Purpose: The goal of this study is to explore the relationship between phenotype, discrimination, and well-being among Filipino Americans. Among people of color, possessing a more stereotypically ethnic phenotype has been found to be related to the experience of racial discrimination and negatively predicts physical and mental health outcomes. In addition, the association between phenotype, discrimination, and well-being may differ according to regional context. In Hawaii, there is an implicit system of social stratification which places Filipinos at lower social status compared to Caucasians and East Asians. Because this racialized hierarchy is analogous to skin color, and is associated with the relative degree of discrimination experienced by each of the groups found within it, we expect the relationships between phenotype, discrimination, and well-being to be more salient for Filipino Americans in Hawaii than those on the US mainland.
Methods: Data for the present study were drawn from the Filipino American Community Epidemiological Study. The sample consisted of 2245 Filipino American adults who lived in either San Francisco, California, or Honolulu, Hawaii, and were administered face-to-face interviews. Phenotype was assessed using an index combining self- and interviewer ratings of physical appearance on a 6-point scale ranging from "Very Non-Filipino" to "Very Filipino." Discrimination was assessed using a 9-item scale assessing frequency of unfair treatment. Mental health was measured using the depressive symptomatology subscale of the Symptoms Checklist-90 Revised, and physical health was assessed using a 2-item index of self-reported overall health.
Results: Using hierarchical multiple regression, we found significant main effects of location and discrimination on depression (β=.14, p<.001, and β=.20, p<.001, respectively), but none of the two-way interactions (phenotype × discrimination, phenotype × location, and location × discrimination) were statistically significant. Additionally, the three-way interaction of phenotype × discrimination × location on depression was not significant. Location had a significant main effect on physical health (β=.13, p<.001), and the two-way interactions of phenotype × discrimination and location × discrimination were statistically significant (β=.11, p<.001, and β=-.13, p<.001, respectively). The three way interaction of phenotype × discrimination × location was also significant (β=-.12, p<.001). Further exploration revealed that in San Francisco the experience of discrimination aggravated the negative effect of phenotype on physical health. However, in Honolulu, possessing a more ethnic phenotype was positively related to physical health, and discrimination appears to actually enhance this relationship.
Implications: Findings call attention to how racialized experiences of Asian Americans vary according to the socio-historical context of their geographic regional communities. The relationship between phenotype and health outcomes varied as a function of both location and discrimination, perhaps indicating that geographic variation was due to qualitatively different racial experiences of Filipino Americans living in Hawaii compared to those living in California. When working with minority clients, social workers must be cognizant of the implications of ethnic phenotype on individual well-being. Furthermore, interventions targeting minority communities should be tailored to unique social, political, and historical factors within that particular region which create geographically-specific racial experiences related to minority status.