Celia B. Fisher, Ph.D.
Marie Ward Doty University Chair in Ethics
Professor of Psychology
Director, Center for Ethics Education
Director, HIV/Drug Abuse Prevention Research Ethics Institute
People from racial and ethnic minorities in the United States have borne a disproportionately higher burden of COVID-19 infection and mortality. During the pandemic, depression and anxiety among American Indian/Alaska Native (AI/AN), Asian, Black, and Hispanic people have also increased. These disparities are rooted in long-standing racial and ethnic inequities in medical and behavioral health treatment utilization and access to culturally relevant health services.
Racial discrimination has long been documented as a psychosocial stressor among racial and ethnic minority individuals and national surveys indicate racism increased during the current pandemic. During the pandemic racially and ethnically marginalized persons in the U.S. were also more likely to be employed in the health care work force or as frontline workers in industries such as food services, pharmacies, personal care and public transportation. Employment in these positions not only increased risk of COVID-19 infection, but increased public perception that racial and ethnic groups were more likely to be infected with the coronavirus. Simultaneously, the U.S, saw an upsurge in racially based hate crimes, particularly directed against Asian Americans. The surge in racial bias and violence underscores the urgency of studying the effects of pandemic-related forms of victimization and discrimination on the mental health of racial and ethnic youth and adults in the U. S.
In online national surveys involving AI/AN, Asian, Black and Hispanic adolescents and adults, my colleagues and I examined the mental health effects of coronavirus victimization distress (i.e., distress in response to being verbally or physically harassed “because someone thought I had the coronavirus”) and coronavirus-related increases in racial bias (belief that the country has become more dangerous for people in one’s racial and ethnic group because of fear of the coronavirus). Across racial and ethnic groups of adults, we found that beyond the effects of pre-existing COVID-19 health risks, any employment or employment disruption during this period (whether as an essential or “non-essential” worker) or financial, health care, and housing insecurity, coronavirus victimization distress and perceived national increases in racial biases contributed to symptoms of depression and anxiety. Perhaps not surprisingly, given the sociopolitically fomented pandemic related anti-Asian bias, Asian participants reported the highest levels of pandemic related national biases against their racial and ethnic group. Sleep quality and duration have also been associated with corresponding mental health disparities among racial and ethnic minority populations in the U.S. Compared to AI/AN, Asian, Latinx and non-Hispanic White young adults during the pandemic, Black individuals reported less hours of sleep duration and quality, explained in part by their reported higher engagement as essential workers and higher levels of reported coronavirus victimization distress.
Racial and ethnic minority youth have also been affected by increases in racial discrimination during COVID. Pandemic shelter-at-home policies and the reignited racial justice movement increased the use of social media among youth of color, potentially exposing them to social media racial discrimination. Whereas offline civic engagement has been associated with positive development among minority youth, online racial justice activities can expose youth to anonymous actors who subject them to different forms of social media racial discrimination. During the pandemic, we found that among 15- to 18-year-old AI/AN, Asian, Black and Latinx youth, hours of use and racial justice civic engagement were associated with increased exposure to social media racial discrimination directed at them both personally and vicariously to members of their racial groups. These experiences were in turn related to increases in depressive symptoms, anxiety, and substance use.
The COVID-19 pandemic has created new pathways to mental health disparities among adolescents and adults of color by reversing formerly protective factors such as employment and social justice civic engagement, and by exacerbating existing mental health and societal inequities linked to race. These patterns highlight the necessity of moving away from aggregated findings that may mask differences among racial groups and call for creating mental health services tailored to the specific needs of different racial and ethnic minority groups during ongoing and future health crises. The pandemic has also highlighted the importance of identifying strategies to mitigate the negative effects of social media racial discrimination on youth mental health and calls for additional public discourse on whether social media algorithms are amplifying exposure to racial bias in ways that jeopardize psychological well-being of racial and ethnic minority adolescents.
Artiga, S., Hill, L., & Halar, S. (2021). COVID-19 cases and deaths by race/ethnicity: Current data and changes over time. https://www.kff.org/racial-equity-and-health-policy/issue-brief/covid-19-cases-and-deaths-by-race-ethnicity-current-data-and-changes-over-time/
Ballard, P. J., Hoyt, L. T. & & Pachucki, M. C. (2019). Impacts of adolescent and young adult civic engagement on health and socioeconomic status in adulthood. Child Development, 90, 1138-1154. doi: 10.1111/cdev.12998
Fisher, C. B., Tao, X., Liu, T., Giorgi, S., & Curtis, B. L. (2021). COVID-Related Victimization, Racial Bias and Employment and Housing Disruption Increase Mental Health Risk Among US Asian, Black and Latinx Adults. Frontiers in Public Health, 1625. doi: 10.3389/fpubh.2021.772236.
Fisher, C. B., Tao., & Yip, T. (2020, preprint). The effects of coronavirus victimization distress and coronavirus racial bias on mental health among AIAN, Asian, Black and Latinx young adults. https://doi.org/10.1101/2020.08.19.20178343
Fisher, C. B., & Yip, T. (2020). The coronavirus racial bias scale (CRBS). https://www.phenxtoolkit.org/toolkit_content/PDF/Fordham_CRBS_2021.pdf
Fisher, C. B. & Yip, T. (2020). The coronavirus victimization distress scale (CVDS). https://www.phenxtoolkit.org/toolkit_content/PDF/Fordham_CVDS_2021.pdf
McKnight-Eily, L. R., Okoro, C. A., Strine, T. W., Verlenden, J., Hollis, N. D., Njai, R., Mitchell, E. W., Board, A., Puddy, R., & Thomas, C. (2021). Racial and Ethnic Disparities in the Prevalence of Stress and Worry, Mental Health Conditions, and Increased Substance Use Among Adults During the COVID-19 Pandemic—United States, April and May 2020. Morbidity and Mortality Weekly Report, 70(5), 162. https:// doi: 10.15585/mmwr.mm7005a3
Paine, L., de la Rocha, P., Eyssallenne, A. P, Andrews, C. A., Loo, L. Jones, C. P., Collins, A. M., & orse, M. (2021). Declaring racism a public health crises in the United States: Cure, poison, or both. Frontiers in Public Health, https://doi.org/10.3389/fpubh.2021.676784
Tao, X., & Fisher, C. B. (2021). Exposure to social media racial discrimination and mental health among adolescents of color. Journal of Youth and Adolescence. https://doi.org/10.1007/s10964-021-01514-z
Yip, T., Feng, Y., Fowle, J. & Fisher, C. B. (2021). Sleep disparities during the COVID-19 pandemic An Investigation of AIAN, Asian, Black, Latinx and White young adults. Sleep Health: Journal of the National Sleep Foundation, 7, 459-467. https://doi.org/10.1016/j.sleh.2021.05.008
Yip T., Cheon, Y.M. (2020). Sleep, psychopathology and cultural diversity. Curr Opin Psychol, 34:123-127. doi: 10.1016/j.copsyc.2020.02.006. Epub 2020 Feb 22. PMID: 32203913; PMCID: PMC7308190.