Pathways of Vulnerability: The Mediating Role of Mental Health in the Link between Ethnic Discrimination and Sleep Among Korean Americans

Background and Purpose: Since the onset of the COVID-19 pandemic, anti-Asian discrimination in the U.S. has risen, disproportionately affecting Asian Americans. While its impact on mental health and sleep quality has received growing attention, fewer studies have explored how mental health mediates the relationship between perceived discrimination and sleep. Identifying factors that negatively affect sleep is crucial, as poor sleep is linked to adverse health outcomes. Research on Asian American experiences, especially in the Deep South, remains limited. Existing studies often treat Asian Americans as a homogeneous group, overlooking the unique experiences of subgroups like Korean Americans. Additionally, racial discrimination research in the region has largely focused on Black-White dynamics, leaving the challenges faced by Korean Americans underexplored. This study addresses these gaps by examining how perceived discrimination impacts sleep quality, with mental health as a potential mediator, among Korean Americans in the Deep South.

Methods: This study employed a cross-sectional online survey of 355 Korean Americans in the Deep South, with data collected through a Qualtrics survey between January and April 2023. The study assessed sleep quality using the Pittsburgh Sleep Quality Index (PSQI; Buysse et al., 1989), experiences of perceived ethnic discrimination using the Perceived Ethnic Discrimination Questionnaire (PEDQ; Brondolo et al., 2005), depression/anxiety symptoms using the Patient Health Questionnaire-4 (PHQ-4; Kroenke et al., 2009), and sociodemographic characteristics (i.e., age, gender, employment status, marital status, education, U.S. citizenship status, English proficiency, and self-rated general health). Data were analyzed using path analysis, with perceived discrimination as the independent variable, depression/anxiety symptoms as a potential mediator, and sleep quality as the dependent variable.

Results: The results of this study demonstrate significant associations between perceived discrimination, depression/anxiety symptoms, and sleep quality among Korean Americans in the Deep South. Direct paths were found between perceived discrimination and both poorer sleep quality (B=.57, p=.023) and increased depressive/anxiety symptoms (B=.31, p<.001). Additionally, depressive/anxiety symptoms were directly associated with worse sleep quality (B=.82, p<.001). An indirect path was also identified, with depressive/anxiety symptoms partially mediating the relationship between perceived discrimination and sleep quality (B=.26, p=.002), indicating that mental health symptoms may, in part, explain the impact of discrimination on sleep quality.

Conclusions and Implications: This study offers critical insight into the underrepresented experiences of Korean Americans in the Deep South, revealing how mental health challenges partially explain the link between discrimination and disrupted sleep. However, the cross-sectional design of the study limits the ability to fully capture the directional relationship between mental health and sleep, particularly since existing research indicates a bi-directional connection between these variables. These findings underscore the urgency of embedding culturally tailored mental health support within anti-discrimination initiatives to improve health outcomes in this population. To address these issues effectively, social work professionals and policymakers must confront cultural stigma and move beyond generalizations about Asian American experiences, recognizing the unique challenges faced by different subgroups. Future research should focus on disaggregating data across Asian subgroups to inform more targeted and equitable interventions that promote community well-being and social justice.