Trajectories of Discrimination Experiences during the COVID-19 Pandemic and Subsequent Mental Health in Young Adults

Background and Purpose. Young adulthood presents numerous stressors which were amplified by the challenges during the COVID-19 pandemic. Discrimination is a prevalent risk factor for young adults’ mental health, and increased discrimination was reported at the onset of the pandemic. It is unknown, however, how the patterns persisted throughout the pandemic and whether such trajectories vary across subgroups. Estimates aggregated at the population level may obscure heterogeneity and potential socioeconomic disparities in subgroups who are at heightened risk of discrimination. Further, it is unknown how such trajectories are linked to subsequent mental health symptoms. Thus, this study aimed to 1) identify subgroups with distinct trajectories of discrimination during the pandemic, 2) examine how sociodemographic factors are associated with group-based patterns of discrimination, and 3) analyze the association between patterns of discrimination and subsequent depressive and anxiety symptoms.

Methods. Data came from a subset (N = 1,408) of young adults (ages 18-34) of the Understanding America Study, a nationally representative panel of approximately 9,500 adults (ages 18 or older) in the U.S. This study used 39 biweekly/monthly surveys from March 2020 to May 2022. COVID-19 related discrimination experiences (March 2020 – July 2021) during the past two weeks (e.g., threatened or harassed due to others thinking you had COVID-19) were summed across 4 items and dichotomized. Depressive and anxiety symptoms (September 2021 – June 2022) were measured by the number of waves diagnosis threshold was met (score > 3) using the PHQ-4. Demographics included sex, race, marital status, poverty, education level, immigrant generation status, and employment insecurity. A growth mixture model was used to identify subgroups of trajectories. Subsequently, multiple logistic regression with survey weights was conducted to evaluate differences in demographic proportions in the trajectory classes. Finally, negative binomial regression was run to analyze how trajectories were associated with subsequent mental health adjusting for demographic variables.

Results. Report of experiencing any discrimination ranged from 13% to 24%, peaking around April of 2020 and gradually decreasing. Fit statistics suggested that a two-class solution fit the data best. Most participants (78%; low group) did not experience discrimination regularly while another group (22%; high increasing group) showed increasing trend of discrimination experiences throughout the year. Results of logistic regression analyses suggested higher proportions of individuals who are male, black, below federal poverty threshold, 2^nd generation immigrants, and underemployed in the high increasing group compared to the low group. Negative binominal regression results suggested that being in the high increasing group was associated with a significantly longer period of depressive and anxiety symptoms.

Conclusion and Implications. A subgroup of young adults was at risk for higher levels of discrimination during the pandemic. This subgroup contained a disproportionate concentration of minority, immigrant, and socioeconomically vulnerable population, indicating added burdens for young adults who may already be at risk for adverse outcomes. They also subsequently demonstrated elevated depressive and anxiety symptoms for a longer period, revealing a need for identification of an at-risk subgroup among young adults and mental health services extending beyond the pandemic.