Abstract: COVID-19 Discrimination and Substance Use Among Asian Americans: Moderating Role of Gender (Society for Social Work and Research 29th Annual Conference)

Schedule:

Thursday, January 16, 2025

Greenwood, Level 3 (Sheraton Grand Seattle)

* noted as presenting author

Dale Maglalang, PhD, MA, MSW, MPH, Assistant Professor, New York University, New York, NY

Nari Yoo, MA, PhD Candidate, New York University, New York, NY

Michael Park, PhD, Assistant Professor, Rutgers University, NJ

Cora de Leon, PhD, MPH, LCSW, Clinical Associate Professor, New York University, New York, NY

Harvey Nicholson, PhD, Assistant Professor, University of Toronto, Toronto, ON, Canada

Sumie Okazaki, PhD, Professor, New York University

Doris Chang, PhD, Associate Professor, New York University, NY

Background and Purpose: Asian Americans have experienced heightened discrimination during the COVID-19 pandemic. Minority Stress Theory posits that experiences of discrimination can lead to negative health behaviors such as substance use, and substance use is often viewed as a gendered and acceptable coping mechanism for men. Additionally, social norms theory suggests that men may be more likely to engage in substance use as a coping mechanism due to perceived social acceptability. This study examined the associations between various forms of COVID-19-related discrimination and substance use among Asian Americans and whether gender moderates these associations.

Methods: Data were from the Asian and Black Americans, Racism, and Allyship (ABRA) survey, conducted in May 2022 with a national sample of 1,078 Asian Americans (Chinese, Filipino/a/x, and Asian Indian) recruited through a Qualtrics panel. Participants resided in the U.S. since January 2020, were at least 18 years old, and completed an online survey in English or Chinese. Measures used in this analysis include the NIDA Quick Screen regarding the use of each type of substance use (alcohol, tobacco, prescription drugs, cannabis, and illegal drugs) and COVID-19 discrimination scale (overt direct racial discrimination, subtle direct racial discrimination, and vicarious racial discrimination). Multiple imputation was used to handle missing data. Logistic regression models with interaction terms were used to examine the associations between COVID-19 discrimination measures and substance use outcomes and the moderating role of gender. Marginal effects were calculated to interpret significant interactions.

Results: Overt direct discrimination was significantly associated with increased alcohol (OR = 1.49, p < .001), tobacco (OR = 1.51, p < .001), prescription drug (OR = 2.10, p < .001), cannabis (OR = 1.45, p < .001), and illegal drug use (OR = 2.08, p < .001). Subtle direct discrimination was significantly associated with increased alcohol (OR = 1.89, p < .001), tobacco (OR = 2.32, p < .001), prescription drugs (OR = 4.03, p < .001), cannabis (OR = 2.25, p < .001), and illegal drug use (OR = 3.54, p < .001). Vicarious discrimination was significantly associated with increased alcohol (OR = 1.46, p < .001), tobacco (OR = 1.26, p < .05), and prescription drugs (OR = 1.29, p < .05). Interaction effects between discrimination and gender were significant for several substance outcomes. The association between overt direct discrimination and alcohol (OR = 1.66, p < .01), cannabis (OR = 1.50, p < .05) and between vicarious discrimination and alcohol (OR = 1.46, p < .05) were stronger for men. The subtle direct discrimination and gender interactions were not significant across substances.

Conclusions: Various forms of COVID-19 discrimination were associated with increased substance use among Asian Americans across substances. Gender played a moderating role, specifically for overt direct racism on alcohol and cannabis use and vicarious racism and alcohol use. These findings highlight the gendered and racialized contexts of discrimination and substance use, which calls for the development of gender-specific intervention on substance use for Asian Americans.