Skip to main content

Main menu

  • Home
  • Content
    • Current issue
    • Past issues
    • Collections
  • Authors & Reviewers
    • Overview for Authors
    • Preparing manuscripts
    • Submission Checklist
    • Publication Fees
    • Forms
    • Editorial Policies
    • Editorial Process
    • Patient-Oriented Research
    • Manuscript Progress
    • Submitting a letter
    • Information for Reviewers
    • Open access
  • Alerts
    • Email alerts
    • RSS
  • About
    • General information
    • Staff
    • Editorial board
    • Contact
  • CMAJ JOURNALS
    • CMAJ
    • CJS
    • JAMC
    • JPN

User menu

Search

  • Advanced search
CMAJ Open
  • CMAJ JOURNALS
    • CMAJ
    • CJS
    • JAMC
    • JPN
CMAJ Open

Advanced Search

  • Home
  • Content
    • Current issue
    • Past issues
    • Collections
  • Authors & Reviewers
    • Overview for Authors
    • Preparing manuscripts
    • Submission Checklist
    • Publication Fees
    • Forms
    • Editorial Policies
    • Editorial Process
    • Patient-Oriented Research
    • Manuscript Progress
    • Submitting a letter
    • Information for Reviewers
    • Open access
  • Alerts
    • Email alerts
    • RSS
  • About
    • General information
    • Staff
    • Editorial board
    • Contact
  • Subscribe to our alerts
  • RSS feeds
  • Follow CMAJ Open on Twitter
Research
Open Access

Lived experiences of Asian Canadians encountering discrimination during the COVID-19 pandemic: a qualitative interview study

Jeanna Parsons Leigh, Stephana Julia Moss, Faizah Tiifu, Emily FitzGerald, Rebecca Brundin-Mathers, Alexandra Dodds, Amanpreet Brar, Chloe Moira de Grood, Henry T. Stelfox, Kirsten M. Fiest and Josh Ng-Kamstra
June 14, 2022 10 (2) E539-E545; DOI: https://doi.org/10.9778/cmajo.20220019
Jeanna Parsons Leigh
School of Health Administration (Parsons Leigh, Moss, Tiifu, FitzGerald, Brundin-Mathers, De Grood), Faculty of Health, Dalhousie University, Halifax, NS; Department of Critical Care Medicine (Dodds, Stelfox, Fiest, Ng-Kamstra), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Surgery (Brar), University of Toronto, Toronto, Ont.; O’Brien Institute for Public Health (Stelfox), Cumming School of Medicine, University of Calgary, Calgary, Alta.; The Queen’s Medical Center (Ng-Kamstra), Honolulu, HI; Department of Surgery (Ng-Kamstra), University of Hawaii at Manoa, John A. Burns School of Medicine, Honolulu, HI
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Stephana Julia Moss
School of Health Administration (Parsons Leigh, Moss, Tiifu, FitzGerald, Brundin-Mathers, De Grood), Faculty of Health, Dalhousie University, Halifax, NS; Department of Critical Care Medicine (Dodds, Stelfox, Fiest, Ng-Kamstra), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Surgery (Brar), University of Toronto, Toronto, Ont.; O’Brien Institute for Public Health (Stelfox), Cumming School of Medicine, University of Calgary, Calgary, Alta.; The Queen’s Medical Center (Ng-Kamstra), Honolulu, HI; Department of Surgery (Ng-Kamstra), University of Hawaii at Manoa, John A. Burns School of Medicine, Honolulu, HI
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Faizah Tiifu
School of Health Administration (Parsons Leigh, Moss, Tiifu, FitzGerald, Brundin-Mathers, De Grood), Faculty of Health, Dalhousie University, Halifax, NS; Department of Critical Care Medicine (Dodds, Stelfox, Fiest, Ng-Kamstra), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Surgery (Brar), University of Toronto, Toronto, Ont.; O’Brien Institute for Public Health (Stelfox), Cumming School of Medicine, University of Calgary, Calgary, Alta.; The Queen’s Medical Center (Ng-Kamstra), Honolulu, HI; Department of Surgery (Ng-Kamstra), University of Hawaii at Manoa, John A. Burns School of Medicine, Honolulu, HI
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Emily FitzGerald
School of Health Administration (Parsons Leigh, Moss, Tiifu, FitzGerald, Brundin-Mathers, De Grood), Faculty of Health, Dalhousie University, Halifax, NS; Department of Critical Care Medicine (Dodds, Stelfox, Fiest, Ng-Kamstra), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Surgery (Brar), University of Toronto, Toronto, Ont.; O’Brien Institute for Public Health (Stelfox), Cumming School of Medicine, University of Calgary, Calgary, Alta.; The Queen’s Medical Center (Ng-Kamstra), Honolulu, HI; Department of Surgery (Ng-Kamstra), University of Hawaii at Manoa, John A. Burns School of Medicine, Honolulu, HI
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Rebecca Brundin-Mathers
School of Health Administration (Parsons Leigh, Moss, Tiifu, FitzGerald, Brundin-Mathers, De Grood), Faculty of Health, Dalhousie University, Halifax, NS; Department of Critical Care Medicine (Dodds, Stelfox, Fiest, Ng-Kamstra), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Surgery (Brar), University of Toronto, Toronto, Ont.; O’Brien Institute for Public Health (Stelfox), Cumming School of Medicine, University of Calgary, Calgary, Alta.; The Queen’s Medical Center (Ng-Kamstra), Honolulu, HI; Department of Surgery (Ng-Kamstra), University of Hawaii at Manoa, John A. Burns School of Medicine, Honolulu, HI
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Alexandra Dodds
School of Health Administration (Parsons Leigh, Moss, Tiifu, FitzGerald, Brundin-Mathers, De Grood), Faculty of Health, Dalhousie University, Halifax, NS; Department of Critical Care Medicine (Dodds, Stelfox, Fiest, Ng-Kamstra), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Surgery (Brar), University of Toronto, Toronto, Ont.; O’Brien Institute for Public Health (Stelfox), Cumming School of Medicine, University of Calgary, Calgary, Alta.; The Queen’s Medical Center (Ng-Kamstra), Honolulu, HI; Department of Surgery (Ng-Kamstra), University of Hawaii at Manoa, John A. Burns School of Medicine, Honolulu, HI
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Amanpreet Brar
School of Health Administration (Parsons Leigh, Moss, Tiifu, FitzGerald, Brundin-Mathers, De Grood), Faculty of Health, Dalhousie University, Halifax, NS; Department of Critical Care Medicine (Dodds, Stelfox, Fiest, Ng-Kamstra), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Surgery (Brar), University of Toronto, Toronto, Ont.; O’Brien Institute for Public Health (Stelfox), Cumming School of Medicine, University of Calgary, Calgary, Alta.; The Queen’s Medical Center (Ng-Kamstra), Honolulu, HI; Department of Surgery (Ng-Kamstra), University of Hawaii at Manoa, John A. Burns School of Medicine, Honolulu, HI
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Chloe Moira de Grood
School of Health Administration (Parsons Leigh, Moss, Tiifu, FitzGerald, Brundin-Mathers, De Grood), Faculty of Health, Dalhousie University, Halifax, NS; Department of Critical Care Medicine (Dodds, Stelfox, Fiest, Ng-Kamstra), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Surgery (Brar), University of Toronto, Toronto, Ont.; O’Brien Institute for Public Health (Stelfox), Cumming School of Medicine, University of Calgary, Calgary, Alta.; The Queen’s Medical Center (Ng-Kamstra), Honolulu, HI; Department of Surgery (Ng-Kamstra), University of Hawaii at Manoa, John A. Burns School of Medicine, Honolulu, HI
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Henry T. Stelfox
School of Health Administration (Parsons Leigh, Moss, Tiifu, FitzGerald, Brundin-Mathers, De Grood), Faculty of Health, Dalhousie University, Halifax, NS; Department of Critical Care Medicine (Dodds, Stelfox, Fiest, Ng-Kamstra), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Surgery (Brar), University of Toronto, Toronto, Ont.; O’Brien Institute for Public Health (Stelfox), Cumming School of Medicine, University of Calgary, Calgary, Alta.; The Queen’s Medical Center (Ng-Kamstra), Honolulu, HI; Department of Surgery (Ng-Kamstra), University of Hawaii at Manoa, John A. Burns School of Medicine, Honolulu, HI
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Kirsten M. Fiest
School of Health Administration (Parsons Leigh, Moss, Tiifu, FitzGerald, Brundin-Mathers, De Grood), Faculty of Health, Dalhousie University, Halifax, NS; Department of Critical Care Medicine (Dodds, Stelfox, Fiest, Ng-Kamstra), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Surgery (Brar), University of Toronto, Toronto, Ont.; O’Brien Institute for Public Health (Stelfox), Cumming School of Medicine, University of Calgary, Calgary, Alta.; The Queen’s Medical Center (Ng-Kamstra), Honolulu, HI; Department of Surgery (Ng-Kamstra), University of Hawaii at Manoa, John A. Burns School of Medicine, Honolulu, HI
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Josh Ng-Kamstra
School of Health Administration (Parsons Leigh, Moss, Tiifu, FitzGerald, Brundin-Mathers, De Grood), Faculty of Health, Dalhousie University, Halifax, NS; Department of Critical Care Medicine (Dodds, Stelfox, Fiest, Ng-Kamstra), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Surgery (Brar), University of Toronto, Toronto, Ont.; O’Brien Institute for Public Health (Stelfox), Cumming School of Medicine, University of Calgary, Calgary, Alta.; The Queen’s Medical Center (Ng-Kamstra), Honolulu, HI; Department of Surgery (Ng-Kamstra), University of Hawaii at Manoa, John A. Burns School of Medicine, Honolulu, HI
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Tables
  • Related Content
  • Responses
  • Metrics
  • PDF
Loading

Abstract

Background: Asian Canadians have experienced increased cases of racialized discrimination after the first emergence of SARS-CoV-2 in China. This study examined how the COVID-19 pandemic has affected Asian Canadians’ sense of safety and belonging in their Canadian (i.e., geographical) communities.

Methods: We applied a qualitative description study design in which semistructured interviews were conducted from Mar. 23 to May 27, 2021. Purposive and snowball sampling methods were used to recruit Asian Canadians diverse in region, gender and age. Interviews were conducted through Zoom videoconference or telephone, and independent qualitative thematic analysis in duplicate was used to derive primary themes and subthemes.

Results: Thirty-two Asian Canadians (median age 35 [interquartile range 24–46] yr, 56% female, 44% East Asian) participated in the study. We identified 5 predominant themes associated with how the COVID-19 pandemic affected the participants’ sense of security and belonging to their communities: relation between socioeconomic status (SES) and exposure to discrimination (i.e., how SES insulates or exposes individuals to increased discrimination); politics, media and the COVID-19 pandemic (i.e., the key role that politicians and media played in enabling spread of discrimination against and fear of Asian people); effect of discrimination on mental and social health (i.e., people’s ability to interact and form meaningful relationships with others); coping with the impact of discrimination (i.e., the way people appraise and move forward in identity-threatening situations); and implications for sense of safety and sense of belonging (i.e., people feeling unable to safely use public spaces in person, including the need to remain alert in anticipation of harm, leading to distress and exhaustion).

Interpretation: During the COVID-19 pandemic, Asian Canadians in our study felt unsafe owing to the uncertain, unexpected and unpredictable nature of discrimination, but also felt a strong sense of belonging to Canadian society and felt well connected to their Asian Canadian communities. Future work should seek to explore the influence of social media on treatment of and attitudes toward Asian Canadians.

SARS-CoV-2, beginning in Wuhan, China, spread rapidly across countries, resulting in a global pandemic. 1 Although many impacts of the COVID-19 pandemic worldwide are clear,2 including loss of life, decreased financial stability, and worsened physical and mental well-being,3–5 the full extent of the damage is unknown.3,6 The narrative that “others” from far-flung places are to blame for epidemics and pandemics is an example of a long-standing tradition of stigma.7 Globally, in the COVID-19 pandemic, there has been an increase in negative attitudes, prejudice and racism toward people of Asian descent, reinforcing long-standing systemic discrimination and negative stereotypes.6,8,9

Racial discrimination is defined as unequal treatment of individuals or groups on the basis of their race or ethnicity. 3 Racial discrimination is not the result only of private prejudices held by individuals.10 It is also produced and reproduced by rules, laws and practices, sanctioned and often implemented by various levels of governments — embedded in cultural and societal norms as well as the economic system.11 Confronting and combatting racial discrimination in Canada requires changing individual attitudes as well as dismantling the institutions and policies that underpin the Canadian racial hierarchy.12

During the COVID-19 pandemic, anti-Asian discrimination and Asian-focused hate crimes have occurred, and Asian people have been subjected to verbal harassment, including racial slurs, and physical attacks.4,6 Reported incidents have led to a heightened awareness of the broad marginalization of Asian populations, globally.13,14 The experience of discrimination and its long-term consequences varies in context, such as where the harassment occurs (e.g., health care system, community), the actors involved (e.g., employers, neighbours15,16) and the people it targets.

A sense of belonging is associated with improved psychological and social functioning during health crises,17 as people’s sense of self can be profoundly shaken when they are separated from groups to which they belong.18 A feeling of belonging can provide protection in the presence of depression and suicidal thoughts19,20 during social isolation from lockdown policies,21 which have been prominent during the COVID-19 pandemic. The objective of this study was to examine how the COVID-19 pandemic has affected Asian Canadians’ sense of safety and belonging in their Canadian (i.e., geographical) communities.

Methods

We applied a qualitative description study design22 using semistructured interviews that were conducted from Mar. 23 to May 27, 2021. Intersectionality is the assertion that aspects of social identity (e.g., gender, race, class, sexuality) are interconnected and operate simultaneously to produce experiences of both privilege and marginalization.23 For the current study we used intersectionality theory24 as the underpinning framework to examine how the COVID-19 pandemic has affected Asian Canadians’ sense of safety and belonging in their communities. The data were analyzed and interpreted using inductive thematic analysis25 to closely examine the data and identify, analyze and interpret repeating patterns of meanings.26 We followed the Consolidated Criteria for Reporting Qualitative Research in reporting this work.27

Setting

This was a qualitative follow-up study to an online national cross-sectional survey of 2000 Canadian adults.28 The survey explored self-reported public perceptions related to the COVID-19 pandemic, including beliefs (e.g., severity, concerns, health), knowledge (e.g., transmission, information sources) and behaviours (e.g., physical distancing), to understand perspectives in Canada and to inform future public health initiatives.28 In addition to other demographic information that was collected, respondents were screened by age, sex at birth and provincially defined regions to ensure population representation based on 2016 Census data (https://www12.statcan.gc.ca/census-recensement/2016/dp-pd/index-eng.cfm). Respondents to the primary study consented to be contacted for future research related to the COVID-19 pandemic.

Participants

We approached eligible participants by email and then conducted snowball sampling from those who consented to participate. Participants were eligible if they were English- or French-speaking adults (≥ 18 yr) residing in Canada and self-identified their ethnic origins as East or South Asian on the primary study for this work,28 were able to provide informed consent, and provided an email address (on the primary survey) to be contacted for research related to the COVID-19 pandemic. Participants were not aware of the researchers for this work.

We purposively sampled for diversity across participants based on age (18–34, 35–55, > 55 yr), sex at birth (female, male) and provincially defined regions (British Columbia, Alberta, Saskatchewan or Manitoba, Ontario, Quebec and Atlantic provinces). We conducted snowball sampling from the participants from the original study who agreed to participate in the current study. All individuals who agreed to participate were interviewed and were compensated with a $50 gift card for their time.

Data collection

A semistructured interview guide was developed iteratively by our ethnically diverse research team, which included 3 Asian, 1 Black and 5 white researchers. The development of the guide was informed by existing literature on the topic of racial discrimination against Asian people during the COVID-19 pandemic13,29,30 and grounded in intersectionality theory.24 It was pilot tested with 4 Asian Canadian participants (connected via but external to the research team) to ensure clarity of interview questions and relevance to our study objective (Appendix 1, available at www.cmajopen.ca/content/10/2/E539/suppl/DC1). Participants who pilot tested the interview guide received a $50 gift card for their time. Minor refinement after pilot testing was to improve language and conversational flow.

Discussion topics in the interview guide included community and personal identity; the racism participants or those in their community had experienced since the onset of the COVID-19 pandemic, as well as the impacts of that racism; and how participants dealt with weathering racism. Participants’ demographic information was collected by self-report at the end of each interview according to predefined categories in the United Nations Demographic Yearbook.31

Two female researchers (C.M.D.G.: white, nonimmigrant; and F.T.: BIPOC [Black, Indigenous and people of colour], immigrant to Canada with English as a second language) trained in qualitative methods conducted interviews via Zoom (without video) or telephone, based on participant preference. The 2 researchers introduced themselves as research assistants affiliated with a university; both researchers took field notes through the conduction of all interviews. Preliminary analysis showed that data saturation was achieved before analysis of the full data set; saturation was determined at the point when no new themes were identified.32

Digitally recorded audio files were sent to a transcription company (www.rev.com) to produce verbatim transcripts. The textual data were reviewed, cleaned and deidentified by C.M.D.G. and F.T. before analysis. Participants were offered the opportunity to review their transcripts as a form of member checking; 3 participants accepted, of whom none identified inconsistencies in information.

Data analysis

Textual data were managed and analyzed by inductive thematic analysis25 using NVIVO 12 (QSR International). Two researchers (C.M.D.G. and F.T.) independently reviewed and coded a small sample of transcripts (n = 3), then in duplicate using open coding. Initial codes were compared and discussed with a senior qualitative researcher (J.P.L.) to create a draft of the codebook. Two researchers (F.T. and A.D.) analyzed an additional 3 transcripts using both open and axial coding,33 iteratively refining the codebook until all relevant ideas were included. Meetings were held (among C.M.D.G., F.T., A.D. and J.P.L.) after coding of every 3 transcripts for the duration of analysis to address new codes, consolidate ideas and rectify disagreements by consensus, thereby drawing on the combined insights of those “handling” the data closely (F.T. and A.D.) and members of the team (C.M.D.G. and J.P.L.) with a wider perspective of methodological and racial discrimination issues.

The complete data set was then coded in duplicate (F.T. and A.D.) with the finalized codebook. The careful use of memos (by C.M.D.G., F.T. and A.D.) during initial stages of analysis provided a visible “audit trail” as the analysis moved from “raw” data, through interpretation, to the production of findings. Although we had reached data saturation before completion of the analysis, we analyzed the transcripts of all participants to increase the diversity of our data set. The data from the pilot interviews were included in the final data set for analysis.

Ethics approval

The University of Calgary Conjoint Health Research Ethics Board (ID: REB20–0358) and Dalhousie University Health Science Research Ethics Board (ID: REB2020–5120) approved this study and permitted participants to provide oral consent in lieu of written consent.

Results

Of 63 eligible participants from the original study, 2 (3%) individuals were not interested in being interviewed on the topic, and 42 (67%) individuals did not respond to 2 contact attempts. A total of 19 (30%) individuals consented to participate. After snowball sampling, an additional 11 potentially eligible individuals reached out to participate. Of these, we interviewed 9; the remaining 2 did not respond to 2 contact attempts.

Thirty-two interviews (including 4 pilot interviews) were conducted, lasting a median of 21 (interquartile range [IQR] 7.75) minutes. Participants had a median age of 35 (IQR 24–46) years, most (56%) were female and 44% self-reported their ethnic identity as East Asian (followed by 31% South Asian, 16% Southeast Asian and 9% West Asian) (Table 1).

View this table:
  • View inline
  • View popup
Table 1:

Demographic characteristics of participants

All participants in our study commented that they had experienced, indirectly through witnessing (n = 14, 44%) or directly through verbal or physical harassment (n = 18, 56%), discrimination during the COVID-19 pandemic in Canada.

Thematic data analysis resulted in development of 5 themes: relation between socioeconomic status (SES) and exposure to discrimination (i.e., how SES insulates or exposes individuals to increased discrimination); politics, media and the COVID-19 pandemic (i.e., the key role that politicians and media played in enabling spread of discrimination against and fear of Asian people); effect of discrimination on mental and social health (i.e., our ability to interact and form meaningful relationships with others); coping with the impact of discrimination (i.e., the way people appraise and move forward in identity-threatening situations); and implications for sense of safety and sense of belonging (i.e., feeling unable to safely use public spaces in person, including the need to remain alert in anticipation of harm, leading to distress and exhaustion).

Relation between SES and exposure to discrimination

The nature and extent of discrimination experienced by Asian Canadians was expressed by participants in relation to SES. (Although questions about SES were not explicitly included in the interview guide, most participants stated their self-determined SES voluntarily during the interviews.) Most participants noted that the discrimination experienced by Asian people of higher SES was more likely to be indirect. One participant commented on their relative immunity to discrimination against Asian Canadians based on their high-SES housing situation (Table 2, Q1). In contrast, some participants suggested that Asian Canadians of lower SES were perhaps more likely to experience direct discrimination (e.g., verbal or physical attacks, or harassment), possibly related to their need to maintain interactions in the community during the pandemic (e.g., through work in public-facing occupations). One participant of self-determined lower SES commented on their direct experiences with discrimination (Table 2, Q2).

View this table:
  • View inline
  • View popup
Table 2:

Exemplar quotations by theme

Politics, media and the COVID-19 pandemic

All participants commented on the key role that politicians and media played in enabling spread of discrimination against and fear of Asian individuals. They described influential and prominent leaders choosing to spread misinformation and disinformation deliberately by blaming and inciting hatred toward Asian people. Participants described upsetting rhetoric such as “China virus” and “Kung flu” used by politicians and their supporters alike. With this rhetoric amplified by the media, some participants perceived that inflamed hate was weaponized to hurt people of Asian descent. Participants commented that politicians, especially in the United States, deliberately misled, triggered and emboldened their supporters to attack or harass Asian people (Table 2, Q3). All participants commented on mainstream media being a platform to spread blame or responsibility for the virus. Some participants experienced cyberbullying, which they found was based mostly on physical appearance or accent. One participant reflected on the effects of the rapid dissemination of misinformation across media platforms (Table 2, Q4).

Effects of discrimination on mental and social health

Most participants described the effects of racism as immeasurable and the impact on their mental and social health (a person’s ability to interact and form meaningful relationships with others) as devastating. The participants illustrated common perspectives while describing variability in their experiences, perceptions and evaluations of discrimination. One participant described their efforts to cope with the psychological impact of discrimination through resiliency, conveying the need for their community to stand against and resist systemic and structural racism collectively (Table 2, Q5).

The lived experiences and psychological and emotional impacts of discrimination among participants during the COVID-19 pandemic included depression, anxiety and persistent stress (Table 2, Q6). Participants discussed their worry about not knowing where a discriminatory attack may occur, or who might attack them and why. The burden of worry led to an additional layer of trauma and exhaustion from precautions for personal safety. One participant described feelings of disconcerted discomfort (Table 2, Q7).

Coping with the impacts of discrimination

Participants dealt with discrimination in different ways. Some coping mechanisms included relying on friends and family for support, ignoring social media and doing activities in groups. One participant’s explanation of how they coped with the stress is shown in Table 2 (Q8). All participants highlighted the countless contextual factors (related to one’s personal life) that are associated with personal experiences of discrimination against Asian Canadians and their ability to draw on resilience, before and within the COVID-19 pandemic. One participant reflected on their inability to cope, describing feelings of hopelessness (Table 2, Q9).

Implications for sense of safety and belonging

Some participants’ sense of physical and psychological safety was greatly affected (i.e., diminished sense of safety). All participants expressed feeling a multitude of emotions simultaneously (e.g., anxious, scared, depressed, angry, outraged) that sometimes were in conflict in dealing with the trauma associated with discrimination during the pandemic. Consequently, participants felt unable to safely use public spaces in person for fear of discrimination. Most participants commented on the uncertainty (e.g., inability to predict who the perpetrator might be), unexpectedness (e.g., sudden attack, harassment or assault) and unpredictability (e.g., random behaviours of others or element of surprise) of discrimination that made it difficult to feel and keep safe. All participants described the need to remain alert in anticipation of harm, leading to distress and exhaustion (Table 2, Q10).

In contrast, some participants noted acts of discrimination as having a limited impact on their sense of belonging. These participants felt connected to and strongly identified with their Canadian and Asian cultures and communities. For example, in addition to their Asian heritage, participants noted that being Canadian was an integral part of their identity. Some participants believed that the discrimination had not affected how they were perceived by the broader Canadian society. Strictly adhering to public prevention practices and guidelines, as part of the greater good, made participants feel they were a part of, and belonged to, the community (Table 2, Q11).

Interpretation

We conducted a qualitative descriptive study to examine discrimination against Asian Canadians during the COVID-19 pandemic, and the impact this had on individual and community sense of safety and belonging. Findings from our study suggest that Asian Canadians felt unsafe owing to the uncertain, unexpected and unpredictable nature of rising discrimination. The overwhelming feeling of unsafety among Asian Canadians was associated with self-reported anxiety, depression, stress, fear and panic. Our findings also suggest that, despite feeling scared during the pandemic, Asian Canadians felt a strong sense of belonging to Canadian society and felt well connected to their Asian Canadian communities. Research is needed to uncover whether Asian Canadians’ sense of belonging, despite experiencing discrimination, is related to the model minority myth that has long dominated the racial framing and perceptions of Asian Canadians.34

Our study suggests that during the COVID-19 pandemic, Asian Canadians experienced psychological distress in response to discrimination. These experiences reflect established vulnerabilities encountered by racialized minorities before the pandemic.8 In line with earlier research, we found that, although Canada prides itself on being a multicultural country, discrimination against Asian Canadians has been common during the pandemic, and Sinophobia during this time may not be simply because of the racialization of the virus (e.g., Chinese virus) but also a result of historical anti-Asian racism.35

Previous research has found that racially stigmatized people experience a high rate of physical, psychological and social illnesses and impairments.36 We found that the threat of discrimination contributed to participants’ mental exhaustion and feelings of unsafety. These findings are mirrored in similar research in which participants described an intense fear for their lives and their loved ones during the pandemic in reaction to discrimination.8

Racism focuses on attacking an entire community37 based on the biased belief that all members of a racial group share an important essence that makes them the same.38 This may explain why participants in our study who did not directly experience discrimination felt affected by discrimination toward other Asian Canadians. In another study, Asian health care workers described contending with COVID-19-related racial microaggressions, and verbal and physical violence, feeling that their experiences had been mostly ignored, and struggling with challenging the harassment that they and their colleagues were facing while maintaining their dedication to patient care.39 Further research should disentangle the differential impact of indirect discrimination from direct discrimination; normalizing the reporting of racial harassment, while making reporting more accessible through a unified database that gathers details of anti-Asian attacks across Canada, is an important next step.

Understanding the socioeconomic spectrum and the relation between race and SES is important for addressing disparities among racial groups during periods of health crises.40 Socioeconomic status is an important determinant of health outcomes.36 Asian Canadians of lower SES encounter higher levels of physical attacks and harassment because they work in and engage in activities that require the use of public spaces, which makes it easier for others to target, identify, access and attack them.41,42 It is possible that Asian individuals with high and low SES might differ in their media consumption (social media compared with conventional media), which could explain the differential experiences with indirect discrimination. 43 Exposure to and consumption of media that portray socially stigmatized groups as a threat to society has increased racial prejudice and negatively influenced public attitudes.44,45 Information disseminated by politicians and mainstream media also has been found to influence public behaviours.43 Croucher and colleagues found that social media users who perceived information on social media to be accurate and fair were more likely to believe that Chinese Americans could pose realistic threats (e.g., threats to physical and material well-being) and symbolic threats (e.g., threats to morals, values and beliefs).6 Additionally, He and colleagues showed that the presence of anti-Asian hate speech on Twitter was more prevalent than counter-hate messages during the COVID-19 pandemic.46 The information dissemination process affects emotions and behaviours that directly affect how public opinions are formed.47 Future work should seek to explore the influence of social media on treatment of and attitudes toward Asian Canadians.48

Limitations

This study needs to be considered in context of limitations. The transferability of lived experiences of Asian Canadians was potentially limited, as our sample comprised primarily highly educated, single Asian Canadians. These demographic characteristics suggest that our sample included mainly people with high SES. However, many participants compared and contrasted their experiences to the experiences of those in their communities or networks with lower SES (whether these experiences were witnessed or communicated), providing meaningful insight into diverse experiences of anti-Asian discrimination in Canada. As well, perspectives from children and youth were missed.

The participants for this work were recruited from an earlier, preliminary study;28 considering our limited sample for ethnic groups of Asian Canadians, we were not able to meaningfully assess commonalities or differences that may exist among Asian Canadians of different ethnicities. Also, despite our best attempts to recruit participants from the Atlantic region of Canada, none of the eligible individuals from Atlantic Canada were interested in participating in an interview, and as such their perspectives were missed.

Although seeking certainty was not the objective of our approach, our study was unable to uncover the extent and directional impact of social media on Asian Canadians fully, for example, whether the positive impact outweighed the negative impact, or vice versa, particularly with participants’ sense of belonging. Future work should seek to conduct a nuanced analysis of data from a diverse sample of Asian Canadians.

We conducted interviews in English and French only, and perspectives from non-English- and non-French-speaking Asian Canadians were missed, which likely excludes experiences of new immigrants.

The 2 researchers who conducted the interviews noted their affiliation with a university as researchers, which may have imposed a status of privilege on the participants, as such careers often require graduate degrees. Relatedly, the lived experiences of researchers who analyzed the transcripts may have affected their interpretation of the data.

Conclusion

During the COVID-19 pandemic, Asian Canadian participants in our study felt unsafe owing to the uncertain, unexpected and unpredictable nature of discrimination. Participants in our study who did not directly experience discrimination felt affected by discrimination toward other Asian Canadians. Participants felt a strong sense of belonging to Canadian society and well connected to their Asian Canadian communities. Future work should seek to explore the influence of social media on treatment of and attitudes toward Asian Canadians, as the information dissemination process can affect emotions and behaviours that directly affect how public opinions are formed.

Footnotes

  • Competing interests: None declared.

  • This article has been peer reviewed.

  • Contributors: All of the authors contributed substantially to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; drafted the work or revised it critically for important intellectual content; gave final approval of the version to be published; and agreed to be accountable for all aspects of the work. Jeanna Parsons Leigh and Stephana Julia Moss are co–first authors; Kirsten Fiest and Josh Ng-Kamstra are co–senior authors.

  • Funding: Jeanna Parsons Leigh has received a grant from the Canadian Institutes of Health Research (no. 440241) to fund this study.

  • Data sharing: The data sets generated and analyzed during the current study are not publicly available owing to the small number of participants, as raw interview transcripts when considered as a whole may potentially be identifying. The data set is available from the corresponding author on reasonable request.

  • Supplemental information: For reviewer comments and the original submission of this manuscript, please see www.cmajopen.ca/content/10/2/E539/suppl/DC1.

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY-NC-ND 4.0) licence, which permits use, distribution and reproduction in any medium, provided that the original publication is properly cited, the use is noncommercial (i.e., research or educational use), and no modifications or adaptations are made. See: https://creativecommons.org/licenses/by-nc-nd/4.0/

References

  1. ↵
    1. Rzymski P,
    2. Nowicki M
    (2020) COVID-19-related prejudice toward Asian medical students: a consequence of SARS-CoV-2 fears in Poland. J Infect Public Health 13:873–6.
    OpenUrl
  2. ↵
    1. Dhanani LY,
    2. Franz B
    (2020) Unexpected public health consequences of the COVID-19 pandemic: a national survey examining anti-Asian attitudes in the USA. Int J Public Health 65:747–54.
    OpenUrl
  3. ↵
    1. Choi S,
    2. Hong JY,
    3. Kim YJ,
    4. et al.
    (2020) Predicting psychological distress amid the COVID-19 pandemic by machine learning: discrimination and coping mechanisms of Korean immigrants in the U.S. Int J Environ Res Public Health 17:6057.
    OpenUrl
  4. ↵
    1. Gover AR,
    2. Harper SB,
    3. Langton L
    (2020) Anti-Asian hate crime during the COVID-19 pandemic: exploring the reproduction of inequality. Am J Crim Justice 45:647–67.
    OpenUrlPubMed
  5. ↵
    1. Liu Y,
    2. Finch BK,
    3. Brenneke SG,
    4. et al.
    (2020) Perceived discrimination and mental distress amid the COVID-19 pandemic: evidence from the Understanding America Study. Am J Prev Med 59:481–92.
    OpenUrl
  6. ↵
    1. Croucher SM,
    2. Nguyen T,
    3. Rahmani D
    (2020) Prejudice toward Asian Americans in the Covid-19 pandemic: the effects of social media use in the United States. Front Commun 5:39, doi:10.3389/fcomm.2020.00039.
    OpenUrlCrossRef
  7. ↵
    1. Vance MA
    (2019) Conflicting views in narratives on HIV transmission via medical care. [JIAPAC]. J Int Assoc Provid AIDS Care 18:2325958218821961, doi:10.1177/2325958218821961.
    OpenUrlCrossRef
  8. ↵
    1. Hahm HC,
    2. Xavier Hall CD,
    3. Garcia KT,
    4. et al.
    (2021) Experiences of COVID-19-related anti-Asian discrimination and affective reactions in a multiple race sample of U.S. young adults. BMC Public Health 21:1563.
    OpenUrl
  9. ↵
    1. Lee S,
    2. Waters SF
    (2021) Asians and Asian Americans’ experiences of racial discrimination during the COVID-19 pandemic: impacts on health outcomes and the buffering role of social support. Stigma Health 6:70–8.
    OpenUrl
  10. ↵
    1. Bailey ZD,
    2. Krieger N,
    3. Agénor M,
    4. et al.
    (2017) Structural racism and health inequities in the USA: evidence and interventions. Lancet 389:1453–63.
    OpenUrlCrossRefPubMed
  11. ↵
    1. Gee GC,
    2. Ford CL
    (2011) Structural racism and health inequities: old issues, new directions. Du Bois Rev 8:115–32.
    OpenUrlCrossRefPubMed
  12. ↵
    1. Williams DR,
    2. Lawrence JA,
    3. Davis BA
    (2019) Racism and health: evidence and needed research. Annu Rev Public Health 40:105–25.
    OpenUrlCrossRefPubMed
  13. ↵
    1. Chen JA,
    2. Zhang E,
    3. Liu CH
    (2020) Potential impact of COVID-19-related racial discrimination on the health of Asian Americans. Am J Public Health 110:1624–7.
    OpenUrlPubMed
  14. ↵
    1. Dionne KY,
    2. Turkmen FF
    (2020) The politics of pandemic othering: putting COVID-19 in global and historical context. Int Organ 74:E213–30.
    OpenUrl
  15. ↵
    1. Darling-Hammond S,
    2. Michaels EK,
    3. Allen AM,
    4. et al.
    (2020) After “the China virus” went viral: racially charged coronavirus coverage and trends in bias against Asian Americans. Health Educ Behav 47:870–9.
    OpenUrl
  16. ↵
    1. Jenkins M,
    2. Houge Mackenzie S,
    3. Hodge K,
    4. et al.
    Physical activity and psychological well-being during the COVID-19 lockdown: relationships with motivational quality and nature contexts. Front Sports Act Living 202(3):637576, doi:10.3389/fspor.2021.637576.
    OpenUrlCrossRef
  17. ↵
    1. Hagerty BM,
    2. Williams RA,
    3. Coyne JC,
    4. et al.
    (1996) Sense of belonging and indicators of social and psychological functioning. Arch Psychiatr Nurs 10:235–44.
    OpenUrlCrossRefPubMed
  18. ↵
    1. Jetten J,
    2. Reicher SD,
    3. Haslam SA,
    4. et al.
    (2020) Together apart: the psychology of COVID-19 (Sage Publications, Thousand Oaks (CA)).
  19. ↵
    1. McCallum C,
    2. McLaren S
    (2010) Sense of belonging and depressive symptoms among GLB adolescents. J Homosex 58:83–96.
    OpenUrlCrossRef
  20. ↵
    1. McLaren S,
    2. Challis C
    (2009) Resilience among men farmers: the protective roles of social support and sense of belonging in the depression-suicidal ideation relation. Death Stud 33:262–76.
    OpenUrlCrossRefPubMed
  21. ↵
    1. Fortgang RG,
    2. Wang SB,
    3. Millner AJ,
    4. et al.
    (2021) Increase in suicidal thinking during COVID-19. Clin Psychol Sci 9:482–8.
    OpenUrl
  22. ↵
    1. Colorafi KJ,
    2. Evans B
    (2016) Qualitative descriptive methods in health science research. HERD 9:16–25.
    OpenUrlCrossRefPubMed
  23. ↵
    1. Carbado DW,
    2. Crenshaw KW,
    3. Mays VM,
    4. et al.
    (2013) Intersectionality: mapping the movements of a theory. Du Bois Rev 10:303–12.
    OpenUrl
  24. ↵
    1. Atewologun D
    (2018) Intersectionality theory and practice (Oxford University Press, Oxford (UK)).
  25. ↵
    1. Thomas DR
    (2006) A general inductive approach for analyzing qualitative evaluation data. Am J Eval 27:237–46.
    OpenUrl
  26. ↵
    1. Kiger ME,
    2. Varpio L
    (2020) Thematic analysis of qualitative data: AMEE Guide No. 131. Med Teach 42:846–54.
    OpenUrlCrossRefPubMed
  27. ↵
    1. Tong A,
    2. Sainsbury P,
    3. Craig J
    (2007) Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care 19:349–57.
    OpenUrlCrossRefPubMed
  28. ↵
    1. Parsons Leigh J,
    2. Fiest K,
    3. Brundin-Mather R,
    4. et al.
    (2020) A national cross-sectional survey of public perceptions of the COVID-19 pandemic: self-reported beliefs, knowledge, and behaviors. PLoS One 15:e0241259.
    OpenUrlPubMed
  29. ↵
    1. Wu C,
    2. Qian Y,
    3. Wilkes R
    (2021) Anti-Asian discrimination and the Asian-white mental health gap during COVID-19. Ethn Racial Stud 44:819–35.
    OpenUrl
  30. ↵
    1. Gao Q,
    2. Liu X
    (2020) Stand against anti-Asian racial discrimination during COVID-19: a call for action. Int Soc Work 64:261–4.
    OpenUrl
  31. ↵
    (2020) Demographic yearbook: 71st issue (United Nations Department of Economic and Social Affairs, New York).
  32. ↵
    1. Saunders B,
    2. Sim J,
    3. Kingstone T,
    4. et al.
    (2018) Saturation in qualitative research: exploring its conceptualization and operationalization. Qual Quant 52:1893–907.
    OpenUrlCrossRefPubMed
  33. ↵
    1. Kendall J
    (1999) Axial coding and the grounded theory controversy. West J Nurs Res 21:743–57.
    OpenUrlCrossRefPubMed
  34. ↵
    1. Sakamoto A,
    2. Takei I,
    3. Woo H
    (2012) The myth of the model minority myth. Sociol Spectr 32:309–21.
    OpenUrlCrossRef
  35. ↵
    1. Lou NM,
    2. Noels KA,
    3. Kurl S,
    4. et al.
    (2021) Can Psychol, Chinese Canadians’ experiences of the dual pandemics of COVID-19 and racism: implications for identity, negative emotion, and anti-racism incident reporting. [advance online publication]. doi:https://doi.org/10.1037/cap0000305.
  36. ↵
    1. Williams DR,
    2. Mohammed SA,
    3. Leavell J,
    4. et al.
    (2010) Race, socioeconomic status, and health: complexities, ongoing challenges, and research opportunities. Ann N Y Acad Sci 1186:69–101.
    OpenUrlCrossRefPubMed
  37. ↵
    1. Karlsen S,
    2. Nazroo JY
    (2002) Relation between racial discrimination, social class, and health among ethnic minority groups. Am J Public Health 92:624–31.
    OpenUrlCrossRefPubMed
  38. ↵
    1. No S,
    2. Hong YY,
    3. Liao HY,
    4. et al.
    (2008) Lay theory of race affects and moderates Asian Americans’ responses toward American culture. J Pers Soc Psychol 95:991–1004.
    OpenUrlCrossRefPubMed
  39. ↵
    1. Shang Z,
    2. Kim JY,
    3. Cheng SO
    (2021) Discrimination experienced by Asian Canadian and Asian American health care workers during the COVID-19 pandemic: a qualitative study. CMAJ Open 9:E998–1004.
    OpenUrlAbstract/FREE Full Text
  40. ↵
    1. Williams DR,
    2. Priest N,
    3. Anderson NB
    (2016) Understanding associations among race, socioeconomic status, and health: patterns and prospects. Health Psychol 35:407–11.
    OpenUrlCrossRefPubMed
  41. ↵
    1. Cheon YM,
    2. Ip PS,
    3. Yip T
    (2019) Adolescent profiles of ethnicity/race and socioeconomic status: implications for sleep and the role of discrimination and ethnic/racial identity. Adv Child Dev Behav 57:195–233.
    OpenUrl
  42. ↵
    1. Gee GC,
    2. Ro A,
    3. Shariff-Marco S,
    4. et al.
    (2009) Racial discrimination and health among Asian Americans: evidence, assessment, and directions for future research. Epidemiol Rev 31:130–51.
    OpenUrlCrossRefPubMed
  43. ↵
    1. Yang CC,
    2. Tsai J-Y,
    3. Pan S
    (2020) Discrimination and well-being among Asians/Asian Americans during COVID-19: the role of social media. Cyberpsychol Behav Soc Netw 23:865–70.
    OpenUrl
  44. ↵
    1. Arendt F
    (2013) Dose-dependent media priming effects of stereotypic newspaper articles on implicit and explicit stereotypes. J Commun 63:830–51.
    OpenUrlCrossRef
  45. ↵
    1. Devine P,
    2. Plant A
    , eds (2013) Advances in experimental social psychology, Dasgupta Implicit attitudes and beliefs adapt to situations: a decade of research on the malleability of implicit prejudice, stereotypes, and the self-concept (Elsevier Science Publishing, San Diego), 47, pp 233–79.
    OpenUrl
  46. ↵
    1. He B,
    2. Ziems C,
    3. Soni S,
    4. et al.
    (2020) Racism is a virus: anti-Asian hate and counter-speech in social media during the COVID-19 crisis (Cornell University, Ithaca (NY)) [COVID-19 e-print]. doi:https://doi.org/10.48550/arXiv.2005.12423.
  47. ↵
    1. Hu H,
    2. Mao H,
    3. Hu X,
    4. et al.
    (2015) Information dissemination of public health emergency on social networks and intelligent computation. Comput Intell Neurosci 2015:181038.
    OpenUrl
  48. ↵
    1. Valkenburg PM,
    2. Peter J,
    3. Walther JB
    (2016) Media effects: theory and research. Annu Rev Psychol 67:315–38.
    OpenUrl
  • © 2022 CMA Impact Inc. or its licensors
PreviousNext
Back to top

In this issue

CMAJ Open: 10 (2)
Vol. 10, Issue 2
1 Apr 2022
  • Table of Contents
  • Index by author

Article tools

Respond to this article
Print
Download PDF
Article Alerts
To sign up for email alerts or to access your current email alerts, enter your email address below:
Email Article

Thank you for your interest in spreading the word on CMAJ Open.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Lived experiences of Asian Canadians encountering discrimination during the COVID-19 pandemic: a qualitative interview study
(Your Name) has sent you a message from CMAJ Open
(Your Name) thought you would like to see the CMAJ Open web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Lived experiences of Asian Canadians encountering discrimination during the COVID-19 pandemic: a qualitative interview study
Jeanna Parsons Leigh, Stephana Julia Moss, Faizah Tiifu, Emily FitzGerald, Rebecca Brundin-Mathers, Alexandra Dodds, Amanpreet Brar, Chloe Moira de Grood, Henry T. Stelfox, Kirsten M. Fiest, Josh Ng-Kamstra
Apr 2022, 10 (2) E539-E545; DOI: 10.9778/cmajo.20220019

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Lived experiences of Asian Canadians encountering discrimination during the COVID-19 pandemic: a qualitative interview study
Jeanna Parsons Leigh, Stephana Julia Moss, Faizah Tiifu, Emily FitzGerald, Rebecca Brundin-Mathers, Alexandra Dodds, Amanpreet Brar, Chloe Moira de Grood, Henry T. Stelfox, Kirsten M. Fiest, Josh Ng-Kamstra
Apr 2022, 10 (2) E539-E545; DOI: 10.9778/cmajo.20220019
Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like

Related Articles

  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

Similar Articles

Collections

  • Clinical
    • Infectious Diseases
      • COVID-19
    • Mental health
    • Public Health
      • Other public health
  • Nonclinical
    • Patients
      • Patients' cultures

Content

  • Current issue
  • Past issues
  • Collections
  • Alerts
  • RSS

Authors & Reviewers

  • Overview for Authors
  • Preparing manuscripts
  • Manuscript Submission Checklist
  • Publication Fees
  • Forms
  • Editorial Policies
  • Editorial Process
  • Patient-Oriented Research
  • Submit a manuscript
  • Manuscript Progress
  • Submitting a letter
  • Information for Reviewers

About

  • General Information
  • Staff
  • Editorial Board
  • Advisory Panel
  • Contact Us
  • Advertising
  • Media
  • Reprints
  • Copyright and Permissions
  • Accessibility
  • CMA Civility Standards
CMAJ Group

Copyright 2023, CMA Impact Inc. or its licensors. All rights reserved. ISSN 2291-0026

All editorial matter in CMAJ OPEN represents the opinions of the authors and not necessarily those of the Canadian Medical Association or its subsidiaries.

To receive any of these resources in an accessible format, please contact us at CMAJ Group, 500-1410 Blair Towers Place, Ottawa ON, K1J 9B9; p: 1-888-855-2555; e: [email protected].

View CMA's Accessibility policy.

 

Powered by HighWire