Racial-ethnic disparities in psychological distress during the COVID-19 pandemic in the United States: the role of experienced discrimination and perceived racial bias

Ming Wen; Lu Shi; Donglan Zhang; Yan Li; Zhuo Chen; Baojiang Chen; Liwei Chen; Lu Zhang; Hongmei Li; Jian Li; Xuesong Han; Dejun Su

doi:10.1186/s12889-023-15912-4

Racial-ethnic disparities in psychological distress during the COVID-19 pandemic in the United States: the role of experienced discrimination and perceived racial bias

BMC Public Health. 2023 May 25;23(1):957. doi: 10.1186/s12889-023-15912-4.

Authors

Ming Wen^{1

2}, Lu Shi³, Donglan Zhang⁴, Yan Li⁵, Zhuo Chen⁶, Baojiang Chen⁷, Liwei Chen⁸, Lu Zhang³, Hongmei Li⁹, Jian Li¹⁰, Xuesong Han¹¹, Dejun Su¹²

Affiliations

¹ Faculty of Social Sciences, University of Hong Kong, Pok Fu Lam, Hong Kong.
² Department of Sociology, University of Utah, Salt Lake City, UT, 84112, USA.
³ Department of Public Health Sciences, Clemson University, Clemson, SC, 29634, USA.
⁴ Division of Health Services Research, Department of Foundations of Medicine, New York University Long Island School of Medicine, Mineola, NY, 11501, USA.
⁵ Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.
⁶ Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, GA, 30602, USA.
⁷ Department of Biostatistics and Data Science, School of Public Health, University of Texas Health Science Center at Houston, 1616 Guadalupe, Suite 6.300, Austin, TX, 78701, USA.
⁸ Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, 90095, USA.
⁹ Department of Media, Journalism and Film, Miami University, Oxford, OH, 45056, USA.
¹⁰ Department of Environmental Health Sciences, Fielding School of Public Health, School of Nursing, University of California Los Angeles, Los Angeles, CA, 90095, USA.
¹¹ Surveillance and Health Equity Science, American Cancer Society, Atlanta, GA, 30303, USA.
¹² Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, NE, 68198, USA. dejun.su@unmc.edu.

Abstract

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.

Keywords: COVID-19; Experienced discrimination; Perceived racial Bias; Psychological distress; Racial-ethnic disparities.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
COVID-19* / epidemiology
Ethnicity / psychology
Humans
Minority Groups
Pandemics
Racism*
United States / epidemiology