COVID-19 related discrimination, social determinants of health, and mental health among Vietnamese living in the United States Restricted; Files Only

Nguyen, My (Spring 2022)

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Background: During the COVID-19 pandemic, anti-Asian xenophobia and violence have spiked with 10,905 discrimination-related acts reported as of December 2021. Racism likely negatively impacts mental well-being and poses barriers to obtaining food and transportation during a crisis. Existing studies focus mostly on aggregated Asians or Chinese populations, with little attention paid to other Asian subgroups. We examined experiences of COVID-19 related discrimination among U.S. Vietnamese, specifically through assessing 1) individual and neighborhood-level correlates of experiencing racism and 2) associations between experiencing racism and mental health, food insecurity, and transportation difficulties.

Methods: We analyzed data from a cross-sectional, nationwide survey with 393 U.S. Vietnamese. Questions inquired about experiencing six Asian-targeted discrimination-related events since COVID-19 began. Multivariable linear and logistic regression models were run to identify correlates of experiencing discrimination and the associations between experiencing discrimination and mental health, food insecurity, and transportation difficulties.

Results: In the sample, 72% experienced no discrimination-related event, 20% experienced 1-2 events, and 8% experienced 3 or more events. Experiencing any discrimination was correlated with lower education, higher English fluency, lower American acculturation, and lower neighborhood cohesion. Experiencing more discrimination-related events was associated with being male, lower education, lower Vietnamese fluency, higher English fluency, lower American acculturation, and lower neighborhood cohesion. Over a quarter of respondents experienced food insecurity, and 10.3% experienced transportation difficulties. When controlling for other sociodemographic and acculturation-related factors, experiencing any discrimination or more discrimination-related events was significantly associated with higher depressive symptoms and a higher likelihood of experiencing food insecurity and transportation difficulties.

Conclusions: More than a quarter of U.S. Vietnamese in this sample encountered COVID-19 discrimination. Experiencing discrimination was associated with worse mental health. Findings indicated an urgent need for actions to combat structural racism. This could include measures to prevent and report hate crimes, support for counseling services and trauma-focused interventions, increased access to food assistance programs, and monitoring of safety on public transportation. Asian subgroup experiences should be disaggregated and explored in future studies.

Keywords: COVID-19, discrimination, social determinants, mental health, Vietnamese

Funding Source: This work is supported by the American Psychological Foundation, the US National Cancer Institute (5F31CA243220-02), the PEO Scholar Award, and the Society of Public Health Education.

Table of Contents

Table of Contents

Chapter 1: Introduction. 1

Problem and Significance Statement 2

Purpose Statement and Research Questions. 3

Theoretical Framework. 3

Chapter 2: Literature Review.. 5

Increased Racial Targeting and Violence Against Asians and Asian Americans during COVID-19 Pandemic. 5

Background of Vietnamese living in the U.S. 6

Stop AAPI Hate Report 7

Discrimination and Mental Health. 7

Discrimination, Food Insecurity, and Transportation Difficulties. 8

Literature Gap and Study Purpose. 9

Chapter 3: Student Contribution and Methodology. 11

Student Contribution. 11

Recruitment and Data Collection. 11

Measurements. 12

Statistical Analysis. 13

Chapter 4: Manuscript 14







Chapter 5: Public Health Implications. 41

References. 43

Tables. 46

Table 1 - Individual-level characteristics, neighborhood-level characteristics, mental health, and health-related social needs of the sample. 46

Table 2a – Correlates of any experiences of discrimination. 48

Table 2b – Correlates of number of discrimination-related events. 49

Table 3 – Correlates of depressive symptoms. 50

Table 4 – Correlates of food insecurity. 52

Table 5 – Correlates of transportation difficulties. 54

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