Health Disparities
Loneliness, discrimination, mental health, and immigration status David Adzrago* David Adzrago Faustine Williams
Introduction: Loneliness and discrimination have increased risks for physical and mental health problems, reduced quality of life, and mortality. Vulnerable groups, including immigrants, those who experienced discrimination, and with mental health, are more burdened with loneliness. However, sparse literature examined the effects of discrimination on loneliness through mental health among immigrants, a population largely understudied. We examined the mediation effects of anxiety/depression on the relationship between discrimination and loneliness based on immigration status, adjusting for resilience and sociodemographics.
Methods: We used a 2021-2022 national cross-sectional survey data on adults aged > 18 years (N= 4,740). We conducted mediation analyses with multivariable linear regression and bootstrapping. We analyzed loneliness (Scores 3-9; >4 as higher loneliness) as the dependent variable; discrimination (Scores 0-20; >1 as higher discrimination) as the independent variable; and anxiety/depression (Scores 0-12; >1 as higher anxiety/depression) as the mediator.
Results: In the immigrant sample (n= 1,029), the total (not accounting for anxiety/depression) (β= 0.124, p< 0.001), direct (after accounting for anxiety/depression) (β= 0.055, p< 0.001), and indirect (discrimination’s effect explained by anxiety/depression) (β= 0.069, p< 0.001) effects of discrimination on loneliness were significantly positive. Anxiety/depression mediated 55.65% of the total effect of discrimination on loneliness.
In the U.S.-born (n= 3,711), the total (β= 0.161, p< 0.001), direct (β= 0.059, p< 0.001), and indirect (β= 0.102, p< 0.001) effects of discrimination on loneliness were positive. Anxiety/depression mediated 63.35% of the total effects.
Conclusions: Anxiety/depression mediates the effect of discrimination on loneliness, especially in the U.S.-born. Mental health and immigration status should be considered in efforts aimed at reducing discrimination and loneliness disparities.