COVID-19 Racial Discrimination and Mental and Physical Health Effects

Background and Purpose: The COVID-19 pandemic has led to increased racial discrimination against Asians globally. Microaggressions, verbal/physical assaults, and murders have led to increased anxiety and fear among this group. This study aims to document the prevalence of COVID-19-related anti-Asian discrimination and to assess the association between COVID-19 related discrimination and poor mental and physical health outcomes.

Methods: We launched the CARES 2020 Project (COVID-19 Adult Resilience Experiences Study, www.cares2020.com) to track the health and well-being of young adults residing in the U.S. (18-30 years) across multiple time points in 2020 and 2021. An online survey (April 13, 2020 to May 7, 2020) was administered approximately one month after the U.S. declared a state of emergency due to COVID-19. Participants were recruited through social media, email, and word of mouth. The predictor is COVID-19 related discrimination (“Have you experienced discrimination that was specifically directed at you or family due to your ace/ethnicity because COVID-19). Outcomes include standardized self-reported measures of depression (PHQ-8), anxiety (GAD-7), PTSD (PCL-C) symptomatology, COVID-19 related worries, COVID-19 related grief, and sleep disturbance. These COVID-19 related predictors and outcomes were developed by our team and have demonstrated adequate reliability.

Results: Out of 732 respondents (mean age 24.5 years), 144 were Asians (19.7%), 457 White (62.4%), 38 Black (5.2%), 39 Hispanic (5.3%,), and 43 mixed (5.9%). Respondents reported a low prevalence of overt discrimination directed toward them or their family members: 13.2% (n = 19) reported verbal assaults, and 2.1% (n = 3) reported physical assults. However, significant proportions reported microaggressions directed toward respondents or their family members: 29.2% reported someone actively avoided physical contact with them or their family members because of their ethnicity; 47.2% reported someone commented about Chinese/Asian people being the source of the virus; 31.9% reported someone commented that they avoid eating Chinese/Asian food due to fear of contracting COVID-19. ANCOVA, controlling for age, gender, and income, found that discrimination was associated with greater symptoms of anxiety (p =0.008), PTSD (p=0.019), COVID-related grief (p= 0.023), COVID-related worries (p = 0.013), and sleep disturbance (p = 0.014). No association was found between COVID-19 and symptoms of depression.

Conclusions and Implications:

During the first month of the COVID-19 pandemic, Asian young adults reported a high prevalence of microaggressions related to COVID-19. These data suggest that higher levels of COVID-19 discrimination were associated with worse mental health, including increased symptoms of anxiety, PTSD, and sleep disturbance, as well as COVID-19-related grief and worries. Clinicians and researchers should develop specific interventions that can help reduce these negative health effects, including cognitive behavioral therapy for individuals facing oppression, and also utilize these results to advocate for structural and policy changes that can reduce the prevalence of race-based discrimination and attacks against minority populations.