Exposure to discrimination has well-documented negative effects on the physical and mental health of ethnic minorities. The majority of discrimination and health studies have focused on African American and Latino American populations. Asian Americans, in particular South Asian Americans (SAAs), are underrepresented in these studies. There are currently more than 3.4 million SAAs living in the US;the following groups comprise 97% of South Asians living in the US: Asian Indians (2,662,112), Pakistanis (211,356), and Bangladeshis (69,687). Although SAAs are comprised of several heterogeneous groups and speak various languages, SAAs share similarities such as having close familial support networks. Collectively, SAAs have experienced a historical legacy of discriminatory immigration policies, violent hate crimes, and chronic insults. SAAs living in New York City are uniquely vulnerable to discrimination and its related health consequences, given that they have been stereotyped, targeted as threats, and victimized by violence and discrimination since the terrorist attacks of September 11, 2001. In the literature exploring discrimination and the health of Asian Americans, relationships have been found between self-reported discrimination (SRD) and depression, anxiety, obesity, and physical pain. However, the discrimination and Asian American health literature can be expanded through a specific focus on SAAs, the inclusion of direct health measures, improved description of the theoretical links between variables, and improved measures. Therefore, the purpose of this study is to address gaps in the current literature, explicate the specific vulnerability of SAAs to discrimination, and explore correlates between discrimination and health outcomes. Ecosocial theory and other stress-related theories underpin the proposed study and suggest that negative, chronic, and stressful experiences of discrimination lead to activation and maintenance of a stress response that can lead to poorer health. The persistent activation of this stress response can result in hig blood pressure, weight gain, anxiety, and depression-all of which are indicators for chronic illness and CVD risk. Therefore, an advanced understanding of how discrimination contributes to poorer SAA health outcomes, which is often theoretically linked to stress, is a timely and significant endeavor in nursing science. Aligned with the mission of NINR to address health disparities, nursing science should investigate how discrimination may increase the health risks of SAAs who are exposed to it on a routine basis. Nursing science can address discrimination as an important promoter of illness and provide future research, community interventions, and social policy recommendations that will ameliorate its impact on the health of SAAs.
The aims of the proposed study are to (1) investigate the relationships between SRD and mental health among adult male and female SAAs (Indian, Pakistani, and Bangledeshi groups) and (2) investigate the relationships between SRD and physical health (self-reported physical health conditions and direct, physiologic measures [BMI, waist-to-hip ratio, and blood pressure]) of SAAs.

Public Health Relevance

Exposure to discrimination has been linked with several deleterious physical and mental health consequences among ethnic minority groups. Despite a pervasive history of discrimination, little is known about how discrimination may be associated with the health of South Asian Americans. Exploring this potential relationship will provide understudied explanations of poorer health among this ethnic minority group. Further, the proposed study will provide impetus for social policy change and improved nursing assessments and interventions.

National Institute of Health (NIH)
National Institute of Nursing Research (NINR)
Predoctoral Individual National Research Service Award (F31)
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National Institute of Nursing Research Initial Review Group (NRRC)
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Banks, David
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New York University
Schools of Nursing
New York
United States
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