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The COVID-19 Pandemic: A Double Threat to Chinese Americans’ Mental Health

Aoli Li1,#, Yan You1,2,#, Kunli Wu3, Huibin Shan4, Younglee Kim5, Qilian He1,*

1 School of Nursing, Dali University, Dali, 671000, China
2 Department of Nursing, Chuxiong Higher Institute of Medicine, Chuxiong, 675005, China
3 Department of Nursing, Kunming Third People’s Hospital, Kunming, 650041, China
4 Department of Quality Management, Dali People’s Hospital, Dali, 671000, China
5 Department of Nursing, College of Natural Science, California State University, San Bernardino, CA 92407, USA

* Corresponding Authors: Qilian He. Email: ;
# The first two authors (Aoli Li and Yan You) contributed equally to this paper and should be considered co-first authors

(This article belongs to this Special Issue: Impact and Expectations by COVID-19 Pandemic: Citizens and Firms Views)

International Journal of Mental Health Promotion 2023, 25(6), 783-797.


Objective: To explore the double psychosocial threats of the COVID-19 pandemic, targeted behavior toward Chinese Americans, and the correlates to their mental health. Methods: A quantitative, cross-sectional, and descriptive design was utilized by using a purposive convenience sample of 301 Chinese Americans over the age of 18 residing in the United States. Online data collection was conducted through the social media platform WeChat from April 8–21, 2021. Descriptive statistical analysis was used for the participants’ demographic characteristics, Multidimensional Scale of Perceived Social Support (MSPSS), Double Threat Situations, COVID-19 Racial Discrimination, and General Anxiety Disorder-7 (GAD-7). Stepwise logistic regression was conducted to verify predictors for anxiety levels by GAD-7. Results: In this sample (N = 301), 127 (42.19%) were male and 174 (57.81%) were female. The average age was 41.67 (SD = 5.89). Among MSPSS subscales, social support from family (MSPSS-Fam, 79.73%, n = 240) and social support from significant others (MSPSS-SO, 73.75%, n = 222) were high. 231 (76.74%) reported threats due to their Chinese ethnic background during the COVID-19 outbreak. Predictors for the high anxiety level by GAD-7 were COVID-19 racial discrimination from the local community (OR = 0.47, 95% CI = 0.39–0.71, p < 0.001), media/online (OR = 0.36, 95% CI = 0.26–0.53, p < 0.001), the perceived threat from the COVID-19 virus (OR = 0.33, 95% CI = 0.23–0.51, p < 0.001) and Perceived racism threat from Chinese background related to COVID-19 (OR = 0.31, 95% CI = 0.21–0.49, p < 0.001). Conclusions: COVID-19 double-threats (The virus and racial discrimination) situations are significantly related to the high level of anxiety among Chinese Americans. The sense of belonging and social perceptions of Chinese immigrants is closely related to public health problems in Western societies and needs to be addressed at all levels. Our findings call for the attention of healthcare workers to specific racism double-threatened situations and high mental health risks, as well as direct and indirect ethnic discrimination that Chinese Americans are experiencing during this pandemic, the long-term influences and effective coping ways related to this issue should be explored in further research.

Graphical Abstract

The COVID-19 Pandemic: A Double Threat to Chinese Americans’ Mental Health


Cite This Article

Li, A., You, Y., Wu, K., Shan, H., Kim, Y. et al. (2023). The COVID-19 Pandemic: A Double Threat to Chinese Americans’ Mental Health. International Journal of Mental Health Promotion, 25(6), 783–797.

This work is licensed under a Creative Commons Attribution 4.0 International License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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