Acculturation level and usage of healthcare services among registered elderly korean women living in an urban area in Japan

Purpose: This study examines the acculturation level of registered elderly Koreans living in an urban area in Japan and the characteristics of their usage of healthcare services. Acculturation has been associated with significant changes in health behavior, health status, and morbidity of ethnic minority groups. Methods: We used the embedded descriptive case study design employed by Yin (2008). We interviewed 15 Korean women aged 65 years or older, using a semi-structured questionnaire. Women were classified according to the four acculturation levels proposed by Berry (2010): integration, assimilation, separation, and marginalization. Results: We classified the elderly women into the integration level and separation level. The elderly women in the integration level utilized health services effectively, while maintaining some degree of cultural identity and customs. Additionally, as members of an ethno-cultural group, they looked for opportunities to integrate their culture of origin in the larger social network to which they belonged. The elderly women in the separation level utilized health services as needed, while placing a value on holding on to their original culture. However, they wished to avoid interaction within the larger social network. Conclusion: We found a difference in the degree of the health service utilization between the acculturation levels. Thus, interventions that will disseminate important information regarding the use of healthcare services should be directed towards the elderly women by using their ethno-cultural community network, especially those who are in the separation level of acculturation.