Returning to the "homeland": work-related ethnic discrimination and the health of Japanese Brazilians in Japan

Ethnic discrimination, asking for fair treatment, and poor self-rated health: a gender stratified analysis of 13,443 Korean Chinese waged workers in South Korea

BACKGROUND

In South Korea, Korean Chinese workers experience ethnic discrimination although they share physical similarities and ethnic heritage with native-born Koreans. This study aimed to examine whether perceived ethnic discrimination is associated with poor self-rated health and whether the association differs by gender among Korean Chinese waged workers in South Korea.

METHODS

We conducted a pooled cross-sectional analysis using data of 13,443 Korean Chinese waged workers from the Survey on Immigrants' Living Conditions and Labor Force conducted in 2018, 2020, and 2022. Based on perceived ethnic discrimination, asking for fair treatment, and subsequent situational improvement, respondents were classified into the following four groups: "Not experienced," "Experienced, not asked for fair treatment," "Experienced, asked for fair treatment, not improved," and "Experienced, asked for fair treatment, improved." Poor self-rated health was assessed using a single question "How is your current overall health?" We applied logistic regression to examine the association between perceived ethnic discrimination and poor self-rated health, with gender-stratified analyses.

RESULTS

We found an association between ethnic discrimination and poor self-rated health among Korean Chinese waged workers. In the gender-stratified analysis, the "Experienced, not asked for fair treatment" group was more likely to report poor self-rated health compared to the "Not experienced" group, regardless of gender. However, gender differences were observed in the group stratified by situational improvements. For male workers, no statistically significant association was found in the "Experienced, asked for fair treatment, improved" group with poor self-rated health (odd ratios: 0.87, 95% confidence intervals: 0.30-2.53). Conversely, among female workers, a statistically significant association was observed (odd ratios: 2.63, 95% confidence intervals: 1.29-5.38).

CONCLUSIONS

This study is the first to find an association between perceived ethnic discrimination and poor self-rated health, along with gender differences in the association between situational improvements after asking for fair treatment and poor self-rated health among Korean Chinese waged workers in South Korea.

Racial Discrimination and Health-Related Quality of Life: An Examination Among Asian American Immigrants

OBJECTIVES

We aimed to examine the relationship between everyday and major racial discrimination with health-related quality of life (HRQOL), which consists of self-rated health, days of poor physical health, mental health, and activity limitation.

DESIGN

In a cross-sectional analytic sample of 524 foreign-born Asian adults, aged 18 years and older, we conducted multivariable logistic regression and multivariable negative binomial regression to examine associations between discrimination and HRQOL. Furthermore, potential effect modification was tested by gender, ethnicity, and social support.

RESULTS

Associations were found between everyday racial discrimination and days of poor physical health (incidence rate ratio, IRR = 1.05), mental health (IRR = 1.03), and activity limitation (IRR = 1.05). Stronger significant associations were observed between major racial discrimination and days of poor physical health (IRR = 1.21), mental health (IRR = 1.16), and activity limitation (IRR = 1.53), adjusting for all covariates. Racial discrimination was not associated with poor self-rated health. In addition, gender significantly modified the relationship between continuous racial discrimination and activity limitation days with associations of greater magnitude among men, while social support significantly modified the association between categorized major racial discrimination and physically unhealthy days. When stratified, the association was only significant among those with low social support (IRR = 3.04; 95% CI: 1.60, 5.79) as opposed to high social support.

CONCLUSIONS

This study supports the association between racial discrimination and worse HRQOL among Asian Americans, which can inform future interventions, especially among men and those with low social support, aimed at improving the quality of life in this population.

Seeking connection: a mixed methods study of mental well-being and community volunteerism among international migrants in Japan

Background

International migration is a stressful process for which non-Western nations are a growing destination. However, little attention has been paid to the psychological well-being of international residents or their local integration in such settings. Prosocial behavior, like volunteering in one’s local community, has been demonstrated to improve mental health in native populations. Volunteerism may be a mental health promotion strategy applicable to non-native migrants as well. In order to assess such a hypothesis, this study investigated the mental well-being of international migrants living in Tokyo, Japan, who did or did not participate in formal volunteering.

Methods

This convergent mixed-methods study assessed mental well-being with the Warwick-Edinburgh Mental Well-being Scale (WEMWBS) and qualitative follow-up interviews. Migrants who contributed their time to structured volunteering roles (formal volunteers, n = 150) were recruited from local non-profit organizations. Migrants who did not formally volunteer (n = 150) were recruited from social media sites. In parallel, a nested participant sample from both groups (n = 20) were interviewed about their satisfaction with life in Tokyo.

Results

After adjusting for sociodemographic characteristics, volunteering was not associated with higher mental well-being score (p = 0.215), but instead, not feeling isolated (p = 0.008), feeling connected to Japan (p = 0.001) and employment satisfaction (p < 0.001) were significantly associated with mental well-being. Follow-up interviews similarly demonstrated that migrants participated in various social activities to promote personal well-being and deeper social connections with Japanese, regardless of volunteering status.

Conclusions

Volunteering status itself was not significantly associated with mental well-being score among international migrants in Japan after adjusting for potential confounding variables. Beyond volunteering, having deeper social connections with the Japanese community is a key to promoting migrant mental well-being.

Mental well-being of international migrants to Japan: a systematic review

BACKGROUND

Migration is a stressful process of resettlement and acculturation that can often negatively impact the mental health of migrants. International migration to Japan, a country with dominant ethnic homogeneity, is growing steadily amid an ageing domestic population and severe labour shortages.

OBJECTIVES

To identify the contemporary barriers to, and facilitators of, mental well-being among the migrant population in Japan.

DESIGN

Systematic review DATA SOURCES: PubMed, ProQuest, Web of Science, Ichushi and J-Stage ELIGIBILITY CRITERIA: Research articles examining the mental well-being of international migrants in Japan that were published in English or Japanese between January 2000 and September 2018 were included.

DATA EXTRACTION AND SYNTHESIS

Full texts of relevant articles were screened and references of the included studies were hand-searched for further admissible articles. Study characteristics, mental well-being facilitators and barriers, as well as policy recommendations were synthesised into categorical observations and were then thematically analysed.

RESULTS

Fifty-five studies (23 published in English), surveying a total of 8649 migrants, were identified. The most commonly studied migrant nationalities were Brazilian (36%), followed by Chinese (27%) and Filipino (8%). Thematic analysis of barriers to mental well-being among migrants chiefly identified 'language difficulties', 'being female' and 'lack of social support', whereas the primary facilitators were 'social networks' followed by 'cultural identity'. Policy recommendations for authorities generally described more migrant support services and cross-cultural awareness among the Japanese public.

CONCLUSION

Access to social support networks of various types appears to be an influential factor affecting the mental well-being of international migrants in Japan. More research is necessary on how to promote such connections to foster a more inclusive and multicultural Japanese society amid rapid demographic change.

PROSPERO REGISTRATION NUMBER

CRD42018108421.

Predictors of Post-Treatment Employment for Individuals with Substance Use Disorders

This study examined the influence of gender, post-treatment issue severities, and treatment participation rate on the post-treatment employment status of consumers with substance use disorders. The study analyzed the archival data of 100 unemployed and underemployed participants from a substance abuse intensive outpatient program. We found significant differences in the characteristics of gender, severity of alcohol use, drug use, psychiatric issues, and treatment participation rate. Female gender and low treatment participation rates negatively predicted employment. This study increased understanding about the interplay of alcohol, drug, and psychiatric influences on post-treatment employment status.

Ethnicity and Health in Colombia: What Do Self-Perceived Health Indicators Tell Us?

OBJECTIVE

To compare self-perceived health indicators between ethnic groups in Colombia.

METHODS

Cross-sectional study with data from the 2007 National Public Health Survey (ENSP-2007). Data from 57,617 people ≥18 years were used. Variables included: belonging to an ethnic group (exposure); self-rated health; mental health problems, injuries for accidents/violence (outcomes); sex, age, education level and occupation (explicative/control). A descriptive study was carried out of the explicative variables, and the prevalence of the outcomes was calculated according to ethnicity, education level and occupation. The association between the exposure variable and the outcomes was estimated by means of adjusted odds ratios (OR) with 95% CI using logistic regression. Analyses were conducted separately for men and women.

RESULTS

The prevalence of outcomes was higher in people reporting to belong to an ethnic group and differences were found by sex, ethnic groups and health outcomes. Women from the Palenquero group were more likely to report poor self-rated health (aOR 7.04; 95%CI 2.50-19.88) and injuries from accidents/violence (aOR 7.99; 95%CI 2.89-22.07). Indigenous men were more likely to report mental health problems (aOR 1.75; 95%CI 1.41-2.17). Gradients according to ethnicity, education, occupation and sex were found.

CONCLUSIONS

Minority ethnic groups are vulnerable to reporting poor health outcomes. Political actions are required to diminish health inequalities in these groups.

Workplace injustice and self-reported disease and absenteeism in South Korea

BACKGROUND

This study investigated whether experience of workplace injustice was associated with self-reported occupational health using a nationally representative sample of Korean workers.

METHODS

We used the first wave of the Korean Working Conditions Survey (KWCS) and included 7,007 wage employees as the study population. Workplace injustice included the experience of discrimination, violence, or harassment, and occupational health was measured as self-reported health problems and absenteeism. Personal, occupational, and job-related characteristics were included as covariates.

RESULTS

An average of 7.2% of workers reported experiencing at least one workplace injustice over the past 12 months. Female workers were significantly more likely to experience age and gender discrimination, and unwanted sexual attention than male workers. Both male and female workers who experienced any workplace injustice (i.e., discrimination, harassment, or violence) reported approximately two- to threefold increased risk for physical and mental health problems (i.e., backaches, muscular pain, stomach pain, overall fatigue, headaches, anxiety/depression, sleeping problems, and injury) and absenteeism due to accidents or due to health problems.

CONCLUSION

Perceived injustice at work was significantly associated with an increased risk of occupational disease and absenteeism for Korean wage employees.

Racial discrimination, gender discrimination, and substance abuse among Latina/os nationwide

This study investigates the relationship between discrimination and substance abuse among Latina/os, and further examines whether this relationship differs by gender and type of discrimination. Analyses focus on the Latina/o respondents (n = 1,039 men; n = 1,273 women) from the National Latino and Asian American Study carried out from 2002-2003. Outcomes were alcohol abuse and drug abuse measured using DSM-IV definitions and criteria. Additional covariates included immigrant characteristics and demographics. Analyses were completed using gender-stratified multinomial logistic regression. Men reported more discrimination (39.6% vs. 30.3%) and had higher prevalence of alcohol abuse (16.5% vs. 4.5%) and drug abuse (9.5% vs. 2.3%) than women. Discrimination was significantly associated with increased risk of alcohol abuse for women and increased risk of drug abuse for men. Men and women also varied in the types of discrimination (e.g., racial vs. gender) reported, and in the associations between these types of discrimination and substance abuse. These data indicate that discrimination is associated with different substance abuse outcomes between genders. Future research should consider the mechanisms that explain these differences.

Suicidal and depressive symptoms in Filipino home care workers in Israel

The study consisted of a cross sectional sample of 178 Filipino home care workers who completed the Paykel Suicide Scale and the Patient Health Questionnaire-9. Respondents also completed questionnaires about exposure to abuse and perceived social support. Overall, 35% of the sample reported exposure to some type of abuse within their home/work environment. For those reporting low levels of satisfaction with care recipient, higher exposure to major lifetime discrimination was associated with higher SIA, whereas for those reporting high levels of satisfaction with care recipient, there was no relationship between exposure to major lifetime discrimination and SIA. Abuse within the home/work environment was the only predictor of depressive symptoms, with greater abuse being associated with higher levels of depressive symptoms. Filipino home care workers in Israel likely are exposed to moderate levels of abuse and discrimination within the home/work environment as well as within society at large. Because live-in home care workers spend the majority of their time within the home/work environment, their relationship with their care recipients have protective qualities that can serve as a buffer against discrimination. Nevertheless, abusive working conditions within their home/work environment have detrimental effects on their mental health.

Measuring discrimination in South Korea: underestimating the prevalence of discriminatory experiences among female and less educated workers?

OBJECTIVES

To investigate the possibility that Koreans show different patterns in reporting discriminatory experiences based on their gender and education level, we analyzed the participants who answered "Not Applicable" for the questions of discriminatory experiences that they were eligible to answer.

METHODS

Discriminatory experiences in eight social situations were assessed using the 7(th) wave of Korean Labor and Income Panel Study. After restricting the study population to waged workers, a logistic regression model was constructed to predict the probability that an individual has experienced discrimination based on the observed covariates for each of eight situations, using the data of participants who answered either Yes or No. With the model fit, the predicted logit score of discrimination (PLSD) was obtained for participants who answered Not Applicable (NA), as well as for those who answered Yes or No. The mean PLSD of the NA group was compared with those of the Yes group and the No group after stratification by gender and education level using an ANOVA model.

RESULTS

On the questions of discrimination in getting hired and receiving income, the PLSD of the NA group was significantly higher than that of the No group and was not different from that of Yes group for female and junior high or less educated workers, suggesting that their NA responses were more likely to mean that they have experienced discrimination. For male and college or more educated workers, the NA group had a PLSD similar to that for the No group and had a significantly higher PLSD than the Yes group, implying that their NA responses would mean they that they have not experienced discrimination.

CONCLUSIONS

Our findings suggest that the responses of NA on the discrimination questionnaire may need different interpretation based on the respondents' gender and education level in South Korea.

Perceived discrimination and self-rated health in South Korea: a nationally representative survey

Background

There is mounting evidence that discriminatory experiences can harm health. However, previous research has mainly focused on the health effects of racial discrimination in U.S. or European countries although there is pervasive discrimination by gender, age, education and other factors in Asian countries.

Methods

We analyzed the data from the 7th wave of Korean Labor and Income Panel Study to investigate the association between perceived discriminatory experience and poor self-rated health in South Korea. Perceived discriminatory experiences were measured in eight situations through a modified Experience of Discrimination questionnaire. In each of eight situations, the lifetime prevalence of perceived discriminatory experience was compared between men and women and the main causes of those experiences were identified separately by gender. After adjusting for potential confounders, we examined the association between perceived discriminatory experience and poor self-rated health in each of eight social situations and also checked the association using the number of situations of perceived discriminatory experiences.

Results

For both men and women, education level and age were the main sources of work-related perceived discriminatory experiences. Gender was one of the main causes among women across eight situations and more than 90% of women reported their gender as a main cause of discriminatory experience in getting higher education and at home. Discriminatory experiences in four situations were positively associated with poor self-rated health. The odds ratio for poor self-rated health for those exposed to one, two, three or four or more social situations of perceived discrimination were respectively 1.06 (95% CI : 0.87–1.29), 1.15 (95% CI : 0.96–1.55), 1.59 (95% CI : 1.19–2.14), and 1.78 (95% CI :1.26–2.51).

Conclusion

There is consistent association between perceived discriminatory experience and poor self-rated health across eight social situations in South Korea.

Comparing Cognitive Interviewing and Psychometric Methods to Evaluate a Racial/Ethnic Discrimination Scale

Proponents of survey evaluation have long advocated the integration of qualitative and quantitative methodologies, but this recommendation has rarely been practiced. We used both methods to evaluate the "Everyday Discrimination" scale (EDS), which measures frequency of various types of discrimination, in a multi-ethnic population. Cognitive testing included 30 participants of various race/ethnic backgrounds and identified items which were redundant, unclear, or inconsistent (e.g., cognitive challenges in quantifying acts of discrimination). Psychometric analysis included secondary data from two national studies, including 570 Asian Americans, 366 Latinos, and 2,884 African Americans, and identified redundant items, as well as those exhibiting differential item functioning (DIF) by race/ethnicity. Overall, qualitative and quantitative techniques complemented one another, as cognitive interviewing findings provided context and explanation for quantitative results. Researchers should consider further how to integrate these methods into instrument pretesting as a way to minimize response bias for ethnic and racial respondents in population-based surveys.

Dimensions of perceived racism and self-reported health: examination of racial/ethnic differences and potential mediators

BACKGROUND

Many details of the negative relationship between perceived racial/ethnic discrimination and health are poorly understood.

PURPOSE

The purpose of this study was to examine racial/ethnic differences in the relationship between perceived discrimination and self-reported health, identify dimensions of discrimination that drive this relationship, and explore psychological mediators.

METHODS

Asian, Black, and Latino(a) adults (N=734) completed measures of perceived racial/ethnic discrimination, self-reported health, depression, anxiety, and cynical hostility.

RESULTS

The association between perceived discrimination and poor self-reported health was significant and did not differ across racial/ethnic subgroups. Race-related social exclusion and threat/harassment uniquely contributed to poor health for all groups. Depression, anxiety, and cynical hostility fully mediated the effect of social exclusion on health, but did not fully explain the effect of threat.

CONCLUSIONS

Our results suggest that noxious effects of race-related exclusion and threat transcend between-group differences in discriminatory experiences. The effects of race-related exclusion and threat on health, however, may operate through different mechanisms.

Workplace Discrimination and Depressive Symptoms: A Study of Multi-Ethnic Hospital Employees

Workplace discrimination reports have recently increased in the U.S. Few studies have examined racial/ethnic differences and the mental health consequences of this exposure. We examined the association between self-reported workplace discrimination and depressive symptoms among a multi-ethnic sample of hospital employees. Data came from the prospective case-control Gradients of Occupational Health in Hospital Workers (GROW) study (N = 664). We used the Center for Epidemiological Studies Depression Scale (CES-D) to assess depressive symptoms and measured the occurrence, types, and frequency of workplace discrimination. African Americans were more likely than other racial/ethnic employees to report frequent and multiple types of discrimination exposure. Multivariate relationships were examined while controlling for socio-demographic factors, job strain, and general social stressors. After adjustment, workplace discrimination occurrence and frequency were positively associated with depressive symptoms. The positive association between workplace discrimination and depressive symptoms was similar across racial and ethnic groups. Reducing workplace discrimination may improve psychosocial functioning among racial/ethnic minority hospital employees at greatest risk of exposure.

Racial discrimination and health among Asian Americans: evidence, assessment, and directions for future research

Research shows that racial discrimination is related to illness among diverse racial and ethnic populations. Studies of racial discrimination and health among Asian Americans, however, remain underdeveloped. In this paper, the authors review evidence on racial discrimination and health among Asian Americans, identify gaps in the literature, and provide suggestions for future research. They identified 62 empirical articles assessing the relation between discrimination and health among Asian Americans. The majority of articles focused on mental health problems, followed by physical and behavioral problems. Most studies find that discrimination was associated with poorer health, although the most consistent findings were for mental health problems. This review suggests that future studies should continue to investigate the following: 1) the measurement of discrimination among Asian Americans, whose experiences may be qualitatively different from those of other racial minority groups; 2) the heterogeneity among Asian Americans, including those factors that are particularly salient in this population, such as ethnic ancestry and immigration history; and 3) the health implications of discrimination at multiple ecologic levels, ranging from the individual level to the structural level.