English Proficiency and Gender-Ethnic Variation in Mental Health Among U.S. Asians

Despite much research documenting the health patterning of U.S. Asians compared to other ethnoracial groups, fewer studies have interrogated social factors contributing to heterogeneity in mental health among U.S. Asians. The present study draws insights from the fundamental cause perspective and intersectionality to examine, first, the association between English proficiency and mental health among U.S. Asian adults, and second, the degree to which gender and ethnicity factor into associations. This study uses nationally representative data from the National Latino and Asian American Study to regress three commonly used indicators of mental health—psychological distress, self-rated mental health, and 12-month anxiety disorder—on English proficiency for Chinese, Filipino, Vietnamese, and other Asian/Pacific Islander men and women (n = 2,065). Results identified English proficiency’s association with lower distress and better perceived health, and Chinese women generally experienced poorer mental health than other groups. Gender and ethnicity moderated relationships between language proficiency and mental health, such that English proficient Chinese men and women and Vietnamese men were more likely to perceive better mental health than their non-proficient counterparts. English proficiency particularly benefited Filipino and other Asian/Pacific Islander men such that each experienced lower psychological distress and odds of anxiety disorder, respectively. This study affirms the importance of examining within-group heterogeneity and investigating social determinants of health, including language proficiency, that are fundamental to the health status of ethnoracially marginalized groups.