Next Article in Journal
When Natural Hazards Intersect with Public Health: A Preliminary Exploration of the Impact of Bushfires and the COVID-19 Pandemic on Australian Coastal Drowning Fatalities
Previous Article in Journal
Risk Perceptions of Low Nicotine Cigarettes and Alternative Nicotine Products across Priority Smoking Populations
 
 
Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
Journals
IJERPH
Volume 18
Issue 10
10.3390/ijerph18105312
ijerph-logo
Submit to this Journal Review for this Journal Propose a Special Issue
► Article Menu

Article Menu

share Share announcement Help format_quote Cite question_answer Discuss in SciProfiles thumb_up
...
Endorse textsms
...
Comment
first_page
settings
Order Article Reprints
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Background:
Article

Discrimination and Health: The Mediating Effect of Acculturative Stress

by
Alfonso Urzúa
1,*,
Alejandra Caqueo-Urízar
2,
Diego Henríquez
1 and
David R. Williams
3
1
Escuela de Psicología, Universidad Católica del Norte, Antofagasta 1240000, Chile
2
Instituto de Alta Investigación, Universidad de Tarapacá, Arica 1000000, Chile
3
TH Chan School of Public Health, Harvard University, Boston, MA 02115, USA
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2021, 18(10), 5312; https://doi.org/10.3390/ijerph18105312
Submission received: 27 March 2021 / Revised: 25 April 2021 / Accepted: 12 May 2021 / Published: 17 May 2021
(This article belongs to the Section Global Health)
Browse Figures
Review Reports Versions Notes

Abstract

:
There is not much evidence on the effects of south–south migration and its consequences on physical and mental health. Our objective was to examine the mediating role of Acculturative Stress in the association between ethnic discrimination and racial discrimination with physical and mental health. This research is a non-experimental, analytical, cross-sectional study. A total of 976 adult Colombian migrants living in Chile were interviewed. We used the Everyday Discrimination Scale, the acculturative stress scale, and the Medical Outcomes Study Short Form (SF-12) for health status; we found that racial and ethnic discrimination had a negative effect on physical and mental health. In the simultaneous presence of both types of discrimination, racial discrimination was completely absorbed by ethnic discrimination, the latter becoming a total mediator of the effect of racial discrimination on mental and physical health. Our findings are consistent with the literature, which suggests that there are various types of discrimination which, individually or in their intersectionality, can have negative effects on health.

1. Introduction

In 2019, 3.5 percent of the world’s population, about 272 million people, were international migrants [1]. Migrating produces effects both on the person who migrates and on the society that receives them, derived mainly from factors linked to the interaction between the two. Two of these factors are perceived as discrimination and acculturative stress, variables that can directly or indirectly affect the physical and mental health of the migrant [2].
Discrimination is conceptualized as the different treatment of a group with common characteristics or of a person belonging to such a group [3]. The perception of being a target of discrimination (isolation and unfair treatment) has been adversely related to both physical and mental health. This pattern has been consistently reported for various types of discrimination and for multiple populations [4,5,6,7,8,9,10,11,12,13,14,15].
In migrant populations, two of the most studied types of discrimination are those based on ethnicity and race, which have been associated with poorer physical and mental health [16,17,18,19,20,21,22,23,24], low self-esteem [25,26], and reduced well-being [27,28,29,30,31,32,33].
The link between discrimination and poor health can be explained by theories about the ways in which stress can affect health [9,34,35]. One particular type of stress is a result of the process of acculturation, understood as the phenomenon derived from continuous and direct contact between groups of people from different cultures, which can lead to changes in the cultural patterns of one or both groups [36]. At the psychological level, it can imply dealing with demands as one confronts new attitudes and values, the need to acquire new social skills and norms, and changes in one’s own group identity and the adjustment or adaptation to a different environment [37]. When these demands of adaptation to a new culture exceed people’s capacities to face them, acculturative stress can arise [38,39,40].
Acculturative stress has been linked to the presence of anxiety and depressive disorders, as well as feelings of marginality, increased psychosomatic disorders, eating behavior, and identity confusion [41,42,43,44,45,46,47,48]. It can also have a mediating effect on the relationship between discrimination and health [9], acculturation and sedentarism [49], the association between acculturation and psychological functioning [50], or between discrimination and psychological stress [51].
Although the literature on the relationship between discrimination and physical and mental health is extensive, research on factors that mediate and/or moderate this relationship in migrant populations is scarce, especially in Latin America. Our review has not found references to studies conducted with South American migrants in a South American country, nor any that refer to the effects that acculturative stress could have, as a specific stressor faced by migrant populations, on the relationship between discrimination and health.
This research is contextualized in the so-called south–south migration processes, i.e., South Americans migrating to countries in the region, a phenomenon that has not been widely studied. In this study, we address Colombian migration to Chile, which is mostly of African descent and which, given its upsurge in recent times, has generated situations of social tension, such as discrimination against migrants, either racially or because of their country of origin. These situations are linked in the social imaginary to drug trafficking, drugs and, in the case of women, sex trade [52,53]. In this context, this study aimed to examine the mediating role of acculturative stress in the association between ethnic discrimination and racial discrimination with physical and mental health. We hypothesize that stress will have a mediating effect on this relationship.

2. Materials and Methods

2.1. Sample

This research is a non-experimental, analytical, cross-sectional study. Given the challenges of identifying the target population, non-probability sampling methods were used that combined snowball sampling techniques with purposive sampling for hard-to-reach groups. Inclusion criteria were a Colombian resident in Chile (not a tourist), over 18 years of age and having been in Chile for more than 6 months. No exclusion criteria were applied. The participants were recruited in three of the cities with the highest rates of Colombian migrants in the country. They were interviewed mainly in public institutions, such as the Chilean Catholic Migration Institute (INCAMI), Global Citizen-Jesuit Migrant Services, Department of Immigration, Colombian Consulate, their workplaces, health centers, and neighborhoods with high migrant populations, among others.

2.2. Measures

To identify respondents’ sociodemographic data, questions were asked relating to years of age, biological sex, nationality, level of studies (e.g., no education, primary school, secondary school, university), years of permanence in the country, city of residence, type of residence, monthly income, and work situation (without work, self-employed, dependent worker, etc.). All the questionnaires described below were previously assessed in Latin American migrant populations through cognitive interviews. These have been used in previous studies on South American migrants.

2.3. Perceived Discrimination

We used the Spanish version of the Everyday Discrimination Scale [54,55]. The questions asked participants to indicate how often they had been treated badly or unfairly in 10 situations. We asked respondents separately to answer the questions on this scale by thinking first about their skin color and then considering their nationality. In the present research, the scale for ethnic discrimination had an Alpha of 0.91, while the scale for racial discrimination had an Alpha of 0.93. We have assessed ethnic discrimination separately from racial discrimination, as there is evidence from previous studies that the two types of discrimination function differently [31].

2.4. Health Status

Health was assessed using the Medical Outcomes Study Short Form—SF-12 [56], adapted to Spanish by Vilagut et al. [57]. It consists of 12 items grouped into two dimensions, one for mental health and the other for physical health [57,58]. There is evidence of the reliability of this scale for use in the Colombian population [59].

2.5. Acculturative Stress Scale

We used a brief version of the acculturative stress scale developed by Ugalde-Watson et al. [60] to evaluate the levels of stress experienced during the acculturation process. This scale consists of 14 items grouped into three dimensions: (a) the stress derived from the preparation and departure from the country of origin, (b) the stress produced by socioeconomic concerns in the host country, and (c) the tensions typical of adaptation to sociocultural changes or Chilean society [61].

2.6. Procedures

The present research is part of the FONDECYT 1180315, which has been reviewed and approved by the Scientific Ethics Committee of Universidad Católica del Norte, Chile. Each of the participants signed a consent form. The data were coded and analyzed with the SPSS-21 software (IBM Corp., Armonk, NY, USA) [62], while the Mplus 8.2 software (Muthen & Muthen, Los Angeles, CA, USA) was used for structural model adjustment analyses [63].

2.7. Statistical Analysis

First, the measurement models for each of the scales were estimated by means of confirmatory factor analyses. Subsequently, four structural equation models were examined (M1, M2, M3 and M4). The first model (M1) estimated the effect of ethnic discrimination and racial discrimination on physical and mental health. The second model (M2) estimated the effects of ethnic and racial discrimination, mediated by acculturative stress, on physical and mental health. The third model (M3) estimated the effect of racial discrimination on mental and physical health. Finally, the indirect effect of racial discrimination on physical and mental health was estimated and mediated in a serial manner by ethnic discrimination and acculturative stress.
The indirect effects of the mediation model (M2, M4) were estimated following the recommendations of Stride, Gardner, Catley, and Thomas [64]. The models were analyzed with the Mplus 8.2 software [58], using the robust weighted least squares (WLSMV) estimation method, which is robust for non-normal ordinal variables [65]. The goodness-of-fit values of all structural models were estimated using Chi-square values (χ2), the approximation mean square error (RMSEA), the comparative fit index (CFI), and the Tucker–Lewis index (TLI). According to recommended standards in the literature (e.g., Schreiber, 2017), RMSEA ≤ 0.08, CFI ≥ 0.95, and TLI ≥ 0.95 values are considered adequate and indicative of a good fit.
Analyses were performed controlling for city, sex and age, and no significant differences were found in the reported values due to the effect of these variables.

3. Results

3.1. Participants

A total of 976 adult Colombian migrants were interviewed, of which 499 (51.1%) resided in Antofagasta, 250 (25.6%) in Arica, and 227 (23.3%) in Santiago. The sample was almost evenly divided by sex with 477 (48.9%) males and 496 (50.8%) females, with missing data for 3 (0.3%). The age of participants ranged from 18 to 89 years (ME = 35.43; SD = 10.28).

3.2. Descriptives

Table 1 shows the average values, as well as the range of scores, for each of the variables studied in the model.

3.3. Measurement Models

Table 2 shows the goodness-of-fit indices of the estimated measurement models. The estimation of the CFI and TLI indicators were adequate in all models, being close to the expected values (CFI > 0.95; TLI > 0.95). However, the estimated RMSEA in all variables exceeded the recommended cut-off point (RMSEA > 0.08) [66]. In this scenario, the results of the structural models should be interpreted with caution, considering this limitation.
Table 3 shows the goodness-of-fit indices of the estimated structural models. All the models presented indicators close to the criteria recommended by the literature, and therefore are good representations of the observed relationships.
In M1, we observe that ethnic discrimination exerts a moderate inverse effect (b > 0.30) [67] on physical and mental health. No significant effects of racial discrimination on physical and mental health are observed (see Figure 1).
In M2, we observe that acculturative stress completely mediates [68] the relationship between ethnic discrimination and physical and mental health (see Figure 2). In contrast, there was no evidence to support the of the idea that acculturative stress mediates the relationship between racial discrimination and physical and mental health.
With regards to direct effects, ethnic discrimination had a positive effect of small magnitude (b > 0.20) [67] on AS, and inverse effects of small magnitude (b > 0.20) on physical and mental health. The racial discrimination did not show statistically significant direct effects on acculturative stress, physical or mental health.
Since we did not detect any significant effect of racial discrimination on the other variables, we generated the new hypothesis that ethnic discrimination could be mediating the relationship between racial discrimination and physical and mental health. Therefore, we tested two alternative models (M3 and M4). The first (M3) estimated the effect that racial discrimination has on physical and mental health, while the second one (M4), estimated a serial mediation model, where ethnic discrimination followed by acculturative stress acted as mediators of the relationship between racial discrimination and physical and mental health.
As can be seen in Figure 3 (M3), racial discrimination showed small inverse effects (b > 0.20) on physical and mental health. Therefore, this gives us a signal to think that, in the previous models, ethnic discrimination may be mediating the relationship between racial discrimination and physical and mental health.
As can be seen in Figure 4, the racial discrimination did not have statistically significant direct effects on acculturative stress, physical and mental health. However, it does show a large positive effect (b > 0.50) [67] on ethnic discrimination. On the other hand, ethnic discrimination has a small positive effect (b > 0.20) on acculturative stress, and inverse effects on physical and mental health. In the case of acculturative stress, it has a moderate inverse effect (b > 0.30) on physical and mental health.
Concerning indirect effects, M4 shows that ethnic discrimination completely mediates the relationship between racial discrimination and physical and mental health (see Figure 4). Acculturative stress does not have significant indirect effects on the relationship between racial discrimination and physical and mental health. Finally, ethnic discrimination followed by acculturative stress completely mediates the relationship between physical and mental health.

4. Discussion

The data analyzed in our research allows us to highlight two results that we believe are important. Firstly, our findings are consistent with the literature, which suggests that there are various types of discrimination which, individually or in their intersectionality, can have negative effects on health. The results reported here reinforce the earlier evidence, since both racial and ethnic discrimination had a negative effect on physical and mental health. In addition, our analyses contribute to the idea that, in the face of the simultaneous presence of both types of discrimination, racial discrimination was completely absorbed by ethnic discrimination, the latter becoming a total mediator of the effect of racial discrimination on mental and physical health. Similar effects have been reported by Zainiddinov [69], who reports in a study with different Muslim ethnic groups that, despite a common basis of discrimination (being Muslim), ethnicity played the more important role in perceived discrimination, supporting the hypothesis that people with multiple intersections and disadvantaged statuses are discriminated against at higher rates than those with only one stigmatized status.
We believe that the effect caused by belonging to an ethnic category (in this case being Colombian) may have various explanations at the base that arise due to recent migration, these being the maintenance of a strong ethnic identity and the widespread presence of negative stereotypes of this group. The Colombian migration into Chile is a relatively recent migration (last few years), that is unlike earlier historical migrations from countries in South America, such as Peru. Peruvian migrants do not manifest a strategy of acculturation associated with integration or biculturalism, but try to maintain their own ethnic identity, sometimes exacerbating it, which can cause greater discrimination from the Chilean population that perceives them as a threat to the dominant culture. In addition, it has been found that, in countries with a recent migratory flow, such as this one, native people tend to prefer that newcomers adopt the practices and customs of the host country, i.e., assimilate into the dominant culture [70].
The maintenance of this strong identity is reinforced by less contact with the host population and marked differences in relational style, which often makes Columbian immigrants function as a group separately from the host society, thus becoming more socially visible by remaining a different group with little permeability to the practices, customs and lifestyles of the host population, thereby generating more behaviors of self-exclusion when they perceive themselves to be discriminated against [71].
The recent nature of this migration also interacts with our second hypothesis, concerning the prevalence of negative stereotypes about the Colombian migrant. Colombian migration is linked to the perceived transfer of violence from the country of origin, which often caused migration combined with an exacerbated sexualization in the case of women, generating greater discrimination from the host population because they are Colombian, and not so much because of the color of their skin. Echeverri [72] suggests that this is because of social representations built around Colombian migration, associated with violence and unwanted stigmatized subjects. In this context, being Colombian and the prejudices and stereotypes associated with it not only increases racial discrimination but is also strong enough that at least some of these stereotypes are accepted as true by Columbian migrants themselves.
Secondly, we found that acculturative stress had a mediating effect on the relationship between discrimination and health. Traditionally, the focus of many studies of stress have been on the inverse relationship it has with various indicators of health and well-being [33,38,73,74]. Few studies have considered it a mediating variable [9,49,50,51]. In this context, our results provide evidence that stress can mediate the relationship between ethnic discrimination and its effect on physical and mental health, probably because this is one of the main outcomes of the discrimination process, and this in turn has a direct effect on the increase of physical and mental health problems.
As has been mentioned, although the literature on the relationship between discrimination and physical and mental health or between discrimination and well-being is extensive, research on factors that mediate and/or moderate this relationship in the migrant population, and especially in Latin America, is still incipient. Accordingly, this research provides new insight regarding how psychosocial factors can affect physical and mental health in the context of these new mass -migratory movements of South American immigrant populations in the Southern Cone of the Americas. Given the frequent exposure of different ethnic groups to discrimination and the high impact of discrimination on individual suffering, loss of well-being and physical and mental health problems, it is important for future research to continue to examine the relationship between discrimination and health (physical and mental) and well-being, including factors that influence the strength of this relationship [74].
The research findings here must be considered in the light of its limitations. First, given the cross-sectional design used, it was not possible to examine the associations between discrimination and health—either physical or mental—over time or to examine the temporal ordering of the associations. Second, given the sampling strategies used, we cannot have confidence that our findings are representative of all Columbian immigrants. Third, the findings from this study cannot be generalized to all South American immigrants to Chile. It is necessary for future research to evaluate how the analyzed models behave in different migrant populations, particularly due to the impact that prejudice seems to have in Chile for certain ethnic groups and the type of acculturation strategy that the migrating population has adopted. In this context, it is necessary to deepen our understanding on the role of culture in the way acculturative stress can influence particular immigrant populations [75].
Possible lines of research to be followed should explore the role that ethnic and racial identity, the search for social support, and the management of emotions have as possible coping strategies for acculturative stress [76], given that such research can provide inputs that allow for clarifying the correlates of discrimination and the needed target factors, so that interventions would be more effective.

5. Conclusions

Racial and ethnic discrimination had a negative effect on physical and mental health. In the simultaneous presence of both types of discrimination, racial discrimination was completely absorbed by ethnic discrimination, with the latter becoming a total mediator of the effect of racial discrimination on mental and physical health. These findings provide evidence to policy makers of the need to intervene at the societal level and in terms of social imaginaries and stereotypes about migrants associated with their ethnic origin, especially in public discourse and policies, generating a positive image of migrants, thus contributing to less discrimination towards this population.

Author Contributions

Conceptualization, A.U.; methodology, A.U., A.C.-U., D.R.W.; formal analysis, D.H.; resources, A.U.; data collection, A.U; A.C.-U.; writing—original draft preparation: all authors; writing—review and editing: all authors; funding acquisition, A.U. All authors have read and agreed to the published version of the manuscript.

Funding

This research was funded by Agencia Nacional de Investigación y Desarrollo—ANID, grant number FONDECYT 1180315.

Institutional Review Board Statement

The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the scientific ethics committees of the Universidad Católica del Norte, through resolution 011/2018.

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study.

Data Availability Statement

The data presented in this study are available on request from the corresponding author. The data are not publicly available because the project has state funding and will only be released once the project is finished.

Conflicts of Interest

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

References

  1. IOM. International Organization for Migration. UN Migration. World Migration Report. Available online: https://publications.iom.int/books/world-migration-report-2020 (accessed on 22 April 2021).
  2. Pascoe, E.A.; Richman, L.S. Perceived discrimination and health: A meta-analytic review. Psychol. Bull. 2009, 135, 531–554. [Google Scholar] [CrossRef] [Green Version]
  3. Krieger, N. A glossary for social epidemiology. J. Epidemiol. Community Health 2001, 55, 693–700. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  4. Cormack, D.; Stanley, J.; Harris, R. Multiple forms of discrimination and relationships with health and wellbeing: Findings from national cross-sectional surveys in Aotearoa/New Zealand. Int. J. Equity Heal. 2018, 17, 1–15. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  5. Hagiwara, N.; Alderson, C.J.; Mezuk, B. Differential Effects of Personal-Level vs Group-Level Racial Discrimination on Health among Black Americans. Ethn. Dis. 2016, 26, 453–460. [Google Scholar] [CrossRef] [Green Version]
  6. Krieger, N. Discrimination and Health Inequities. Int. J. Heal. Serv. 2014, 44, 643–710. [Google Scholar] [CrossRef]
  7. Landrine, H.; Corral, I.; Hall, M.B.; Bess, J.J.; Efird, J. Self-rated health, objective health, and racial discrimination among African-Americans: Explaining inconsistent findings and testing health pessimism. J. Heal. Psychol. 2016, 21, 2514–2524. [Google Scholar] [CrossRef] [PubMed]
  8. Espinosa, A. Discrimination, Self-Esteem, and Mental Health Across Ethnic Groups of Second-Generation Immigrant Adolescents. J. Racial Ethn. Heal. Disparities 2020, 1–12. [Google Scholar] [CrossRef]
  9. Lewis, T.T.; Cogburn, C.D.; Williams, D.R. Self-Reported Experiences of Discrimination and Health: Scientific Advances, Ongoing Controversies, and Emerging Issues. Annu. Rev. Clin. Psychol. 2015, 11, 407–440. [Google Scholar] [CrossRef] [Green Version]
  10. Priest, N.; Perry, R.; Ferdinand, A.; Kelaher, M.; Paradies, Y. Effects over time of self-reported direct and vicarious racial discrimination on depressive symptoms and loneliness among Australian school students. BMC Psychiatry 2017, 17, 50. [Google Scholar] [CrossRef] [Green Version]
  11. Williams, D.R.; Mohammed, S.A. Discrimination and racial disparities in health: Evidence and needed research. J. Behav. Med. 2008, 32, 20–47. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  12. Williams, D.R.; Mohammed, S.A. Racism and Health, I. Am. Behav. Sci. 2013, 57, 1152–1173. [Google Scholar] [CrossRef] [PubMed]
  13. Williams, D.R. Stress and the Mental Health of Populations of Color: Advancing Our Understanding of Race-related Stressors. J. Heal. Soc. Behav. 2018, 59, 466–485. [Google Scholar] [CrossRef] [PubMed]
  14. Williams, D.R.; Lawrence, J.A.; Davis, B.A. Racism and Health: Evidence and Needed Research. Annu. Rev. Public Heal. 2019, 40, 105–125. [Google Scholar] [CrossRef] [Green Version]
  15. Williams, D.R.; Lawrence, J.A.; Davis, B.A.; Vu, C. Understanding how discrimination can affect health. Heal. Serv. Res. 2019, 54, 1374–1388. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  16. Borrell, C.; Muntaner, C.; Gil-González, D.; Artazcoz, L.; Rodríguez-Sanz, M.; Rohlfs, I.; Pérez, K.; García-Calvente, M.; Villegas, R.; Álvarez-Dardet, C. Perceived discrimination and health by gender, social class, and country of birth in a Southern European country. Prev. Med. 2010, 50, 86–92. [Google Scholar] [CrossRef]
  17. Finch, B.K.; Kolody, B.; Vega, W.A. Perceived Discrimination and Depression among Mexican-Origin Adults in California. J. Heal. Soc. Behav. 2000, 41, 295–313. [Google Scholar] [CrossRef]
  18. Hatch, S.L.; SELCoH Study Team; Gazard, B.; Williams, D.R.; Frissa, S.; Goodwin, L.; Hotopf, M. Discrimination and common mental disorder among migrant and ethnic groups: Findings from a South East London Community sample. Soc. Psychiatry Psychiatr. Epidemiol. 2016, 51, 689–701. [Google Scholar] [CrossRef] [Green Version]
  19. Keys, H.M.; Kaiser, B.N.; Foster, J.W.; Minaya, R.Y.B.; Kohrt, B.A. Perceived discrimination, humiliation, and mental health: A mixed-methods study among Haitian migrants in the Dominican Republic. Ethn. Health 2014, 20, 219–240. [Google Scholar] [CrossRef]
  20. Priest, N.; Williams, D.R. Racial Discrimination and Racial Disparities in Health, 1st ed.; Oxford Handbooks Online: Oxford, UK, 2017. [Google Scholar]
  21. Schunck, R.; Reiss, K.; Razum, O. Pathways between perceived discrimination and health among immigrants: Evidence from a large national panel survey in Germany. Ethn. Heal. 2014, 20, 493–510. [Google Scholar] [CrossRef] [PubMed]
  22. Shishehgar, S.; Gholizadeh, L.; Di Giacomo, M.; Davidson, P.M. The impact of migration on the health status of Iranians: An integrative literature review. BMC Int. Heal. Hum. Rights 2015, 15, 20. [Google Scholar] [CrossRef] [Green Version]
  23. Urzúa, A.; Cabrera, C.; Carvajal, C.C.; Caqueo-Urízar, A. The mediating role of self-esteem on the relationship between perceived discrimination and mental health in South American immigrants in Chile. Psychiatry Res. 2019, 271, 187–194. [Google Scholar] [CrossRef] [PubMed]
  24. Ward, J.B.; Feinstein, L.; Vines, A.I.; Robinson, W.R.; Haan, M.N.; Aiello, A.E. Perceived discrimination and depressive symptoms among US Latinos: The modifying role of educational attainment. Ethn. Heal. 2017, 24, 271–286. [Google Scholar] [CrossRef]
  25. Bourguignon, D.; Seron, E.; Yzerbyt, V.; Herman, G. Perceived group and personal discrimination: Differential effects on personal self-esteem. Eur. J. Soc. Psychol. 2006, 36, 773–789. [Google Scholar] [CrossRef]
  26. Urzúa, A.; Ferrer, R.; Olivares, E.; Rojas, J.; Ramírez, R. El efecto de la discriminación racial y étnica sobre la autoestima individual y colectiva según el fenotipo autoreportado en migrantes colombianos en Chile. Ter. Psicológica 2019, 37, 225–240. [Google Scholar] [CrossRef]
  27. Jasinskaja-Lahti, I.; Liebkind, K.; Perhoniemi, R. Perceived discrimination and well-being: A victim study of different immigrant groups. J. Community Appl. Soc. Psychol. 2006, 16, 267–284. [Google Scholar] [CrossRef]
  28. Mesch, G.S.; Turjeman, H.; Fishman, G. Perceived Discrimination and the Well-being of Immigrant Adolescents. J. Youth Adolesc. 2007, 37, 592–604. [Google Scholar] [CrossRef]
  29. Sevillano, V.; Basabe, N.; Bobowik, M.; Aierdi, X. Health-related quality of life, ethnicity and perceived discrimination among immigrants and natives in Spain. Ethn. Heal. 2014, 19, 178–197. [Google Scholar] [CrossRef] [Green Version]
  30. Urzúa, A.; Ferrer, R.; Godoy, N.; Leppes, F.; Trujillo, C.; Osorio, C.; Caqueo-Urízar, A. The mediating effect of self-esteem on the relationship between perceived discrimination and psychological well-being in immigrants. PLoS ONE 2018, 13, e0198413. [Google Scholar] [CrossRef]
  31. Urzúa, A.; Caqueo-Urízar, A.; Henríquez, D.; Domic, M.; Acevedo, D.; Ralph, S.; Reyes, G.; Tang, D. Ethnic Identity as a Mediator of the Relationship between Discrimination and Psychological Well-Being in South—South Migrant Populations. Int. J. Environ. Res. Public Heal. 2021, 18, 2359. [Google Scholar] [CrossRef] [PubMed]
  32. Urzúa, A.; Henríquez, D.; Caqueo-Urízar, A. Affects as Mediators of the Negative Effects of Discrimination on Psychological Well-Being in the Migrant Population. Front. Psychol. 2020, 11, 602537. [Google Scholar] [CrossRef] [PubMed]
  33. Urzúa, A.; Leiva-Gutiérrez, J.; Caqueo-Urízar, A.; Vera-Villarroel, P. Rooting mediates the effect of stress by acculturation on the psychological well-being of immigrants living in Chile. PLoS ONE 2019, 14, e0219485. [Google Scholar] [CrossRef] [Green Version]
  34. Kessler, R.C.; Mickelson, K.D.; Williams, D.R. The Prevalence, Distribution, and Mental Health Correlates of Perceived Discrimination in the United States. J. Heal. Soc. Behav. 1999, 40, 208–230. [Google Scholar] [CrossRef]
  35. Pearlin, L.I.; Schieman, S.; Fazio, E.M.; Meersman, S.C. Stress, Health, and the Life Course: Some Conceptual Perspectives. J. Health Soc. Behav. 2005, 46, 205–219. [Google Scholar] [CrossRef]
  36. Redfield, R.; Linton, R.; Herskovits, M.J. Memorandum for the Study of Acculturation. Am. Anthr. 1936, 38, 149–152. [Google Scholar] [CrossRef]
  37. Berry, J. Globalisation and acculturation. Int. J. Intercult. Relations 2008, 32, 328–336. [Google Scholar] [CrossRef]
  38. Bekteshi, V.; Kang, S.-W. Contextualizing acculturative stress among Latino immigrants in the United States: A systematic review. Ethn. Health 2020, 25, 897–914. [Google Scholar] [CrossRef]
  39. Caplan, S. Latinos, Acculturation, and Acculturative Stress: A Dimensional Concept Analysis. Policy Politi Nurs. Pr. 2007, 8, 93–106. [Google Scholar] [CrossRef] [PubMed]
  40. Romero, A.; Piña-Watson, B. Acculturative Stress and Bicultural Stress, 1st ed.; Oxford Handbooks Online: Oxford, UK, 2017. [Google Scholar]
  41. Berry, J.W.; Kim, U.; Power, S.; Young, M.; Bujaki, M. Acculturation Attitudes in Plural Societies. Appl. Psychol. 1989, 38, 185–206. [Google Scholar] [CrossRef]
  42. Kwan, M.Y.; Gordon, K.H.; Minnich, A.M. An examination of the relationships between acculturative stress, perceived discrimination, and eating disorder symptoms among ethnic minority college students. Eat. Behav. 2018, 28, 25–31. [Google Scholar] [CrossRef]
  43. Revollo, H.-W.; Qureshi, A.; Collazos, F.; Valero, S.; Casas, M. Acculturative stress as a risk factor of depression and anxiety in the Latin American immigrant population. Int. Rev. Psychiatry 2011, 23, 84–92. [Google Scholar] [CrossRef] [PubMed]
  44. Sirin, S.R.; Ryce, P.; Gupta, T.; Rogers-Sirin, L. The role of acculturative stress on mental health symptoms for immigrant adolescents: A longitudinal investigation. Dev. Psychol. 2013, 49, 736–748. [Google Scholar] [CrossRef] [PubMed]
  45. Sánchez, A.; López, M. Ansiedad y modos de aculturación en la población inmigrante. Apunt. De Psicol. 2008, 26, 399–410. [Google Scholar]
  46. Urzúa, A.; Heredia, O.; Caqueo-Urízar, A. Salud mental y estrés por aculturación en inmigrantes sudamericanos en el norte de Chile. Revista médica de Chile 2016, 144, 563–570. [Google Scholar] [CrossRef] [Green Version]
  47. Hun, N.; Urzúa, A.; Henríquez, D.T.; López-Espinoza, A. Effect of Ethnic Identity on the Relationship Between Acculturation Stress and Abnormal Food Behaviors in Colombian Migrants in Chile. J. Racial Ethn. Health Disparities 2021, 1–7. [Google Scholar] [CrossRef]
  48. Hun, N.; Urzúa, A.; López-Espinoza, A. Anxiety and eating behaviors: Mediating effect of ethnic identity and acculturation stress. Appetite 2021, 157, 105006. [Google Scholar] [CrossRef] [PubMed]
  49. Park, C.; Nam, S.; Redeker, N.S.; Shebl, F.M.; Dixon, J.; Jung, T.H.; Whittemore, R. The effects of acculturation and environment on lifestyle behaviors in Korean immigrants: The mediating role of acculturative stress and body image discrepancy. Ethn. Heal. 2019, 19, 1–17. [Google Scholar] [CrossRef]
  50. Wang, S.C.; Schwartz, S.J.; Zamboanga, B.L. Acculturative Stress Among Cuban American College Students: Exploring the Mediating Pathways Between Acculturation and Psychosocial Functioning. J. Appl. Soc. Psychol. 2010, 40, 2862–2887. [Google Scholar] [CrossRef]
  51. Torres, L.; Driscoll, M.W.; Voell, M. Discrimination, acculturation, acculturative stress, and Latino psychological distress: A moderated mediational model. Cult. Divers. Ethn. Minor. Psychol. 2012, 18, 17–25. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  52. Barbieri, E.N.G.; Baleisan, C.P.; Rodríguez, F. Inmigración reciente de colombianos y colombianas en Chile: Sociedades plurales, imaginarios sociales y estereotipos. Estudios Atacameños 2019, 62, 127–141. [Google Scholar] [CrossRef]
  53. Barbieri, E.N.G.; De Chile, U.; Suárez, G.G. Integración y exclusión de inmigrantes colombianos recientes en Santiago de Chile: Estrato socioeconómico y “raza” en la geocultura del sistema-mundo. Papeles de Población 2017, 23, 151–179. [Google Scholar] [CrossRef] [Green Version]
  54. Williams, D.R.; Yu, Y.; Jackson, J.S.; Anderson, N.B. Racial Differences in Physical and Mental Health. J. Heal. Psychol. 1997, 2, 335–351. [Google Scholar] [CrossRef] [Green Version]
  55. Krieger, N.; Smith, K.; Naishadham, D.; Hartman, C.; Barbeau, E.M. Experiences of discrimination: Validity and reliability of a self-report measure for population health research on racism and health. Soc. Sci. Med. 2005, 61, 1576–1596. [Google Scholar] [CrossRef] [Green Version]
  56. Ware, J.E.; Kosinski, M.; Keller, S.D. A 12-Item Short-Form Health Survey. Med. Care 1996, 34, 220–233. [Google Scholar] [CrossRef] [Green Version]
  57. Vilagut, G.; Valderas, J.M.; Ferrer, M.; Garin, O.; López-García, E.; Alonso, J. Interpretation of SF-36 and SF-12 questionnaires in Spain: Physical and mental components. Med. Clin. 2008, 130, 726–735. [Google Scholar] [CrossRef] [Green Version]
  58. Alegría, M.; Canino, G.; Shrout, P.E.; Woo, M.; Duan, N.; Vila, D.; Torres, M.; Chen, C.-N.; Meng, X.-L. Prevalence of Mental Illness in Immigrant and Non-Immigrant U.S. Latino Groups. Am. J. Psychiatry 2008, 165, 359–369. [Google Scholar] [CrossRef] [Green Version]
  59. Ramírez-Vélez, R.; Agredo-Zuñiga, R.; Jerez-Valderrama, A. Confiabilidad y valores normativos preliminares del cuestionario de salud SF-12 (Short Form 12 Health Survey) en adultos Colombianos. Rev. Salud Pública 2010, 12, 807–819. [Google Scholar] [PubMed]
  60. Ugalde-Watson, K.; Smith-Castro, V.; Moreno-Salas, M.; Rodríguez-García, J.M. Estructura, correlatos y predictores del estrés por Aculturación. El caso de personas refugiadas colombianas en Costa Rica. Univ. Psychol. 2010, 10, 759–774. [Google Scholar] [CrossRef] [Green Version]
  61. Urzúa, A.; Henríquez, D.; Caqueo-Urízar, A.; Smith-Castro, V. Validation of the brief scale for the evaluation of acculturation stress in migrant population (EBEA). Psicologia Reflexão e Crítica 2021, 34, 1–10. [Google Scholar] [CrossRef] [PubMed]
  62. IBM Corp. IBM SPSS Statistics for Windows, Version 25.0; IBM Corp.: Armonk, NY, USA, 2017. [Google Scholar]
  63. Muthen, L.; Muthen, B. Mplus User’s Guide. Seventh Edition; Muthén & Muthén: Los Angeles, CA, USA, 2012. [Google Scholar]
  64. Stride, C.B.; Gardner, S.; Catley, N.; Thomas, F. Mplus Code for Mediation, Moderation, and Moderated Mediation Models. Available online: http://www.offbeat.group.shef.ac.uk/FIO/models_and_index.pdf (accessed on 17 February 2017).
  65. Beauducel, A.; Herzberg, P.Y. On the Performance of Maximum Likelihood Versus Means and Variance Adjusted Weighted Least Squares Estimation in CFA. Struct. Equ. Model. A Multidiscip. J. 2006, 13, 186–203. [Google Scholar] [CrossRef]
  66. Schreiber, J.B. Update to core reporting practices in structural equation modeling. Res. Soc. Adm. Pharm. 2017, 13, 634–643. [Google Scholar] [CrossRef]
  67. Cohen, J. Statistical Power Analysis for the Behavioral Sciences, 2nd ed.; Erlbaum: Hillsdale, NJ, USA, 1988. [Google Scholar]
  68. Ato, M.; Vallejo, G. Los efectos de terceras variables en la investigación psicológica. Anales de Psicología 2011, 27, 550–561. [Google Scholar]
  69. Zainiddinov, H. Racial and ethnic differences in perceptions of discrimination among Muslim Americans. Ethn. Racial Stud. 2016, 39, 2701–2721. [Google Scholar] [CrossRef]
  70. Piontkowski, U.; Florack, A.; Hoelker, P.; Obdrzálek, P. Predicting acculturation attitudes of dominant and non-dominant groups. Int. J. Intercult. Relations 2000, 24, 1–26. [Google Scholar] [CrossRef]
  71. Viuche, A. Entre utopías y realidades: ¿qué significados le otorga un/a colombiano/a al hecho de vivir en Santiago de Chile? Rev. Búsquedas Políticas 2015, 4, 9–25. [Google Scholar]
  72. Echeverri, M. Otredad racializada en la migración forzada de afrocolombianos a Antofagasta (Chile). Nómadas 2016, 45, 91–103. [Google Scholar] [CrossRef] [Green Version]
  73. Cervantes, R.C.; Gattamorta, K.A.; Berger-Cardoso, J. Examining Difference in Immigration Stress, Acculturation Stress and Mental Health Outcomes in Six Hispanic/Latino Nativity and Regional Groups. J. Immigr. Minor. Heal. 2018, 21, 14–20. [Google Scholar] [CrossRef] [PubMed]
  74. Urzúa, A.; Basabe, N.; Pizarro, J.J.; Ferrer, R. Afrontamiento del estrés por aculturación: Inmigrantes latinos en Chile. Univ. Psychol. 2018, 16, 1–13. [Google Scholar] [CrossRef] [Green Version]
  75. Mewes, R.; Asbrock, F.; Laskawi, J. Perceived discrimination and impaired mental health in Turkish immigrants and their descendents in Germany. Compr. Psychiatry 2015, 62, 42–50. [Google Scholar] [CrossRef]
  76. Brondolo, E.; Halen, N.B.V.; Pencille, M.; Beatty, D.; Contrada, R.J. Coping with racism: A selective review of the literature and a theoretical and methodological critique. J. Behav. Med. 2009, 32, 64–88. [Google Scholar] [CrossRef]
Ijerph 18 05312 g001 550
Figure 1. Model of direct effects of ethnic and racial discrimination on physical and mental health. Note: * p < 0.05; dashed lines represent non-significant routes.
Figure 1. Model of direct effects of ethnic and racial discrimination on physical and mental health. Note: * p < 0.05; dashed lines represent non-significant routes.
Ijerph 18 05312 g001
Ijerph 18 05312 g002 550
Figure 2. Model of indirect effects of acculturative stress on the relationship between ethnic and racial discrimination and physical and mental health. Note: * p < 0.05; dashed lines represent non-significant routes; ED, ethnic discrimination; RD, racial discrimination; AS, acculturative stress; PH, physical health; MH, mental health.
Figure 2. Model of indirect effects of acculturative stress on the relationship between ethnic and racial discrimination and physical and mental health. Note: * p < 0.05; dashed lines represent non-significant routes; ED, ethnic discrimination; RD, racial discrimination; AS, acculturative stress; PH, physical health; MH, mental health.
Ijerph 18 05312 g002
Ijerph 18 05312 g003 550
Figure 3. Model of direct effects of racial discrimination on physical and mental health.
Figure 3. Model of direct effects of racial discrimination on physical and mental health.
Ijerph 18 05312 g003
Ijerph 18 05312 g004 550
Figure 4. Model of direct effects of racial discrimination, mediated by ethnic discrimination and acculturative stress, on physical and mental health. Note: * p < 0.05; dashed lines represent non-significant routes; ED, ethnic discrimination; RD, racial discrimination; AS, acculturative stress; PH, physical health; MH, mental health.
Figure 4. Model of direct effects of racial discrimination, mediated by ethnic discrimination and acculturative stress, on physical and mental health. Note: * p < 0.05; dashed lines represent non-significant routes; ED, ethnic discrimination; RD, racial discrimination; AS, acculturative stress; PH, physical health; MH, mental health.
Ijerph 18 05312 g004
Table
Table 1. Descriptive statistics.
Table 1. Descriptive statistics.
VariablesMeanSDRangeMinMaxn
Perceived discrimination
Racial discrimination0.550.70303837
Ethnic discrimination0.720.71303930
Acculturation stress3.070.91415744
Health status
Physical health75.2917.887921100942
Mental health70.9217.428317100953
Note: Health status scores were recoded in a range from 0 to 100.
Table
Table 2. Indicators of global adjustment of measurement models and structural models.
Table 2. Indicators of global adjustment of measurement models and structural models.
ModelsParametersχ2DFpCFITLIRMSEARMSEA CI 90%
LowSuperior
ED40783.767350.000.9430.9270.1480.1400.158
RD40691.463350.000.9650.9560.1460.1370.156
AS73544.257740.000.9800.9750.0810.0750.087
SF-1252408.221190.000.9490.9250.1450.1330.157
M11372436.5963440.000.9400.9340.0790.0760.082
M22143012.9598060.000.9540.9510.0530.0510.055
ED, ethnic discrimination; RD, racial discrimination; AS, acculturative stress; SF-12, physical and mental health.
Table
Table 3. Indicators of global adjustment of structural models.
Table 3. Indicators of global adjustment of structural models.
ModelsParametersχ2DFpCFITLIRMSEARMSEA CI 90%
LowSuperior
M11372436.5963440.000.9400.9340.0790.0760.082
M22143012.9598060.000.9540.9510.0530.0510.055
M394831.9291320.000.9700.9660.0740.0690.079
M42143012.9598060.000.9540.9510.0530.0510.055
CFI, comparative adjustment index; TLI, Tucker–Lewis index; RMSEA, root mean square error of approximation.
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Share and Cite

MDPI and ACS Style

Urzúa, A.; Caqueo-Urízar, A.; Henríquez, D.; Williams, D.R. Discrimination and Health: The Mediating Effect of Acculturative Stress. Int. J. Environ. Res. Public Health 2021, 18, 5312. https://doi.org/10.3390/ijerph18105312

AMA Style

Urzúa A, Caqueo-Urízar A, Henríquez D, Williams DR. Discrimination and Health: The Mediating Effect of Acculturative Stress. International Journal of Environmental Research and Public Health. 2021; 18(10):5312. https://doi.org/10.3390/ijerph18105312

Chicago/Turabian Style

Urzúa, Alfonso, Alejandra Caqueo-Urízar, Diego Henríquez, and David R. Williams. 2021. "Discrimination and Health: The Mediating Effect of Acculturative Stress" International Journal of Environmental Research and Public Health 18, no. 10: 5312. https://doi.org/10.3390/ijerph18105312

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

Article Metrics

Back to TopTop