November 14, 2014 / 5:35 PM / 5 years ago

Discrimination may affect health of older Chinese-Americans

(Reuters Health) - One in five older Chinese Americans in Chicago has experienced discrimination, and this source of added stress could have negative health effects, according to a new study.

Combined with a cultural preference for tolerance, instead of fighting back, “Discrimination may operate as a stressor that decreases older adults’ self-esteem and increases the risk of psychological distress, social isolation, thus leading to poorer health status,” said Dr. Xinqui Dong, who led the study.

“This study highlights that U.S. Chinese older adults still experienced considerable discrimination, with the majority of older adults tending to have passive responses to unfair treatment,” said Dong, a professor at Rush University Medical Center in Chicago and director of its Chinese Health, Aging and Policy Program.

The researchers used data from a survey of 3,159 Chinese adults in Chicago who were over age 60 and living in their own homes or with family.

Survey participants reported any experiences where they were prevented from doing something, were hassled or were made to feel inferior because of their race. They also described their responses in those situations.

The researchers found that 21 percent of the participants had experienced racial discrimination. The most common setting was in public, where 10 percent of people were treated unfairly. This was followed by the work setting, where 8 percent of people experienced discrimination.

Older adults living in places other than Chicago’s Chinatown, those with higher socioeconomic status and those with poorer health were more likely to report discrimination.

David Chae warned that the true rates of discrimination are likely higher than these numbers suggest. Chae, who studies racial discrimination and its impacts on health at the University of Maryland, College Park, said that this treatment can often be subtle and “people may not recognize the social insults they experience as being instances of discrimination.”

For example, Chae said in an email, such instances can take the form of something commonplace like poorer service at a restaurant or store.

Almost 75 percent of participants said that they accept unfair treatment as a fact of life and about half also kept it to themselves.

About 29 percent had a moderate response to the discrimination, meaning that they either took action or talked to others about the experience. Only 23 percent both took action and spoke to others about the incidents.

Dong’s team notes that these results are very different from studies with white and black adults, who are much more likely to take action and speak to others when facing unfair treatment. Over 80 percent of white people and almost 70 percent of black people responded actively to discrimination in past studies, he said.

Dong said this mostly passive response is partly influenced by “the traditional Chinese cultural value of collectivism and the belief that tolerance is a ‘key moral virtue.’” He also cited language barriers and lower socioeconomic status as reasons that participants may not be aware of services available to help them cope with discrimination.

Discrimination has been associated with “a wide range of health problems, including depressive disorders, substance use, cardiovascular diseases,” according to Gilbert Gee at the University of California, Los Angeles, who studies the links between discrimination and health.

Dong and his colleagues caution that because their study did not track the participants’ health over time, they cannot say that discrimination was the cause of poor health.

Gee noted that passive coping strategies in the face of discrimination, if they’re consistent with a person’s worldview, may not be a problem. “Some research in psychology suggests that such ‘passive’ strategies among Asians may be protective because of this cultural alignment,” he told Reuters in an email.

Dong, however, said “Community, social services and health care organizations should improve older adults’ awareness on discrimination, promote coping strategies and improve the availability of coping resources related to discrimination.”

He added, “Healthcare and other service providers should improve the cultural competence of services provided to Chinese older adults. This would likely involve greater resources and training to work through language barriers.”

Dong also stressed the importance of family support, which has great cultural significance to older Chinese adults.

SOURCE: bit.ly/1x80FPJ The Journal of Gerontology: Medical Sciences, online October 29, 2014.

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