Mask-wearing was a risk factor for COVID-related discrimination during the early stage of the pandemic, study finds

2020/7/20 ©PsyPost


Asian Americans are more likely than other ethnic groups to have experienced an incident of COVID-related discrimination, which appears to be partially related to wearing face masks, according to new research published in the American Journal of Preventive Medicine30273-7/fulltext). The study also found evidence that perceived discrimination was linked to greater mental distress during the early stages of the pandemic.

“Disease-associated discrimination is nothing new in the history of outbreaks of novel viruses,” said study author Ying Liu, a research scientist at the Dornsife Center for Economic and Social Research at the University of Southern California.

“Lessons from past outbreaks (e.g., SARS, H1N1) has told us that such discrimination does not only compound the adverse effects of the public health crisis (e.g., the unnecessary mental health burden that we observed in the study), but also may hinder the disease control efforts (e.g., people experienced discriminatory acts may be fearful and thus less likely to seek for medical help when they are infected or think they are infected).”

“Both the CDC and WHO have called to prevent COVID-related discrimination since the very beginning of the pandemic. Therefore, ‘is it still happening’ and ‘what drives it’ are natural and important questions to answer,” Liu told PsyPost.

“Another personal reason is that since late January or February, I’ve heard friends complaining about discriminatory acts (e.g., against Asians, and those who lived in Seattle when Washington State first reported the outbreak). I wondered to what extent those incidents were just occasional or random events, or they were more prevalent and systematic.”

The researchers used online surveys to gather data from a nationally representative sample of 3,665 U.S. residents in March and April, during the early stage of the pandemic in the United States. The participants reported whether they had experienced discrimination due to people thinking they might have the coronavirus. Specifically, they were asked if they had been treated with less courtesy and respect than others; received poorer service at restaurants or stores; noticed people acting as if they were afraid of them; or whether they had been threatened or harassed.

The researchers found that the overall percentage of participants perceiving discrimination due to the coronavirus doubled from 4% in March to 10% in April. The percentages were higher among certain minority groups. About 11% of Asians and 9% of African Americans had experienced discrimination in March, compared to 4% of whites. This increased to 16% of Asians and 15% of African Americans in April, compared to 9% of whites.

Wearing face masks and being an immigrant were also found to be risk factors associated with coronavirus-related discrimination. The higher degree of discrimination experienced by Asians in March was partially explained by their immigration status and mask-wearing.

“Discrimination against people who are thought to have COVID-19, even if they weren’t actually infected, is a serious social and public health matter,” Liu said.

“Although the overall trend seems tilting down a bit, the racial/ethnic gap is very persistent with no indication it’s closing. Cumulatively, 1 in 3 of these minority groups have experienced at least one incident since March, relative to 1 in 5 of white people. We also found that people who wore face masks were more susceptible to discrimination, especially at earlier stages of the pandemic when mask-wearing was rarer.”

The researchers also found that experiences of discrimination were associated with increased mental distress.

“This kind of discrimination also has direct consequences on public health and current disease control. We observed that people with COVID-related discriminatory experiences showed more symptoms of anxiety and depression,” Liu told PsyPost.

“Furthermore, lessons from previous outbreaks such as SARS and H1N1 tell us mental distress and fears triggered by such social stigma could make affected people less likely to seek for help, for instance, when they are infected or suspect they are infected, because they could be more afraid of exposing themselves to COVID-related encounters, e.g., hospitals and testing sites. In other words, this discrimination could potentially undermine current disease control efforts.”

“To combat this kind of discrimination, public awareness is the first step. Combating racial bias is also critical. The sooner we stop thinking of people of color as being ‘others’ or part of a less than equal group, the sooner we can end this type of discrimination and blaming of who are responsible for the pandemic.”

The ongoing Understanding Coronavirus in America tracking survey has found evidence that “people of color are, in fact, the ones most harmed from pandemic,” Liu said.

“For the interested public (including policymakers and health care practitioners), we’d encourage everyone to visit our Understanding Coronavirus in America Study website, at which we provide a dashboard updated daily on the trends, on this topic and beyond.TrendMD v2.4.8