Adverse Childhood Experiences and Depressive Symptoms Among Older Korean Americans in Affordable Senior Housing: The Moderating Role of Social Networks and Family Solidarity

Abstract

Despite growing evidence of the long-term mental health effects of adverse childhood experiences (ACEs), little is known about protective factors that buffer this relationship among older adults. This study examined personal (e.g., sense of mastery), interpersonal (e.g., social networks and family solidarity), and community (e.g., social cohesion) resources as potential moderators of the association between ACEs and depressive symptoms among older Korean Americans residing in affordable senior housing. Survey data from 315 residents (mean age = 79.4) revealed significant interactions between ACEs and both social networks and family solidarity: stronger social and familial ties buffered the adverse effects of ACEs on depressive symptoms. These findings suggest that close social and family connections serve as key coping resources rooted in Korean cultural values. The study underscores the importance of fostering relationships in senior housing programs that promote engagement, peer support, and family involvement for individuals affected by ACEs.

Keywords

adverse childhood experience mental health social networks family solidarity older immigrants

What This Paper Adds

• The negative impact of ACEs on mental health was found in older Korean Americans residing in affordable senior housing.

• Personal, interpersonal, and community resources play a role in predicting mental health.

• Social networks and family solidarities buffered the mental health impact of ACEs.

Applications of Study Findings

• Ecological systems model has applications in explaining the mental health impact of ACEs.

• Intervention efforts should focus on enhancing social engagement, peer support, and familial involvement in assisting older adults with a history of ACEs.

• Greater attention should be given to recognizing the long-term impact of ACEs on mental health and tailoring support strategies accordingly.

Introduction

Adverse childhood experiences (ACEs) refer to traumatic events that occur before the age of 18, including neglect, abuse (physical, emotional, or sexual), and various forms of household dysfunction, such as substance use, mental health problems, parental separation, or incarceration (Centers for Disease Control and Prevention [CDC], 2024). While health and mental health risks associated with ACEs have been well-documented across different age groups (Felitti et al., 1998; Kim et al., 2022; Petruccelli et al., 2019), recent studies have begun to explore the long-lasting effects of ACEs on older adults. The original ACE study, which examined over 9,500 members of Kaiser Health Plan, found that approximately 40% of adults aged 65 and older had experienced at least one or more ACEs and that those exposed to multiple categories of ACEs were more likely to face greater health risks later in life (Felitti et al., 1998). Other studies focusing on older adults have provided evidence of the long-lasting adverse effects of ACEs on both physical and mental health well into later life (Haczkewicz et al., 2024; Kim et al., 2021b; Wilson-Genderson et al., 2022), and the association between ACEs and mental health is significantly stronger than that with physical health among older populations (Liu et al., 2024).

Despite the accumulating evidence linking ACEs to late-life depressive symptoms in older adults (Haczkewicz et al., 2024; Kim et al., 2021b; Liu et al., 2024; Wilson-Genderson et al., 2022), research on the mental health impacts of ACEs in Asian older adults, particularly those in low socioeconomic status (SES) contexts, such as affordable senior housing, remain scarce. There is considerable variation in ACEs across sociodemographic groups, with higher rates reported among individuals in low SES and racial and ethnic minority groups (Felitti et al., 1998; Petruccelli et al., 2019; Swedo et al., 2023). Additionally, Asian Americans with limited English proficiency experience higher levels of unmet mental health needs and disparities compared to the national U.S. population (Zhang et al., 2012). This highlights the need to address the mental health effect of ACEs among older Asian adults in low SES groups. Furthermore, most studies on ACEs primarily examine their direct effect on depressive symptoms in older adults, overlooking the context in which ACEs impact mental health (Haczkewicz et al., 2024).

Although social support is well established as a protective factor against the negative effects of ACEs on depressive symptoms (Brinker & Cheruvu, 2017; Von Cheong et al., 2017), prior research has not clearly identified the sources of such support, whether from family, friends, or broader community networks. Existing studies have also largely focused on interpersonal resources, overlooking the broader ecological contexts in which individuals are embedded. For instance, in collectivistic cultures like Korea, family dynamics play a key role in mental health, either protecting against or contributing to depression depending on relationship quality (Jang et al., 2023; Park et al., 2020), with negative interactions often having stronger effects (Guo & Stensland, 2018). This highlights the need for research on how social support may buffer the effects of ACEs on depression in this population.

To address these gaps, this study explores ACEs among socioeconomically disadvantaged and linguistically isolated older Korean Americans living in affordable senior housing in the greater Los Angeles area, where this fifth-largest Asian American subgroup is highly concentrated (Budiman & Ruiz, 2021; Esterline & Batalova, 2022). Furthermore, many older Korean Americans are survivors of the Korean War, having endured extreme poverty, displacement to refugee camps, and the loss of family members (Esterline & Batalova, 2022; Kim et al., 2019). Consequently, the intensity of childhood trauma may be greater for them than for those who did not experience war. Additionally, their challenges likely intensified upon immigrating to the United States after the War, as they faced immigration-related issues such as language barriers and cultural adaptation (Kim et al., 2019). Thus, it is crucial to examine the specific ACEs experienced by older Korean Americans and their impact on mental well-being.

In selecting potential factors that may determine the mental health impact of ACEs, we draw upon the Ecological Systems Model (Bronfenbrenner, 1979), which highlights the dynamic interactions between individuals and their environments across different levels (e.g., individual, interpersonal, community, and societal) that contribute to development and well-being. Informed by this framework, we focused on factors at three levels: personal (e.g., sense of mastery), interpersonal (e.g., social networks and family solidarity), and community (e.g., community social cohesion). The function of these factors in the context of ACEs and mental health is guided by the stress-buffering hypothesis (Cohen & Wills, 1985), which posits the protective roles of individuals’ resources against stressful life experiences. According to this hypothesis, social support and resources attenuate the relationship between stress and negative health outcomes (Cohen & Wills, 1985). Although extensive research has examined the roles of sense of mastery, social networks, family solidarity, and community cohesion as potential stress buffers among older adults (Guo et al., 2018; Jang & Tang, 2022; Park et al., 2022; Pudrovska et al., 2005), these factors have been comparatively understudied in the context of ACEs.

Based on the reviews, we hypothesize that ACEs are positively associated with depressive symptoms and that this relationship is moderated by a sense of mastery, social networks, family solidarity, and community social cohesion. It is anticipated that the mental health impact of ACEs would be attenuated in the presence of a stronger sense of mastery, larger social networks, greater solidarity among family members, and higher levels of community cohesion. This examination will provide insight into the context in which ACEs impact mental health and help guide interventions to mitigate these effects.

Methods

Data and Sample

Participants were Korean American residents of the participating affordable senior housing communities who could complete the survey. We identified affordable senior housing facilities using an area resource database established by our research team, which lists available resources and services within Asian communities in the greater Los Angeles area. Through purposive sampling, we selected six facilities within a 20-mile radius of our research site with a high concentration of Koreans. Data were collected between April and June 2023, following institutional review board (IRB) approval for human subjects research at the University of Southern California. We recruited study participants with the assistance of housing staff who distributed invitation flyers. After obtaining informed consent, we administered the surveys in common areas of the facilities, such as meeting rooms and cafeterias. The surveys, designed in a paper-and-pencil format, consisted of 10-page structured questions and were available in both English and Korean. Bilingual and bicultural research personnel were present at each survey site to assist participants in completing the survey when necessary. Once each participant finished the survey, trained research personnel assessed their cognitive functioning using the Mini-Mental State Examination (MMSE; Folstein et al., 1975). Study participants received $20 for their participation. Out of 351 participants who responded to the survey, we excluded 36 individuals with potential cognitive impairment (MMSE ≤ 10) or those with more than 10% missing data. The final sample included 315 participants.

Measures

Depressive Symptoms

We measured depressive symptoms using the Patient Health Questionnaire-9 (PHQ-9; Kroenke et al., 2001), which consists of nine items based on the DSM-IV criteria for depressive disorders. Participants reported how often they experienced issues such as “little interest or pleasure in doing things,” “feeling down, depressed or hopeless,” and “trouble falling or staying asleep or sleeping too much” over the past 2 weeks. Each item was scored on a four-point scale ranging from 0 (not at all) to 3 (nearly every day), resulting in a total score of 0 to 27. Higher scores indicate greater levels of depressive symptoms. The psychometric properties of the Korean-translated PHQ-9 have been validated (Han et al., 2008; Shin et al., 2010), and Cronbach’s alpha for the current sample was 0.86.

Adverse Childhood Experiences

Childhood adversity was assessed using the ACE questionnaire, adapted from the CDC-Kaiser ACE Study (Centers for Disease Control and Prevention & Kaiser Permanente, 2016). The questionnaire includes 10 items that evaluate childhood experiences before the age of 18, such as maltreatment (e.g., neglect, physical, verbal, or sexual abuse) and household dysfunction (e.g., parental separation or incarceration, substance use, or mental health issues). Each item is scored on a binary scale (0 = no, 1 = yes), and the total ACE score is the sum of the items experienced, ranging from 0 to 10. A previously validated Korean-language version of the instrument was used to assess ACEs, and its psychometric properties have been validated (Kang et al., 2021; Kim et al., 2021a; Park et al., 2026).

Sense of Mastery

The feelings of mastery were measured with the Pearlin’s seven-item Mastery Scale (Pearlin & Schooler, 1978). Participants were asked to indicate their feelings about each item (e.g., “I cannot solve my problems” and “My future mostly depends on me”) on a four-point scale ranging from 1 (strongly disagree) to 4 (strongly agree). Responses to negatively worded items were reverse-coded. Summary scores ranged from 7 (low sense of mastery) to 28 (high sense of mastery). The scale has been translated into the Korean language, and its psychometric properties have been validated (Kim et al., 2015). Cronbach’s alpha for the current sample was 0.73.

Social Networks

The social network was measured using the Lubben Social Network Scale-6 (LSNS-6; Lubben et al., 2006), which consists of six items: three assessing family ties and three assessing friend ties. The scale measures the number of family members and friends the participant (1) sees or hears from at least once a month, (2) feels comfortable discussing private matters with, and (3) feels close to and can rely on for assistance. Each item is rated on a six-point scale, from 0 (none) to 5 (nine or more). Total scores for the LSNS-6 range from 0 to 30, with higher scores indicating stronger social networks. The Korean version of the LSNS-6 was validated in previous studies involving older Korean Americans (Hong et al., 2011), and the Cronbach’s alpha for the current sample was 0.89.

Family Solidarity

Family solidarity was assessed using a scale on positive interactions with family members (Schuster et al., 1990). The six items included “How much does your family care about you?” and “How much can you rely on your family for assistance with a serious problem?” Responses were coded on a four-point scale, 1 (not at all) to 4 (very much), and total scores ranged from 6 to 24, with higher scores indicating greater family solidarity. A validated Korean-language version of the instrument (Jang et al., 2023) was used, and Cronbach’s alpha in the current study was 0.92.

Community Social Cohesion

A five-item questionnaire adapted from prior research (Cagney et al., 2009) assessed community social cohesion. Participants rated each question on a five-point scale, from 0 (strongly disagree) to 4 (strongly agree), regarding their perceptions of other residents in their senior apartment as (1) a close-knit community, (2) willing to help each other, (3) sharing the same values, (4) getting along well, and (5) trustworthy. Total scores ranged from 0 to 20, with higher scores reflecting greater social cohesion within the residential community. A Korean-language version of the instrument was used, with its psychometric properties validated in previous studies (Jang et al., 2020). The Cronbach’s alpha for this measure in the current sample was 0.90.

Covariates

The study’s covariates included sociodemographic characteristics such as age (in years), sex (0 = male, 1 = female), marital status (0 = not married, 1 = married), education (0 = ≤ high school graduation, 1 = > high school graduation), and length of stay in the United States (in years). Additionally, chronic medical conditions and functional disability were considered. Chronic medical conditions were measured using a checklist of 10 diseases and conditions common among older adults (e.g., diabetes, cancer, arthritis, heart disease, and high blood pressure), summing the positive responses for a total count ranging from 0 to 10. Functional disability was assessed with a composite score from the activities of daily living (ADL) and instrumental activities of daily living (IADL) (Fillenbaum, 2013). The scale included 16 activities (e.g., walking, bathing, dressing, and managing medication), with participants indicating their performance for each activity. Responses were coded as 0 (without help), 1 (with some help), or 2 (unable to do). Total scores ranged from 0 (no functional disability) to 32 (severe functional disability). The scale demonstrated high internal consistency in the present sample (α = .89). These covariates were selected based on their established empirical associations with mental health status (Choi et al., 2016; Fässberg et al., 2016; Luo et al., 2020), which may influence the relationship between our primary variables. By adjusting for these factors, we aim to ensure that the observed associations accurately represent the specific effect of ACEs on mental health and the role of potential moderators.

Analytic Strategies

Descriptive statistics and bivariate correlations were conducted to explore the sample characteristics and detect collinearity among the associations between the study variables. Multivariate linear regression was used to examine the main effect of ACEs and the interaction effects of ACEs with moderators on depressive symptoms. We included an array of predictors: (1) demographic and health variables, (2) ACEs, (3) personal, interpersonal, and community resources, and (4) interaction terms between ACEs and resources. Significant interaction terms were further analyzed for group-specific moderating effects using simple slope tests. All statistical analyses were conducted using STATA version 16.1.

Results

Descriptive Characteristics of the Sample

Table 1 summarizes the sample characteristics. The mean age of participants was 79.4 years (SD = 6.62), with ages ranging from 65 to 102. Over 70% of the participants were female, nearly 40% were married, and about 36% had more than a high school education. All participants were foreign-born immigrants to the United States, most of whom migrated in their 40s or later and had lived in the United States for an average of 32.5 years (SD = 11.1). The mean number of chronic medical conditions and functional disability scores were 1.78 (SD = 1.17) and 3.73 (SD = 4.59), respectively. Approximately 67% of the samples experienced at least one type of the 10 ACEs, with an average of 1.11 ACEs (SD = 1.29). The mean scores for a sense of mastery and social networks were 19.3 (SD = 3.36) and 15.1 (SD = 6.11), respectively. The average score for family solidarity was 18.6 (SD = 3.67), while the average score for community social cohesion was 11.9 (SD = 5.38). The average score for depressive symptoms was 5.70 (SD = 4.60).

Table 1.

Descriptive Characteristics of the Sample (n = 315)

	%	M ± SD (range)
Age		79.4 ± 6.62 (65−102)
Female	71.7
Married	39.4
> High school graduation	36.3
Years in the United States		32.5 ± 11.1 (3−63)
Chronic medical conditions		1.78 ± 1.17 (0−7)
Functional disability		3.73 ± 4.59 (0−22)
Adverse childhood experiences		1.11 ± 1.29 (0−9)
Sense of mastery		19.3 ± 3.36 (7−28)
Social networks		15.1 ± 6.11 (0−29)
Family solidarity		18.6 ± 3.67 (6−24)
Community social cohesion		11.9 ± 5.38 (0−20)
Depressive symptoms		5.70 ± 4.60 (0−24)

Bivariate Correlations Among Study Variables

The bivariate correlations presented in Table 2 indicate no collinearity issues among the study variables. The strongest correlation was found between functional disability and depressive symptoms (r = .44, p < .001), followed by the correlation between sense of mastery and depressive symptoms (r = −.43, p < .001). Higher levels of depressive symptoms correlated with older age, lower education levels, a greater number of chronic medical conditions, and greater levels of functional disability. Additionally, depressive symptoms positively correlated with ACEs and lower levels of sense of mastery, social networks, and family solidarity.

Table 2.

Bivariate Correlations Among Study Variables

	1	2	3	4	5	6	7	8	9	10	11	12	13
1. Age	──
2. Female	−.03	──
3. Married	−.13*	−.26***	──
4. >High school graduation	−.09	−.26***	.19***	──
5. Length of stay in the United States	.01	−.04	−.02	.06	──
6. Chronic medical conditions	.07	.14*	−.13*	−.20***	−.00	──
7. Functional disability	.34***	.11	−.08	−.15*	−.03	.31***	──
8. Adverse childhood experiences	−.12*	−.02	−.08	−.08	.06	.07	.04	──
9. Sense of mastery	−.12*	−.02	.02	.18**	.11*	−.19***	−.33***	−.12*	──
10. Social networks	−.07	.15**	.13*	.03	.03	.11	.02	−.15**	.18**	──
11. Family solidarity	.13*	.06	.13*	.00	−.01	.09	.14*	−.12*	.13*	.38***	──
12. Community social cohesion	.11*	.05	.08	−.12*	−.06	.10	.07	.05	.05	.14*	.28***	──
13. Depressive symptoms	.15*	.01	−.10	−.15**	−.09	.24***	.44***	.27***	−.43***	−.23***	−.17**	−.04	──

*p < .05. **p < .01. ***p < .001.

Multivariate Models of Depressive Symptoms

Table 3 displays the results of the regression models for depressive symptoms. The first model, which included demographic and health variables, explained 23% of the total variance in depressive symptoms, with greater functional disability predicting higher depressive symptoms. When ACEs were added to the second model, they significantly predicted depressive symptoms after adjusting for covariates and increased the explained variance by 5%. In the next step, the study’s personal, interpersonal, and community resources (sense of mastery, social networks, family solidarity, and community social cohesion) were included in the third model. Lower levels of sense of mastery, social networks, and family solidarity were significantly associated with depressive symptoms, while ACEs remained significant. This model increased the explained variance by 10%, accounting for 38% of the total variance in depressive symptoms. In the fourth model, interaction terms between ACEs and moderating variables were added. The interactions between ACEs and social networks, as well as between ACEs and family solidarity, were significant. The full model explained approximately 42% of the total variance in depressive symptoms.

Table 3.

Multivariate Models for Depressive Symptoms

	B (SE)
Age	−.03 (.04)	.00 (.03)	.01 (.03)	.03 (.03)
Sex (female)	−.77 (.57)	−.57 (.55)	−.12 (.53)	−.28 (.52)
Marital status (married)	−.67 (.51)	−.48 (.50)	−.23 (.48)	−.26 (.47)
Education (>high school graduation)	−.73 (.53)	−.53 (.52)	−.17 (.49)	−.41 (.49)
Length of stay in the United States	−.03 (.02)	−.03 (.02)	−.02 (.02)	−.02 (.02)
Chronic medical conditions	.41 (.22)	.37 (.21)	.40 (.20)	.26 (.19)
Functional disability	.44 (.06)***	.42 (.06)***	.35 (.06)***	.34 (.06)***
Adverse childhood experiences (ACEs)		.84 (.18)***	.68 (.17)***	.46 (.19)*
Sense of mastery			−.31 (.07)***	−.28 (.07)***
Social networks			−.10 (.04)*	−.08 (.04)*
Family solidarity			−.13 (.07)*	−.16 (.07)*
Community social cohesion			−.04 (.07)	−.05 (.06)
ACEs × sense of mastery				.10 (.06)
ACEs × social networks				−.07 (.03)*
ACEs × family solidarity				−.16 (.05)**
ACEs × community social cohesion				.01 (.05)
R ²	.23***	.28***	.38***	.42***
Changes in R²	──	.05***	.10***	.04**

*p < .05. **p < .01. ***p < .001.

Subgroup Comparisons Based on Significant Moderators

A subgroup analysis was conducted based on the significant interaction terms. Using the mean score of the two significant moderating factors, we divided participants into two groups for each: high and low social networks, and high and low family solidarity. The analysis revealed that individuals with low social networks experienced a significant detrimental impact of ACEs on depressive symptoms (B = 1.04, SE = .21, p < .001), whereas the impact of ACEs was not significant among those with high social networks (B = .58, SE = .44, p > .05). Regarding family solidarity, individuals with lower family solidarity showed a significant association between ACEs and higher depressive symptoms (B = 1.43, SE = .36, p < .001), while this relationship was not significant among those with strong family solidarity (B = .04, SE = .39, p > .05). Figure 1 illustrates how social networks and family solidarity moderate the relationship between ACEs and depressive symptoms. The findings suggest that high levels of social networks and family solidarity buffer the negative mental health effects of ACEs.

Discussion

Drawing on the Ecological Systems Model (Bronfenbrenner, 1979) and the stress-buffering hypothesis (Cohen & Wills, 1985), this study examined the impact of ACEs on depressive symptoms among older Korean Americans in affordable senior housing, focusing on whether resources at personal, interpersonal, and community levels would buffer these effects.

Approximately 67% of participants reported at least one ACE, and 18% met criteria for moderate to severe depression (PHQ-9 ≥10; Kroenke et al., 2001). These rates are substantially higher than those observed in the general U.S. older population, where 40–51% report ACEs (Felitti et al., 1998; Swedo et al., 2023) and 8% experience moderate to severe depression (Brody et al., 2018). The findings align with prior research indicating that older adults in subsidized senior housing and those from racial and ethnic minority groups face greater vulnerability to both ACEs and mental health challenges (Gonyea et al., 2018; Park et al., 2026; Robison et al., 2009). However, the higher prevalence of ACEs and moderate to severe depression among participants should also be understood within the unique historical and sociocultural contexts of many older Korean Americans. Childhood exposure to the Korean war, post-war poverty, and immigration-related challenges may have intensified childhood adversity and contributed to poorer mental health outcomes in later life, which underscores the need for targeted screening and culturally sensitive interventions.

Regarding the long-term mental health effects of ACEs, the study found that ACEs were positively associated with depressive symptoms in older Korean Americans, consistent with prior research (Haczkewicz et al., 2024; Kim et al., 2021b; Liu et al., 2024; Wilson-Genderson et al., 2022). Greater functional disability, lower sense of mastery, limited social networks, and weaker family solidarity were also associated with increased depressive symptoms. These findings highlight the critical role of both personal and interpersonal resources in supporting the mental health of older Korean Americans, particularly in the context of ACEs.

The study provided partial support for the moderating effects of personal, interpersonal, and community factors on the relationship between ACEs and mental health. Social networks and family solidarity were significant moderators, whereas sense of mastery and community social cohesion were not. The negative impact of ACEs on depressive symptoms was stronger among those with smaller social networks and weaker family solidarity but mitigated by stronger social and familial connections, highlighting the buffering role of interpersonal support in older adults’ mental health (Jang & Tang, 2022; Park et al., 2022; Reiner & Steinhoff, 2024). The strong protective role of social networks and family solidarity among older Korean Americans may reflect their unique cultural, historical, and immigrant experiences. The Korean cultural emphasis on family and social connections as sources of emotional and practical support (Chang, 2010; Jang & Tang, 2022; Park et al., 2022) may have been reinforced among participants who lived through the Korean War, experiencing family loss or relying on family solidarity to overcome severe poverty. Additionally, later-life migration, limited English proficiency, and lower levels of acculturation may have further increased their reliance on close family and friends, explaining the weaker buffering effect of broader community resources.

These findings have important theoretical and practical implications, demonstrating how ACEs, family and social resources, and psychological well-being interact in later life, particularly among older Korean Americans. The moderating effects of social networks and family solidarity extend the Ecological Systems Model and stress-buffering hypothesis by demonstrating that resources at multiple levels provide varying protection against ACEs and buffer the long-term impacts of stress, particularly in ethnic minority older adults. These findings highlight protective factors and the need for future studies on how different levels of individual resources function across cultural and immigrant contexts. From a practice perspective, mental health interventions for older Korean Americans, particularly those living in affordable senior housing with ACE histories, should leverage culturally salient resources. Strategies such as family engagement activities or peer support groups within housing communities can strengthen interpersonal networks, offering accessible protection against the combined psychological impacts of ACEs, war-related trauma, and later-life immigration experiences. Evidence suggests that family-engaged and social support interventions can reduce depression in older adults (Lee et al., 2022; Stahl et al., 2016). When adapted to collectivistic values and family dynamics, these approaches may help older Korean Americans buffer the long-term mental health effects of ACEs, underscoring the need for culturally informed interventions that consider the unique role of social and family ties in immigrant and minority populations.

This study has several limitations. First, its cross-sectional design restricts the ability to establish casual relationships between ACEs, personal, interpersonal, and community resources, and depressive symptoms. Future research should employ longitudinal designs to capture the long-term effects of ACEs more effectively and the evolving role of social networks and family solidarity. Second, the reliability of self-reported data may be affected by both recall bias and cognitive impairment. For example, recall bias may have influenced self-reported measures of ACEs, as older adults might underreport or inaccurately recall past experiences due to memory limitations or social desirability. Additionally, the possible inclusion of individuals with mild to moderate cognitive impairment may have compromised the accuracy of their responses. Future research should consider using more rigorous and objective verification methods to reduce the effects of recall bias and cognitive impairment on self-reported data. Third, the measurement of certain variables such as ACEs, social networks, and family solidarity was limited, restricting the exploration of the more nuanced dynamics underlying the findings. For instance, examining the effects of specific types of ACEs on mental health outcomes could help identify which forms of adversity are most strongly linked to negative outcomes, thereby informing more targeted interventions. Future research should use a larger sample and adopt a mixed-methods approach to examine more comprehensive aspects of these variables, including how the intensity or types of ACEs contribute to detrimental mental health outcomes, and which aspect of social networks and family solidarity provide particularly significant protective benefits. Fourth, although our model explains a significant amount of the variance in depressive symptoms, a substantial proportion remains unexplained. In future studies, other biological, psychological, environmental, or contextual factors need to be considered to gain a more comprehensive understanding of the determinants of depressive symptoms. Finally, the findings may not be generalizable to the broader population of older Asian immigrants beyond older Korean Americans in affordable senior housing, as cultural and socioeconomic factors can influence the availability and impact of social support differently across ethnic groups. This limitation should be taken into account when interpreting the study’s implications. Expanding research to include more diverse older adults would enhance the broader applicability of these findings.

Despite these limitations, this study sheds light on the context in which ACEs impact mental well-being among older Korean Americans living in affordable senior housing. Our findings highlight the protective role of interpersonal resources; how strong family solidarity and social networks buffer the impact of ACEs on depressive symptoms. These results suggest that interventions promoting family engagement, peer support, and social participation within housing communities can enhance belonging and foster resilience against the long-term mental health effects of ACEs. By integrating cultural and historical contexts, culturally grounded strategies can effectively reduce mental health risks in this population, emphasizing the value of contextually informed approaches for ethnic minority older adults.

Footnotes

ORCID iDs

Min-Kyoung Rhee

Juyoung Park

Yuri Jang

Funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Data collection was supported by a grant from the National Institute of Dental and Craniofacial Research (R21DE029579, PI: Yuri Jang, PhD).

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

IRB Approval

The study was approved by the Institutional Review Board (IRB) at the University of Southern California (Protocol #UP-23-00115).

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