Anti-Asian hate incidents and mental health outcomes among Asian Americans during the COVID-19 pandemic in the U.S.: An extensive scoping review

Mental health care among marginalized populations in the United States

Asian American Mental Health: Looking Beyond the COVID-19 Pandemic

BackgroundDuring the COVID-19 pandemic, increased social media usage has led to worsened mental health outcomes for many people. Moreover, due to the sociopolitical climate during the pandemic, the prevalence of online racial discrimination has contributed to worsening psychological well-being. With increases in anti-Asian hate, Asian and Asian American social media users may experience the negative effects of online racial discrimination in addition to the reduced psychological well-being resulting from exposure to online COVID-19 content.ObjectiveThis study aims to investigate the impact of COVID-19–related social media use and exposure to online racial discrimination during the pandemic on the mental health outcomes (ie, anxiety, depression, and secondary traumatic stress [STS]) of Asian Americans compared with those of non-Asian Americans. In addition, this study explores the mediating role of negative affect and the moderating role of racial/ethnic identification.MethodsAn online survey was conducted through Amazon Mechanical Turk and a university-wide research portal from March 3 to March 15, 2021. A total of 1147 participants took the survey. Participants’ social media usage related to COVID-19 and exposure to 2 online forms of racial discrimination (individual and vicarious), mental health outcomes (anxiety, depression, and STS), racial/ethnic identification, negative affect, and demographics were assessed.ResultsOur results showed that COVID-19–related social media use, individual discrimination, and vicarious discrimination were predictors of negative mental health outcomes (anxiety, depression, and STS). Asian Americans reported higher vicarious discrimination than Latinx and White Americans, but Asian Americans’ mental health outcomes did not differ substantially from those of the other racial/ethnic groups. Racial/ethnic identification moderated the relationship between both types of discrimination and STS, and negative affect served as a mediator between both types of discrimination and all 3 mental health outcomes.ConclusionsThese results suggest that social media exposure continues to have a dire effect on mental health during the COVID-19 pandemic. This study helps to contextualize the rise of anti-Asian American hate and its impact on mental health outcomes in the United States.

The Name of Hate

Longitudinal Assessment of Changes in Mental and Sexual Health Outcomes Due to COVID-19 Among Latinx SMM and TGW.

Between Empirical Data and Anti-BlacknessA Critical Perspective on Anti-Asian Hate Crimes and Hate Incidents Janelle Wong (bio) and Rossina Zamora Liu (bio) After a US president (with connections to white nationalists), raised the specter of Yellow Peril and white shooters engaged in mass killings of Asian Americans in Atlanta and Indianapolis in the spring of 2021, white violence toward Asian Americans was difficult to ignore. Yet one leading story of anti-Asian violence in the wake of the pandemic is of an Asian American senior, often termed an "elder" in reporting, or young woman brutally beaten by a person who "appears to be Black." This story and others like it have circulated throughout the Asian American community via viral videos. The story has been the subject of calls for attention to "Black-Asian conflict" in the recent past.1 In March 2021, for example, Vox reporters noted that "Many of the attacks that have gained widespread attention have featured Black assailants, and have threatened to inflame tensions between Asian Americans and Black Americans."2 In April of 2021, a story by an NBC local affiliate in Seattle observed that "There have also been widely circulated videos that show Black men attacking Asian Americans."3 Meanwhile, survey and crime data suggest a different trend. Empirical data, for instance, shows that, compared to their share of the population, Asian American elders (over age 65) are underrepresented among victims of Asian American hate crimes and hate incidents. While women are more likely to report a hate incident to the StopAAPIHate reporting site, multiple sources of data show that men are as likely or more likely to experience a hate incident than women. Further, the vast majority of violence against Asian Americans [End Page 387] consists not of physical assaults but of verbal harassment and "shunning." The data also shows that Black offenders make up a minority of offenders. And, comparatively, Black Americans are up to ten times more likely to report being the victim of a hate crime than Asian Americans, and this pattern persists even in places like California, where Asian Americans comprise nearly double the population of Black Americans.4 This is true despite the fact that people of all racial backgrounds indicate that they are reluctant to report hate crimes. The point here is not to minimize the disturbing incidents, crimes, and even killings that have been widely circulated as part of anti-Asian hate media coverage; rather, placing these incidents in a broader context allows them to be better understood and ultimately addressed by well-informed policy. As two Asian American women and non-Black educators of Color, we seek to better understand the disconnection between the empirical data and the many Black-Asian conflict narratives of anti-Asian violence. We note that, despite a wealth of compelling empirical data, the media arc of anti-Asian violence—historically a symptom of white supremacy—quickly turned from the China-focused rhetoric of a white president and the heinous actions of white mass shooters to a focus on Black individuals physically assaulting Asian American elders. What is disturbing about this second narrative, which we describe as the "Black-on-Asian crime" narrative, is that it eclipses systematic racism captured by data, while gaining a widely accepted place in the discourse of Black aggression as a root cause of anti-Asian violence. The Black-on-Asian crime narrative has not only (re)ignited the Black-Asian conflict trope but seems to have also illuminated an undercurrent of anti-Blackness in narratives of Asian American victimization and perceptions of safety. In this paper, we present data regularly ignored in widely circulating Black-on-Asian crime narratives around anti-Asian violence, followed by a theoretically grounded reflection on the gap between empirical data and viral videos that emphasize Asian American vulnerability against the threat of Black violence. To be clear, we acknowledge that the anti-Asian incidents shown on viral videos are not only real and abhorrent but they have understandably elicited anger and fear in our community. What we hope to illustrate is the way in which these incidents have become prominent in discourses around anti-Asian violence, even though...

Deployment of personnel to military operations: impact on mental health and social functioning.

The global COVID-19 pandemic disproportionately affected Asian Americans and Pacific Islanders (AAPIs) and revealed significant health disparities with reports of increased discrimination and xenophobia. Among AAPIs, the pandemic exacerbated their social, linguistic, and geographic isolation. Social support may be especially important for AAPIs given the salience of collectivism as a cultural value. Another mechanism for support among AAPIs was technology use, as it is generally widespread among this population. However, older adults may not perceive the same benefits. We examined social support and technology use and their relationships with mental and physical health outcomes through the COVID-19 pandemic among AAPIs. Data were drawn from the COVID-19 Effects on the Mental and Physical Health of AAPI Survey Study (COMPASS) for the time period of October 2020 to February 2021. COMPASS was a cross-sectional, multilingual, national survey conducted online, by phone, and in person with AAPI adults who were ≥18 years of age, in collaboration with academic and community partners in the United States. Data were analyzed using multivariable linear regression using the outcome variables of mental and physical health with various predictors such as social support and technology use. We tested for interactions specific to age and ethnicity. Among 4631 AAPIs (mean age 45.9, SD 16.3 years; 2992/4631, 63.1% female), we found that (1) increased social support was associated with better physical health, (2) total social support was positively associated with better mental health, (3) higher technology use was associated with poorer mental health and inversely associated with poorer physical health, (4) the association of technology use with mental health was weaker among those with low social support (vs those with high social support), (5) adults younger than 60 years old (vs ≥60 years old) were more negatively affected with social support and mental health, and (6) Korean Americans appeared to be a high-risk group for poor physical health with increased technology use. Our paper identified mental and physical health needs along with supportive therapies observed among AAPIs during the pandemic. Future research on how social support can be leveraged, especially among AAPIs younger than 60 years old, and how various types of technology are being utilized are important to guide the recovery efforts to address both mental and physical disparities across communities as a result of the COVID-19 pandemic.

Policy Recommendations to Promote Integrated Mental Health Care for Children and Youth.

The aim of this study was to confirm and extend the authors' previous work indicating that symptoms of traumatic grief are predictors of future physical and mental health outcomes. The study group consisted of 150 future widows and widowers interviewed at the time of their spouse's hospital admission and at 6-week and 6-, 13-, and 25- month follow-ups. Traumatic grief was measured with a modified version of the Grief Measurement Scale. Mental and physical health outcomes were assessed by self-report and interviewer evaluation. Survival analysis and linear and logistic regressions were used to determine the risk for adverse mental and physical health outcomes posed by traumatic grief. Survival and regression analyses indicated that the presence of traumatic grief symptoms approximately 6 months after the death of the spouse predicted such negative health outcomes as cancer, heart trouble, high blood pressure, suicidal ideation, and changes in eating habits at 13- or 25-month follow-up. The results suggest that it may not be the stress of bereavement, per se, that puts individuals at risk for long-term mental and physical health impairments and adverse health behaviors. Rather, it appears that psychiatric sequelae such as traumatic grief are of critical importance in determining which bereaved individuals will be at risk for long-term dysfunction.

Reports of escalated discrimination experiences among Asian American and Native Hawaiian Pacific Islanders (AANHPI) continue. Using the original and follow-up surveys of the COVID-19 Effects on the Mental and Physical Health of AAPI (Asian American and Pacific Islanders) Survey Study (COMPASS I and COMPASS II) (n = 3177), we examined changes over approximately a 1-year period in discrimination experiences attributable to being AAPI and factors associated with worse mental health outcomes. Experiences of discrimination remained high in COMPASS II with 60.6% (of participants (compared to 60.2% among the same people in COMPASS I) reporting one or more discrimination experiences, and 28.6% reporting worse mental health outcomes. Experiences of discrimination were associated with modest but significant increase in the odds of worse mental health: adjusted OR 1.02 (95% CI 1.01-1.04). Being younger, being of Native Hawaiian/Pacific Islander or Hmong descent (relative to Asian Indian), and having spent 50% or less of their lifetime in the US (vs. US born), were significantly associated with worse mental health. The fall-out from the pandemic continues to adversely impact AANHPI communities. These findings may help influence policy initiatives to mitigate its effects and support interventions designed to improve mental health outcomes.

Mental health outcomes during COVID-19: A scoping review & recommendations for geriatrics research

Objectives. To summarize data collection on anti-Asian American and Native Hawaiian/Pacific Islander (AANHPI) experiences during COVID-19 and measure the associations of anti-AANHPI hate incidents with mental health, health access, and public safety among AANHPI adults. Methods. We cataloged COVID-19 surveys conducted in 2020 and 2021 on anti-AANHPI experiences. We then analyzed the 2020 California Health Interview Survey (CHIS) AANHPI COVID-19 module by constructing a variable of experiencing or witnessing a hate incident and estimating its associations with serious psychological distress, forgone care, and perceived neighborhood safety. Results. Estimates of being a victim of a hate incident ranged from 6% to 30%. In the CHIS, 28% of respondents experienced or witnessed a hate incident. Experiencing or witnessing a hate incident was significantly associated with serious psychological distress (adjusted odds ratio [AOR] = 5.33), forgoing care (AOR = 2.27), and not feeling safe in one's neighborhood (AOR = 2.70). Conclusions. Evidence from a multitude of data sources corroborates the toll of hate incidents suffered by AANHPIs. Findings regarding the negative effects of anti-AANHPI hate on mental health, health access, and public safety compel public and private investment to end victimization of AANHPI communities. (Am J Public Health. 2022;112(10):1446-1453. https://doi.org/10.2105/AJPH.2022.306977).

Honoring Asian diversity by collecting Asian subpopulation data in health research.

Research has shown that the COVID-19 pandemic affected individual’s mental and physical health. The aim of this study was to estimate associations between greenspace use and proximity with perceived mental and physical health during the COVID-19 pandemic. We surveyed metropolitan Philadelphia residents, October 20–December 1, 2020, about walking time to the nearest greenspace from their home, frequency of greenspace use in the past 30 days, change in frequency of greenspace use during the COVID-19 pandemic, and perceived physical and mental health outcomes. We ran unadjusted and adjusted log-binomial regression models to derive Risk Ratio (RR) and 95% Confidence Intervals (CI) estimates of associations of loneliness, physical and mental health outcomes with: (1) self-reported walking time to nearest greenspace; (2) reported greenspace use frequency; and (3) changes in greenspace use frequency. Of 485 survey participants, 244 (51.4%) reported feeling lonelier, 147 (31.37%) reported higher perceived stress, 261 (54.9%) reported worsened mental health, and 137 (28.7%) reported worsened physical health during vs. before the start of pandemic-restrictions in mid-March of 2020. After adjustment for gender, age, and change in financial status, RR estimates suggested modest protective associations between visiting greenspaces more frequently during vs. before the pandemic and worsened mental (RR: 0.84, 95% CI: 0.70–1.00), and physical health (RR 0.77, 95% CI: 0.56–1.10), and loneliness (RR: 0.91, 95% CI: 0.75–1.1) and perceived stress (RR 0.83, 95% CI: 0.61–1.13). Shorter walking distances to the nearest greenspace were associated with reduced risk of reporting worsened physical health and higher perceived stress; however, living shorter walking distances from greenspace were not associated with protection against worsened mental health or loneliness. These results suggest that active greenspace use may provide mental and physical health protection, particularly during a stressful public health crisis.