Date of Award

January 2018

Document Type


Degree Name

Medical Doctor (MD)



First Advisor

Cindy Crusto


Acculturation is the process by which aspects of an individual’s self-identity are modified by information and experiences as he or she moves from one culture to another. Acculturation has been measured in various communities using the Vancouver Index of Acculturation (VIA). Given that previous research on the immigrant paradox demonstrated that certain groups of immigrants were protected from anxiety and depressive disorders, our objective was to use the VIA to evaluate how African American women and women from the African Diaspora experienced race-related stresses, discrimination and depressive symptoms in the United States. We hypothesized that women who had a strong identity with their non-American cultural heritage (1) were less likely to perceive race-related stresses, (2) would report less rates of depression compared to those who identified more with an American heritage, and (3) would report fewer experiences of discrimination. The number of race-related stressors and the number of experiences of discrimination reported by the participants who indicated a non-American heritage culture were not significantly different from the numbers reported by women who associated with American heritage culture. Our analysis did on the other hand demonstrate a significant negative relationship between the VIA subscale scores and the Beck Depression Inventory scores. Women who reported being able to assimilate to both the mainstream culture and to their heritage culture (bicultural individuals) demonstrated lower depression scores. A better understanding of the impact of bicultural identity will not only help health professionals better support their immigrant patients but will also allow us to build a health system better equipped to service an increasingly diverse patient population.


This thesis is restricted to Yale network users only. It will be made publicly available on 06/25/2100