Unequal burdens: Mental health effects of anti-Asian hate incidents across ecological contexts

Reports of anti-Asian hate incidents (AAHIs) increased during the COVID-19 pandemic, yet their mental health consequences and the contextual factors shaping them remain insufficiently understood. Guided by Ecological Systems Theory, this study examines whether changes in AAHI exposure are associated with anxiety and depression symptoms and whether this association varies across ecological contexts. We merged respondent-level data from the Understanding America Study COVID-19 panel (waves 3-34; March 2020-July 2021) with FBI hate-crime records. The analytic sample included 6,552 adults contributing 152,276 person-wave observations. Individual fixed-effects models were estimated to isolate within-person changes in mental health associated with changes in hate incidents occurring in the prior survey wave. Models adjusted for time trends and used multi-way clustered standard errors by respondent, county of residence, and survey wave. Moderators captured microsystem (e.g., victim-respondent gender match), mesosystem (e.g., county COVID-19 deaths), exosystem (e.g., incident characteristics), and macrosystem (e.g., county political affiliation). Increases in AAHIs were associated with statistically significant but modest increases in anxiety and depression symptoms. A one-unit increase in lagged AAHI exposure corresponded to a 0.06-point increase in PHQ-4 scores (0-12 scale), indicating a small effect size relative to within-person variation in mental health. Associations varied modestly by incident characteristics, particularly shared victim-respondent gender and physical injury, while COVID-19 mortality and partisan composition showed limited moderation. Targeted, trauma-informed interventions may help mitigate the mental health burden of hate exposure during periods of social instability.