Racial Discrimination, Mental Health and Behavioral Health During the COVID-19 Pandemic: a National Survey in the United States

Abstract

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 pandemic. Design In October 2020, we conducted a national survey with minorities oversampled that covered respondents’ sociodemographic background and health-related information. Participants A total of 2709 participants responded to the survey (response rate: 4.2%). Main Measures The exposure variables included (1) experienced and encountered racial discrimination, (2) experienced racial and ethnic cyberbullying, and (3) perceived racial bias. Mental health outcomes were measured by psychological distress and self-rated happiness. Measures for behavioral health included sleep quality, change in cigarette smoking, and change in alcohol consumption. Weighted logistic regressions were performed to estimate the associations between the exposure variables and the outcomes, controlling for age, gender, race and ethnicity, educational attainment, household income, eligibility to vote, political party, COVID-19 infection, and geographic region. Separate regressions were performed in the six racial and ethnic subgroups: non-Hispanic White, non-Hispanic Black, Hispanic, East Asian, South Asian, and Southeast Asian respondents. Key Results Experienced racial discrimination was associated with higher likelihood of psychological distress (adjusted odds ratio [AOR] = 2.18, 95% confidence interval [95% CI]: 1.34–3.55). Experienced racial discrimination (AOR = 2.31, 95% CI: 1.34–3.99) and perceived racial bias (AOR = 1.05, 95% CI: 1.00–1.09) were both associated with increased cigarette smoking. The associations between racial discrimination and mental distress and substance use were most salient among Black, East Asian, South Asian, and Hispanic respondents. Conclusions Racial discrimination may be associated with higher likelihood of distress, and cigarette smoking among racial and ethnic minorities. Addressing racial discrimination is important for mitigating negative mental and behavioral health ramifications of the pandemic. Supplementary Information The online version contains supplementary material available at 10.1007/s11606-022-07540-2.

Impact of COVID-related Discrimination on Psychological Distress and Sleep Disturbances across Race-Ethnicity

“…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.…”

Substance use, racial/ethnic identity, and suicidal ideation during COVID-19 lockdown in an international adult sample

“…Nevertheless, our results are consistent with other recent investigations using US and UK samples ( Bray et al, 2021 ; Czeisler et al, 2020 ; Fitzpatrick et al, 2020 ; Proto and Quintana-Domeque, 2021 ) which have documented disparities in psychological distress and suicidality among Black and other racial/ethnic groups compared to their White peers. Numerous studies have demonstrated that factors such as overt racial discrimination and racial microaggressions ( Paradies et al, 2015 ; Quinn et al, 2020 ; Rosario-Williams et al, 2022 ; Shi et al, 2022 ), socioeconomic inequalities ( Lo and Cheng, 2018 ; Williams, 2018 ), and medical mistrust ( Hammond, 2010 ; Powell et al, 2019 ) have contributed significantly to greater risks of suicidality, particularly among racial/ethnic minority groups in the United States. The substantially greater relative risk of suicidality among racial/ethnic minorities highlights the critical need of culturally responsive suicide prevention services for this population, particularly given that disparities in mental health by race/ethnicity in the United States have been demonstrated in the emerging COVID-19 literature.…”

The infected and the affected: A longitudinal study of the impact of the COVID-19 pandemic on schoolchildren in Florida

“…In the general population of the US, researchers have identified racial and ethnic disparities in mental health outcomes during the pandemic, including worsened outcomes of depression and anxiety among Black, Hispanic, and Asian adults when compared to White adults ( 24 ). A study found that those who have experienced racial discrimination in the US were at higher risk of psychological distress and increased unhealthy behaviors (e.g., smoking) than those who have not ( 25 ). Persistent systemic social inequities, the additional barriers minorities face when trying to access mental health care, disparities in food security that exacerbated during the pandemic, and the co-occurrence of racially motivated attacks (e.g., murders of minorities by the police) are also cited as reasons for the widening racial disparities in mental health outcomes observed during the pandemic ( 24 , 26 ).…”