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感知到的歧视对移民和难民身心健康的影响。

The Effects of Perceived Discrimination on Immigrant and Refugee Physical and Mental Health.

作者信息

Szaflarski Magdalena, Bauldry Shawn

机构信息

Department of Sociology, University of Alabama at Birmingham, HHB 460H, 1720 2nd Ave South, Birmingham, AL 35294-1152.

Department of Sociology, Purdue University, 700 W. State Street, Stone 326 B, West Lafayette, IN 47907.

出版信息

Adv Med Sociol. 2019;19:173-204. doi: 10.1108/S1057-629020190000019009.

Abstract

PURPOSE

Discrimination has been identified as a major stressor and influence on immigrant health. This study examined the role of perceived discrimination in relation to other factors, in particular, acculturation, in physical and mental health of immigrants and refugees.

METHODOLOGY/APPROACH: Data for US adults (18+ years) were derived from the National Epidemiologic Survey on Alcohol and Related Conditions. Mental and physical health was assessed with SF-12. Acculturation and perceived discrimination were assessed with multidimensional measures. Structural equation models were used to estimate the effects of acculturation, stressful life effects, perceived discrimination, and social support on health among immigrants and refugees.

FINDINGS

Among first-generation immigrants, discrimination in health care had a negative association with physical health while discrimination in general had a negative association with mental health. Social support had positive associations with physical and mental health and mediated the association of discrimination to health. There were no significant associations between discrimination and health among refugees, but the direction and magnitude of associations were similar to those for first-generation immigrants.

IMPLICATIONS

Efforts aiming at reducing discrimination and enhancing integration/social support for immigrants are likely to help with maintaining and protecting immigrants' health and well-being. Further research using larger samples of refugees and testing moderating effects of key social/psychosocial variables on immigrant health outcomes is warranted.

ORIGINALITY/VALUE: This study used multidimensional measures of health, perceived discrimination, and acculturation to examine the pathways between key social/psychosocial factors in health of immigrants and refugees at the national level. This study included possibly the largest national sample of refugees.

摘要

目的

歧视已被确定为影响移民健康的主要压力源。本研究探讨了感知到的歧视与其他因素,特别是文化适应,对移民和难民身心健康的作用。

方法/途径:美国成年人(18岁及以上)的数据来自全国酒精及相关状况流行病学调查。使用SF-12评估身心健康状况。使用多维度测量方法评估文化适应和感知到的歧视。采用结构方程模型来估计文化适应、应激性生活影响、感知到的歧视和社会支持对移民和难民健康的影响。

研究结果

在第一代移民中,医疗保健方面的歧视与身体健康呈负相关,而一般意义上的歧视与心理健康呈负相关。社会支持与身心健康呈正相关,并介导了歧视与健康之间的关联。难民中歧视与健康之间没有显著关联,但关联的方向和程度与第一代移民相似。

启示

旨在减少歧视并加强对移民的融合/社会支持的努力可能有助于维护和保护移民的健康与福祉。有必要开展进一步的研究,采用更大规模的难民样本,并测试关键社会/心理社会变量对移民健康结果的调节作用。

原创性/价值:本研究使用健康、感知到的歧视和文化适应的多维度测量方法,在国家层面研究移民和难民健康方面关键社会/心理社会因素之间的路径。本研究纳入了可能是最大规模的全国难民样本。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0022/6553658/69012fbefc49/nihms-1007164-f0001.jpg

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