Psychological Symptoms as Mediators in the Association between Discrimination and Health among South Asian Americans.

Objective: To examine psychological symptoms (symptoms of depression, anger, anxiety) as potential mediators between discrimination and health outcomes among South Asian Americans. We hypothesized that psychological symptoms would be significant mediators in the pathways between discrimination and health.

Research design and methods: The Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study examines risk factors for heart disease among South Asian Americans using self-reported and medical data collected from participants in the San Francisco Bay Area and Chicago regions of the U.S. (N=1164). For this study we assessed the associations among the everyday discrimination scale, symptoms of depression, anxiety, and anger, and health outcomes using structural equation modeling.

Results: We found significant positive associations between discrimination and symptoms of depression (ß .69, p<.0001), anger (ß .38, p<.0001), and anxiety (ß .64, p<.0001). Exposure to discrimination had a direct negative association with HDL level (ß -.37, p=.01). Indirect associations between discrimination and health outcomes were seen via depression (tobacco use: ß 1.08, p=.007), via anger (triglyceride level: 11.88, p=.03; alcohol consumption: ß 1.66, p=.002; calories consumed per day: ß 108.04, p=.02), and via anxiety (tobacco use: ß -1.05, p=.004; alcohol consumption: ß -1.88, p=.03).

Conclusion: Our hypothesis was partially confirmed with proximate health indicators (tobacco use, alcohol consumption, caloric intake) and triglyceride levels. These results suggest that psychological symptoms mediate the association between discrimination and adverse health risk behaviors among South Asian Americans.