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日常和重大歧视经历与新冠疫情期间暴力和不良心理健康结果的关联。

The associations of everyday and major discrimination exposure with violence and poor mental health outcomes during the COVID-19 pandemic.

机构信息

Center on Gender Equity and Health, University of California San Diego School of Medicine, 9500 Gilman Drive #0507, La Jolla, CA, 92093, USA; School of Social and Political Science, University of Edinburgh, Chrystal Macmillan Building, 15a George Square, Edinburgh EH8 9LD United Kingdom.

Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA.

出版信息

Soc Sci Med. 2023 Feb;318:115620. doi: 10.1016/j.socscimed.2022.115620. Epub 2022 Dec 15.

Abstract

Research on discrimination and risks for violence and mental health issues under the pandemic is notably absent. We examined the relative effects of perceived everyday discrimination (e.g., poorer service, disrespectful treatment in a typical week) and major experiences of race-based discrimination (e.g., racial/ethnic discrimination in housing or employment at any point in the lifetime) on experiences of violence and the PHQ-4 assessment of symptoms of depression and anxiety under the pandemic. We analyzed state-representative cross-sectional survey data from California adults (N = 2114) collected in March 2021. We conducted multivariate regression models adjusting for age, race/ethnicity, gender, sexual identity, income, and disability. One in four Californians (26.1%) experienced everyday discrimination in public spaces, due most often to race/ethnicity and gender. We found that everyday discrimination was significantly associated with past year physical violence (single form Adjusted Odds Ratio [AOR] 5.0, 95% CI 2.5-10.3; multiple forms AOR 2.6, 95% CI 1.1-5.8), past year sexual violence (multiple forms AOR 2.5, 95% CI 1.4-4.4), and mental health symptoms (e.g., severe symptoms, multiple forms AOR 3.3, 95% CI 1.6-6.7). Major experiences of race-based discrimination (reported by 10.0% of Californians) were associated with past year sexual violence (AOR 2.0, 95% CI 1.1-3.8) and severe mental health symptoms (AOR 2.7, 95% CI 1.2-6.2). Non-race-based major discrimination (reported by 23.9% of Californians) was also associated with violence and mental health outcomes Everyday discrimination, more than major experiences of discrimination, was associated with higher risk for violence and poor mental health outcomes during the pandemic. Non-race-based forms of major discrimination independently were also associated with these negative outcomes. Findings indicate that efforts to reduce and ultimately eliminate discrimination should be a focus of public health and COVID-19 rebuilding efforts.

摘要

在大流行背景下,针对暴力和心理健康问题的歧视和风险研究明显不足。我们研究了感知到的日常歧视(例如,在典型的一周内服务质量较差、受到不尊重的待遇)和基于种族的重大歧视经历(例如,一生中任何时候在住房或就业方面受到种族/族裔歧视)对大流行期间经历暴力和 PHQ-4 评估抑郁和焦虑症状的相对影响。我们分析了 2021 年 3 月从加利福尼亚州成年人(N = 2114 人)收集的具有代表性的州横断面调查数据。我们通过多元回归模型,调整了年龄、种族/族裔、性别、性身份、收入和残疾等因素。四分之一的加利福尼亚人(26.1%)在公共场所经历过日常歧视,最常见的原因是种族/族裔和性别。我们发现,日常歧视与过去一年的身体暴力(单一形式调整后的优势比 [AOR] 5.0,95%置信区间 2.5-10.3;多种形式 AOR 2.6,95%置信区间 1.1-5.8)、过去一年的性暴力(多种形式 AOR 2.5,95%置信区间 1.4-4.4)和心理健康症状(例如,严重症状,多种形式 AOR 3.3,95%置信区间 1.6-6.7)显著相关。10.0%的加利福尼亚人报告的基于种族的重大歧视经历与过去一年的性暴力(AOR 2.0,95%置信区间 1.1-3.8)和严重心理健康症状(AOR 2.7,95%置信区间 1.2-6.2)相关。23.9%的加利福尼亚人报告的非基于种族的重大歧视也与暴力和心理健康结果有关。在大流行期间,日常歧视比重大歧视经历更与暴力和心理健康不良结果相关。非基于种族的重大歧视形式也与这些负面结果独立相关。研究结果表明,减少歧视并最终消除歧视的努力应成为公共卫生和 COVID-19 重建工作的重点。

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