The COVID-19 epidemic has been accompanied by an uptick in depression symptoms as well as a rising consciousness of systemic racism and health disparities in the United States. For a study, researchers sought to investigate the relationship between mental health and commonplace prejudice throughout the All of Us Research Program pandemic.
Mixed-effects models were fitted to assess the associations of discrimination with depressive symptoms and suicidal ideation using repeated assessments in the early months of the pandemic, and inverse probability weights were used to account for nonrandom probabilities of completing the voluntary survey. The 9-item Patient Health Questionnaire (PHQ-9) and the Everyday Discrimination Scale were used, respectively, to determine the exposure and outcome measures. Any affirmative response to the ninth item on the PHQ-9 scale was taken into consideration as displaying suicidal thoughts, and scores for the PHQ-9 that was more than or equal to 10 were classed as moderate to severe depressive symptoms.
Between May and July 2020, 62,651 people (mean [SD] age, 59.3 [15.9] years; 41,084 [65.6%] of whom were female at birth) completed at least 1 evaluation. As the levels of prejudice grew, there was a correlation with a considerably higher risk of moderate to severe depression symptoms and suicidal thoughts. There was a dose-response relationship, with increases in the probabilities of moderate to severe depressive symptoms and suicidal thoughts, respectively, on encountering discrimination more than once per week of 17.68-fold (95% CI, 13.49-23.17; P<.001) & 10.76-fold (95% CI, 7.82-14.80; P<.001). Additionally, among Hispanic or Latino individuals at all three time periods and among non-Hispanic Asian participants in May and June 2020, the connection with depressive symptoms was stronger when the primary factor in discrimination was race, ancestry, or national origin. Furthermore, the history of being diagnosed with a prepandemic mood illness was just as significantly linked to high levels of prejudice as it was to moderate to severe depressive symptoms.
Increased levels of discrimination were linked to a greater likelihood of having moderate to severe depression symptoms in this large and varied population. The connection was especially strong among Hispanic or Latino individuals and, early in the pandemic, among non-Hispanic Asian participants when race, ancestry, or national origins were the primary grounds for discriminating.