 2007), a phenomenon which is defined by previous scholars as mail-order brides or the commodification of cross-border marriage (Wang and Chang 2002). Because international marriages begin as economic arrangements, many Korean husbands think of themselves as owners and think of their foreign wives as products and this relationship continues throughout the marriage (Kim 2008b). Moreover, with paying the large amount of fee, Korean husbands and their parents expect that foreign-born wives will serve their husbands and their parents-in-law and dedicate themselves to their husbands lineage by bearing a child (Lim 1997). In addition to economic reasons, psychological dimensions also may contribute to the strong husband dependence observed among foreign wives. Generally migrants (including those who come to Korea) face decreased social support due to the separation from family members and friends left in their countries of origin. Although local governments have various programs to offer social support to female

migrant partners, some of these women find it difficult to recreate a useful support system, mostly because many of them do not work outside the home and they have no prior social connections in Korea (Jung and Kang 2008), or others live in rural areas where institutions for social activities are relatively rare (Kim and Shin 2007). Under these circumstances, husbands are an important source of direct social support and also provide social networks by helping foreign wives to establish other types of social connections (Jeong et al. 2009). Another factor influencing marriage migrant women s subordinate position in households is the procedure for obtaining residency status in South Korea. In order to gain citizenship, immigrants must maintain residence in the country for at least two years and women must obtain consent from their husbands. Sometimes husbands and their families use this condition for the requesting of citizenship to force foreign brides to tolerate unequal relationships (Kim 2010). Although the divorce rate between Korean males and foreign women is much higher than for native couples (Statistic Korea, 2011), previous studies indicate that marriage migrant women have few alternatives but to remain in their current marriages because divorce is viewed in negative terms by friends and family in their original countries and once divorced, the new divorcee would be unable to support herself financially (Lee, Lee and Kim 2012b). This reliance on husbands to provide support during the citizenship acquisition process, and a lack of alternatives to staying in the marriage can reinforce male dominance in international marriage households. In response to the important role of the husband s characteristics in understanding marriage migrant women s various life experiences, studies of foreign brides in Korea generally consider the husband s support, SES and their relationship with their foreign brides as points to explaining migrant women s health outcomes (Kim et al. 2006; Lee, Lee and Kim 2012b). In particular, the findings of several qualitative studies of marriage migrant women all agree that the health outcomes for the migrant women are strongly related to their husband s economic circumstances and the quality of their relationship. But despite the attention given to the husband s characteristics, the question of to what extent the husband s SES is related to their foreign wives health outcomes is still ambiguous. This is due

mainly to an earlier study pattern: Although many studies have taken husband characteristics into account in the multivariate analysis, research has generally viewed the health problems of foreign wives only from an individual perspective or migrant women s own background, dealing with husband characteristics to be simple confounders without appropriately controlling for them. This pattern is also found in studies that examine the various health indicators of migrant women which are closely related to a woman s husband; such as contraception (Kim, Kim and Kwon 2008), spousal support (Kim 2008a), acculturative stress, and family conflict (Park, Park and Kim 2007). Furthermore, most of the studies that have explored the correlation between husbands SES and foreign wives health outcomes have been limited by small sample sizes, or have focused only on certain racial/ethnic groups, with findings not generalizable to the larger population. Thus, in this study we investigate how the husband s two SES indicator - education and employment status - affects their migrant partner s health and life satisfaction. We make use of a large-scale dataset that contains detailed demographic, socioeconomic and migration information about partners in multicultural families. To provide a broad understanding of marriage migrant health outcomes, we focus on female migrant partners from four sending countries, which represented 85.7% of all foreign wives in South Korea in 2010. Hypotheses Based on the above arguments regarding the health outcomes of marriage migrant women and husband s SES, the hypotheses of this study are as follows: 1. A review of the relationship between spouse s SES and health status suggests Korean husband s SES may affect the health outcomes of their migrant wives (Kim et al. 2006; Monden et al. 2007). Thus we first expect that marriage migrants who married Korean husbands with a higher education and level of employment are more likely to report good health and life satisfaction (hypothesis 1). We expect that migrant women who married men of higher SES, measured by their education and employment status, will report good health and life satisfaction.

2. In addition to the influence of socioeconomic characteristics of the husband, migrant women s high spousal dependency, and their poor socioeconomic position in Korean society leads us to assume that the influence of husband s SES on the migrant partner s health and life satisfaction maybe similar to or stronger than foreign bride s own SES indicators (hypothesis 2). We expect that the influence of husband s SES on female migrant s health and life satisfaction will be as strong as or stronger than the foreign bride s own SES. 3. Since the influences of husband s socioeconomic characteristics on the foreign wife s health and life satisfaction is essentially cumulative over time after they marry, we can assume that the magnitude of the effect varies by the duration of marriage. Further, when migrating to a different social environment female migrant women tend to confront various challenges such as the stress of adapting to the new society, psychological isolation, social exclusion and language barriers in Korea (Kim 2010; Kim and Shin 2007; Lee, Lee and Kim 2012b). This series of events would erode their physical and mental health over time even though they have a good health status upon arrival to the country given their young age and positive selection among other potential immigrants. We assume that this cumulative negative effect over time may vary in relation to who migrant partners live with. Accordingly, we expect an interactive effect between duration of marriage and husband s SES, when a foreign wife lives with Korean husband with a higher SES they are likely to show better health outcomes than those who live with low SES husbands (hypothesis 3). Data and Analysis Sample Data are drawn from the 2009 National Survey on Multicultural Families carried out by the Ministry for Health and Welfare, and Family Affairs. The survey investigated various dimensions of life among foreign brides and grooms including family relations, employment, children, social activities, health status and need for welfare. The sample included about 131,000 multicultural families who reside

in Korea, among about 167,000 marriage migrant or marriage migrant who naturalized as a Korean citizen listed in the Ministry of Public Administration and Security, South Korea. Overall response rate for the survey was 56%. The survey was conducted during 20th July to 20th September 2009. We select female marriage migrants age 14 and over who came from China, Vietnam, The Philippines and Japan or are ethnic Korean Chinese (n=63,048). The respondents who are divorced or widowed (n=3,628) and those with missing information are not included in the analysis. Excluding divorced or widowed respondents may arise selection bias as they might have worse relationship with their spouse than those who within marriage, but the proportion of this group is very small (less than one percent) and we think it would not affect our results. The number of excluded observations due to missing information across covariates of interest is about 18% and in preliminary analyses we found no significant changes in results due to missing data. Consequently, our finial sample includes 49,087 marriage migrant women. Measures Two outcomes are chosen to investigate the health of female marriage migrants: self-rated health (SRH) and self-reported life satisfaction. Several research has documented SRH is relevant to physical health outcomes such as mortality and morbidity (Gogers, Hummer and Nam 2000; Hoeymans et al. 1997) and has been used in prior studies to represent health status of immigrants (Cho et al. 2004; Newbold 2005). Furthermore, given that migrant women have lower access to the health care system and lack official health records, it is possible that self-reported health may provide a more accurate and reliable health measure. The other dependent variable, life satisfaction, has been previously found to serve as not only physical and mental health indicator (Koivumaa-Honkanen et al. 2000; Tran and Nguyen 1994), also other aspects of individual health that pertain to general well-being, one s sense of security and relative assessment of material and psychological environments (Strine et al. 2008). Thus, these two measures of health would allow us to identify female migrants physical health and quality of life simultaneously. In the survey, respondents were asked to rate their general health as very good, quite good, neutral, bad and

very bad and we classified these in two categories: very good and quite good for good health and else. Similarly, the survey asked the level of life satisfaction as a whole with a five-point scale; Very much satisfied, satisfied, neither satisfied nor dissatisfied, dissatisfied and very much dissatisfied. Like SRH, respondents are defined good life satisfaction if they reported very much satisfied and satisfied life satisfaction. Independent variables are largely divided into three dimensions: female migrant characteristics, husband characteristics and couple s characteristics. For each partner, we included age measured in years, employment status and level of education. Employment status is categorized into employed and unemployed. Education is classified into three categories: less than 9 years of schooling (less than middle school), 10 to12 years (some high school to high school graduate), and 13 years or more (at least some college). In addition to these variables, female migrant women characteristics include nationality or ethnicity (Ethnic Korean Chinese, Chinese, Vietnamese, Filipina and Japanese) and having social networks. Whether respondents have social networks is assessed using the question in the survey: Who do you spend your time with in the following situation? to which respondents gave answers for four different situations: Having an individual or family trouble, Leisure, recreation, hobby, Celebrations or ceremonies (Wedding, funeral). We define migrant women have access to a social network if they answer they have Korean friends to rely on for at least one of the suggested situations and migrant women are defined as not having social network if she does not have Koreans for all of four situations. Couple s characteristics include educational and employment differences between spouses, monthly household income, duration of the marriage, number of children and how the couple met. The survey measures average household income before tax and this is coded in five groups; less than 1.0 Korean million won (KMW, about 1,000 USD), 1.1 to 2.0 KMW, 2.1 to 3.0 KMW, more than 3.1 KMW and don t know. We did not exclude respondents who answer don t know for household income as we found marriage migrant women who select this category were statistically different from others regarding health outcomes in the preliminary analysis. Previous literature indicates that many of foreign females involved

in international marriages have limited or false information on their future South Korean husbands, mostly because international marriage agencies distort or even withhold information on husband s characteristics such as his age and income to facilitate the negotiation of the marriage match (Seol et al. 2005). During marriage, sometimes native-husbands are reluctant to share information about household property even if foreign brides contribute for it because of concern that the woman will ask for a divorce upon finding out she was given wrong information regarding her husband s economic status (Kim et al. 2006). Whether before or during marriage, the fact that a foreign wife is not aware of information that is supposed to be shared in advance to the marriage or the denial of women s requests for equal partnership shows the imbalanced partner relationship inherent to these types of marriages, which is the cornerstone to our argument regarding the disadvantageous position of foreign wives in South Korea. The duration of marriage was measured in years. Number of children was classified in three groups: none, one, and two or more children. Since this study posits the marriage migrant women s subordinate position and dependence on husband in a household increase the influence of husband s SES on their health, SES differences between couple may explain the effect of husband s SES well. Thus, in addition to educational attainment and employment status of each partner, we included the differences in education and employment status between partners. For education, three categories were used; same education level, wife has lower education than husband and wife has higher education. Difference in employment status was also measured in three categories: same employment status, only husband working and only wife working. Methods We first present descriptive statistics on the sample and the main covariates of interest by our two health outcomes. Next, we use four different logistic regression models to address our hypotheses for the two health outcomes, SRH and life satisfaction.. In the baseline model (model 1), only female migrant s characteristics were included, model 2 adds husband s characteristics. And model 3 adds couple s

characteristics such as income, marriage duration, number of children, and the way in which the couple met. In model 4, instead of controlling for each spouse level of education and employment status, we controlled for the differences in education and employment status between spouses. In addition to these models and to test hypothesis 3, we estimate additional models with interaction terms between both husband s education and the educational difference between spouses, and duration of marriage. Results from these models are presented in table 4. Employment status of partners was not considered because, unlike educational attainment, one s employment could be different over time and the data we used here do not include employment history after marriage. Results Table 1 shows percentage distributions of the health outcomes and other covariates. Among the all national/ethnic groups, ethnic Korean Chinese accounted for the highest proportion of respondents in the sample (39.4%), followed by Vietnamese (28.3%) and Chinese (15%). The proportion of Filipina and Japanese women is relatively small, making up about 10 percent and seven percent of women respectively. Overall, about half of foreign brides (52.8%) reported good health and almost 58% reported good life satisfaction. About 44% of migrant women have a high school diploma and 20.5% of them have college degree or higher education. The distribution of women s education is similar to the distribution of husbands education, in that half of husbands have a high school diploma and 21.8% of husbands have higher than college degree. In contrast to education, there are considerable differences between wives and husbands employment status and age. Regarding employment status, only about six percent of husbands were unemployed at the time of survey, while unemployment among female migrant wives is about ten times as much (59.7%). In addition, husbands are almost 10 years older than their migrant wives, the mean age of husbands is 43.3 years and for women the mean age is 33.3 years. Turning to couple s characteristics, nearly half of spouses have the same degree of education and in about 30 percent of couples, migrant women have lower education than their Korean husband. The proportion of couple with

equal employment status is 35.1% and in 5.7% of couples the wife is the only one employed. These descriptive information suggesting differences in the employment status and the educational difference supporting the basic concept of our hypotheses which is marriage migrant women s subordinate position in household. The monthly household income of sample is low, 18.2% responded that their household income is less than 1.0 KMW, and for 40.3% their monthly household income is less than 2.0 KMW. Only 8.9% of couples report more than 3.0 KMW monthly household income. The average length of marriage is 5.5 years, and multicultural families who have children comprise about 65% of the total sample. The highest proportion of migrant women responded that they met their husband through commercialized agencies or brokers (27.4%) and similar proportions of women reported they did so through family member or relative (25.7%) or in other ways (26.8). Columns 2 and 3 in Table 1 show the distribution of sample by the two health outcomes. In here, we can observe that female migrant partners whose husbands have college or higher education, are currently employed and younger, represent a higher percentage of those who report good health and good life satisfaction. Table 2 and 3 are set up to examine our first and second hypotheses. The former table presents the results of the logistic regression models for SRH. Model 1 which is base model only includes migrant women s characteristics and shows that migrant women with college education or higher have 26% increased odds of reporting better self-reported health than women with less than high school education. The age of migrant women has a negative effect on their health in that younger foreign brides are more likely to report better SRH (OR:0.96). Migrant women who have a social network exhibit much higher odds of having better SRH than migrant women who do not have a social network (OR:1.61). Model 2 adds husband s characteristics and we found a positive and significant effect of husband s education and employment status. For example, marriage migrant women whose husbands have a high school diploma and college education or higher have 16% and 30% higher odds of reporting better SRH compared to women marrying Korean husband with less than a high school diploma respectively. Notably, the effects shown in the odds ratios for husband s educational characteristics are higher than those of women s own

education, suggesting that the SRH disparity among foreign brides is more influenced by their husband s education than by their own education. This pattern is also found in husband s employment status, migrant women whose husband is currently working have 26% increased odds of having better SRH than their counterparts, but employment status shows weak association with their SRH (OR:1.06). In model 3 which adds controls for couple s characteristics we see that the odds ratios for both spouses educational level are reduced, and the effect of employment status is no longer significant. Yet, despite the decreased influence of husbands SES on women s SRH, the effect of husband s education remains significant and is still larger than the effect of migrant women s own education. Among couple s characteristics, we observe substantial SRH differences by household income, suggesting that the advantage of husband s higher education observed in model 2 is due in part to household wealth. The duration of marriage has a significant negative effect on migrant women s SRH (OR:0.97), every one-year increase in marriage duration is associated to a three percent decrease in the odds of reporting better SRH. There is no significant association between SRH and the number of children or the way the couple met. Odds ratios in model 4 reveal that marriage migrant women who have a higher educational attainment than their Korean husbands exhibit 9% lower odds of reporting better SRH compared to women with the same degree of education with their husbands. But there is no significant difference by the couple s employment status gap. The results from table 2 support out hypotheses that the higher husband s SES significantly increase the chance of reporting better SRH and this effect is stronger than that of women s SES. With regard to life satisfaction, the results show a more dynamic pattern. In model 1 in Table 3, only female migrant women with a college education or higher have increased odds of reporting better life satisfaction compared to the reference group, but the advantage of migrant women with college education disappears after adjusting for husband s characteristics in model 2. Instead, foreign brides with high school education or higher have decreased odds of reporting good life satisfaction. Reduced odds ratios are also found in model 3 that additionally stratified couple s characteristics, suggesting the covariates included in husband s and couple s characteristics have a protective effect for marriage migrant

wives in terms of their life satisfaction. Despite of decreased odds of showing good life satisfaction in model 2, we found,again, an education gradient in the impact of husband s education for reporting good life satisfaction. For instance, marriage migrant women with college or higher education have 7% decreased odds of reporting good life satisfaction, however, those who marry Korean men with college education or higher have 58% increased odds of reporting good life satisfaction. We also observe a substantial difference in the effect of employment status between spouses, employed women exhibit only 8% lower odds of showing satisfaction with their life than unemployed migrant women, but women whose husband are currently employed have 84% increased odds of reporting good life satisfaction than women with unemployed husbands (model 2). Model 3 shows a stronger negative effect of migrant women s education on their life satisfaction compared to model 2. Although the increased odds of reporting higher life satisfaction associated to husband s education diminished after controlling for couple s characteristics, husband s education continues to be significantly associated to increased odds of reporting life satisfaction for their foreign wives. Employment status of spouses follow opposite directions, employed migrant women have lower odds of having life satisfaction than the reference group (OR: 0.86), but the odds of reporting good life satisfaction is higher for women who have employed husbands (OR: 1.45). Unlike results in model 3 of SRH, most of the couple s characteristics are significantly associated with foreign brides life satisfaction. Similar to SRH, higher monthly household income is related to increased odds of reporting higher life satisfaction, and duration of marriage is negatively associated with women s life satisfaction. Migrant women who met their husband through their friends, family members and religious groups have increased odds of showing better life satisfaction than foreign brides who met their husband through commercialized agencies. In model 4 we observe significant relations between foreign wife s life satisfaction and the differences in education and employment characteristics between spouses. Migrant partners tend to show lower life satisfaction when their educational attainment is higher than that of their husbands compared to women who have the same level of education than their husbands. Similarly, marriage migrant women show lower odds of reporting

better life satisfaction when they are currently working, and increased odds of reporting higher life satisfaction when their husbands are employed. These results from logistic models point to significant difference in migrant women s life satisfaction by their husband s SES substantiate the hypothesis 1 but it is not clear that husband s SES have a stronger effect than that of women s SES because odds ratios for education categories and employments status show opposite direction. Results from the models with interaction effects for the two health outcomes are presented in Tables 4 and 5, Table 4 shows the interaction effect between husband s education and marriage duration, while table 5 suggests the interaction effect between education differences between spouses and marriage duration. With regard to the interaction effect of husband s education and duration of marriage, no significant interactions were found for both outcomes. However, we find a significant interaction effect of interaction between duration of marriage and the difference in education among spouses. In specific, marriage migrant women who have lower educational attainment than their husbands have a lower likelihood of reporting better SRH and life satisfaction as they spend more time in the marriage than women who have the same degree of education than their Korean husbands. Discussion The current study examined the effect of Korean husband s SES on SRH and life satisfaction among about 43,000 female international marriage migrants from four countries in East Asia who reside in South Korea. Due mainly to the commercialized international marriage process in East Asia and particular circumstances in South Korea which increase foreign brides dependence on husbands and increase inequality in gender roles within the household, we hypothesized a significant a strong influence of husband s SES on their foreign wives health and life satisfaction. The results of this study, on the whole, show significant disparities of SRH and life satisfaction among female migrant partners by

husband s educational attainment and employment status, and the effect of husband s SES indicators remains even when we adjust for women s own SES. In fact, the effect of husband s SES is greater than the effect of women s characteristics Health disparities by Korean husband s educational attainment were found even after adjustment for variety of covariates of interest. Interestingly, the effect of the education and employment status of spouses follow opposite direction, marriage migrant women s education and employment status are associated with lower odds of reporting higher life satisfaction, while the education and employment status of their husbands have a positive effect on women s life satisfaction. The results from the logistic regression models, on the one hand, are largely similar to findings of previous studies that explored the relationship between spouse SES indicators and one s health behaviors and health status (Kalmuss and Straus 1982; Moser, Pugh and Goldblatt 1988; Van Berkel and De Graaf 1995). Other studies also found that husband s or spouse s socioeconomic characteristics such as occupational status and educational attainment are significantly associated with one s health, emphasizing the important role of spouse s SES in explaining one s health and life satisfaction. On the other hand, in spite of those similarities, the present analysis shows differing results than those of earlier research in several ways: first, despite of close relationships between spouse s SES and one s health, previous studies have found that one s SES indicators are better predictors of health status than spouses economic characteristics (Martikainen 1995; Monden et al. 2007; Moser, Pugh and Goldblatt 1988). That is, studies generally explain the socioeconomic characteristics of spouses as subsidiary information that may also affect one s health beyond one s own characteristics. In this study, however, as we expected, Korean husband s SES -education and employment status- play a more important role in explaining migrant women s self-rated health. Another difference from previous findings is that the strong effect of husband s SES on their migrant wife in the analysis is consistent even after controlling for many other covariates including household income. This result shows important implications for our understanding of the relationship between Korean husbands and international marriage migrant women. The earlier studies mostly explain the influence of spouse s SES on one s health from material perspectives indicating that

economic support in a household from one s spouse could affect SES of members of household and then this would influence one s health outcomes. But the results of this study show there are more than economic reasons in the relationship between husband s SES and foreign bride s health, which could be linked to healthy lifestyle, information, access to asocial network and the relationship between partners. With regard to life satisfaction in model 3, higher education and employment status of husband are associated to higher odds of reporting better life satisfaction. However, foreign wives own education and employment have a negative effect on their odds of reporting life satisfaction (model 3) which is different from what we expected. This result is also not in line with the general idea that education has positive effect on individual s material conditions and well-being as higher education levels are related to better wealth and material conditions. Although there is evidence that the direction of the correlation between education and life satisfaction is mixed, a negative relationship between these two variables usually emerges in high income people, rather than among people in low income, to which marriage migrant women mostly belong to (Palmore and Luikart 1972). This reversed relationship between migrant women s SES and life satisfaction may be understood when we think about foreign brides economic motivations for cross-border marriage and their relatively poor life conditions in South Korea. As discussed earlier, marriage migrant women try to send remittances to their family back in their home countries and expect to improve their life conditions in Korea in terms of material wealth. However, this expectation of improved life conditions is often not achieved because, ironically, the Korean men who marry foreign brides are likely to come from a more disadvantaged socioeconomic background compared to other Korean men, which is precisely what made it difficult for them to find spouses in the domestic marriage market. Wang (2007) who investigated international marriage between Taiwanese man and Vietnamese women in Taiwan, which is a case similar to that of South Korea, clearly documented this contradiction, no sooner had they arrived in Taiwan than they found out that their husbands social status was not what they had imagined (Wang 2007). In fact, qualitative research on marriage migrant s life in South Korea indicates that foreign brides experience frustration and conflict with their Korean husbands

when they fail to send remittances to their family in the country of origin. In contrast to self-rated health, which is mainly determined by physical health status, the concept of life satisfaction is affected by how people rate their life in terms of relative standards compared to what they would expect their life to be given their circumstances and social status (Duncan 1975). Thus migrant women with higher levels of education are more likely to feel disappointment of their current circumstances when they could have had a better economic status and more equality in a relationship in their country of origin. The result of a negative effect of the age independent duration of marriage in model 3 and 4 is consistent with earlier studies (Park, Park and Kim 2007). Also these changes in health outcomes during marriage are similar to the healthy migrant effect theory which explains that immigrant s health advantages at the time of arrival to the U.S. worsened over time as they acculturate to the U.S. culture (Lopez-Gonzalez, Aravena and Hummer 2005). In the context of U.S., studies highlight that the rate of health deterioration as immigrants spend a longer time in the country could vary with their socioeconomic characteristics, such as education (Cho and Hummer 2001). In the case of marriage migrant women in Korea, we found that the negative effect of time spent in Korea on health varies depending on the educational gaps between spouses, rather than their own educational levels. Given the very low proportion of employed migrant women and their low economic power in a household, migrant wives with lower education than their husbands tend to be more subordinate to husbands than do other women who have an equal or higher education than their husbands. After migration, immigrants generally start to integrate into the mainstream culture of the host country and in this process, they choose how to they acculturate based on to what extent to they want to maintain their origin culture and interact within the host society (Berry 1997). Marriage migrant women in Korea, however, lose the freedom to choose how they integrate into the mainstream within a maledominated household and isolation which constrains their access to local culture and their opportunities to be in contact with the larger society, so they have limitations in their destinies of acculturation. In this process, immigrants are likely to be forced to place little value on their own culture while accepting the

culture of the husband. We think two aspects of this process create outcomes of worse life satisfaction for marriage migrants. First, when a foreign wife is limited in her freedom to pursue the social or cultural behaviors of her home country and is forced to adopt those of her husband s culture, the foreign wife is more likely to experience acculturative stress (Dona and Berry 1994). For instance, qualitative research on the health risks for international marriage migrant women in Korea shows that migrant women married to Korean husbands suffer stress due to having to adopt a new diet that may be radically different in comparison to the cuisine of their country of origin, yet they are forced to follow the Korean dietary culture as their husbands and parent-in-laws prefer (Lee, Lee and Kim 2012b). Since the second half of the twentieth century studies on international migration have paid particular attention to the emergence of female migration, suggesting the various patterns of women participating in international migration and the trigger factors behind these new migration trends (Curran et al. 2006). International marriage migration is one of the main features of female migration in East and South East Asia, however, little research has been done on the role of social determinants in relation to the wellbeing of international marriage migrants in the country of destination. Among other things, the health outcomes of these migrants have not received appropriate attention in the research scholarship (Wang and Chang 2002). Our findings demonstrate the importance of the husband s SES in relation to the health and life satisfaction of female marriage migrants. Therefore future health interventions and policies aimed at helping international marriage migrants should take into account the husband s characteristics in their analysis.