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Currently submitted to: Journal of Medical Internet Research

Date Submitted: Sep 25, 2020
Open Peer Review Period: Sep 24, 2020 - Nov 19, 2020
(currently open for review)

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

Social Stigma and Mental Health Among Overseas Chinese During the COVID-19 Pandemic

  • Junling Gao; 
  • Zhizhong Wang; 
  • Hao Chen; 
  • Yi Wang; 
  • Huihui Yan; 
  • Yingwei Chen; 
  • Jixiang Xu



The COVID-19 has led to stigma and discrimination among various groups of people in different populations. However, there is no data quantifying the pattern of COVID-19 social stigma and its impacts on mental health.


To assess COVID-19 social stigma and mental health, and to examine their association among overseas Chinese during the COVID-19 pandemic.


A cross-sectional study was conducted among 519 overseas Chinese from 23 countries who were sampled using the snowball sampling method and invited to participate in an online survey during April 21 to May 7, 2020. Depression was assessed by the Chinese version of the World Health Organization Five Well-Being Index (WHO-5), and anxiety was assessed by the Chinese version of the Generalized Anxiety Disorder Scale (GAD-7). COVID-19 social stigma was assessed by a validated 6-item COVID-19 social stigma scale. Covariates included gender, age (10-year categories), educational level, marital status, occupation, length of stay in the immigrant country, perceived severity of COVID-19 (PSC), and perceived effectiveness of prevention and control measures (PEPC) in the city where they currently lived.


A total of 519 participants from 23 countries were involved in the current study. The prevalence of depression was 37.2% (95%CI: 33.0%–41.5%), and that of anxiety was 15.8% (95%CI: 12.8%–19.2%). During the COVID-19 pandemic, 24.2% and 26.0% of participants reported having been refused services and work or study, more than 85% reported having read “Chinese virus” or “Wuhan virus” in the media, and 54.6% reported having heard these phrases during interpersonal communication. After controlling for covariates, perceived severity, and perceived effectiveness of control, compared to those with the lowest-quartile social stigma, the odds ratios (ORs) of depression among those with the third- and highest-quartile social stigma were 2.41(95%CI: 1.25–4.65) and 3.33 (95%CI: 1.71–6.48). The OR of anxiety among those with the highest-quartile social stigma was 5.40 (95%CI: 1.95–14.95).


Overseas Chinese face some increased social stigma, including discrimination and labeling, which is associated with a high prevalence of depression and anxiety, during the COVID-19 pandemic.


Please cite as:

Gao J, Wang Z, Chen H, Wang Y, Yan H, Chen Y, Xu J

Social Stigma and Mental Health Among Overseas Chinese During the COVID-19 Pandemic

JMIR Preprints. 25/09/2020:24575

DOI: 10.2196/preprints.24575


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