Asian Indians have been in the United States as early as 1790. The Alienation of Land Act in India under British rule, which prohibited certain non-farming castes from owning agricultural land, prompted 3000 people to move to West Coast of the US in 1908. In 1946, legislation gave Asian Indians the right to become American citizens and bring relatives to the US, but the annual quota was small.

The population did not grow significantly until passage of the Immigration and Naturalization Act of 1965, which opened the doors for individuals of certain professional or educational backgrounds. Hence, the 1960s cohort of Asian Indians who immigrated to the United States was a very highly educated and skilled group. Thereafter, laws were passed that allowed families to be reunited, and the Asian Indian population grew steadily through the 1970s and 1980s until a second spurt in the 1990s, heralded by the information technology boom. Elders continue to come to the US as “followers of children”. Between 1989 and 1992, for example, almost 14,000 individuals aged 60 and over immigrated to the US from India.

There are two distinct groups of Asian Indian older adults in the United States:

The two groups differ greatly demographically and face different issues. The former tend to be more acculturated, affluent, and independent. Those in the latter group are at high risk of being isolated and lonely (language barriers, lack of independent transportation), lack health benefits, depend on their children or family, and suffer from culture shock.

Given their degree of acculturation, this group’s communication skills, decision-making patterns, clinical adherence patterns, dietary habits are likely to differ significantly from those of the older adults who immigrate to the US post retirement, to be reunited with their adult children.