Variation in the Association of Discrimination and Mental Health By Place of Origin Among U.S. Latinos

Background and purpose. The U.S. Latino population experiences high rates of discrimination, which has been linked to psychiatric disorders (Cook, Alegría, Lin, & Guo, 2009). Specifically, perceived discrimination increases risk of depression, anxiety, substance abuse, and suicidal ideation (Ai, Weiss, & Fincham, 2014; Ornelas & Perreira, 2011; Salgado et al., 2014). While this link is well supported, little is known about how the impact of discrimination varies for Latinos by country of origin. This study investigates variation in the relationship between discrimination and psychiatric disorders by Latino subgroup.

Methods. Data were drawn from the 2002-2003 National Latino and Asian American Study (NLAAS), which is one of the largest nationally representative studies of Latinos. Data were collected through in-person household interviews or telephone interviews, either in English or the respondent’s native language. Study sample included all Latino respondents (N=2503): Cuban (n=569), Puerto Rican (n=481), Mexican (n=851), and other Latino (n=602). Perceived discrimination was measured using nine items that assessed frequency of discrimination experiences on a 6-point Likert scale items (1=almost never experience discrimination, 6=experience discrimination daily). Additional measures included acculturative stress (measured with 9 items), immigration variables (length of stay in the U.S. and English proficiency), and demographic measures. Separate logistic regression analyses were conducted to examine the effects of perceived discrimination on the following psychiatric disorders (yes/no): any psychiatric disorder, mood disorder, anxiety disorder, substance use disorder, and eating disorder.

Results. The mean score of perceived discrimination was 1.8 (SE=0.03) and 21.2% of respondents had experienced any psychiatric disorder. The most prevalent disorder was anxiety (14.3%) followed by mood disorder (8.9%). Rates of anxiety and eating disorders were both significantly different by place of origin (p<.05). Puerto Ricans had the highest rates of anxiety disorders (20.6%), followed by Cubans (14.7%) and Mexicans (13.9%). The probability of having an eating disorder was also highest among Puerto Ricans (4.3%) and lowest among Mexicans (2.3%). Significant variation by place of origin was present for perceived discrimination (F=30.91, p<.001), with Puerto Ricans experiencing the highest score (1.95) and Cubans the lowest score (1.44). In terms of psychiatric disorders, Mexicans were less likely than Puerto Ricans to have any psychiatric disorder (OR=0.52, CI=0.33-0.82, p<.001). However, in regards to the effect of discrimination, the effect on psychiatric disorders was greater for Mexican than Puerto Ricans (OR=1.76, CI=1.17-2.89, p<.05).

Conclusions and Implications. The findings suggest that the effect of discrimination on psychiatric disorders varies by country of origin. Specifically, Mexican respondents may be more susceptible to the damaging impact of discrimination than their Puerto Rican counterparts. Mexicans have an oppressive immigration history and can face substantial discrimination in the United States, which worsens risk of mental illness. This study raises awareness for social work practice with Latino populations and the relevance for future research to examine consequences of negative events and mental health needs not for Latinos as a homogenous group, but specifically for Latinos by country of origin.