Assessing the Impact of COVID-19 on the Health of Native Hawaiian/Pacific Islander People in the United States, 2021.

OBJECTIVES: Minimal research has assessed COVID-19's unique impact on the Native Hawaiian/Pacific Islander (NH/PI) population-an Indigenous-colonized racial group with social and health disparities that increase their risk for COVID-19 morbidity and mortality. To address this gap, we explored the scope of COVID-19 outcomes, vaccination status, and health in diverse NH/PI communities. METHODS: NH/PI staff at partner organizations collected survey data from April through November 2021 from 319 community-dwelling NH/PI adults in 5 states with large NH/PI populations: Arkansas, California, Oregon, Utah, and Washington. Data were analyzed with descriptive statistics, Pearson χ2 tests, independent and paired t tests, and linear and logistic regression analyses. RESULTS: During the COVID-19 pandemic, 30% of survey participants had contracted COVID-19, 16% had a close family member who died of the disease, and 64% reported COVID-19 vaccine uptake. Thirty percent reported fair/poor health, 21% currently smoked cigarettes, and 58% reported obesity. Survey participants reported heightened COVID-19-related psychosocial distress (mean score = 4.9 on 10-point scale), which was more likely when health outcomes (general health, sleep, obesity) were poor or a family member had died of COVID-19. Logistic regression indicated that age, experiencing COVID-19 distress, and past-year use of influenza vaccines were associated with higher odds of COVID-19 vaccine uptake (1.06, 1.18, and 7.58 times, respectively). CONCLUSIONS: Our empirical findings highlight the acute and understudied negative impact of COVID-19 on NH/PI communities in the United States and suggest new avenues for improving NH/PI community health, vaccination, and recovery from COVID-19.

Minority stress, pandemic stress, and mental health among gender diverse young adults: Gender dysphoria and emotion dysregulation as mediators

Gender diverse people in the United States are uniquely vulnerable to deleterious health outcomes because of long-enshrined systems of oppression and marginalization in American society. Trans young adults are especially vulnerable to these deleterious outcomes owing to their unique position in the life course. However, more research is needed on the mechanisms through which this marginalization contributes to mental health disparities in trans populations. Using a minority stress framework and online cross-sectional survey design, the current study examines potential mediators of the relationship between transgender identity-related distal stress and psychological distress from late May to early July 2020 in a sample of transgender young adults (N = 239;ages 18-29). More than half the sample scored above the K6 cutoff for severe psychological distress. Distal stress had a significant direct (beta = .17, SE = .04, t = 2.76, p = .006) and indirect effect on psychological distress. Distal stress was indirectly associated with psychological distress through gender dysphoria (beta = .04;95% CI [.001, .10]) and emotion dysregulation (beta = .16;95% CI [.09, .23]). COVID-19 pandemic stressors were also positively associated with psychological distress (beta = .36, SE = .12, t = 5.95, p < .001). Results highlight the significant mental health burden facing the trans community especially in the COVID-19 context, support a conceptualization of gender dysphoria as connected to experiences of oppression, and affirm the relevance of emotion dysregulation within minority stress frameworks. Mental health resources cognizant of the specific challenges experienced by trans young adults as well as policy changes that seek to address underlying structural transphobia in American culture and institutions are urgently needed. (PsycInfo Database Record (c) 2022 APA, all rights reserved) Impact Statement This study surveying young adults with minority gender identities found (a) high rates of psychological distress during COVID-19, (b) that pandemic stress was associated with greater psychological distress, and (c) transphobic discrimination was associated with greater gender dysphoria and emotion dysregulation, which were both associated with greater psychological distress. This highlights the mechanisms underlying trans health disparities and the importance of recognizing transphobic/cisnormative experiences and systems of oppression when conducting research, creating policies, and/or providing services to support the transgender community. (PsycInfo Database Record (c) 2022 APA, all rights reserved)