Coronavirus stigmatization and psychological distress among Asians in the United States

Coronavirus stigmatization may be disproportionately impacting ethnoracial minority groups in the US. We test three hypotheses: [H1] Asians in the US are more likely to report experiencing coronavirus stigmatization than non-Hispanic Whites; [H2] Coronavirus stigmatization is associated with psychological distress; [H3] Magnitude of association between coronavirus stigmatization and psychological distress is more pronounced among US-born Asians, compared to non-Hispanic Whites.

We analyzed cross-sectional survey data from the 10-31 March 2020 wave of the Understanding America Survey, a nationally representative survey of adults in the US. Psychological distress was assessed with the PHQ-4. Measures of association were estimated using multiple logistic regression and survey sampling weights. Predicted probabilities were calculated using marginal standardization ( 6707).

[H1] The adjusted predicted probability of experiencing any coronavirus stigma among foreign-born Asians (11.2%, 95% CI: 5.5-17.0%; E-value = 4.52), US-born Asians (10.9%, 95% CI: 5.8-16.0%; E-value = 4.23), Blacks (8.0%, 95% CI: 5.3-10.7%; E-value = 2.92), and Hispanic Whites (7.3%, 95% CI: 4.6-9.9%; E-value = 2.58) was significantly greater than non-Hispanic Whites (4.5%, 95% CI: 3.7-5.4%). [H2] Individuals reporting any coronavirus stigma experience were significantly more likely to exhibit psychological distress (19.9%, 95% CI: 14.6-25.2% vs 10.6%, 9.6-11.6%; E-value = 3.16). [H3] The overall magnitude of association between experience of any coronavirus stigma and psychological distress was not significantly between US-born Asians and non-Hispanic Whites, though we found gender to mask this effect. US-born Asian females who experienced coronavirus stigmatization were more likely to exhibit psychological distress than non-Hispanic white females who experienced coronavirus stigmatization (relative risk (RR): 10.21, 95% CI: 2.69-38.74 vs 1.24, 95% CI: 0.76-2.01; p < 0.01).

Comprehensive measures around care seeking, public awareness, and disaggregated data collection are needed to address ethnoracial coronavirus stigmatization and its impact on psychological health and well-being.