Introduction: This study examines COVID-19−associated discrimination regardless of infection status. It evaluates the contribution of various risk factors (e.g., race/ethnicity and wearing a face mask) and the relationship with mental distress among U.S. adults in March and April 2020, when the pandemic escalated across the country. Methods: Participants consisted of a probability-based, nationally representative sample of U.S. residents aged ≥18 years who completed COVID-19−related surveys online in March and April (n=3,665). Multivariable logistic regression was used to predict the probability of a person perceiving COVID-19−associated discrimination. Linear regression was used to analyze the association between discrimination and mental distress. Analyses were conducted in May 2020. Results: Perception of COVID-19−associated discrimination increased from March (4%) to April (10%). Non-Hispanic Black (absolute risk from 0.09 to 0.15 across months) and Asians (absolute risk from 0.11 to 0.17) were more likely to perceive discrimination than other racial/ethnic groups (absolute risk from 0.03 to 0.11). Individuals who wore face masks (absolute risk from 0.11 to 0.14) also perceived more discrimination than those who did not (absolute risk from 0.04 to 0.11). Perceiving discrimination was subsequently associated with increased mental distress (from 0.77 to 1.01 points on the 4-item Patient Health Questionnaire score). Conclusions: Perception of COVID-19−associated discrimination was relatively low but increased with time. Perceived discrimination was associated with race/ethnicity and wearing face masks and may contribute to greater mental distress during early stages of the pandemic. The longterm implications of this novel form of discrimination should be monitored.
The COVID-19 pandemic is linked to a rise in stigma and discrimination against Chinese and other Asians, which is likely to have a negative impact on mental health, especially when combined with additional outbreak-related stressors. We discuss the need to consider the potential harms of these anti-Asian sentiments during both the height of the pandemic and longer-term recovery through (a) research—examining how it affects mental health and recovery; (b) practice—implementing evidence-based stigma reduction initiatives; and (c) policy—coordinating federal response to anti-Asian racism including investment in mental health services and community-based efforts.
This article reviews studies examining health issues associated with commercial sexual exploitation and sex trafficking (CSE/ST) of children in the United States. We searched five health and social sciences databases for peer-reviewed articles published in English between January 1990 and April 2017. After independent screening of the records, we identified 27 studies that met the inclusion criteria. Descriptions of the included studies and their definitions of CSE/ST are provided. Most of the studies sampled children and youth in urban, metropolitan areas and employed cross-sectional surveys or reviewed case files and medical records of convenience samples. Studies differed widely in their operationalization of CSE/ST, which limit systematic comparison across studies and the generalizability of findings. Qualitative analysis of the included studies shows that among commercially sexually exploited/trafficked children, there are elevated burdens of substance use and abuse, mental health disorders such as depression, PTSD, suicidal behaviors, and sexual and reproductive health issues including STIs, HIV, and pregnancy. This review underscores the need for more empirical studies, to guide an evidence-based understanding of and response to the range and complexity of the health issues in this population. Of particular utility are studies that address some of the methodological limitations of prior research in this field (e.g., cross-sectional, convenience samples) and those that assess overlooked health issues (e.g., malnutrition, eating disorders, post-trauma growth, and long-term health consequences).
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