The pathways from perceived discrimination to self-rated health among the Chinese diaspora during the COVID-19 pandemic: investigation of the roles of depression, anxiety, and social support

Abstract

Background. Research indicates the adverse impacts of perceived discrimination on health, and discrimination inflamed by the COVID-19 pandemic, a type of social exclusion, could affect the well-being of the Chinese diaspora. The relationship and pathways of perceived discrimination’s effect on health among the Chinese diaspora in the context of the pandemic were examined to contribute to the literature on discrimination in this population under the global public health crisis.Methods. We analysed data from 705 individuals of Chinese descent residing in countries outside of China, who participated in a cross-sectional online survey carried out between April 22 and May 9, 2020. This study utilizes a structural equation model (SEM) to evaluate both direct and indirect effects of perceived discrimination on self-rated health (SRH) and assessed the mediating roles of psychological distress (namely, anxiety and depression) and social support from family and friends. Results. In this online sample comprised predominantly of young adults and those of relatively high socioeconomic status, this study confirmed the positive and direct effect of perceived discrimination on poor SRH but found the indirect effect was mainly mediated by depression. The association between anxiety and SRH was not significant in this SEM, while a higher level of social support from family leads to better SRH, and the level of social support from friends negatively predicted SRH. Conclusions. Our findings suggest discrimination negatively affected the well-being of the Chinese diaspora, and depression acted as a major mediator between the discrimination-health relationship. Therefore, interventions for reducing discrimination in order to preserve the well-being of the Chinese diaspora are necessary, and that prompt intervention to address depression may partially relieve the disease burden caused by the surge of discrimination.

Examining coping and acculturative stress as mediators between perceived discrimination and internalising symptoms among African immigrants

“…For example, Pascoe and Smart Richman (2009) suggest that perceptions of chronic exposure to discrimination frequently activate stress responses that can lead to a consistent negative emotional state. In response to this, research also shows that having friends or family to talk to after exposure to discrimination negates development of mental health symptoms potentially through validating an individual's experience and helping rebuild or enhance their feelings of self-worth (Chen et al, 2021;Pascoe & Smart Richman, 2009;Smart Richman et al, 2008).…”

“…However, studies among diverse ethno‐racial groups in the United States have shown negative coping behaviours as mediators between discrimination and health. For example, Chen and Yang (2014) found that racial discrimination was associated with increased smoking that in turn led to worsening mental health symptoms and subsequent poorer self‐rated health, while higher levels of social support facilitated better mental health (Chen et al, 2021; Chen & Yang, 2014). Additionally, a study among Latinx youth found that experiences of racial microaggressions were associated with increased utilisation of detachment coping which led to higher levels of psychological distress, with adaptive coping buffering the discrimination‐health relationship (Ayala, 2019).…”

“…Discrimination among minority groups has been linked to disproportionate rates of psychosomatic symptoms and negative mental health outcomes including depression, anxiety, and insomnia (Cheng et al, 2020; Davis et al, 2016; Kauff et al, 2017; Saasa et al, 2021) and adverse physical health outcomes such as chronic diseases and accelerated ageing (Priest & Williams, 2018; Simons et al, 2021). Conversely, the past few decades have seen increased research attention toward examining factors associating discrimination with negative health outcomes among historically disenfranchised US populations and other minority groups (Chen et al, 2021; Chen & Yang, 2014; Williams et al, 2019). For instance, recent studies have shown that acculturative stress and coping strategies utilised in the face of discrimination can facilitate or mitigate adverse health consequences among immigrant groups (Chang et al, 2019; Choi et al, 2019; Li et al, 2019; Silva et al, 2017; Torres et al, 2012).…”