Experience of Discrimination Among U.S. Chinese Older Adults

Experiences of discrimination may affect people’s health by operating as a stressor and by triggering unhealthy health behaviors (1). Existing literature provides ample evidence suggesting that experiences of discrimination may lead to increased risk for high-blood pressure (2), chronic health conditions (3), psychological distress (eg, depression) (4), and even mortality (5). Yet the effect of discrimination on health and well-being may be moderated by responses to discrimination. Data from the 2004 to 2005 National Epidemiologic Survey of Alcohol and Related Conditions found that accepting and not disclosing experiences of discrimination was associated with higher risk for mood disorders among black adults and anxiety disorders among women than those who did not accept and disclose discrimination experience (6). Other research has demonstrated that active coping responses were more effective in alleviating the effect of depression brought on by discrimination than passive coping, which may exacerbate the effect of psychological distress (7). Experiences of discrimination differ by cultural and racial/ethnic groups. Although Asian Americans are often portrayed as a “model minority,” discrimination against this group is common in some areas. The 2002–2003 National Latino and Asian American study reported that 62.4% of Asian Americans have experienced some racial/ethnic discrimination in their lifetime (8). A report by the Department of Housing and Urban Development indicates that one in five Asian Americans have encountered discrimination in home buying (9). Although there has been increasing research interest in discrimination encountered by Asian Americans, researchers tend to consider Asian Americans as a whole, despite vast subgroup heterogeneity (10). Thus, existing knowledge on discrimination faced by Chinese Americans is scarce, and even less is known about discrimination among U.S. Chinese older populations, who may be more adherent to traditional Chinese culture and less likely to share common traits with people in the mainstream culture. The traditional Chinese cultural value of collectivism and the belief that “tolerance is a key moral virtue” may shape the way Chinese Americans perceive and respond to discrimination, possibly exacerbating adverse health outcomes arising from discrimination. The population of U.S. Chinese adults aged 65 and older has increased by 55% in the past decade, far exceeding the general U.S. older adult population growth rate of 15% (11). Chinese older adults in the United States are confronted by substantial language and cultural barriers, as well as disparities in utilization of health and social services (12), all of which may increase their vulnerability to discrimination. As the largest Asian American subgroup population in the United States and the first minority group that faced legally suspended immigration on the basis of race with the passage of the Chinese Exclusion Act in 1882, Chinese Americans have a long history of enduring discrimination, hostility, and violence. Although negative attitudes toward Chinese Americans have decreased over time, recent studies suggest that Chinese Americans still suffer from discrimination and prejudice (3,13).Given the potentially deleterious effect of discrimination, there is a need to improve our understanding of the experiences of discrimination among U.S. Chinese older adults. In this study, we aimed to (i) examine the prevalence of discrimination experienced by Chinese older adults in the Greater Chicago area, (ii) assess how Chinese older adults respond to unfair treatment, and (iii) explore the correlates of experiences of discrimination and responses to unfair treatment.