Social Determinants of Mental Health Problems Among Lower-Wage Chinese Immigrants

Background: The social conditions in which individuals work and live critically shape life experiences, resource access, and ultimately health. Food service continues to be an important entry point to the US labor force for Chinese immigrants. For this economically vulnerable, low resource workforce, mental health concerns rank highly. Knowledge deficits about work-related and daily life social conditions on mental health limit capacity to address related health disparities. Purpose: To examine the combined influences of social determinants (social discrimination, job concerns, social support) on Chinese immigrant mental health. Methods: Participants included Chinese immigrants in food service occupations, who completed a comprehensive, in-person interview, using Likert-type response options for which higher scores indicated higher construct values. Following descriptive analysis, hierarchical multiple regression models were tested. Results: Analysis revealed (n=60) on average participants had lived in the US 10.4 years (SD=9.6); 55% understood some spoken English; and 47% were female. Controlling for demographics and relevant covariates (e.g. gender, education, citizenship, insurance, health), social discrimination and job concerns predicted mental health problems (ß=.30; ß=.38, p<.05; R²_adj=.37). Focused analyses revealed that overt discriminatory actions (ß=.50) and interpersonal work problems (ß=.23) were primary sources of these effects (R²_adj=.50, p<.01); importantly social support interacted with discrimination and job concerns to moderate mental health problems. Discussion: Exposure to discrimination and difficult work relations contribute to mental health problems, but are moderated by available social support. These findings uncover focal points for mental health promotion among Chinese immigrants, and point to new avenues for addressing health disparities.