Improving Asian American health during the Syndemic of COVID-19 and racism

Saw, Anne; Yi, Stella S.; Ðoàn, Lan; Tsoh, Janice Y.; Horse, Aggie J. Yellow; Kwon, Simona; Samoa, Raynald; Aitaoto, Nia; Takeuchi, David T.

doi:10.1016/j.eclinm.2022.101313

Cited by 31 publications

(31 citation statements)

References 7 publications

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“…Our study findings highlight the syndemic nature of the current pandemic. 14 A syndemic perspective acknowledges the biosocial complex that views disease and the social and environmental factors that promote and enhance the negative effects of disease interaction as a systemic entity requiring intervention at these upstream levels to limit further prolongation of the harmful effects of disease in populations left vulnerable by these social and environmental disease promoters.…”

Section: Implications For Health Equitymentioning

confidence: 99%

Socioeconomic Inequities in Vaccine Hesitancy Among Native Hawaiians and Pacific Islanders

Samoa

Ðoàn²,

Saw

et al. 2022

Health Equity

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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.

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Section: Implications For Health Equitymentioning

confidence: 99%

Socioeconomic Inequities in Vaccine Hesitancy Among Native Hawaiians and Pacific Islanders

Samoa

Ðoàn²,

Saw

et al. 2022

Health Equity

Self Cite

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“…These observed associations reflected the differential impacts of COVID-19–specific sequelae that have significant policy implications. Our findings may also reflect a consequence of pre-existing systemic and structural racism that was further exacerbated differentially at multiple levels during the pandemic [ 36 - 38 ].…”

Section: Discussionmentioning

confidence: 99%

Racial Bias Beliefs Related to COVID-19 Among Asian Americans, Native Hawaiians, and Pacific Islanders: Findings From the COVID-19 Effects on the Mental and Physical Health of Asian Americans and Pacific Islanders Survey Study (COMPASS)

Park¹,

Tsoh²,

Dougan³

et al. 2022

J Med Internet Res

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Background During the COVID-19 pandemic, there have been increased reports of racial biases against Asian American and Native Hawaiian and Pacific Islander individuals. However, the extent to which different Asian American and Native Hawaiian and Pacific Islander groups perceive and experience (firsthand or as a witness to such experiences) how COVID-19 has negatively affected people of their race has not received much attention. Objective This study used data from the COVID-19 Effects on the Mental and Physical Health of Asian Americans and Pacific Islanders Survey Study (COMPASS), a nationwide, multilingual survey, to empirically examine COVID-19–related racial bias beliefs among Asian American and Native Hawaiian and Pacific Islander individuals and the factors associated with these beliefs. Methods COMPASS participants were Asian American and Native Hawaiian and Pacific Islander adults who were able to speak English, Chinese (Cantonese or Mandarin), Korean, Samoan, or Vietnamese and who resided in the United States during the time of the survey (October 2020 to May 2021). Participants completed the survey on the web, via phone, or in person. The Coronavirus Racial Bias Scale (CRBS) was used to assess COVID-19–related racial bias beliefs toward Asian American and Native Hawaiian and Pacific Islander individuals. Participants were asked to rate the degree to which they agreed with 9 statements on a 5-point Likert scale (ie, 1=strongly disagree to 5=strongly agree). Multivariable linear regression was used to examine the associations between demographic, health, and COVID-19–related characteristics and perceived racial bias. Results A total of 5068 participants completed the survey (mean age 45.4, SD 16.4 years; range 18-97 years). Overall, 73.97% (3749/5068) agreed or strongly agreed with ≥1 COVID-19–related racial bias belief in the past 6 months (during the COVID-19 pandemic). Across the 9 racial bias beliefs, participants scored an average of 2.59 (SD 0.96, range 1-5). Adjusted analyses revealed that compared with Asian Indians, those who were ethnic Chinese, Filipino, Hmong, Japanese, Korean, Vietnamese, and other or multicultural had significantly higher mean CRBS scores, whereas no significant differences were found among Native Hawaiian and Pacific Islander individuals. Nonheterosexual participants had statistically significant and higher mean CRBS scores than heterosexual participants. Compared with participants aged ≥60 years, those who were younger (aged <30, 30-39, 40-49, and 50-59 years) had significantly higher mean CRBS scores. US-born participants had significantly higher mean CRBS scores than foreign-born participants, whereas those with limited English proficiency (relative to those reporting no limitation) had lower mean CRBS scores. Conclusions Many COMPASS participants reported racial bias beliefs because of the COVID-19 pandemic. Relevant sociodemographic contexts and pre-existing and COVID-19–specific factors across individual, community, and society levels were associated with the perceived racial bias of being Asian during the pandemic. The findings underscore the importance of addressing the burden of racial bias on Asian American and Native Hawaiian and Pacific Islander communities among other COVID-19–related sequelae.

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“…Due to misinformation about the novel coronavirus (e.g., referring to it as the "China virus" or "Kung Flu"), anti-Asian racism and xenophobic attacks against Asian Americans have significantly increased since the beginning of the COVID-19 pandemic (1)(2)(3)(4)(5). From March 19, 2020 to March 31, 2022, the data tracking system developed by the Stop Asian American and Pacific Islander (AAPI) Hate coalition reported a total of 11,467 hate incidents against AAPI persons (6).…”

Section: Introductionmentioning

confidence: 99%

Association of everyday discrimination with health outcomes among Asian and non-Asian US older adults before and during the COVID-19 pandemic

Zhang

Cruz-Gonzalez

Lin

et al. 2022

Front. Public Health

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Increases in anti-Asian COVID-19 related discriminatory behaviors have been observed, many of which targeted older adults. Studies demonstrate that racial discrimination is associated with worse health outcomes, including anxiety, depression, and sleep difficulties. No previous studies have examined the impact of day-to-day experiences of discrimination before and during COVID-19 on both Asian and non-Asian older adults within the same sample. We examined whether everyday discrimination was associated with increased anxiety and depression symptoms, decreased levels of functioning, and increased sleep difficulties among Asian and non-Asian US older adults before and during the pandemic. Data came from the Positive Minds-Strong Bodies randomized clinical trial, an evidence-based mental health and disability prevention intervention for racially and ethnically diverse older adults with elevated depression or anxiety symptoms and minor to moderate disability. We conducted secondary data analyses in a cohort of 165 older adults (56 Asian and 109 non-Asian) assessed before COVID-19 (May 2015-May 2018) and during COVID-19 (March 2021-July 2022). Regression models examined whether everyday discrimination impacted health outcomes differently before and during COVID-19, and whether this effect was stronger among Asian compared to non-Asian older adults. Non-Asian older adults reported the same levels of everyday discrimination before and during COVID-19. Consistent with literature suggesting that social distancing has inadvertently kept US Asian populations from experiencing discrimination, Asian older adults reported marginally lower levels of everyday discrimination during the pandemic compared with pre-pandemic. We found that everyday discrimination was not associated with health outcomes before COVID-19. In contrast, during the pandemic, everyday discrimination was associated with worse anxiety and depression symptoms and worse levels of functioning, although only the impact on depression was significantly stronger compared with before the pandemic. This negative impact of everyday discrimination on health outcomes during the pandemic appeared to affect both Asian and non-Asian older adults similarly. Social support and social cohesion buffered against the negative effect of everyday discrimination on depression and level of functioning during the pandemic. Results suggest that public health interventions aimed at reducing everyday discrimination and emphasizing social support and cohesion can potentially improve health outcomes for all US older adult populations.Clinical trial registrationwww.ClinicalTrials.gov; identifier: NCT02317432.

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Improving Asian American health during the Syndemic of COVID-19 and racism

Cited by 31 publications

References 7 publications

Socioeconomic Inequities in Vaccine Hesitancy Among Native Hawaiians and Pacific Islanders

Socioeconomic Inequities in Vaccine Hesitancy Among Native Hawaiians and Pacific Islanders

Racial Bias Beliefs Related to COVID-19 Among Asian Americans, Native Hawaiians, and Pacific Islanders: Findings From the COVID-19 Effects on the Mental and Physical Health of Asian Americans and Pacific Islanders Survey Study (COMPASS)

Association of everyday discrimination with health outcomes among Asian and non-Asian US older adults before and during the COVID-19 pandemic

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