Racial and Gender Discrimination Predict Mental Health Outcomes among Healthcare Workers Beyond Pandemic-Related Stressors: Findings from a Cross-Sectional Survey.

Rachel Hennein,Jessica Bonumwezi,Sarah R Lowe,Max Jordan Nguemeni Tiako,Petty Tineo

doi:10.3390/ijerph18179235

Abstract

Racial and gender discrimination are risk factors for adverse mental health outcomes in the general population; however, the effects of discrimination on the mental health of healthcare workers needs to be further explored, especially in relation to competing stressors. Thus, we administered a survey to healthcare workers to investigate the associations between perceived racial and gender discrimination and symptoms of depression, anxiety, posttraumatic stress, and burnout during a period of substantial stressors related to the COVID-19 pandemic and a national racial reckoning. We used multivariable linear regression models, which controlled for demographics and pandemic-related stressors. Of the 997 participants (Mean Age = 38.22 years, SD = 11.77), 688 (69.01%) were White, 148 (14.84%) Asian, 86 (8.63%) Black, 73 (7.32%) Latinx, and 21 (2.11%) identified as another race. In multivariable models, racial discrimination predicted symptoms of depression (B = 0.04; SE: 0.02; p = .009), anxiety (B = 0.05; SE: 0.02; p = .004), and posttraumatic stress (B = 0.01; SE: 0.01; p = .006) and gender discrimination predicted posttraumatic stress (B = 0.11; SE: 0.05; p = .013) and burnout (B = 0.24; SE: 0.07; p = .001). Discrimination had indirect effects on mental health outcomes via inadequate social support. Hospital-wide diversity and inclusion initiatives are warranted to mitigate the adverse mental health effects of discrimination.

Highlights

Introduction iationsThe COVID-19 pandemic has significantly impacted the mental health of healthcare workers (HCWs) since the outbreak began in 2019
The negative effects of discrimination on mental health may be more pronounced for female HCWs of color; for example, one study found that female HCWs of color who reported both racial and gender discrimination were more likely to experience burnout compared with male HCWs of color [7]
Our study adds to these findings by emphasizing the ongoing and persistent negative effects of racial and gender discrimination on HCW wellbeing even during times of other competing stressors, i.e., social and work stressors associated with the COVID-19 pandemic

Summary

Introduction

Introduction iationsThe COVID-19 pandemic has significantly impacted the mental health of healthcare workers (HCWs) since the outbreak began in 2019. A meta-analysis of 65 studies assessing mental health outcomes among HCWs during the pandemic found that the prevalence of anxiety was 22.1%, depression was 21.78%, and posttraumatic stress disorder was. Studies have identified that certain pandemic-related stressors were associated with increased risk of adverse mental health outcomes among HCWs, including work stressors (e.g., frontline status) and social stressors (e.g., childcare shortages) [2]. In addition to these pandemic-related stressors, racial/ethnic minority and female. HCWs face stressors related to racial and gender discrimination [3,4], putting them at increased risk for adverse mental health outcomes. A meta-analysis of 293 studies found that racism was associated with psychological distress in the general

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