Experience of Language Discrimination and Coping Strategies of Chinese and Mexican-Origin Immigrants in Healthcare and across Multiple Socioecological Levels

Background and Purpose: Studies have heavily focused on racial and gender discrimination as a determinant of health, while focusing on race and gender are important, other facets of discrimination due to language may be particularly critical to health and wellbeing.Together, Asian and Latino immigrants make up about 80% of the total U.S. immigrant population, making them key populations to focus on. Using the socioecological model, this paper seeks to examine the intrapersonal, interpersonal, community, and institutional experiences of language discrimination across sectors (healthcare, social services, employment, education, and law enforcement) among a sample of Mexican and Chinese immigrants living in California.

Methods: This study analyzed semi-structured interviews from the Research on ImmiGrant HealTh and State policy (RIGHTS) study, a mixed-methods study assessing multi-sectoral policy experiences and consequent impacts on health.Twenty-eight Chinese and 32 Mexican-born participants were recruited in Los Angeles and Orange counties through convenience and snowball sampling. Interviews were conducted in person and in the participant’s preferred language (i.e. Cantonese, English, Mandarin, and Spanish). We used a hybrid inductive-deductive thematic analysis approach.

Results: For both Chinese and Mexican immigrants, language discrimination persisted across multiple sociological levels and multiple sectors. In the healthcare sector, for example, participants described differential interpersonal treatment and institutional factors such as lack of interpreters leading to increased wait time and lack of access to healthcare information. Experiences of language discrimination among participants led to exclusion from employment, social services, and healthcare services. Participants relied on intrapersonal (i.e., using phone applications like Google translate to communicate with employers) and interpersonal (i.e., using community networks such as family members or co-workers for translation) coping strategies to navigate the barriers associated with language discrimination but these were often inadequate.

Conclusion: Chinese and Mexican immigrants continue to experience language discrimination across multiple sectors, including but not limited to healthcare. These experiences span socioecological levels with individual and interpersonal coping strategies predominating. Intervention strategies that address language discrimination are necessary at various levels of influence, including community and institutional levels, to comprehensively address immigrants’ experiences of language discrimination.