Introduction
Immigration into the United States has resulted in a variety of different communities living together in the country. People moving to a new region combine their heritage, their home country’s culture, and new principles. As a result, immigrants and their descendants may hold beliefs and engage in rituals that differ from Western beliefs and practices.
In healthcare, providers must consider these unique features when providing transcultural care. For instance, one of the significant populations present in the U.S. is people of Korean heritage. The following paper examines the characteristics of this population, including its demographics, socioeconomics, and health risks. People of Korean descent have cultural, social, and genetic differences that expose them to several health-related issues, which nurses and other healthcare workers have to acknowledge in their practice.
Korean Heritage
The chosen population includes individuals who have moved to the United States from the Korean peninsula, as well as descendants of first-generation immigrants. Although the definition usually refers to people arriving from South Korea, North Koreans may also leave their countries and become American citizens, thereby becoming part of this demographic (Budiman, 2021). The group has been chosen for a review because it is one of the major immigrant categories – in 2017, the U.S. was home to about 1 million Korean immigrants (O’Connor & Batalova, 2021).
Furthermore, many Korean Americans were born in the U.S., as their parents, grandparents, and older generations have immigrated in the previous decades (Im, 2013). Therefore, a substantial segment of the nation’s population is considered when talking about Koreans in America. Another vital reason for choosing this group is Korean culture, which differs significantly from Western patterns of behavior.
Demographics
As noted above, Korean Americans, both recent immigrants and natural-born citizens, constitute a considerable portion of the nation’s population. In 2019, the total number of Korean Americans was estimated at approximately 1.9 million people (Budiman, 2021). More than 80% of these individuals have lived in the U.S. for over 10 years, indicating a large proportion of people born in or assimilated to this country (Budiman, 2021).
Further statistics show that about half of Korean Americans currently living in the U.S. are foreign-born, and the other half were born and raised in America (Budiman, 2021). Most adults (about 55%) are married, while the rest are either divorced (about 10%) or have never married (over 30%) (Budiman, 2021). An apparent prevalence of family households is evident, with about 70% of individuals living together as a married couple, with or without children and other relatives (Budiman, 2021). These demographics indicate that Korean Americans usually have a support system or people with similar views living in the same space.
Socioeconomics
When discussing the socioeconomic factors of Koreans living in the U.S., one has to consider whether these individuals are recent immigrants or U.S.-born citizens who grew up in the local culture. For instance, there is a significant difference in English proficiency between these groups. Among Korean Americans born in the country, almost 95% of people aged 5 or older can speak the language easily (Budiman, 2021). However, foreign-born persons report only 50% proficiency, which can be explained by the need to learn the language as adults (Budiman, 2021).
Similarly, U.S.-born Koreans are reported to have higher employment levels and lower rates of poverty than people born in Korea. Interestingly, more Korean-born American citizens own their homes than individuals born in America, who are more likely to rent (Budiman, 2021). Higher education rates are substantial across the entire adult population, as learning and having a profession are considered extremely important and highly respected in the culture (Im, 2013). Thus, Korean Americans do not experience severe socioeconomic problems, such as poverty or a lack of employment opportunities.
Environmental Hazards
Although Korean Americans live in different neighborhoods and states in the U.S., some research demonstrates environmental risks that impact the community as a whole. For example, a study by Grineski et al. (2019) notes that Asian Americans, including people of Korean descent, are often exposed to carcinogenic air toxins more often than white Americans. Metro areas have large populations of people from Asian countries, and the high density of these districts, along with the presence of businesses, transportation, and public spaces, negatively affects air quality (Grineski et al., 2019).
This disadvantage to their health may be explained by lower rents in certain parts of large cities and by the presence of Asian cultures, such as markets and other minority households (Im, 2013). For people who recently arrived in the U.S. from South Korea, another hazard is the presence of asbestos in their previous living conditions (Im, 2013). Overall, Korean Americans face the same environmental problems as the rest of the country’s population, such as climate change, pollution, and natural disasters.
Access to Healthcare
Although Korean Americans reportedly have a high median income, the population still faces limited access to care. Many Korean Americans lack health insurance, although the gap has narrowed since the Affordable Care Act was enacted (Jin et al., 2019). Therefore, the risk of American citizens from Korea not being able to afford specific medical procedures is very high.
Furthermore, the high rates also indicate that many people are less likely to visit the doctor for routine checkups or preventive care. Moreover, for people with limited English proficiency, the absence of qualified interpreters may be a crucial barrier (Stanhope & Lancaster, 2019). These two major issues deter Korean Americans from seeking medical help.
Mortality and Morbidity Risk Factors
Risks that significantly impact the health of people of Korean heritage depend on a variety of factors. The first one is the lack of preventive treatment and diagnostics outlined above. Korean Americans are less likely to get screened for cancer as they defer regular check-ups and do not learn about self-examination at school (Im, 2013; Jin et al., 2019). As a result, the high rates of breast and cervical cancer constitute a significant mortality and morbidity risk for Korean women.
Second, Korean culture is primarily connected to drinking alcohol, as adults often drink in social gatherings, business settings, and after work (Im, 2013; Lee et al., 2019). Thus, high alcohol consumption leads to such problems as substance use disorder and renal and cardiovascular illnesses. Third, people of Korean descent have high rates of hypertension, which leads to further cardiovascular issues (Im, 2013; Lee et al., 2019). Finally, many Koreans are lactose intolerant, and a switch to an American diet and products may expose them to milk-containing products, causing gastrointestinal problems.
Health Promotion Activity
The identified health issues require the healthcare industry to pay specific attention to education and communication for providers and patients. Systemic changes, such as air quality programs, can serve as a health promotion activity to address the environmental hazards Korean Americans face. Next, to address access issues, healthcare workers should create educational materials and collaborate with social, cultural, and religious centers to disseminate information on the value of insurance and preventive medicine.
It should be noted that Korean patients may not take advice from materials if they are not delivered in a familiar setting (Im, 2013). Finding and working with interpreters is another step towards increasing people’s access to care (Stanhope & Lancaster, 2019). If patients are more comfortable with being understood by the provider, they can talk more openly about their problems and be receptive to advice and treatment.
The main morbidity and mortality factors rely on the Korean people’s knowledge about cancer, timely screening, and healthy habits. Programs that target Korean American women should focus on self-examination for breast cancer, information about cervical cancer, and the role of pap smears and similar procedures. Booklets and materials about managing hypertension can be distributed in local community centers. Finally, it is crucial to create awareness campaigns about alcohol consumption as well as corporate education programs to change the relationship between alcohol and mental health.
Conclusion
People of Korean heritage are a significant part of the American population. Many of them have been living in the country for more than 10 years, and the second and third generations are well assimilated into the local culture. Nevertheless, some still experience language barriers and misunderstandings due to their different backgrounds. The most significant issues for this community are the lack of education about preventive healthcare and dietary preferences, and the low insurance rates. To address these concerns, healthcare workers must create awareness campaigns and work with community centers to share materials.
References
Budiman, A. (2021). Koreans in the U.S. fact sheet. Pew Research Center.
Grineski, S., Morales, D. X., Collins, T., Hernandez, E., & Fuentes, A. (2019). The burden of carcinogenic air toxics among Asian Americans in four US metro areas. Population and Environment, 40, 257-282.
Im, E.-O. (2013). People of Korean heritage. In L. D. Purnell (Ed.), Transcultural health care: A culturally competent approach (4th ed., pp. 357-373). F.A. Davis.
Jin, S. W., Lee, H. Y., & Lee, J. (2019). Analyzing factors of breast cancer screening adherence among Korean American women using Andersen’s behavioral model of healthcare services utilization. Ethnicity & Disease, 29(Suppl 2), 427-434.
Lee, I., Kim, S., & Kang, H. (2019). Lifestyle risk factors and all-cause and cardiovascular disease mortality: Data from the Korean Longitudinal Study of Aging. International Journal of Environmental Research and Public Health, 16(17), 3040.
O’Connor, A., & Batalova, J. (2021). Korean immigrants in the United States. MPI.
Stanhope, M., & Lancaster, J. (2019). Public health nursing: Population-centered health care in the community (10thed.). Elsevier Health Sciences.
