Perceived Discrimination and Psychological Distress: A Survey of Filipinx Americans in Massachusetts during the COVID-19 Pandemic

The onset of the COVID-19 pandemic has led to an upsurge of discrimination against Asian American populations, and Filipinx Americans (FA) have reported high cases of perceived discrimination. Prior studies have shown a relationship between experiences of discrimination and poor mental health. The purpose of this study was to examine the association of perceived discrimination and psychological distress among FA living in Massachusetts from a survey collected during the COVID-19 pandemic (N = 133). Multiple regression analysis revealed that experiences of perceived discrimination were associated with psychological distress. Older participants were less likely to report psychological distress. Compared to men, womxn were more likely to report psychological distress. Our findings highlight the potential mental health consequences of perceived discrimination experienced by FA, which may have been exacerbated during the COVID-19 pandemic.


Introduction
Since the beginning of the COVID-19 pandemic, there has been a signi cant increase in anti-Asian discrimination in the United States (U.S.). From March 2020 to February 2021, Stop AAPI Hate amassed 3,795 self-reported hate crimes against Asian Americans [1]. Within Asian ethnic groups, Filipinx Americans (FA) were the fourth-leading Asian ethnic group that self-reported experiencing discrimination [1]. One of the horri c attacks on FA occurred in New York City this year -Noel Quintana was riding the subway and was slashed in the face with a box cutter, and received no aid from bystanders on the train [2].
Historically, FA have experienced numerous forms of race-targeted violence. In 1930 in Watsonville, California, a white mob attacked FA men for dancing with white women at a taxi dance hall, which led to the death of one FA [3]. In 1999, Joseph Ileto, a postal worker, was murdered by a white supremacist in Los Angeles, California [4]. These discriminatory experiences can have negative health effects.
Perceived discrimination has been associated with adverse health behaviors and outcomes [5]. This can include poor physical and mental health by increasing the risk for cardiovascular disease, substance use, and symptoms of depression, and psychological distress. Previous studies on FA showed similar associations of perceived discrimination, mental health problems, and substance abuse [6].
There has been limited research on the health outcomes of FA during the pandemic. One of the few studies published found that experiences of perceived discrimination were negatively associated with symptoms of depression and anxiety, though not statistically signi cant, among FA [7]. This study examined data that was collected during the COVID-19 pandemic, and explored the association of perceived discrimination and psychological distress among FA in Massachusetts.

Data Collection
The data analyzed was from the FA in Massachusetts Health Study. Participants were recruited online through organization listservs and social media platforms. Participants took the survey through Qualtrics and were asked questions about their demographic characteristics, health behaviors and outcomes, and cultural beliefs. Surveys were collected from June through August of 2020. Participants who completed the survey were entered into a ra e to win one of the 15 $15 gift cards. A total of 178 participants took

Perceived Discrimination
Participants responded to the Everyday Discrimination Scale (EDS), which measures day-to-day experiences of perceived discrimination in the previous 12 months [9]. The EDS consists of 5 items asking about experiences of perceived discrimination. Examples include "receiving poor service" and "treated with less courtesy." The items are measured on a six-point Likert scale of 1 (Almost everyday) to 6 (Never). The items are reverse coded and averaged with possible ranges of 1-6. The internal consistency for EDS is acceptable (Cronbach's α = .93).

Analysis
Univariate analysis described the frequency of the distribution of the variables. Following this, Pearson's correlation and t-tests were conducted to examine correlations and signi cant differences between the means of the predictors and psychological distress. We then conducted multiple regression to investigate the association of experiences of perceived discrimination and psychological distress controlling for the identi ed covariates. We checked for the multicollinearity of the model and the mean VIF is 1.18. We handled missing cases using listwise deletion. Data were analyzed using Stata 16 SE.

Discussion
Our study found that discrimination is associated with psychological distress among our sample even after controlling for confounders. This nding is generally consistent with prior studies that examined similar constructs among FA [6]. However, our results differ from Woo and Jun's ndings [7] that found a negative association of perceived discrimination and depressive symptoms among FA during the COVID-19 pandemic. This suggests that overall experiences of perceived discrimination may have been further compounded by the racialization of the COVID-19 virus, thereby contributing to poorer mental health among FA.
We also found that age is negatively associated with psychological distress. A potential explanation for this nding is that older participants may have support networks and coping strategies that buffer or alleviate experiences of psychological distress.
FA womxn are also more likely to report psychological distress compared to men. The fetishization of FA womxn to be subservient and docile through the traditional Maria Clara image [10] may contribute to experiences of psychological distress among womxn. Interestingly, FA men reported a slightly higher mean of perceived discrimination but FA womxn reported a higher mean of psychological distress. This may suggest that there are gendered differences in how FA womxn experience and internalize stress compared to FA men.

New Contributions to the Literature
To date, there is little to no data on the experiences of perceived discrimination and mental health among FA in Massachusetts. Furthermore, the time period in which the study was conducted may help provide insight on the mental health effects of perceived discrimination that occurred before and during the COVID-19 pandemic among FA. This can inform mental health providers, researchers, and politicians to implement interventions and policies that addresses discrimination experienced by racial and ethnic minorities in this geographic location and during a pandemic.
Limitations A limitation to this study is that the measure of perceived discrimination includes the last 12 months from which the participants took the survey, indicating that their experiences of perceived discrimination may have occurred before or during the COVID-19 pandemic. However, the K10 scale asked about experiences of psychological distress within the last 30 days from when the participants took the survey. Nevertheless, the continuing rise of anti-Asian discrimination highlights the importance of this research. Another limitation is that the participants were from Massachusetts, thus, generalizations cannot be made to all FA in the U.S.