Race, Flourishing, and All-Cause Mortality in the United States, 1995-2016.

We assessed whether race moderates the association between flourishing and all-cause mortality. We used panel data from the Midlife in the United States Study (MIDUS) (1995-2016; n = 2,851). Approximately 19% of White respondents and 23% of Black respondents in the baseline sample died over the course of the 21-year study period (n = 564). Cox proportional hazard models showed that Blacks had a higher mortality rate relative to Whites and higher levels of flourishing were associated with a lower mortality rate. Furthermore, a significant interaction between flourishing and race in predicting death was observed. Blacks with higher levels of flourishing had a mortality rate that was not significantly different from that of Whites. However, Blacks, but not Whites, with low flourishing scores had a higher mortality rate. As such, health-promotion efforts focused on enhancing flourishing among Black populations may reduce the Black-White gap in mortalityrate.

Experiences of Ethnic Discrimination Among US Hispanics: Intersections of Language, Heritage, and Discrimination Setting.

BACKGROUND: Informed by Latino Critical Race Theory, the present study examined how intersections between English use/proficiency, Spanish use/proficiency, and heritage group shape the varying experiences of ethnic discrimination reported by US Hispanic adults. METHODS: The study utilized data from 7,037 Hispanic adults from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III. Multivariable binomial logistic regression modeled language use/proficiency, heritage, and demographic characteristics as predictors of past-year self-reported perceived ethnic discrimination, overall and in six different settings. RESULTS: Both English and Spanish use/proficiency were positively associated with increased adjusted odds of reporting ethnic discrimination overall, in public, or with respect to employment/education/ housing/courts/police; however, with respect to being called a racist name or receiving verbal/physical threats/assaults, a positive association was observed for English, yet not Spanish. Results also indicated a significant interaction between English use/proficiency and Spanish use/proficiency when predicting past-year ethnic discrimination overall or for any of the six types/settings examined, although the relationship between language use/proficiency and ethnic discrimination varied by Hispanic heritage group. CONCLUSION: Study findings emphasize that experiencing some form of ethnic discrimination is relatively common among US Hispanic adults, yet the prevalence and types or settings of ethnic discrimination vary widely on the basis of demographics, immigrant generation, heritage, and the interplay between English and Spanish use/proficiency.

Racial discrimination, ethnic-racial socialization, and cultural identities among Asian American youths.

OBJECTIVES: This study investigates whether and how racial discrimination is associated with ethnic-racial socialization in the family and how distinct aspects of ethnic-racial socialization influence children's ethnic and American identity among Filipino American and Korean American families. METHOD: The data are obtained from the Midwest Longitudinal Study of Asian American Families Project (N = 1,580; 379 Filipino American youths and 377 parents, and 410 Korean American youths and 414 parents; Mage of youths = 15.01). Using the bootstrapping and maximum likelihood with missing values approaches, we conducted path analyses to test the hypothesized associations concurrently and longitudinally for each ethnic group. RESULTS: Youth-reported racial discrimination was directly associated with weaker American identity, both concurrently and longitudinally. In concurrent models, racial discrimination experienced by both youth and parents was positively associated with youth-reported preparation for bias, which in turn was linked with stronger ethnic identity among Filipinos, whereas no indirect pathways reached statistical significance among Koreans. In longitudinal models, parent-reported discrimination was linked with higher levels of promotion of mistrust among both groups, which predicted weaker ethnic identity among Filipino youth but stronger American identity among Korean youth. CONCLUSIONS: The present study highlights how exposure to racial discrimination may have a lasting influence in cultural identity development among Asian Americans and possibly through ethnic-racial socialization in the family, which might have been shaped by such experiences. Our results also underscore the importance of considering the experiences of both children and parents in studies of discrimination and ethnic-racial socialization. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Citizenship as Privilege and Social Identity: Implications for Psychological Distress.

Citizenship is both a system of privilege and a source of social identity. This study examines whether there are disparities in psychological distress between citizens and noncitizens, and whether these disparities may be explained by markers of social disadvantage (e.g., poverty, discrimination) or perceptions of success in the United States (i.e., subjective social status). We analyze data from the Asian subsample (n = 2,095) of the National Latino and Asian American Study. The data show that noncitizens report greater psychological distress compared with naturalized citizens and native-born citizens after accounting for sociodemographics (e.g., age, gender, Asian subgroup), socioeconomic characteristics (education, employment, income-to-poverty ratio), immigration (e.g., interview language, years in the United States, acculturative stress), health care visits, and everyday discrimination. Preliminary evidence suggests that subjective social status may explain some of the disparities between naturalized citizen and noncitizen Asian Americans.

Prevalence, risk, and correlates of posttraumatic stress disorder across ethnic and racial minority groups in the United States.

OBJECTIVES: We assess whether posttraumatic stress disorder (PTSD) varies in prevalence, diagnostic criteria endorsement, and type and frequency of potentially traumatic events (PTEs) among a nationally representative US sample of 5071 non-Latino whites, 3264 Latinos, 2178 Asians, 4249 African Americans, and 1476 Afro-Caribbeans. METHODS: PTSD and other psychiatric disorders were evaluated using the World Mental Health-Composite International Diagnostic Interview (WMH-CIDI) in a national household sample that oversampled ethnic/racial minorities (n=16,238) but was weighted to produce results representative of the general population. RESULTS: Asians have lower prevalence rates of probable lifetime PTSD, whereas African Americans have higher rates as compared with non-Latino whites, even after adjusting for type and number of exposures to traumatic events, and for sociodemographic, clinical, and social support factors. Afro-Caribbeans and Latinos seem to demonstrate similar risk to non-Latino whites, adjusting for these same covariates. Higher rates of probable PTSD exhibited by African Americans and lower rates for Asians, as compared with non-Latino whites, do not appear related to differential symptom endorsement, differences in risk or protective factors, or differences in types and frequencies of PTEs across groups. CONCLUSIONS: There appears to be marked differences in conditional risk of probable PTSD across ethnic/racial groups. Questions remain about what explains risk of probable PTSD. Several factors that might account for these differences are discussed, as well as the clinical implications of our findings. Uncertainty of the PTSD diagnostic assessment for Latinos and Asians requires further evaluation.

Beyond conventional socioeconomic status: examining subjective and objective social status with self-reported health among Asian immigrants.

Despite mounting evidence for a strong and persistent association between socioeconomic status (SES) and health, this relationship is largely unknown among Asian immigrants, a fast growing minority group in the US population. Previous research has typically focused on objective SES (primarily education and income) and ignored self-perceived SES. Using data from the National Latino and Asian American Study (NLAAS) (N = 1,570), we examined the impact of subjective as well as objective SES upon multiple self-reported health outcomes among Asian immigrants. Results indicated that conventional SES indicators by and large were non-significantly related to self-rated physical health, physical discomfort, self-rated mental health, and psychological distress. In contrast, subjective SES relative to people in the United States and people in the community showed strong associations with health outcomes above and beyond conventional SES markers. This study suggested a promising avenue to incorporate subjective SES in health disparities research, especially among immigrants.

Workplace Discrimination and Short Sleep Among Healthcare Workers: The Buffering Effect of People-Oriented Culture.

OBJECTIVE: Examine the association of discrimination and short sleep and the buffering effect of people-oriented culture in the workplace among nurses and patient care associates. METHODS: Used a mixed-methods design from the 2018 Boston Hospital Workers Health Study (N = 845) and semi-structured interviews among nurse directors (N = 16). RESULTS: We found that people-oriented culture reduced the odds of short sleep and slightly attenuated the association of discrimination and short sleep. People-oriented culture did not buffer the effects of discrimination on short sleep. Qualitative findings showed that discrimination occurred between co-workers in relation to their job titles and existing support in the workplace does not address discrimination. CONCLUSIONS: Healthcare industries need to implement specific programs and services aimed at addressing discrimination which can potentially improve health outcomes among workers.

English proficiency and language preference: testing the equivalence of two measures.

OBJECTIVES: We examined the association of language proficiency vs language preference with self-rated health among Asian American immigrants. We also examined whether modeling preference or proficiency as continuous or categorical variables changed our inferences. METHODS: Data came from the 2002-2003 National Latino and Asian American Study (n = 1639). We focused on participants' proficiency in speaking, reading, and writing English and on their language preference when thinking or speaking with family or friends. We examined the relation between language measures and self-rated health with ordered and binary logistic regression. RESULTS: All English proficiency measures were associated with self-rated health across all models. By contrast, associations between language preference and self-rated health varied by the model considered. CONCLUSIONS: Although many studies create composite scores aggregated across measures of English proficiency and language preference, this practice may not always be conceptually or empirically warranted.

Discrimination and mental health-related service use in a national study of Asian Americans.

OBJECTIVES: We examined the association between perceived discrimination and use of mental health services among a national sample of Asian Americans. METHODS: Our data came from the National Latino and Asian American Study, the first national survey of Asian Americans. Our sample included 600 Chinese, 508 Filipinos, 520 Vietnamese, and 467 other Asians (n=2095). We used logistic regression to examine the association between discrimination and formal and informal service use and the interactive effect of discrimination and English language proficiency. RESULTS: Perceived discrimination was associated with more use of informal services, but not with less use of formal services. Additionally, higher levels of perceived discrimination combined with lower English proficiency were associated with more use of informal services. CONCLUSIONS: The effect of perceived discrimination and language proficiency on service use indicates a need for more bilingual services and more collaborations between formal service systems and community resources.

Smoking and the Asian American workforce in the National Latino and Asian American Study.

BACKGROUND: Smoking among the Asian American workforce has not been extensively researched. This study examines smoking prevalence among a nationally representative sample of Asian Americans with an emphasis on occupational classification. METHODS: Cross-sectional data come from the National Latino and Asian American Study. Multivariate logistic regression analyses were used to determine smoking prevalence by occupation, gender, and nativity, among 1,528 participants self-identifying as in the labor force. RESULTS: Blue collar workers reported the highest smoking prevalence (32%) followed by unemployed (19%), other (17%), service (14%), and white collar (10%). Among both employed males and females, blue collar workers had the highest prevalence (45% and 18%, respectively). By nativity, smoking was highest among blue collar workers for immigrants (25%) and highest among the unemployed for U.S. born (16%). Blue collar employment was significantly associated with being a current smoker (OR = 2.52; 95% CI: 1.23-5.16; P < 0.05) controlling for demographics (e.g., age, gender, ethnic group, nativity, etc.). CONCLUSIONS: Findings reveal that smoking differs by occupation among Asian Americans. Future research should examine factors explaining differences while considering gender and nativity.

Associations of employment frustration with self-rated physical and mental health among Asian American immigrants in the U.S. Labor force.

OBJECTIVE: This study examined the associations between employment frustration and both self-rated physical health (SRPH) and self-rated mental health (SRMH) among Asian American immigrants. DESIGN AND SAMPLE: A cross-sectional quantitative analysis was conducted utilizing data from 1,181 Asian immigrants participating in the National Latino and Asian American Study. MEASURES: Employment frustration was measured by self-report of having difficulty finding the work one wants because of being of Asian descent. SRPH and SRMH were each assessed using a global one-item measure, with responses ranging from poor to excellent. Control variables included gender, age, ethnicity, education, occupation, income, whether immigrated for employment, years in the United States, English proficiency, and a general measure for everyday discrimination. RESULTS: Ordered logistic regression showed that employment frustration was negatively associated with SRPH. This relationship, however, was no longer significant in multivariate models including English proficiency. The negative association between employment frustration and SRMH persisted even when including all control variables. CONCLUSIONS: The findings suggest that Asian immigrants in the United States who experience employment frustration report lower levels of both physical and mental health. However, English proficiency may attenuate the relationship of employment frustration with physical health.

Recent/Childhood Adversities and Mental Disorders Among US Immigrants.

Past research documents the heterogeneity in US immigrants, particularly in terms of racial and ethnic categories and specific ethnic subgroups. The present study builds on this research foundation by investigating heterogeneity in immigrants' experiences of adversity, both recent and during childhood, and associations with mental disorders. Data are drawn from 6,131 adult immigrants in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III. Prevalence estimates for mental disorders and adversities were calculated overall and by gender. Latent class analysis was utilized to characterize patterns of self-reported experiences of childhood and recent adversities, and multinomial logistic regression established the statistical association between latent class membership and past-year mental disorder outcomes (substance use disorder only, mood/anxiety/trauma disorder only, co-occurring disorder, or no mental disorder). Neglect was the most commonly-reported childhood adversity among immigrant men and women. Prevalence of meeting criteria for a substance use disorder only, or a mood/anxiety/trauma disorder only, varied between men and women, yet no gender differences were observed in prevalence of co-occurring disorders. For latent class analyses, a five-class solution was selected based on fit indices and parsimony. Approximately 10.0% of the sample was categorized in the latent class characterized by severe childhood adversities, while 57.5% was classified in the latent class with low probabilities of reported adversities. The relative risk of meeting criteria for a past-year substance use disorder only (compared to no substance use or mood/anxiety/trauma disorder) was more than three times as high for members of the class with severe childhood adversities (RRR, 3.26; 95% CI, 2.08-5.10), as well as the class with recent employment/financial adversities (RRR, 3.82; 95% CI, 2.36-6.19), compared to the class with low adversities. The relative risk of past-year co-occurring disorders (compared to no disorder) was more than 12 times as high for those in the severe childhood adversities class (RRR, 12.21; 95% CI, 7.06-21.10), compared to the class with low adversities. Findings underscore the importance of considering both recent and childhood adversities when assessing and providing services for US immigrant groups.

Associations of Sociodemographic Factors With Health-Related Social Networks Among Premigration Filipinos.

Social networks provide health information that is useful to prevent illness, promote health, and facilitate treatment for health problems. One understudied facet is which people in social networks provide health information. The present article fills a critical gap in the empirical literature by identifying which social networks are reported based on a premigrant's sociodemographic status that operate as their source of health information. Data were analyzed from the Health of the Philippine Emigrants Study (HoPES) (n = 829) migrant sample. Findings indicated having high English proficiency and educational attainment reduces the likelihood of reporting no one in their network as a source of health information. Those who reported family/relatives are less likely to be younger, and those who reported friends are also less likely to be living-in with a partner. This article informs social work researchers and practitioners in implementing interventions among premigration immigrants to help increase and broaden their social networks.

Gender, family, and community correlates of mental health in South Asian Americans.

Nationally representative data from the National Latino and Asian American Study (Alegría et al., 2004) was used to examine both disorder prevalence rates and correlates of distress for the South Asian American subgroup (n = 164). South Asian Americans generally appeared to have lower or comparable rates of lifetime and 12-month mood and anxiety disorders when compared with the overall Asian American sample. A multiple-regression model fitted to predict recent psychological distress, with 12-month diagnosis as a covariate, found gender differences. For women, lack of extended family support was related to higher levels of distress, whereas for men, greater conflict with family culture, and a lower community social position (but higher U.S. social position) predicted higher distress scores. Findings suggest that mental health services consider a broad framework of psychological functioning for South Asian Americans that reflect their gendered, familial, and sociopolitical realities.

Perceived Social Standing among Asian Immigrants in the U.S.: Do Reasons for Immigration Matter?

We investigate the association between a subjective measure of social status and the reasons for immigration among Asian immigrants in the U.S. We use data from the National Latino and Asian American Study to test several hypotheses about this association. Our analyses show the positive effect on perceived social standing of migrating for better education, the negative effect of migrating to seek employment, and the negative impact of refugee status. Migrating for family reunification can be associated with various circumstances, which lead to differing outcomes. The results suggest that the notion that immigrants arrive in the U.S. with limited resources and few skills and move slowly up the socioeconomic ladder must be reassessed in light of the complex social context and factors such as ethnicity, gender, divergent immigration paths, and a range of associated circumstances.

The role of racial/ethnic identity in the association between racial discrimination and psychiatric disorders: A buffer or exacerbator?

The present study tests whether and how racial/ethnic identity moderates the psychological burden associated with racial discrimination. The theoretical concept of identity-relevant stressors suggests that racial discrimination will be associated with stronger psychological burden for people who put more values on their racial/ethnic backgrounds (i.e., racial/ethnic identity as an exacerbator). Conversely, racial/ethnic identity may be a protective resource to buffer any negative mental health consequences of racial discrimination (i.e., racial/ethnic identity as a buffer). We adjudicate these two competing hypotheses, while also examining whether the moderating effect of racial/ethnic identity varies by race/ethnicity or nativity. The data are from the 2013 National Epidemiologic Survey on Alcohol and Related Conditions-III. Our findings reveal a race/ethnicity-dependent pattern: High racial/ethnic identity functions as an exacerbator for Whites, American Indians/Alaska Natives, and Latinxs, but moderate racial/ethnic identity functions as a buffer for Asians and Blacks in handling racial discrimination. In addition, the moderating effect of racial/ethnic identity is more pronounced among the U.S.-born than the foreign-born. The present study contributes to the knowledge base by showing that racial/ethnic identity does not universally protect-nor does it universally exacerbate-the psychiatric burden of racial discrimination. Rather, whether it mitigates or intensifies the mental burden of racial discrimination depends on its level and race/ethnicity.

Residential Segregation and Racial/Ethnic Disparities in Ambient Air Pollution.

Race and ethnicity are consequential constructs when it comes to exposure to air pollution. Persistent environmental racial/ethnic inequalities call for attention to identifying the factors that maintain them. We examined associations between racial residential segregation and racial/ethnic inequalities in exposure to three types of air pollutants. Using data from the Panel Study of Income Dynamics (1990-2011), the U.S. Census (1990- 2010), and the Environmental Protection Agency, we tested the independent and joint contributions of race/ethnicity and metropolitan-level residential segregation on individual levels of exposure to air pollution nationwide. We found that racial and ethnic minorities were exposed to significantly higher levels of air pollution compared to Whites. The difference between minorities and Whites in exposure to all three types of air pollution was most pronounced in metropolitan areas with high levels of residential segregation. The environmental inequities observed in this study call for public health and policy initiatives to ameliorate the sources of racial/ethnic gaps in pollution exposure. Given the links between the physical environment and health, addressing such uneven environmental burdens may be a promising way to improve population health and decrease racial/ethnic inequalities therein.

Disentangling the effects of racial and weight discrimination on body mass index and obesity among Asian Americans.

OBJECTIVES: We examined whether racial discrimination is associated with increased body mass index (BMI) and obesity among Asian Americans. Further, we explored whether this association strengthens with increasing time in the United States. METHODS: We analyzed data from the 2002 to 2003 National Latino and Asian American Study (n=1956). Regression models tested whether reports of racial discrimination were associated with BMI and obesity, after accounting for weight discrimination, age, gender, marital status, ethnicity, generation, employment, health status, and social desirability bias (the tendency to seek approval by providing the most socially desirable response to a question). RESULTS: We found that (1) racial discrimination was associated with increased BMI and obesity after we controlled for weight discrimination, social desirability bias, and other factors and (2) the association between racial discrimination and BMI strengthened with increasing time in the United States. CONCLUSIONS: Racial discrimination may be an important factor related to weight gain among ethnic minorities.

Workplace discrimination and health among Filipinos in the United States.

OBJECTIVES: We examined the association between work discrimination and morbidity among Filipinos in the United States, independent of more-global measures of discrimination. METHODS: Data were collected from the Filipino American Community Epidemiological Survey. Our analysis focused on 1652 participants who were employed at the time of data collection, and we used negative binomial regression to determine the association between work discrimination and health conditions. RESULTS: The report of workplace discrimination specific to being Filipino was associated with an increased number of health conditions. This association persisted even after we controlled for everyday discrimination, a general assessment of discrimination; job concerns, a general assessment of unpleasant work circumstances; having immigrated for employment reasons; job category; income; education; gender; and other sociodemographic factors. CONCLUSIONS: Racial discrimination in the workplace was positively associated with poor health among Filipino Americans after we controlled for reports of everyday discrimination and general concerns about one's job. This finding shows the importance of considering the work setting as a source of discrimination and its effect on morbidity among racial minorities.

Unfair treatment, racial/ethnic discrimination, ethnic identification, and smoking among Asian Americans in the National Latino and Asian American Study.

OBJECTIVES: We examined the relations of self-report of general unfair treatment and self-report of race/ethnicity-specific discrimination with current smoking among Asian Americans. We investigated whether ethnic identification moderated either association. METHODS: Weighted logistic regressions were performed among 1977 Asian Americans recruited to the National Latino and Asian American Study (2002-2003). RESULTS: In weighted multivariate logistic regression models including both general unfair treatment and racial/ethnic discrimination, odds of current smoking were higher among Asian Americans who reported high levels of unfair treatment (odds ratio [OR]=2.80; 95% confidence interval [CI]=1.13, 6.95) and high levels of racial/ethnic discrimination (OR=2.40; 95% CI=0.94, 6.12) compared with those who reported no unfair treatment and discrimination, respectively. High levels of ethnic identification moderated racial/ethnic discrimination (F(3) =3.25; P =.03). High levels of ethnic identification were associated with lower probability of current smoking among participants reporting high levels of racial/ethnic discrimination. CONCLUSIONS: Our findings suggest that experiences of unfair treatment and racial/ethnic discrimination are risk factors for smoking among Asian Americans. Efforts to promote ethnic identification may be effective in mitigating the influence of racial/ethnic discrimination on smoking in this population.