Discrimination took a toll on the mental health of racial and ethnic minority groups during the COVID-19 pandemic

Key Takeaways

• People who reported experiencing discrimination more than once a week early in the pandemic had seventeen-fold increased odds of moderate to severe depressive symptoms, and ten-fold increased odds of suicidal ideation, compared to those who reported no discrimination
• Based on data from NIH’s All of Us Research Program, the study learned that individuals who experienced the greatest discrimination showed the highest levels of depressive symptoms and suicidal ideation
• The association appeared to be greatest among those self-identifying as Hispanic/Latino and Asian, especially when the main reason given for discrimination was race, ancestry or national origins during the pandemic

BOSTON – Everyday discrimination experienced by people of racial and ethnic minority groups during the early phase of the COVID-19 pandemic was associated with significantly increased odds of moderate to severe depression and thoughts of suicide, researchers from Massachusetts General Hospital (MGH) and their colleagues have found.

In a study in JAMA Psychiatry, the team reported that the greater the discrimination, the more pronounced the depressive symptoms.

The associations with depression during the pandemic were highest among Hispanic/Latino and Asian/Pacific Islander participants when the main reason for discrimination was based on race, ancestry, or national origin.

“Previous studies have documented the adverse health effects of discrimination, but we were surprised at the magnitude of the effect on the mental health and quality of life of people who have often had to deal with intolerance in their everyday lives,” says Jordan Smoller, MD, ScD, associate chief for research in the MGH Department of Psychiatry.

“In fact, at high levels of everyday discrimination, the association with moderate to severe depressive symptoms was similar to the effect of having a pre-pandemic mood disorder diagnosis, which is pretty dramatic.”

For communities that routinely face structural racism – including Black, Hispanic/Latino, and Asian/Pacific Islander – the pandemic has been a particularly stressful period, given higher rates of unemployment, food and housing insecurity, limited access to healthcare, and even racially motivated violence.

Drawing on the NIH’s All of Us Research Program, a highly diverse database that is fueling research across a host of health fields (including mental health), the MGH team probed the consequences of discrimination during the early pandemic period within a cohort of nearly 63,000 individuals in the largest and most diverse analysis of its type.

Investigators learned that among participants who reported discrimination due to race or ancestry more than once a week, there were seventeen-fold increased odds of moderate to severe depressive symptoms, and a ten-fold increased risk of suicidal ideation.

The COVID-19 Participant Experience (COPE) survey of the All of Us Research Program defined discrimination as being treated with less courtesy or respect than other people, for example, receiving poorer service at restaurants and other facilities, or being called names, threatened, or harassed.

“The pandemic precipitated a dramatic increase in racially motivated attacks on Asian Americans and Pacific Islanders,” notes lead author Younga “Heather” Lee, PhD, an MGH investigator who emigrated from South Korea to the U.S. 11 years ago to continue her education.

“Our study and others suggest that the consequences of anti-Asian racism include stress, depression, anxiety, and even thoughts of suicide.”

Smoller emphasized the need for clinicians and society-at-large to more fully recognize the “toxic effect” that discrimination and racism can have on the mental health of individuals.

“Inequities are not inevitable,” he says, “but for changes to occur, we must work harder to understand and address the kinds of discrimination that some communities experience and the toll it can take on their health and everyday lives.”

Smoller is a professor of Psychiatry at Harvard Medical School (HMS). Lee is a postdoctoral research fellow in the Department of Psychiatry, HMS, and in the Psychiatric & Neurodevelopmental Genetics Unit, Center for Genomic Medicine at MGH. Co-author Cheryl Clark, MD, is an assistant professor of Medicine, HMS, and associate chief, Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital.

The study was supported by the International HundredK+ Cohorts Consortium (IHCC), which has been created in collaboration with the Global Alliance for Genomics and Health (GA4GH) and the Global Genomics Medicine Collaborative (G2MC) with support from the National Institute of Health and the Wellcome Trust.

About the Massachusetts General Hospital

Massachusetts General Hospital, founded in 1811, is the original and largest teaching hospital of Harvard Medical School. The Mass General Research Institute conducts the largest hospital-based research program in the nation, with annual research operations of more than $1 billion and comprises more than 9,500 researchers working across more than 30 institutes, centers and departments. In July 2022, Mass General was named #8 in the U.S. News & World Report list of "America’s Best Hospitals." MGH is a founding member of the Mass General Brigham healthcare system.