Day-to-day discrimination and health among Asian Indians: A population-based study of Gujarati men and women in Metropolitan Detroit

Factors associated with COVID-19-related mental health among Asian Indians in the United States

Background

In the United States, the COVID-19 pandemic has caused increased mental health symptoms and mental illness. Specific subgroups such as Asian Indians in the US have also been subject to additional stressors due to unprecedented loss of lives in their home country and increased Asian hate due to the misperception that Asians are to be blamed for the spread of the SARS-CoV-2.

Objective

We examined the various factors including discrimination associated with COVID-19-related mental health symptoms among Asian Indians.

Methods

We administered an online survey between May 2021 and July 2021 using convenient and snowball sampling methods to recruit Asian Indian adults (age > 18 years, N = 289). The survey included questions on mental health and the experience with unfair treatment in day-to-day life. Descriptive analysis and logistic regressions were performed.

Results

Overall, 46.0% reported feeling down, depressed, or lonely and feeling nervous, tense, or worried due to the COVID-19 pandemic; 90.0% had received at least one dose of vaccination and 74.7% reported some form of discrimination. In the fully-adjusted logistic regression, age (AOR = 0.95; 95%CI- 0.92, 0.97;p < 0.01) and general health (AOR=0.84; 95%CI- 0.73, 0.97; p < 0.015) were negatively associated with mental health symptoms. Participants who experienced discrimination were more likely (AOR=1.26; 95%CI- 1.08, 1.46; p < 0.01) to report mental health symptoms.

Conclusion

In this highly vaccinated group of Asian Indians discriminatory behaviors were associated with mental health symptoms suggesting the need for novel institutional level policy responses to reduce anti-Asian racism.

Acculturative stress, everyday racism, and mental health among a community sample of South Asians in Texas

South Asian Americans are part of the fastest growing racial/ethnic group in the United States and make up a substantial portion of the U.S. immigrant population. Research on this group has often focused on acculturation, the adoption of different values and behaviors in a new sociocultural environment. While there is evidence to suggest that acculturation (and the stress associated with this process) has a negative effect on the health and well-being of Asian Americans, more recent research has emphasized the need to examine the role of broader social forces-including everyday racism-in impacting mental health. Drawing on the stress process model, this study uses an original survey instrument to investigate the relationships between acculturative stress, anti-Asian racism, and mental health among a community sample of 200 South Asians in Texas. Results from hierarchical multiple regression models indicate that both acculturative stress and everyday racism are strongly linked to higher levels of anxiety-related symptoms and more frequent depressive symptoms. Everyday racism, however, explained variance in these outcomes, well beyond the effect of acculturative stress and other sociodemographic factors. These results underscore the potential benefit and importance of including questions about racism in community health surveys that aim to study health disparities among Asian Americans and highlight the persistence of social issues that U.S. South Asians face.

"No, but where are you really from?" Experiences of perceived discrimination and identity development among Asian Indian adolescents

Asian Indians were the first South Asians to immigrate to the United States in the late 1800s and are currently the largest ethnic group of South Asians living in the United States. Despite this the literature on perceived ethnic and racial discrimination experiences among this group is relatively understudied. The documented experiences of Asian Indians who either recently immigrated from India or were born and raised in America pose an important question: what are the experiences of perceived discrimination among Asian Indians living in America, particularly among younger populations who are continuing to develop their racial and ethnic identities? The current study utilized phenomenological methodology to explore the experiences of nine Asian Indian American adolescents' (ages 12-17 years). Data were collected via semi-structured interviews to assess participants' experiences of ethnic and racial discrimination and identity development. Thematic analysis was used to identify themes and subthemes among the participants' responses. Asian Indian adolescents living in the United States report experiencing discrimination at a young age. It is also evident that Asian Indian youth experience significant challenges when developing their sense of ethnic and racial identity while living within the United States. Findings document the racial and ethnic discrimination that Asian Indian adolescents living in the United States may experience from a young age. Importantly, these discrimination experiences are occurring as Asian Indian adolescents are developing their racial and ethnic identities. This study provides insight for future research, which is necessary to fully understand the experiences of Asian Indian adolescents.

Psychological Distress Among Asian Indians and Non-Hispanic Whites in the United States

Introduction:

The prevalence of psychological distress (PD) among Asian Indians is unknown. This study estimated and compared moderate–serious PD in Asian Indians and non-Hispanic Whites (NHWs) in the United States.

Methods:

We used a cross-sectional design using the National Health Interview Survey (2012–2017). Adult (age >18 years) NHWs and Asian Indians (N=2,218) were included. PD was measured using the six-item Kessler (K6) scale. We used multivariable logistic regression to determine the association of Asian Indian ethnicity with PD.

Results:

In the analysis, 19.9% of NHWs and 11.0% of Asian Indians reported moderate–serious PD. Asian Indians were less likely to report PD in both unadjusted (unadjusted odds ratio=0.50; 95% confidence interval [CI]=0.42–0.58) and fully adjusted (adjusted odds ratio=0.7; 95% CI 0.59–0.82) models.

Conclusions:

Asian Indians had a lower prevalence of PD than NHWs, likely due to multiple protective factors such as high socioeconomic status and lower multimorbidity.

Health Implications of Racialized State Violence Against South Asians in the USA

South Asians, one of the fastest growing ethnic groups in the USA today, trace their roots to countries in the Indian subcontinent (e.g., Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan, Sri Lanka) and its global diaspora. With a wide range of cultural, religious, and linguistic diversity, as well as immigration experiences and inequality, South Asians have experienced racialized violence and discrimination since first arriving in the USA in the 1700s. Following September 11, 2001, South Asians and other groups racialized as "Brown," including Muslim, Sikh, Middle Eastern, and Arab Americans, have experienced a marked increase in state violence, including racist laws, policies, and immigration enforcement. Despite abundant evidence of the adverse effects of violence on mental and physical health, there is limited research examining the impact of this racialized state violence on the health of South Asians in the USA. We summarize and synthesize existing peer-reviewed and gray literature on the prevalence and types of violence experienced by South Asians in the USA and enumerate their potential detrimental health impacts. We highlight the paucity of public health data and propose a conceptual framework describing how racialized violence and hate have significant implications for health among South Asians in the USA. Ultimately, these findings illuminate the need for change at the highest levels of governance to mitigate and resist hate violence, including through political participation and inclusion and equitable allocation of social and economic resources, to improve the health of South Asians in the USA.

Associations Between Discrimination and Cardiovascular Health Among Asian Indians in the United States

Asian Indians (AI) have a high risk of atherosclerotic cardiovascular disease. The study investigated associations between discrimination and (1) cardiovascular risk and (2) self-rated health among AI. Higher discrimination scores were hypothesized to relate to a higher cardiovascular risk score (CRS) and poorer self-rated health. Asian Indians (n = 757) recruited between 2010 and 2013 answered discrimination and self-reported health questions. The CRS (0-8 points) included body-mass index, systolic blood pressure, total cholesterol, and fasting blood glucose levels of AI. Multiple linear regression analyses were conducted to evaluate relationships between discrimination and the CRS and discrimination and self-rated health, adjusting for psychosocial and clinical factors. There were no significant relationships between discrimination and the CRS (p ≥ .05). Discrimination was related to poorer self-reported health, B = -.41 (SE = .17), p = .02. Findings suggest perhaps there are important levels at which discrimination may harm health.

Depression, a Hidden Mental Health Disparity in an Asian Indian Immigrant Community

Cultural influences are deeply rooted, and continue to affect the lives of Asian-Indian (AI) immigrants living in Western culture. Emerging literature suggests the powerful nature of traditions and culture on the lives, mental and physical health of AI immigrants, particularly women. The purpose of this study was to explore depression among AI women in Central California (CC). This mixed-methods research was conducted in collaboration with the CC Punjabi community and the support of local religious leaders. All interviews were conducted in Punjabi and English. Whenever possible we utilized validated scales aligned with emerging themes from the qualitative data, which also provided contextualization to survey responses. In all we conducted 11 key informant interviews, four focus groups (n = 47) and a rigorously developed anonymous survey (n = 350). Social dynamics and traditional expectations including gendered roles significantly affected mental health among women participants. Subgroups along the lines of language choice (Punjabi vs. English) experience and report depression differently in part due to the highly stigmatized nature of mental health issues in this model minority community. The findings of this study highlight the importance of utilizing mixed methods to access hard to reach populations regarding sensitive topics such as mental health.