Discrimination Associated With Higher Risk of Depression

The pitfall of self-reported stress levels is that the baseline stress for some people is so high, a cancer diagnosis doesn’t even register.
The pitfall of self-reported stress levels is that the baseline stress for some people is so high, a cancer diagnosis doesn’t even register.
A group of researchers explored whether individuals who experienced ongoing discrimination had a higher risk for depression.

The COVID-19 pandemic exposed several public health issues, not to mention structural inequalities and systemic racism. Using survey results and demographic information from a large sample of individuals from the All of Us Research Program, a group of researchers explored whether individuals who experienced ongoing discrimination had a higher risk for depression. The findings were published in JAMA Psychiatry.

A total of 62,651 individuals from the program completed the COVID-19 Participant Experience (COPE) survey at least once. The researchers compared race, ancestry, and the national origin of people who reported everyday discrimination with those who did not. Depression symptoms were assessed using the 9-item Patient Health Questionnaire (PHQ-9).

“Perhaps reflecting the concurrent sociopolitical circumstances in the United States, Hispanic Black participants reported the highest levels of discrimination, especially in June 2020, followed by participants self-identifying as Black or African American,” the researchers reported. Among White participants, age and gender were the main reasons for discrimination. Among minorities, discrimination was believed to be based on race or ethnicity.

Overall prevalence of depression and suicidal thoughts was highest in May 2020 but leveled out soon after. As levels of discrimination increased, so did increased likelihood of moderate to severe depression. “Those who reported discrimination a few times a

month and at least once a week over the past month had up to a 3-fold and 10-fold increase, respectively, in the odds of moderate to severe depressive symptoms,” the researchers stated.

Although the study is presumed the largest US study to examine the mental health impact of chronic discrimination, it had its limitations. The researchers did not have the means to measure discrimination or depression levels before the pandemic, so they can’t report on how the situation evolved over time. In addition, the sample is not an accurate reflection of the US population.

They concluded, “by demonstrating the complex and dynamic relationship between discrimination and adverse mental health outcomes in a large and diverse sample of the United States, this study provides empirical evidence regarding the adverse mental health consequences of discrimination based on race, ancestry, or national origins during the COVID-19 pandemic, especially among individuals self-identifying as Hispanic or Latino or non-Hispanic Asian.”

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures. 

Reference

Lee YH, Liu Z, Fatori D, et al. Association of everyday discrimination with depressive symptoms and suicidal ideation during the COVID-19 pandemic in the All of Us Research Program. JAMA Psychiatry. Published online July 27, 2022. doi:10.1001/jamapsychiatry.2022.1973