During the Pandemic, Discrimination Has Taken a Toll on the Mental Health of Racial and Ethnic Minority Populations

August 23, 2022

Ruta Nonacs, MD PhD

In this large and diverse sample, increased levels of discrimination were associated with a marked increase in the likelihood of experiencing moderate to severe depressive symptoms and suicidal ideation.

According to a study from the Psychiatric and Neurodevelopmental Genetics Unit (PNGU) at Mass General, everyday discrimination experienced at the height of the pandemic was associated with a marked increase in depressive symtppoms and sucidial ideation.

The pandemic has had a profound impact on the health and well-being of many in the United States, particularly those from communities that face structural racism, such as American Indian and Alaska Native, Asian, Black, Hispanic or Latino, and Pacific Islander populations. During the pandemic, individuals living in these communities have experienced higher rates of COVID-related morbidity and mortality and lower access to health care, as well as higher rates of unemployment and food and housing insecurity than other groups.

Members of these communities have also experienced discrimination. This is by no means a new phenomenon; however, people from all major racial and ethnic minority groups have reported experiencing more COVID-19–related discrimination than White adults during the pandemic. Most notably, the COVID-19 pandemic brought an increase in attacks on individuals of Asian and Pacific Island descent.

A recent study from Younga “Heather” Lee, PhD and colleagues in the Psychiatric & Neurodevelopmental Genetics Unit sought to measure the impact of everyday discrimination on mental health at the height of the pandemic. This study analyzed data from a subset of adult participants in the All of Us Research Program, an NIH-funded longitudinal study of an ethnically and racially diverse population of Americans.

Participants completed the monthly COVID-19 Participant Experience (COPE) survey, a brief online survey administered in order to determine how the pandemic has affected people over time, including questions on COVID-19 symptoms, physical and mental health, social distancing, economic effects, and coping strategies.

The Everyday Discrimination Scale was used to measure discrimination events during the last month (e.g., being treated with less courtesy or respect, being considered as dishonest or threatening). Depressive symptoms and suicidal ideation were measured using the 9-item Patient Health Questionnaire (PHQ-9), with a score of 10 or greater indicating moderate to severe depressive symptoms.

The analysis included a total of 62,651 individuals (mean [SD] age, 59.3 [15.9] years; female 65.6%) completing at least one assessment between May and July 2020. Overall, Hispanic Black participants reported the highest levels of discrimination, followed by participants self-identifying as non-Hispanic Black or African American; non-Hispanic white people reported the least. While age and gender were the most frequently reported reasons for discrimination by non-Hispanic White participants, non-Hispanic Asian and Black or African American participants most commonly reported ancestry, national origins, and race as main reasons for discrimination.

Lee and colleagues observed a strong association between discrimination and increased likelihood of moderate to severe depressive symptoms and suicidal ideation during the early phase of the COVID-19 pandemic. Furthermore, they observed that there was a dose-response association between discrimination and depressive symptoms. Individuals experiencing discrimination more than once a week were more that 17 times as likely to report moderate to severe depressive symptoms and were nearly 11 times as likely to report suicidal ideation (odds ratios 17.68 and 10.76, respectively). Moreover, the association with depressive symptoms was greater when the main reason for discrimination was race, ancestry, or national origins among Hispanic or Latino and non-Hispanic Asian participants.

Previous studies have documented that everyday discrimination is a strong risk factor for adverse mental health outcomes. The current study, conducted during the pandemic, adds to this literature. In this large and diverse sample, increased levels of discrimination were associated with a marked increase in the likelihood of experiencing moderate to severe depressive symptoms and suicidal ideation. This association was particularly evident in Hispanic or Latino and non-Hispanic Asian participants when the main reason for discrimination was race, ancestry, or national origin.

Lee YH, Liu Z, Fatori D, Bauermeister JR, Luh RA, Clark CR, Bauermeister S, Brunoni AR, Smoller JW. Association of Everyday Discrimination With Depressive Symptoms and Suicidal Ideation During the COVID-19 Pandemic in the All of Us Research Program. JAMA Psychiatry. 2022 Jul 27.