Another health factor associated with depression was the participant's perceived health status, which is commonly used in health appraisal because it assesses an individual's overall health as distinguished from the results of physical examinations based on biological and medical knowledge. This study showed that immigrant women with poor perceived health status were at more than three times greater risk for depression than those reporting good perceived health status. Our finding is consistent with research on health in Asia and other immigrants. Ihara [58] found in a study of health among Asian Americans that more Asian Americans described their health as fair or poor than nonHispanic White Americans; more specifically, 45.0% of Vietnamese Americans reported poor perceived health status. In contrast, the majority of immigrant Latino women (89.2%) in the United States had good selfrated health [59]. This literature suggests that immigrants have a tendency to evaluate their health as less than optimal. It may be caused by cultural and racial disparities in health perceptions between the destination and origin countries along with adjustment difficulties.