ABSTRACT
Incidents of discrimination against Asian American Pacific Islanders (AAPI) have continued to rise during the COVID pandemic. Previous research supports the relationship between discrimination and alcohol-related problems, possibly putting this population at greater risk. The goals of the current study were to do the following: 1) Characterize the relationship between alcohol use and reported incidents of discrimination for AAPIs, 2) identify group-level differences in experiences between East Asians and other Asian Americans (i.e., Southeast Asian, South Asian, and Pacific Islanders), and 3) identify culturally relevant risk or protective factors that moderate the relationship between incidents of discrimination and alcohol use. Participants were 102 participants who identified racially as Asian American (Mean age = 33.2 years (±10.5 SD), 56.7% male, and 56.9% East Asian). Participants completed an online survey including measures of demographics, alcohol use, mental health, culturally relevant factors, racial discrimination, and random responding checks. A series of moderation regression analyses was conducted in SPSS using the PROCESS macro. After controlling for age, gender and generational status (e.g., being a first-generation immigrant), higher discrimination frequency was related to more alcohol use (B = 7.30, p < 0.001);however, attributing racism directed at their race was related to less alcohol use (B = -0.92, p = 0.016). These relationships held across individuals identifying as East Asian and as other Asian Americans (p > 0.065). Reporting experiencing more discrimination events and having poorer collective self-esteem related to more alcohol use (B = -0.478, p = 0.024). There was a significant interaction between acculturative stress and discrimination frequency (B = 0.312, p < 0.001), such that at one standard deviation above the mean on acculturative stress, there was a significant positive relationship between discrimination frequency and alcohol use (B = 5.46, p < 0.001), but at one standard deviation below the mean on acculturative stress the relationship was significant and negative (B = -5.15, p = 0.03) and there was no relationship at the mean level acculturative stress (B = -0.63, p = 0.69). Our findings support previous literature that suggest discrimination is related to more alcohol use. Additionally, we identified acculturative stress and collective self-esteem as potential risk and protective factors for alcohol use in Asian Americans, respectively. Although overall, AAPIs are at lower risk for alcohol abuse, these factors may help us identify subgroups who are at higher risk.
ABSTRACT
Background: The University of Cincinnati Stroke Team provides acute stroke care to the southwest Ohio, northern Kentucky, and southeast Indiana catchment area of ∼2 million people and 30 healthcare facilities. We previously published a significant decline in stroke activations and reperfusion treatment (IV thrombolysis and EVT) rates following state announcements of COVID-19 mitigation measures. Here, we update these trends after state reopening guidelines. Methods: We compared Stroke Team activations and reperfusion treatments logged in a prospectively collected database, comparing the same period in 2020 versus 2019. Kentucky and Ohio announced school and restaurant closures on March 12 and 13, respectively, followed by Indiana. A stepwise reopening of our tristate area started on May 1, 2020. We also compared trends in activations and treatment rates before (Weeks 1-10), during (Weeks 11-17), and after (Weeks 18- 26) the lifting of COVID-19 mitigation efforts using the Poisson test, and graphically with segmented regression analysis. Results: Compared to 2019, stroke team activations declined by 12% in 2020 (95% CI 7 - 16%;p<0.01). During 2020, an initial decline in stroke activations following COVID-19 mitigation announcements was followed by a 28% increase in activations after reopening (Weeks 18-26: 95% CI 15 - 42%;p<0.01). In contrast, compared to 2019, treatment rates were unchanged (0%, 95% CI -15 - 18%;p=1.00), including specifically IV thrombolysis and thrombectomy rates. Similarly, an initial decline in reperfusion treatments was followed by a 24% nonsignificant increase after reopening (95% CI -10 - 71%;p=0.19) in 2020. Conclusion: The initial decline in stroke team activations during COVID-19 mitigation efforts was followed by an increase in activations after reopening. Hospital capacity and 911 services remained fully intact, suggesting that the reduction in activations were related to reduced presentation by patients for emergent stroke care.(Figure Presented).