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Background:
While hate crimes rose during the COVID-19 pandemic, few studies examined whether this pandemic-time racial discrimination has led to negative health consequences at the population level.
Objective:
We examined whether experienced and perceived racial discrimination were associated with mental or behavioral health outcomes during the...
Contexts in source publication
Context 1
... the variables used in our models had few missing values (among 2709 respondents, we had 2699 complete cases for the serious psychological distress, 2629 for the decrease in happiness, 2613 for the increase in smoking, 2621 for the increase in alcohol consumption, and 2584 complete cases for the sleep quality models), we decided not to impute these missing values. Table 1 shows the characteristics of the analytic sample. About 8.81% of the participants had experienced racial discrimination during the COVID-19 pandemic by October 2020, with higher percentages seen in racial and ethnic minorities (Table 2). ...Context 2
... the variables used in our models had few missing values (among 2709 respondents, we had 2699 complete cases for the serious psychological distress, 2629 for the decrease in happiness, 2613 for the increase in smoking, 2621 for the increase in alcohol consumption, and 2584 complete cases for the sleep quality models), we decided not to impute these missing values. Table 1 shows the characteristics of the analytic sample. About 8.81% of the participants had experienced racial discrimination during the COVID-19 pandemic by October 2020, with higher percentages seen in racial and ethnic minorities (Table 2). ...Citations
... Increased experiences of racism were also apparent within other racial communities. A recent study surveyed minoritized groups in October 2020 to assess the association between perceived racism and negative mental health outcomes [44]. It was found that perceived racism was the highest among participants who identified as non-Hispanic Black. ...
Racism has been a long-standing influential factor that has negatively impacted both past and current health disparities within the United Sates population. Existing problems of racism and its impact on both health disparities and health inequalities were only amplified during the COVID-19 pandemic. The pandemic allowed both clinicians and researchers to recognize a growing list of health concerns at the macro-, meso-, and micro-level among underserved racially minoritized patients with specific chronic illnesses such as cancer. Based on these concerns, this Special Issue was designed to highlight the challenges of cancer screening, cancer treatment, and cancer-centered educational outreach among racially minoritized communities.
... The COVID-19 pandemic became a health threat for faculty with medical conditions (e.g., diabetes, HIV, etc.), which made them fearful of contagion and to engage in preventative measures such as wearing masks and practicing social distancing (Majowicz, 2020). The concern of severe illness from COVID-19 infection is an important factor because a U.S. study found that those with COVID-19 infection experienced higher rates of racial discrimination, which led to mental distress and poor sleep patterns (Shi et al., 2022). Currently, it is unknown whether faculty who are more susceptible to severe illness from COVID-19 are more likely to experience WPCB. ...
... However, people who have experienced COVID-19-related discrimination may face greater pre-existing health challenges, reduced access to healthcare, lower quality housing conditions, diminished or unequal employment opportunities, and more restricted social interactions, all of which can further exacerbate health disparities [21,22]. Data collected on various populations since the onset of the COVID-19 pandemic have shown that perceived discrimination was associated with depression, anxiety, suicidal ideation, negative affect, insomnia, physical symptoms, post-traumatic stress, and substance use (Colombian COVID-19 survivors [23]; adults in five U.S. cities [24]; Asians and Asian Americans [16]; general U.S. adults [25][26][27]; U.S. and Canadian adults [28]; Californian adults [29]). Experiences of COVID-19-related discrimination were associated with increased mental disorders for all Americans and COVID-19-related discrimination partially explains the disproportionate mental health impact of the pandemic on Asians [17]. ...
This study investigates the impact of COVID-19 pandemic on perceived everyday discrimination using data from the 2018 and 2021 General Social Survey. The study included representative samples of 1,499 adults in 2018 and 2,361 adults in 2021 in the United States. The study found that the overall level of perceived everyday discrimination had a slight decline from 2018 to 2021. However, frequency of being threatened/harassed increased in all racial/ethnic groups and more substantially among Asian Americans and people in the “other race” category. Most social statuses had a similar association with perceived everyday discrimination in 2018 and 2021 (e.g., higher among younger age, homo/bisexual, non-Hispanic Black, U.S. born, divorced/separated). In 2018, perceived discrimination was also higher among Hispanics, people of multiple races, Jews and people of “other religions.” In 2021, it was also higher among “other races” and parents who were never married. Perceived everyday discrimination was associated with all health and well-being outcomes. Also, the negative association between perceived discrimination and health and well-being appears to be stronger in 2021 than in 2018. These findings suggest that the pandemic intensified the relationship between perceived everyday discrimination and health and well-being. They point to an urgent need to develop effective efforts to mitigate the harmful impact of discrimination.
... Racism, a system of oppression that has been unfolding globally for centuries, had unique COVID-19 manifestations from day one. It drove physical and verbal attacks against Asian people and other minorities, and ubiquitous calls for foreigners to "go home"; circulated in political discourses and pushed on new online platforms; manifested in discriminatory policy responses and restrictions, disproportionately targeting migrants as "suspect" spreaders; and could be gauged through disparate rates of pandemic-related infections, hospitalizations, and deaths, alongside other critical health and socio-economic outcomes (Dhanani and Franz 2020;Shi, et al. 2022). 1 More than three years on, the world is struggling to achieve a "post-pandemic" recovery. And while the pandemic has largely subsided (WHO 2023), 2 its long-term consequences and legacies continue to affect us. ...
... The trajectories in the prevalence and forms of racism have changed throughout the pandemic. The pandemic broke out in a climate of mounting xenophobic sentiments, which contributed to the sharp rise in COVID-racism, with numerous reports suggesting that racism spiked in the first couple of months (e.g., Shi, et al. 2022). Early manifestations of racism included scapegoating in media reporting, antiimmigrant statements by politicians, and everyday racist attacks in public places (Ben and Elias, under review;Li and Chen 2021). ...
The COVID-19 pandemic has been one of the most acute global crises in recent history, which profoundly impacted the world across many dimensions. During this period, racism manifested in ways specifically related to the pandemic, including xenophobic sentiments, racial attacks, discriminatory policies, and disparate outcomes across racial/ethnic groups. This paper examines some of the pressing questions about pandemic racism and inequity. We review what research has revealed about the nature and manifestations of racism, the entrenchment of structural racism, and trajectories of racism during COVID-19.
... The adverse mental health impacts of such racism have been documented in a variety of circumstances. For example, everyday racial discrimination during the COVID-19 pandemic or COVID-19-related discrimination against Asian people in the US was associated with negative affect and difficult peer relations among Chinese American adolescents [33], anxiety among Asian American college students [34], depressive symptoms among Asian adults [35], hypervigilance and nervousness about being in public among Asian adults [36], COVID-19-related stress among Bhutanese and Burmese refugees [37], and psychological distress among East and South Asian respondents to a U.S. national survey [38]. Vicarious racism was associated with increased depression and anxiety among Asian American and Black American adults from five U.S. cities [3] and with compromised sleep quality among Asian American adults [39] during the first months of the pandemic. ...
Purpose:
To examine within-individual time trends in mental well-being and factors influencing heterogeneity of these trends.
Methods:
Longitudinal telephone survey of adults over 3 waves from the New York City (NYC) Metropolitan area during the COVID-19 Pandemic. Participants reported depression using the Patient Health Questionnaire (PHQ)-8, anxiety using the Generalized Anxiety Disorder (GAD)-7, and past 30-day increases in tobacco or alcohol use at each wave. Adjusted mixed effects logistic regression models assessed time trends in mental well-being.
Results:
There were 1227 respondents. Over 3 study waves, there were statistically significant decreasing time trends in the odds of each outcome (adjusted OR (95% CI) 0.47 (0.37, 0.60); p < 0.001 for depression; aOR (95% CI) 0.55 (0.45, 0.66); p < 0.001 for anxiety; aOR (95% CI) 0.50 (0.35, 0.71); p < 0.001 for past 30-day increased tobacco use; aOR (95% CI) 0.31 (0.24, 0.40); p < 0.001 for past 30-day increased alcohol use). Time trends for anxiety varied by race and ethnicity (p value for interaction = 0.05, 4 df); anxiety declined over time among white, Black, Hispanic, and Other race and ethnicity but not among Asian participants.
Conclusions:
In a demographically varied population from the NYC Metropolitan area, depression, anxiety and increased substance use were common during the first months of the pandemic, but decreased over the following year. While this was consistently the case across most demographic groups, the odds of anxiety among Asian participants did not decrease over time.
... Discrimination against both Asian Americans and Black Americans has increased during the pandemic (e.g., Lee & Waters, 2021;Ruiz et al., 2020), amplifying stress exposure. Individuals in the US identifying as Asian, Asian American, or Pacific Islanders (Lee & Waters, 2021;Oh & Litam, 2022), as well as those in other groups (e.g., Lee et al., 2022;Shi et al., 2022), who reported greater discrimination during the pandemic also evidenced greater psychological distress, but perceiving other sources of support (e.g., from friends, significant others) during or prior to the pandemic may buffer some of these detrimental effects (Adesogan et al., 2022;Lee & Waters, 2021). Another US study found that Black (compared with White) young adults experienced increases in everyday discrimination and social isolation from before to during the pandemic, which was partly explained by the increase in discrimination (Fuller-Rowell et al., 2022). ...
The COVID‐19 pandemic continues to affect couples worldwide who vary in sociocultural values, norms, and expectations, but most work examining connections between pandemic‐related stress and couples' relationships has been conducted in the US or similar Western cultures. Guided by the vulnerability‐stress‐adaptation (VSA) model (Karney & Bradbury, 1995), we present a revised theoretical framework for evaluating how sociocultural contexts may moderate the ways in which pandemic‐related stress risks poor couple functioning or promotes couples' resilience. We briefly describe the theoretical model and associated relationship research in the pandemic context and then evaluate how two illustrative sociocultural contexts (country/culture and race/ethnicity) might impact pandemic‐related external (disease risks and stress exposure) and internal (psychological distress and felt belonging) stress and adaptive relationship functioning. Our review reveals that much remains to be learned about how couples embedded in different sociocultural contexts have adapted over the course of the global pandemic and highlights key areas for future research.
... Lived experiences including, for instance, factors related to structural racism that contribute to lack of access to material and social resources as well as racial-ethnic discrimination concurrent with the pandemic also contribute to poorer sleep, potentially further contributing to disparities. [34][35][36] Women who are primarily responsible for caregiving were also more likely to have children in the household, which may cause additional stress and has also been associated with poorer sleep during the pandemic. 16 Intersectional identities (eg, racially minoritized women) and financial hardship during the pandemic may synergistically contribute to poorer sleep health. ...
Objective:
In the United States (US), the health and financial consequences of COVID-19 have disproportionately impacted women and minoritized racial-ethnic groups. Yet, few US studies have investigated financial hardship during the COVID-19 pandemic and sleep health disparities. Our objective was to investigate associations between financial hardship and sleep disturbances during the COVID-19 pandemic by gender and race and ethnicity in the United States.
Methods:
We used the nationally representative COVID-19's Unequal Racial Burden cross-sectional survey data collected among 5339 men and women from 12/2020 to 2/2021. Participants reported financial hardship (eg, debt, employment/work loss) since the pandemic began and completed the Patient-Reported Outcomes Management Information System Short Form 4a for sleep disturbances. Prevalence ratios (PRs) and 95% confidence intervals were estimated using adjusted, weighted Poisson regression with robust variance.
Results:
Most (71%) participants reported financial hardship. Prevalence of moderate to severe sleep disturbances was 20% overall, higher among women (23%), and highest among American Indian/Alaska Native (29%) and multiracial adults (28%). Associations between financial hardship and moderate to severe sleep disturbances (PR = 1.52 [95% confidence interval: 1.18, 1.94]) did not differ by gender but varied by race and ethnicity: associations were strongest among Black/African American (PR = 3.52 [1.99,6.23]) adults.
Conclusions:
Both financial hardship and sleep disturbances were prevalent, and their relationships were strongest among certain minoritized racial-ethnic groups, particularly Black/African American adults. Interventions that alleviate financial insecurity may reduce sleep health disparities.
... National data showed that, in April 2020, 13.6% of US adults reported symptoms of severe psychological distress, relative to 3.9% in 2018 [12]. Depressive symptoms also became considerably more prevalent during COVID-19 compared with before [13] and cumulative evidence from a rapidly growing literature pointed to a disproportionate burden of mental health among racial-ethnic minorities [14][15][16][17][18][19][20][21] . ...
Background
Research on mental health disparities by race-ethnicity in the United States (US) during COVID-19 is limited and has generated mixed results. Few studies have included Asian Americans as a whole or by subgroups in the analysis.
Methods
Data came from the 2020 Health, Ethnicity, and Pandemic Study, based on a nationally representative sample of 2,709 community-dwelling adults in the US with minorities oversampled. The outcome was psychological distress. The exposure variable was race-ethnicity, including four major racial-ethnic groups and several Asian ethnic subgroups in the US. The mediators included experienced discrimination and perceived racial bias toward one’s racial-ethnic group. Weighted linear regressions and mediation analyses were performed.
Results
Among the four major racial-ethnic groups, Hispanics (22%) had the highest prevalence of severe distress, followed by Asians (18%) and Blacks (16%), with Whites (14%) having the lowest prevalence. Hispanics’ poorer mental health was largely due to their socioeconomic disadvantages. Within Asians, Southeast Asians (29%), Koreans (27%), and South Asians (22%) exhibited the highest prevalence of severe distress. Their worse mental health was mainly mediated by experienced discrimination and perceived racial bias.
Conclusions
Purposefully tackling racial prejudice and discrimination is necessary to alleviate the disproportionate psychological distress burden in racial-ethnic minority groups.
... To date, only one study has assessed the impact of COVID-related discrimination on sleep among Asian adults [19]. A few other analyses have examined discrimination (COVID-and non-COVID-related) during the pandemic and sleep among Asian, Black/African American, and White adults [29,30]. All found that COVID-related discrimination was associated with sleep disturbances and shorter sleep time. ...
COVID-related discrimination towards historically marginalized racial-ethnic groups in the United States has been well-documented; however, its impact on psychological distress and sleep (overall and within specific racial-ethnic groups) is largely unknown. We used data from our nationally representative, online survey of 5,500 American Indian/Alaska Native, Asian, Black/African American, Native Hawaiian/Pacific Islander, Latino, White, and multiracial adults, conducted from 12/2020-2/2021. Participants were asked how often they experienced discriminatory behaviors “because they think you might have COVID-19” (modified Everyday Discrimination Scale). Psychological distress was captured as having experienced anxiety-depression symptoms (Patient Health Questionairre-4, PHQ-4), perceived stress (modified Perceived Stress Scale), or loneliness-isolation (“How often have you felt lonely and isolated?”). Sleep disturbances were measured using the Patient-Reported Outcomes Information System Short Form Sleep Disturbance scale (PROMIS-SF 4a). Overall, 22.1% reported COVID-related discriminatory behaviors (sometimes/always: 9.7%; rarely: 12.4%). 48.4% of participants reported anxiety-depression symptoms (moderate/severe: 23.7% mild: 24.8%), 62.4% reported feeling stressed (moderate/severe: 34.3%; mild: 28,1%), 61.0% reported feeling lonely-isolated (fairly often/very often: 21.3%; almost never/sometimes: 39.7%), and 35.4% reported sleep disturbances (moderate/severe:19.8%; mild: 15.6%). Discrimination was only associated with increased psychological distress among racial-ethnic minorities. For example, COVID-related discrimination was strongly associated with anxiety-depression among Black/African American adults (mild: aOR=2.12, 95% CI=1.43-5.17; moderate/severe: aOR=5.19, 95% CI=3.35-8.05), but no association was observed among White or multiracial adults. Mitigating pandemic-related discrimination could help alleviate mental and sleep health disparities occurring among minoritized racial-ethnic groups.
Supplementary Information
The online version contains supplementary material available at 10.1007/s40615-023-01614-5.
... Specifically, higher levels of PD mediated the relationships between racial discrimination and current use of alcohol, cannabis, and tobacco. These findings are consistent with prior research that suggests that experiences of racial bias and discrimination-related stress are associated with increased risk of PD and cigarette smoking among Black Americans (Shi et al., 2022;Shpigel et al., 2021). Although several studies among Black emerging adults have shown that racial discrimination is associated with cannabis use (Ahuja et al., 2022;Motley Jr. et al., 2022;Saint-Fleur & Anglin, 2021), few have considered PD as a mediator. ...
Introduction:
Discrimination is associated with poor mental health and substance use among Black Americans, but research is needed on mediators and moderators of these relationships. This study tested whether: 1) discrimination is associated with current alcohol, tobacco (cigarette or e-cigarette), and cannabis use among US Black emerging adults; 2) psychological distress (PD) and positive well-being (PW) are mediators of discrimination-substance use relationships; and 3) these relationships are moderated by sex and attributions to discrimination (racial vs. nonracial).
Methods:
Using data from a 2017 US nationally representative survey, we conducted bivariate and multiple-group moderated mediation analyses among 1118 Black American adults aged 18-28. The study assessed discrimination and attribution to discrimination using the Everyday Discrimination scale, past 30-day PD with the Kessler-6 scale, and past 30-day PW with the Mental Health Continuum Short Form. We utilized probit regression for all structural equation models and adjusted final models for age.
Results:
Discrimination was positively associated with past 30-day cannabis and tobacco use directly and indirectly through PD in the overall model. Among males who reported race as the sole/main attribution to discrimination, discrimination was positively associated with alcohol, cannabis, and tobacco use through PD. Among females who reported race as the sole/main attribution to discrimination, discrimination was positively associated with cannabis use through PD. Discrimination was positively associated with tobacco use among those who reported nonracial attributions to discrimination and with alcohol use among those whose attribution was not assessed. Discrimination was positively associated with PD among those who reported race as a secondary attribution to discrimination.
Conclusions:
Discrimination specifically attributed to race may contribute to greater PD and in turn alcohol, cannabis, and tobacco use among Black emerging adults, especially males. Future substance use prevention and treatment efforts targeted to Black American emerging adults may benefit from addressing racial discrimination and PD.
