Meta-Analysis of Acculturation and Suicide-Related Outcomes: A Test of the Immigrant Paradox

Christina Seowoo Lee, Selcuk R. Sirin, Elysia Choi, Esther J. Sin

Research output: Contribution to journalArticlepeer-review


Objective: This meta-analysis aimed to systematically test the relation between acculturation and suicide-related outcomes among immigrants, with attention to key methodological (i.e., measure of suicide-related outcome, measure of acculturation) and demographic (i.e., race, gender, age, geographic region, publication year) moderators. Method: We conducted a meta-analysis of 72 independent samples from 50 studies (38 peer-reviewed articles, 12 dissertations) representing more than 1.4 million immigrants. Participants’ age ranged from 11.20 to 74.70 years (M = 29.96, SD = 15.07). Random effects models were used for both main and moderation analyses. Results: We found significant positive associations between acculturation and suicidal ideation, but not suicide attempts and deaths. We also found a significant and positive effect of acculturation on suicide-related outcomes when acculturation was measured by psychological scales, but not by generation status, length of residence in the host country, and proficiency in the host country’s language. More acculturated Latinx immigrants were at higher risk for suicide-related outcomes, whereas a reverse pattern was found among Asian immigrants. Meta-regressions revealed that the moderating effects of participants’ age and publication year were also significant. Conclusion: Our results show partial support for the immigrant paradox but suggest that the relation between acculturation and suicide-related outcomes is complex and multifaceted. We discuss the implications of our findings and recommendations for research and prevention.

Original languageEnglish (US)
Pages (from-to)913-927
Number of pages15
JournalJournal of Racial and Ethnic Health Disparities
Issue number2
StatePublished - Apr 2024


  • Acculturation
  • Immigrant Paradox
  • Immigration
  • Meta-analysis
  • Suicide

ASJC Scopus subject areas

  • Health(social science)
  • Anthropology
  • Sociology and Political Science
  • Health Policy
  • Public Health, Environmental and Occupational Health


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