From marginalized to strength: Socio-ecological coping strategies of older Korean Americans with language barriers and healthcare needs.

Abstract

This study, with research questions guided by the socio-ecological model, examined how ethnic minority older adults with limited English proficiency navigate cultural and language barriers in their daily lives, relationships, and healthcare interactions, and what challenges and strategies emerge in their efforts while living in the U.S. Individual in-depth interviews with Korean American older adults with limited English proficiency and chronic medical conditions (N=12) were conducted over a 90-day period between November 2023 and January 2024. Using the thematic analysis technique of constant comparative method, data analysis identified 9 coping strategies, which were organized into four levels: (1) individual-level strategies (resilience in self-management); (2) family-level strategies (prioritizing family in health decisions, mitigating acculturative hurdles, and avoiding burdening family); (3) co-ethnic peer-level strategies (reciprocal information sharing and expectations of cohesion); and (4) community-level strategies (reliance on Korean-speaking healthcare providers, community services, and religious groups). The findings highlight the importance of culturally tailored services and balanced support from family, peers, and community organizations to ensure equitable healthcare access among older ethnic immigrants. Future research should explore in what ways these findings may apply to other ethnic immigrant groups in the U.S. in efforts to develop interventions toward improving health and social outcomes.