Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA.
University of California San Francisco, Institute for Health & Aging, Center for Aging in Diverse Communities, San Francisco, CA, USA.
J Racial Ethn Health Disparities. 2024 Jun;11(3):1374-1384. doi: 10.1007/s40615-023-01614-5. Epub 2023 May 1.
COVID-related discrimination towards historically marginalized racial-ethnic groups in the United States has been well-documented; however, its impact on psychological distress and sleep (overall and within specific racial-ethnic groups) is largely unknown. We used data from our nationally representative, online survey of 5,500 American Indian/Alaska Native, Asian, Black/African American, Native Hawaiian/Pacific Islander, Latino, White, and multiracial adults, conducted from 12/2020-2/2021. Participants were asked how often they experienced discriminatory behaviors "because they think you might have COVID-19" (modified Everyday Discrimination Scale). Psychological distress was captured as having experienced anxiety-depression symptoms (Patient Health Questionairre-4, PHQ-4), perceived stress (modified Perceived Stress Scale), or loneliness-isolation ("How often have you felt lonely and isolated?"). Sleep disturbances were measured using the Patient-Reported Outcomes Information System Short Form Sleep Disturbance scale (PROMIS-SF 4a). Overall, 22.1% reported COVID-related discriminatory behaviors (sometimes/always: 9.7%; rarely: 12.4%). 48.4% of participants reported anxiety-depression symptoms (moderate/severe: 23.7% mild: 24.8%), 62.4% reported feeling stressed (moderate/severe: 34.3%; mild: 28,1%), 61.0% reported feeling lonely-isolated (fairly often/very often: 21.3%; almost never/sometimes: 39.7%), and 35.4% reported sleep disturbances (moderate/severe:19.8%; mild: 15.6%). Discrimination was only associated with increased psychological distress among racial-ethnic minorities. For example, COVID-related discrimination was strongly associated with anxiety-depression among Black/African American adults (mild: aOR=2.12, 95% CI=1.43-5.17; moderate/severe: aOR=5.19, 95% CI=3.35-8.05), but no association was observed among White or multiracial adults. Mitigating pandemic-related discrimination could help alleviate mental and sleep health disparities occurring among minoritized racial-ethnic groups.
在美国，与 COVID 相关的针对历史上处于边缘地位的种族群体的歧视得到了充分记录；然而，其对心理困扰和睡眠（整体和特定种族群体内）的影响在很大程度上仍不清楚。我们使用了从 2020 年 12 月至 2021 年 2 月期间对 5500 名美国印第安人/阿拉斯加原住民、亚裔、非裔美国人、夏威夷原住民/太平洋岛民、拉丁裔、白人和多种族成年人进行的全国代表性在线调查的数据。参与者被问及他们经历过多少次因“他们认为你可能患有 COVID-19”而受到歧视行为（经修改的日常歧视量表）。心理困扰的评估标准是出现焦虑抑郁症状（患者健康问卷-4，PHQ-4）、感知压力（经修改的感知压力量表）或孤独隔离感（“你经常感到孤独和孤立吗？”）。睡眠障碍使用患者报告的结果信息系统简式睡眠障碍量表（PROMIS-SF 4a）进行测量。总体而言，22.1%的人报告了与 COVID 相关的歧视行为（有时/总是：9.7%；很少：12.4%）。48.4%的参与者报告出现焦虑抑郁症状（中度/重度：23.7%；轻度：24.8%），62.4%的参与者感到有压力（中度/重度：34.3%；轻度：28.1%），61.0%的参与者感到孤独隔离（相当频繁/非常频繁：21.3%；几乎从不/有时：39.7%），35.4%的参与者报告存在睡眠障碍（中度/重度：19.8%；轻度：15.6%）。歧视仅与少数族裔的心理困扰增加有关。例如，与 COVID 相关的歧视与非裔美国人的焦虑抑郁密切相关（轻度：aOR=2.12，95%CI=1.43-5.17；中度/重度：aOR=5.19，95%CI=3.35-8.05），但在白人和多种族成年人中则没有观察到这种关联。减轻与大流行相关的歧视可能有助于减轻少数族裔群体中出现的心理健康和睡眠健康差距。
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