Measuring and Assessing the Health Implications of Perceived Islamophobia Discrimination among South Asian Muslim Americans

South Asian Americans have high prevalence rates of Type II diabetes (15.9%) and hypertension (25%). Existing research on this topic has primarily focused on risk factors for these conditions, such as genetics, diet, and physical activity, but a gap remains in our knowledge of stress, specifically exposure to discrimination, as a contributing factor to these health outcomes. This cross-sectional, mixed methods study involved the development and assessment of a novel scale for measuring perceived Anti-Muslim discrimination, and examined associations among discrimination, depressive symptoms, and health risk behaviors (diet, physical activity, tobacco use, alcohol consumption) for Type II diabetes and hypertension. In-depth qualitative interviews (N=40) were conducted with Muslim Americans on how they define Islamophobia, how Muslims are treated and perceived in the U.S., and experiences with Islamophobia. Findings from qualitative interviews, expert reviews (N=5), and cognitive interviews (N=9) informed the development and validation of the 19-item Societal Anti-Muslim Discrimination Index (SAMDI) and the 9-item Interpersonal Anti-Muslim Discrimination Index (IAMDI). Quantitative data (N=347) were collected from Muslim Americans using an online survey. Correlation tests and principal component analysis were used to assess the SAMDI and IAMDI scales (N=347), and structural equation modeling was used to examine relations among discrimination and health using a sub-sample of South Asian Muslim American participants (n=173). Qualitative findings indicate that Islamophobia and xenophobia are significant sources of long-term stress. Participants recounted physical assaults in public locations, persistent questioning regarding their country of origin, and verbal harassment in the form of derogatory terms and comments. Vicarious exposure to Islamophobia was mentioned in relation to observations of other Muslims being harassed and hearing about bias incidents from relatives, friends, and media reports. Quantitative results indicate one-component models and modest to high reliability of the IAMDI (.77) and SAMDI (.88) scales. SAMDI was associated with an increase in depressive symptoms (.19, p<.05), as was IAMDI (.20, p<.05). Neither scale was associated with dietary patterns, tobacco use, or alcohol consumption. Study results demonstrate the link between Islamophobia and depressive symptoms, and provide a unique tool for measuring Anti-Muslim discrimination, which will aid researchers in studying the health implications of Islamophobia