Self-reported discrimination among Asian Americans: An examination of its measurement and relationship with health-related quality of life

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dc.contributor.advisorLee, Sunminen_US
dc.contributor.authorJung, Maryen_US
dc.contributor.departmentEpidemiology and Biostatisticsen_US
dc.contributor.publisherDigital Repository at the University of Marylanden_US
dc.contributor.publisherUniversity of Maryland (College Park, Md.)en_US
dc.date.accessioned2020-02-01T06:31:37Z
dc.date.available2020-02-01T06:31:37Z
dc.date.issued2019en_US
dc.description.abstractLabeled as a “model minority,” Asian Americans have often been excluded from the dialogue on discrimination. Previous studies frequently used discrimination measures that were initially developed for African Americans and lack items related to language and nativity. Although discrimination adversely affects mental and physical health, its relationship to health-related quality of life (HRQOL) has been understudied in this population. This dissertation evaluated self-reported discrimination among Asian Americans by examining its measurement and relationship with HRQOL. Manuscript 1 assessed the psychometric properties of everyday (ERDS) and major racial discrimination scales (MRDS) that were developed for Asian Americans. In a sample of 569 Asian American immigrant adults, reliability was excellent for ERDS but moderate for MRDS (Cronbach’s α=0.94 and 0.60). The latter is likely low given that MRDS is an inventory of events. For construct validity, weak positive linear correlations with perceived stress and depressive symptoms were observed (r=0.22 and 0.28 for ERDS and r=0.11 and 0.14 for MRDS; p<0.001). Factor analysis confirmed the unidimensionality of both measures. Manuscript 2 cross-sectionally examined the association between the racial discrimination measures from Manuscript 1 and HRQOL among 524 foreign-born Asian American adults. Multivariable logistic regression and negative binomial regression were performed to examine self-rated health (poor vs. good) and days of poor physical health, mental health, and activity limitation. ERDS (IRR range: 1.04-1.08) and MRDS scores (IRR range: 1.19-1.61) were significantly and positively associated with worse HRQOL for all measures, except for self-rated health. Manuscript 3 examined discrimination trajectories and assessed their relationship with self-rated health in a longitudinal, multi-ethnic sample of 2,004 middle-aged women in the Study of Women’s Health Across the Nation (SWAN). Group-based trajectory analysis identified three distinct discrimination groups. The “high and decreasing” but not “moderate and decreasing” group was significantly associated with poor self-rated health compared to the “low and decreasing” group (OR=1.61; 95% CI: 1.12-2.31). This dissertation provides insight into discrimination measures and their relationships with HRQOL among Asian Americans. Proper measurement and health impact assessment of discrimination in this population can contribute to better monitoring and provide improved accountability and support for interventions and public policies.en_US
dc.identifierhttps://doi.org/10.13016/7gbr-wxjy
dc.identifier.urihttp://hdl.handle.net/1903/25363
dc.language.isoenen_US
dc.subject.pqcontrolledEpidemiologyen_US
dc.subject.pqcontrolledPublic healthen_US
dc.subject.pqcontrolledAsian American studiesen_US
dc.subject.pquncontrolledAsian Americansen_US
dc.subject.pquncontrolledDiscriminationen_US
dc.subject.pquncontrolledHealth-Related Quality Of Lifeen_US
dc.subject.pquncontrolledPsychometricsen_US
dc.subject.pquncontrolledWomenen_US
dc.titleSelf-reported discrimination among Asian Americans: An examination of its measurement and relationship with health-related quality of lifeen_US
dc.typeDissertationen_US

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