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

Int J Equity Health. 2021 Aug 28;20(1):192. doi: 10.1186/s12939-021-01537-9.

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. We analyzed the relationship and pathways of perceived discrimination's effect on health among the Chinese diaspora in the context of the pandemic to contribute to the literature on discrimination in this population under the global public health crisis.

Methods: We analyzed data from 705 individuals of Chinese descent residing in countries outside of China who participated in a cross-sectional online survey between April 22 and May 9, 2020. This study utilized a structural equation model (SEM) to evaluate both direct and indirect effects of perceived discrimination on self-rated health (SRH) and to assess the mediating roles of psychological distress (namely, anxiety and depression) and social support from family and friends.

Results: This online sample comprised predominantly young adults and those of relatively high socioeconomic status. This study confirmed the total and direct effect of recently perceived discrimination on SRH and found the indirect effect was mainly mediated by depression. Mediating roles of anxiety and social support on the discrimination-health relationship were found insignificant in this SEM.

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 to preserve the well-being of the Chinese diaspora are necessary. Prompt intervention to address depression may partially relieve the disease burden caused by the surge of discrimination.

Keywords: COVID-19; Chinese diaspora; Cross-sectional; Mental health; Perceived discrimination; Self-rated health; Social support; Structural equation model.

MeSH terms

  • Adolescent
  • Adult
  • Anxiety / epidemiology
  • COVID-19* / epidemiology
  • China / ethnology
  • Cross-Sectional Studies
  • Depression / epidemiology
  • Diagnostic Self Evaluation*
  • Emigrants and Immigrants* / psychology
  • Emigrants and Immigrants* / statistics & numerical data
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pandemics*
  • Racism* / psychology
  • Social Support
  • Surveys and Questionnaires
  • Young Adult