Varying Associations of Racial/Ethnic Identity with Depression in Asian-American Subgroups nationwide

Background: Asian Americans (AA) belong to the fastest growing ethnic minority in the US, (approximately 17.3 million) according to the latest US Census.  AAs constitute tremendous heterogeneity with varying impacts on their mental health. Accordingly, we examined differential influencess of protective factors in subgroup AAs nationwide. 

Method: Using the first national sample from the National Latino and Asian American Study (NLAAS), we explored the direct effect of racial identity, social support, and religious attendance, on major depression in Chinese, Filipino, and Vietnamese Americans (n=2095), controlling for known predictive factors.  

Results: Chinese are most likely to suffer from major depressive disorder (5.3%), followed by Filipinos (4.3%), and Vietnamese (3.3%). Filipinos, as the most acculturated subgroup, experienced the highest levels of Discrimination but also reported the highest levels of social support; followed by Chineses. Filipinos. In addition, almost all Catholics reported the highest levels of religious involvement. Not surprisingly, Vietnamese reported the highest level of Acculturation Stress, closely followed by Chinese. Bivariate correlations for Depression showed considerable inter-group variation. Hierarchical logistic regression models associated Female gender, US-Born and Racial/Ethnic Identity with major depression in Chinese. Social Support reduced their likelihood of depression by 70% (p<.01). In Filipinos, however, English Proficiency (p<.01) and Racial/Ethnic Identity (p<.05) were inversely linked with major depression, whereas higher education and discrimination predicted the likelihood of a diagnosis. In Vietnamese, each one-level-increase in Religious Attendance reduced the likelihood of major depression by 47% (p<.05), while Social Support reduced the likelihood by 89% (p<.001).  

Conclusion: In contrary to the empirical finding in other populations, based on Social Identity Theory and Religious Support Theory, our findings do not lend overall support for the protective effect of the three protective factors in all Asian Americans. The differences are interpreted within culturally unique contexts and immigration history with implications for mental health care.