The Association of Perceived Abuse and Discrimination After September 11, 2001, With Psychological Distress, Level of Happiness, and Health Status Among Arab Americans

Objectives. We assessed the prevalence of perceived abuse and discrimination among Arab American adults after September 11, 2001, and associations between abuse or discrimination and psychological distress, level of happiness, and health status.Methods. We gathered data from a face-to-face survey administered in 2003 to a representative, population-based sample of Arab American adults residing in the greater Detroit area.Results. Overall, 25% of the respondents reported post–September 11 personal or familial abuse, and 15% reported that they personally had a bad experience related to their ethnicity, with higher rates among Muslims than Christians. After adjustment for socioeconomic and demographic factors, perceived post–September 11 abuse was associated with higher levels of psychological distress, lower levels of happiness, and worse health status. Personal bad experiences related to ethnicity were associated with increased psychological distress and reduced happiness. Perceptions of not being respected within US society and greater reported effects of September 11 with respect to personal security and safety were associated with higher levels of psychological distress.Conclusions. Perceived post–September 11 abuse and discrimination were associated with increased psychological distress, reduced levels of happiness, and worse health status in our sample. Community-based, culturally sensitive partnerships should be established to assess and meet the health needs of Arab Americans.The events of September 11, 2001, adversely affected Americans both near and far from the destruction, with different psychological consequences across different demographic lines. Studies have shown that Hispanics,¹ women,^2,3 younger individuals,³ and those with a history of anxiety or depression² have experienced greater psychological distress and have been more at risk for adverse health outcomes. To date, however, there has been no representative, population-based investigation of the psychological impact of September 11 and its aftermath on Arabs or Muslims living in the United States.In the United States, prejudice, discrimination, and violence against Muslims and Arabs have increased since September 11.⁴ Estimates of the American Muslim population vary widely but average 5.4 million,^5–9 consisting of equivalent numbers of African Americans, South Asians, and Arabs.⁹ In addition, up to 2.5 million non-Muslim Arabs reside in the United States.¹⁰ The Federal Bureau of Investigation (FBI) reported a 1600% increase in hate crimes against these populations in the year after the events of September 11.^10–13 Similarly, in a population-based survey of Middle Eastern Arabic-speaking adults in the United States, approximately 30% of Arabs and 50% of Muslims reported discrimination in the 8 months after September 11.¹⁴ Mosques and Muslim-owned business were vandalized, and individuals Muslim in appearance were verbally abused, physically assaulted, and, in some cases, murdered.¹² Anti-Muslim and anti-Arab hate crimes continue to be at higher levels than before September 11.^15,16US governmental policies have also targeted Muslims and Arabs and their community organizations. Muslim civic and religious organizations have been raided by the FBI,^17,18 Muslim charities have had their assets frozen,¹⁹ and racial profiling has occurred at airports and on the streets.²⁰ Further coloring the social environment are the US-led wars in Afghanistan and Iraq. These wars may create increased tension between the general American population and people of Afghani and Iraqi ancestry residing in the United States, in addition to increasing psychological distress among the US-based relatives of Iraqis and Afghanis.An important but largely unanswered question is how this climate has affected the health of American Arab and Muslim populations. Racial and ethnic discrimination is associated with increased psychological distress^21,22 and anxiety,²³ increased risk for adverse mental health outcomes,^22,23 and poorer health status.^21,24,25 Moreover, immigrants who perceive increased discrimination in their new country are more likely to have high levels of psychological distress and decreased levels of trust in society, potentially leading to underuse of mental health services by those in need.²⁶ However, research within US Arab or Muslim communities in the post–September 11 environment is scant. To date, only a handful of small studies have been conducted, and these investigations have involved convenience samples.^27,28To address the lack of representative surveys of Arab Americans, we examined the psychological and health effects of perceived discrimination and abuse approximately 2 years after September 11, 2001, in a representative sample of Arab American adults residing in greater Detroit. The Detroit-area Arab community is the largest such community outside of the Middle East; a result of its size, affluence, and long history in the United States, it possesses arguably greater social capital than other US-based Arab communities.²⁹Our research questions were as follows: How prevalent is reported abuse and discrimination in our study population? How are reports of abuse or discrimination associated with self-reported psychological distress, level of happiness, and health status? What role do sociodemographic factors play in reported abuse or discrimination? We examined these questions among individuals who took part in the 2003 Detroit Arab American Survey (DAAS).³⁰