OMNES : The Journal of multicultural society
[ Article ]
OMNES: The Journal of Multicultural Society - Vol. 8, No. 3, pp.30-67
ISSN: 2093-5498 (Print)
Print publication date 31 Jul 2018
Received 14 Feb 2018 Revised 15 Jun 2018 Accepted 10 Jul 2018
DOI: https://doi.org/10.14431/omnes.2018.07.8.3.30

Employment Status Matters: Differential Patterns of Female Marriage Migrants’ Support Service Usage

Kyung-Eun Yang
Sungkonghoe University, South Korea

Abstract

This study examined factors that determine immigrant women’s service usage, using Gelberg-Andersen’s Behavioral Model for Vulnerable Populations as a conceptual framework. Considering that the degree to which female marriage migrants take advantage of support services varies considerably within the group, special analytic attention was given to possible differences in service utilization patterns depending on their employment status. The study utilized “National Survey on Multicultural Families” data set from 2009. Among the total 154,333 individuals, the study used a sub-sample of 53,155 female marriage migrants. Structural equation modeling (SEM) was used to examine possible differences in service utilization in relations to employment status. The relationship between the two support services (adjustment assistance services and family care services) was examined. In addition, the three domains of factors that jointly explain the use of services among female marriage migrants were explored. The study found that female marriage migrants have different needs depending on their employment status. In terms of adjustment assistance service use determinants, the strongest predictor was having Joseonjok (Korean-Chinese) ethnicity for both the employed and unemployed group. When predicting the family care service use, number of children turned out to be the strongest predictor for the employed group, whereas perceived needs turned out as the strongest predictor for the unemployed group. Findings from the study may provide useful implications for the development of social work services and/or service delivery systems that are tailored to the different needs of immigrant women based on their positions within the labor market.

Keywords:

female marriage migrants, support service utilization, employment status, Gelberg–Andersen’s Behavioral Model for Vulnerable Populations

Acknowledgments

This paper evolved from a part of the author’s doctoral dissertation and was supported by a grant awarded to the Center for SSK Multicultural Research (CSMR) from the National Research Foundation of Korea

References

  • Aday, L. A., & Andersen, R. (1978). Insurance coverage and access: Implications for health policy. Health Services Research, 13, 369-377.
  • Akresh, I. A. (2009). Health service utilization among immigrants to the United States. Population Research and Policy Review, 28, 795-815. [https://doi.org/10.1007/s11113-009-9129-6]
  • Andersen, R. (1968). A behavioral model of families' use of health services Center for Health Administration Studies Research Series. Chicago: University of Chicago Press.
  • Andersen, R. (1978). Access to medical care in the U. S.: Realized and potential. Medical Care, 16(7), 533-546. [https://doi.org/10.1097/00005650-197807000-00001]
  • Andersen, R. (1995). Revisiting the behavioral model and access to medical care: Does it matter? Journal of Health and Social Behavior, 36, 1-10. [https://doi.org/10.2307/2137284]
  • Arling, G. (1985). Interaction effects in a multivariate model of physician visits by old people. Medical Care, 23(4), 361-371. [https://doi.org/10.1097/00005650-198504000-00008]
  • Brown, H. M., & Harrick, C. A. (1998). Underutilization of mental health services by Asian-Americans residing in the United States. Mental Health Nursing, 19, 225-240. [https://doi.org/10.1080/016128498249042]
  • Burnette, D., & Mui, A. C. (1999). Physician utilization by Hispanic elderly persons: National perspective. Medical Care, 37(4), 362-374. [https://doi.org/10.1097/00005650-199904000-00006]
  • Chappell, N. (1987). The interface among three systems of care: Self, informal and formal. In R. Ward & S. Tobin (Eds.), Health and Aging: Sociological Issues and policy directions. New York: Springer.
  • Chavez, L. R., Cornelius, W. A., & Jones, W. O. (1985). Mexican immigrants and the utilization of health services: the case of San Dieo. Social Science and Medicine, 21, 93-102. [https://doi.org/10.1016/0277-9536(85)90291-6]
  • Denktas, S., Koopmans, G., Bimie, E., Foets, M., & Bonsel, G. (2009). Ethnic background and differences in health care use: A national cross-sectional study of native Dutch and immigrant elderly in the Netherlands. International Journal for Equity in Health, 8, 1-9. [https://doi.org/10.1186/1475-9276-8-35]
  • Derose, K. P., Bahney, B. W., & Lurie, N. (2009). Immigrants and health care access, quality, and cost. Medical Care Research and Review, 66(4), 355-408. [https://doi.org/10.1177/1077558708330425]
  • Fergurson, C., Lee, M. L., & Wallace, R. (1976). Effects on hospital use: A disease-specific study. Medical Care, 14, 574-589. [https://doi.org/10.1097/00005650-197607000-00003]
  • Fiscella, K., Franks, P., Doescher, M. P., & Saver, B. G. (2002). Disparities in health care by race, ethnicity and language among the insured. Medical Care, 40(1), 52-59. [https://doi.org/10.1097/00005650-200201000-00007]
  • Gelberg, L., Andersen, R., & Leake, B. D. (2000). The behavioral model for vulnerable populations: Applications to medical care use and outcomes for homeless people. Health Services Research, 34(6), 1273-1302.
  • Han, K. H. (2014). Factors associated with educational support services utilization among adeolescents of multicultural families (Master's thesis). Seoul National University, Seoul. (In Korean)
  • Ho, P. Y. A. (2000). Determinants of health service utilization for adults with cerebral palsy. Doctoral dissertation, University of Wisconsin- Madison, Madison, WI.
  • Katzburg, J. R. (2002). Access to pap smears and mammograms for Latina women living in Los Angeles County: The impact of citizenship status and acculturation. Doctoral dissertation, University of California, LA.
  • Kim, H. M. (2012). Factors associated with service utilization patterns among foreign spouses of multicultural families in Korea (Doctoral dissertation). Seoul National University, Seoul. (In Korean)
  • Kim, J. Y. (2012). Factors associated with social welfare service utilization among individuals with developmental disabilities (Master's thesis). Seoul National University, Seoul. (In Korean)
  • Kronenfeld, J. J. (1980). Sources of ambulatory care and utilization models. Health Services Research, 15, 3-20.
  • Lahana, E., Pappa, E., & Niakas, D. (2011). Do place of residence and ethnicity affect health services utilization? evidence from greece. International Journal for Equity in Health, 10(1), 16-24. [https://doi.org/10.1186/1475-9276-10-16]
  • Leclere, F. B., Jensen, & Biddlecom, A. E. (1994). Health care utilization, family context, and adaptation among immigrants to the United States. Journal of Health and Social Behavior, 35, 370-384. [https://doi.org/10.2307/2137215]
  • Lee, C. J., & Kim, S. G. (2010). Factors affecting the social welfare service use among immigrant women in Korea. Korean Journal of Family Social Work, 30, 299-322.
  • Lee, O. B. (2013). The influence of family support on the use of social welfare services of marriage-based female immigrants: Focusing on mediating effects of teh quantity of the service information. Social Science Research Review, 29(3), 1-18. (In Korean)
  • Linton, K. F., & Shafer, M. S., & Shafer, M. S. (2014). Factors associate with the health service utilization of unsheltered, chronically homeless adults. Social Work in Public Health, 29, 73-80. [https://doi.org/10.1080/19371918.2011.619934]
  • Ma, G. X. (1999). The culture of health: Asian communities in the United States. Westport, Conneticut: Greenwood Publishing Group.
  • Padgett, D., Struening, E. L., Andrews, H., & Pittman, J. (1995). Predictors of emergency room use by homeless adults in New York City: The influence of predisposing, enabling and need factors. Social Science and Medicine, 41, 547-556. [https://doi.org/10.1016/0277-9536(94)00364-Y]
  • Portes, A., Kyle, D., & Eaton, W. W. (1992). Mental illness and help-seeking behavior among Mariel Cuban and Haitian refugees to South Florida. Journal of Health and Social Behavior, 33, 283-298. [https://doi.org/10.2307/2137309]
  • Portes, A., & Sensenbrenner, J. (1993). Embeddedness and immigration: Notes on the social determinants of economic action. American Journal of Sociology, 98(6), 1320-1350. [https://doi.org/10.1086/230191]
  • Rabin, D. L., Bice, T. W., & Starfield, B. (1974). Use of health services by Baltimore Medicaid recipients. Medical Care, 12, 561-270. [https://doi.org/10.1097/00005650-197407000-00002]
  • Raffety, J. (1975). Enfranchisement and rationing: effects of Medicare on discretionary hospital use. Health Services Research, 10, 51-62.
  • Seo, J. E., & Choi, H. M. (2012). Determinants of family counseling service utilization of internationally married migrant women. Social Science Research Review, 28(3), 23-43. (In Korean) [https://doi.org/10.18859/ssrr.2017.08.33.3.23]
  • Seol, D. H., Kim, Y. T., Kim, H. M., Yoon, H. S., Lee, H. K., Yim, K. T., et al. (2005). Foreign wives’ life in Korea: Focusing on the policy of welfare and health. Seoul: Ministry of Health and Welfare. (In Korean)
  • Shortell, S. M. (1975). The effects of patterns of medical care on utilization and the continuity of services. In R. Andersen (Ed.), Equity in health services: Empirical analyses in social policy. Cambridge, MA: Ballinger Publishing.
  • Statistics Korea. (2016). Marriage immigrants statistics Retrieved July 31, 2017, from http://index.go.kr/potal/main/EachDtlPageDetail.do?idx_cd=2819
  • Stuyft, P. V. D., Muynck, A. D., Schillemans, L., & Timmerman, C. (1989). Migration, acculturation and utilization of primary health care. Social Science and Medicine, 29(1), 53-60. [https://doi.org/10.1016/0277-9536(89)90127-5]
  • Sussman, M. (1976). The family life of old people. In R. B. A. E. Shanas (Ed.), Handbook of Aging and the social sciences. New York: Van Nostrand Reinhold.
  • Weisman, C. S. (1996). Women's use of health care. In M. M. Falik & K. Collins, S. (Eds.), The Commonwealth Fund Survey. London: The Johns Hopkins University Press.
  • Wolinsky, R. D., & Johnson, R. J. (1991). The use of health services by older adults. Journal of Gerontology, 46(6), 345-357. [https://doi.org/10.1093/geronj/46.6.S345]
  • Yang, K. E. (2017). Employment gap between immigrant and native women in South Korea: Discrimination in the labor market pre-entry stage. OMNES: The Journal of Multicultural Society, 7(2), 99-127. [https://doi.org/10.15685/omnes.2017.01.7.2.99]
  • Yao, L. J. (2016). Predicted factors associated with social service utilization among migrant workers in South Korea: Focused on Geberg- Andersen’s Behavioral Model for Vulnerable Populations (Master's thesis). Mokpo National University, Mokpo. (In Korean)

Appendix

Appendix 1

Operational Definition of Variables

Change between the Equal Constrained Model & the Equality Unconstrained Model

Biographical Note

Kyung-Eun Yang received her Ph.D. from the Factor-Inwentash Faculty of Social Work, University of Toronto. She is currently an assistant professor at Yeollim Academy of Liberal Arts, Sungkonghoe University. She has published on the causes and consequences of social and economic inequalities associated with race/ethnicity and gender issues as well as effective approaches to reducing them. E-mail: kyungeun.yang@skhu.ac.kr

Table 6.

Operational Definition of Variables

Variable (variable name) Variable type Definition
Predispositional factors
Adjustment assistance service usage Dichotomous 0 = not having AAS service usage experience
1 = having AAS service usage experience
Family care assistance service usage Dichotomous 0 = not having service usage experience
1 = having FCS service usage experience
Ethnicity dummies Pob1 - 5 Dummy Pob1 = having Joseonjok ethnicity
Pob2 = having Mainland Chinese and Han
Chinese ethnicity
Pob3 = having Vietnamese ethnicity
Pob4 = having Philippines ethnicity
Pob5 = having ethnicities other than Joseonkok,
Chinese, Vietnamese and Philippines(reference group)
Length of residence Continuous Total length residence measured in months
Region of residence Dichotomous 0 = Living in rural areas
1 = Living in urban areas
Number of children Continuous Total number of children
Enabling factors
Education level 1 - 4 Dummy Edu1 = less than middle school graduate
(reference group)
Edu2 = high school graduate
Edu3 = college graduate
Edu4 = graduate school graduate
Internet usage Dichotomous 0 = not using internet
1 = using internet
Korean language proficiency level Continuous Total score of Korean speaking, reading and writing
Household’s monthly income Ordinal 1 = Very unsatisfied
2 = Not satisfied
3 = Moderate
4 = Satisfied
5 = Very satisfied
NBLS status Dichotomous 0 = not being the recipient of NBLS
Relationship with husband Ordinal 1 = Less than 500 thousand Korean won
2 = 500 thousand ~7 million Korean won
3 = 1~2 million Korean won
4 = 2~3 million Korean won
5 = 3~4 million Korean won
6 = 4~5 million Korean won
7 = 5~6 million Korean won
8 = 6~7 million Korean won
Existence of Korean friends Dichotomous 0 = Having no friends
1 = Having more than one Korean friend
Existence of friends from home country Dichotomous 0 = Having no friends
1 = Having more than one friend from home country
Existence of friends from other countries Dichotomous 0 = Having no friends
1 = Having more than one friend from other countries
Perceived needs factors
Perceived needs for AAS Ordinal 1 = Not needed at all
2 = Not needed
3 = Moderate
4 = Needed
5 = Very needed
Perceived needs for FCS Ordinal 1 = Not needed at all
2 = Not needed
3 = Moderate
4 = Needed
5 = Very needed

Table 7.

Change between the Equal Constrained Model & the Equality Unconstrained Model

∆x2 ∆df p-value
p < .001***
p < 0.01**
p < .05*
Age → AAS 2.233 1 0.135
Pob1→ AAS 35.942 1 0.000
Pob2→ AAS 149.356 1 0.000
Pob3→ AAS 5.168 1 0.023
Pob4→ AAS 23.541 1 0.000
Length of residence → AAS 15.439 1 0.000
Region of residence → AAS 26.488 1 0.000
Number of children → AAS 44.291 1 0.000
Education → AAS 0.383 1 0.534
Internet → AAS 1.667 1 0.197
Korean language proficiency → AAS 21.275 1 0.000
Household’s monthly income → AAS 11.749 1 0.001
NBLS → AAS 0.899 1 0.343
Relationship with husband → AAS 0.499 1 0.480
Friends from home country → AAS 0.011 1 0.917
Friends from elsewhere countries → AAS 5.643 1 0.018
Perceived needs for AAS → AAS 39.001 1 0.000
Perceived needs for Family care services → AAS 0.184 1 0.668
Age → Family care service usage (FCS) 7.758 1 0.005
Pob1 → FCS 35.962 1 0.000
Pob2 → FCS 0.486 1 0.485
Pob3 → FCS 2.374 1 0.123
Pob4 → FCS 0.414 1 0.520
Length of residence → FCS 14.751 1 0.000
Region of residence → FCS 20.529 1 0.000
Number of children → FCS 3.916 1 0.047
Internet → FCS 0.201 1 0.654
Korean language proficiency → FCS 7.409 1 0.008
Household’s monthly income → FCS 3.947 1 0.047
NBLS status → FCS 0.793 1 0.373
Relationship with husband → FCS 0.040 1 0.841
Friends from home country → FCS 0.990 1 0.320
Friends from different countries → FCS 0.189 1 0.664
Perceived needs for AAS → FCS 0.491 1 0.483
Perceived needs for FCS → FCS 26.76 1 0.000