Perceived Safety and Mental Health among Asian American Women: Exploring the Moderating Role of Loneliness and Resilience

Asian American women are an understudied population facing substantial mental health burden, largely driven by the increasing rates of gender- and race-based violence and discrimination. Perceived safety, a key factor influencing mental health, has been underexplored. This study aimed to 1) examine the relationship between perceived safety with mental health outcomes (i.e., depression and anxiety); 2) examine the link between behavioral changes due to safety concerns and mental health outcomes; and 3) explore the moderating effects of loneliness and resilience on these relationships, drawing from a community sample of n=345 Asian American women. Perceived safety was defined as feeling safe in public spaces, transportation and neighborhoods. In our study, 28.7%, 56.2% and 20.6% of women reported feeling unsafe in public spaces, transportation and neighborhoods, respectively. Feeling unsafe in public spaces was associated with higher odds of depression (aOR=2.37, 95%CI: 1.40, 4.02) and anxiety (aOR=2.61, 95%CI: 1.56, 4.37). Avoiding public spaces, leaving home or transportation were linked to increased odds of depression (aOR=2.05, 95%CI: 1.23, 3.40; aOR=2.26, 95%CI: 1.37, 3.74; aOR=2.03, 95%CI: 1.16, 3.57, respectively) while only avoiding leaving home was associated with anxiety (aOR=2.04, 95%CI: 1.24, 3.36). Loneliness moderated the association between avoiding public spaces and anxiety: women were not lonely who avoided public spaces had significantly higher odds of anxiety (aOR=4.77, 95% CI: 1.24, 18.34), whereas no moderating effect was observed amongst women who were lonely (aOR=0.93, 95% CI: 0.53, 1.64). Resilience did not moderate these relationships (all P>0.050). Our findings highlight the mental health impacts associated with reduced perceptions of safety and avoidance behaviors in this group, highlighting the pervasive fear experienced by Asian American women in their day-to-day lives, and emphasizing the need for targeted interventions to address the unique safety challenges faced by Asian American women.