Mental Health Needs Among Asian and Asian American Adults During the COVID-19 Pandemic.

OBJECTIVE: Disaggregated data on the mental health of Asian/Asian American people are needed to inform public health interventions related to reports of racism during the COVID-19 pandemic. We describe the prevalence of psychological distress and unmet mental health needs among Asian/Asian American adults during the COVID-19 pandemic across various sociodemographic subgroups. METHODS: We used cross-sectional, weighted data from the US-based 2021 Asian American and Native Hawaiian/Pacific Islander COVID-19 Needs Assessment Study (unweighted n = 3508) to estimate prevalence rates of psychological distress and unmet mental health needs, overall and by nativity status. We conducted population-weighted multivariable logistic regression analyses to examine sociodemographic factors associated with these mental health outcomes. RESULTS: About one-third (1419 of 3508) of Asian/Asian American adults (32.9%; 95% CI, 30.6%-35.2%) reported psychological distress; odds of psychological distress were increased among adults who were female, trans, and nonbinary; aged 18-44 years; US-born; Cambodian; multiracial; and low income. Of those reporting psychological distress (638 of 1419), 41.8% (95% CI, 37.8%-45.8%) reported unmet mental health needs; unmet mental health needs were highest among Asian/Asian American adults who were aged 18-24 years; Korean, Japanese, and Cambodian; US-born female; non-US-born young adults; and non-US-born with ≥bachelor's degree. CONCLUSIONS: The mental health of Asian/Asian American people is an important public health concern, with some groups more vulnerable and in need of services than others. Mental health resources need to be designed for vulnerable subgroups, and cultural and systemic barriers to mental health care need to be addressed.

Internalization of the model minority myth and sociodemographic factors shaping Asians/Asian Americans' experiences of discrimination during COVID-19.

Despite appearing positive, the model minority myth (MMM), or the perception that Asian Americans are "problem-free" minorities, maintains unfair racial hierarchies and discredits the pervasiveness of systemic racism faced by Asian Americans and other Black, Indigenous, and people of Color. This study investigated the role of internalized MMM in Asian/Asian Americans' (A/AA) experiences during the syndemic of COVID-19 and our society's racial reckoning. Using a mixed methods approach, we analyzed A/AA college students' open-ended responses to a query about their experiences as A/AA during COVID-19, which resulted in qualitative themes of Personal and Vicarious Discrimination, Vigilance, Safety due to Ethnicity, Safety due to Environment, and No Difference during COVID-19. We then conducted a series of logistic and linear regression models to examine how internalized MMM and sociodemographic factors (i.e., ethnic group, gender, and generational status) were associated with qualitative themes and quantitative measures of COVID-related discrimination. Overall, findings demonstrated that greater internalized MMM, as well as identifying as South Asian, male, and an international/first-generation immigrant student, were linked to fewer qualitative and quantitative reports of vicarious discrimination. We conclude with implications for research and practice in community psychology that further examine the racialized experiences among A/AA college students and ultimately seek to challenge the MMM and racial hierarchies perpetuating systems of oppression.

Profiles of a COVID-19 Syndemic: Anti-Asian Racism, Economic Challenges, and Mental and Physical Health.

BACKGROUND: During the COVID-19 pandemic, Asians/Asian Americans have experienced co-occurring threats of anti-Asian racism, economic challenges, and negative mental and physical health symptoms. OBJECTIVES: We examined the co-occurrence of COVID-19-related anti-Asian discrimination and collective racism, economic stressors, and mental and physical health challenges for Asians/Asian Americans during the COVID-19 pandemic. We also examined Asian/Asian American subgroups associated with these threats. METHODS: Nationally representative data from the 2021 Asian American and Native Hawaiian/Pacific Islander COVID-19 Needs Assessment Project (unweighted N = 3,508) were used to conduct a latent profile analysis to identify unique typologies of the co-occurrence of these threats. We also conducted chi-square analyses to investigate subgroup differences by latent profile. RESULTS: We identified five distinct latent profiles: multi-threat impact, low impact, collective racism, health challenges, and economic/health challenges. Forty percent of Asians/Asian Americans were in the multi-threat impact profile, indicating high levels across COVID-19-related threats. Subgroup analyses revealed significant differences in profile membership. East Asians, US-born Asians/Asian Americans, and those aged 25-44 seemed to be particularly affected by the proposed syndemic; results also differed by income. CONCLUSION: Asians/Asian Americans have experienced co-occurring and interrelated threats during COVID-19 that suggest the presence of a syndemic. Results from our study point to vulnerable Asian/Asian American subgroups and the need for targeted public health efforts to address racism, health challenges, and economic challenges in the context of COVID-19.

Trends in Racial Discrimination Experiences for Asian Americans During the COVID-19 Pandemic.

BACKGROUND: Asian Americans (AAs) are experiencing increased rates of anti-Asian racism during COVID-19. Experiences of racism, whether personal or collective, constitute stress and psychosocial trauma that negatively impact mental and physical health. OBJECTIVES: Examine subgroup differences in rates of personal experience of discrimination and COVID-related collective racism and how each is associated with mental and physical health for AAs. METHODS: Nationally representative data from the 2021 Asian American and Native Hawaiian/Pacific Islander COVID-19 Needs Assessment Project were used to estimate prevalence rates of discrimination and average COVID-related collective racism scores for AAs (unweighted N = 3478). We conducted logistic and linear regression models to examine subgroup differences by sociodemographic factors. We also conducted hierarchical logistic regression models to examine associations between racism and psychological distress and health decline. RESULTS: Twenty-four percent of AAs (95% CI: 21.6, 25.6) reported experiencing discrimination during the first year of the COVID-19 pandemic. Subgroup analyses revealed that Chinese, younger adults, and AAs who completed the survey in an Asian language were significantly more likely to experience discrimination compared to their counterparts. For COVID-related collective racism, subgroup analyses revealed that Chinese, women, and adults ages 25-44 were more likely to report experiences of collective racism compared to their counterparts. Both discrimination and collective racism were independently associated with negative mental and physical health. CONCLUSION: Discrimination and COVID-related collective racism are associated with negative mental and physical health outcomes for AAs. Results point to vulnerable AA subgroups and the need for targeted public health efforts to address racism in the context of COVID-19.

Socioeconomic Inequities in Vaccine Hesitancy Among Native Hawaiians and Pacific Islanders.

Purpose: COVID-19 vaccine hesitancy exists in communities of color who are disproportionately impacted by COVID-19. In many states, Native Hawaiians and Pacific Islanders (NHs/PIs) experience the highest rates of COVID-19 confirmed cases and mortality among U.S. ethnic/racial groups. National trends regarding vaccine hesitancy among NHs/PIs are currently lacking. Methods: Data were derived from the Asian American and NH/PI COVID-19 Needs Assessment Project, a national survey conducted during January-April 2021. The final analytic sample included 868 NH/PI adults. Logistic regression analyses were conducted to estimate odds ratios for vaccine hesitancy. Results: Vaccine hesitancy ranged from 23% among Other PIs to 56.3% among Tongan adults. Younger adults (18-24 and 25-44 years), those with lower educational attainment, and those with lower income were more vaccine hesitant. Overall, education and income showed a strong association with vaccine hesitancy in bivariate logistic models. However, the associations between vaccine hesitancy and education and income varied by NH/PI groups. NHs, Samoans, and Multiethnic NHs/PIs showed the most consistent associations between the socioeconomic position variables and vaccine hesitancy. Conclusions: The examination of vaccine hesitancy among NHs/PIs follows the socioeconomic gradient for some ethnic groups but not others. More studies are needed to determine what other socioeconomic indicators may be associated with health among specific NH/PI ethnic groups. Policy Implications: Reforms are needed to overcome structural racism underlying NH/PI evidence production, which currently renders NHs/PIs invisible. Innovative solutions based on successful community efforts can help deconstruct racist data inequities experienced by NHs/PIs.

Applying culturalist methodologies to discern COVID-19's impact on communities of color.

The coronavirus disease 2019 (COVID-19) pandemic has disproportionately impacted communities of color (CoC) amid increasing incidents of racial injustices and racism. In this article, we describe our culturalist methodologies for designing and implementing a multi-ethnic, interdisciplinary national needs assessment developed in partnership with CoC. Instead of a typical western-centric social science approach that typically ignores and perpetuates structural racism and settler colonialism, the research team implemented culturalist and community-partnered approaches that were further contextualized to the context of structural racism and settler colonialism. The culturalist approach yielded two sets of themes both related to the impact of the pandemic on CoC. The first set involved syndemic factors that contribute to the adverse impact of COVID-19. These include historical trauma; racism, racial stress, and discrimination; and cultural mistrust. The second set consisted of factors that potentially mitigate the impact of the COVID-19. These include cultural protective factors; community engagement; communal ethos, and data disaggregation. Our methodologies and the resulting findings encourage research praxis that uplifts the shared effects of the social determinants of health while honoring unique cultural and contextual experiences-a lesson that social science researchers largely have yet to learn.