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Impact of Racism on Mental Health: We Are Not Coronavirus

Leanna M.W. Lui, HBSc

Disclosures

June 09, 2021

For as long as I can remember, I've always felt the need to please. Whether it was in the way I dressed, the food I ate, or the way I spoke, there was a hint of shame over the things that made me who I am. I'd tell myself that these feelings were weak and insignificant and shouldn't take time away from the "important" things in life. Who was I to complain about being part of the "model minority" or have my feelings validated when my relatives had gone through much worse to provide what I have today?

So, when the COVID-19 pandemic hit and the words of Cathy Park Hong became the theme song for the year — "We don't have coronavirus. We are coronavirus." — it felt as though our tenuous position in society finally had an X marked on our backs.

Over the past 14 months, the number of racist attacks and discriminatory remarks against Asians has increased. Historical events of infectious disease outbreaks, hypotheses around the origins of COVID-19, misleading media coverage, and general fear surrounding the virus became motivations to upvote discriminatory behaviors and negative attitudes against Asians.

  • In April 2020, 11.6% of participants from a Canadian survey of 467 Chinese immigrants reported experiences of racial discrimination. Strikingly, a survey conducted in early 2021 reported preliminary results where this number jumped to 35%.

  • In March 2020, a US survey of 1141 residents reported that more than 40% of participants admitted to engaging in at least one discriminatory act.

  • From March-May 2020, a US survey of Chinese-American families found that almost half of participants reported experiences of online discrimination linked to the pandemic.

  • In June 2020, a US survey by the Pew Research Center of 9654 adults reported the following:

    • 31% of Asians were targets of racially motivated slurs/jokes

    • 26% of Asians felt threatened or feared physical assault

    • About 40% participants admitted that racist behaviors toward Asians were common practice

Impact of Racism and Discrimination on Mental Health

Originally, the Minority Stress Theory (MST) was a model developed to provide insight into the impact of discrimination against sexual minorities. More recently, the MST has been adapted to study racism and discrimination among ethnic and racial minorities. Through this lens, it becomes increasingly apparent that racist and discriminatory acts foster hostile, negative, and stressful environments which contribute to the higher prevalence of mental disorders among minority populations. As a result, it's not uncommon for this to lead to "race-based traumatic stress," which refers to the psychological injury of racial trauma.

Over the course of the current pandemic, Asians have reported higher levels of mental disorders partially related to COVID-19 acute discrimination when compared with Whites. Asians also often have the lowest rates of mental health–related service utilization, amplifying the urgent need to address COVID-19–associated discrimination.

"In the Asian context, a lack of acknowledgement of racism can lead to internalized racism — especially given the myth of the model minority. This means people's experiences with racist attacks may be invalidated, minimized or not understood in their appropriate cultural context. This leads to people internalizing racism or feeling shy to stand up to racism ... It's often a part of Asian culture to build harmony, which can make people reluctant to come forward," Kenneth Fung, psychiatrist and associate professor at the University of Toronto, stated in U of T News.

Racism and discrimination also extend to other aspects of life related to social determinants of health (eg, employment). For example, Asians have reported difficulty finding and obtaining employment due to (1) lack of recognized credentials; (2) language barriers; (3) accent. Even those who were born and raised in a North American society experience race-based disparities with respect to employment and promotions.

From personal experience, it's a common trend to hear friends and colleagues use their "westernized" name or purposefully remove their "non-westernized" middle name on their resumes and job applications in fear of rejection. Taken together, there has been a consistent finding that Asians in North America have higher rates of mental disorders due to the stressors of perceived and real discrimination.

Looking Toward Resilience

What can we do to reduce the impact of racism and discrimination on mental health? According to Dr Fung, we can build resilience. What exactly is resilience? Dr Fung explains that, in short, resilience is our ability to cope and adapt from negative experiences — and importantly, he stresses that this is not the same as "not caring."

In order to be resilient, we must have internal and external resilience. To build internal resilience, he states that we need to acknowledge the psychological impact of racism, and we need to be ready to learn how to heal from this trauma rather than simply internalize it. External resilience comes from our environment (eg, services, resources, security, sense of belonging in the community). Resilience is built upon the collective support of our community.

Future Thoughts

The COVID-19 pandemic has certainly been a unique time. As we go forward, accepting and appreciating the diversity around us means that we need to see each other as human.

"If a tree falls in a forest and no one is around to hear it, does it make a sound?" Likewise, if we call on our community to support us in a time of need, but no one listens, was there ever a call to action?

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About Leanna Lui
Leanna M.W. Lui, HBSc, completed an HBSc global health specialist degree at the University of Toronto, where she is now an MSc candidate. Her interests include mood disorders, health economics, public health, and applications of artificial intelligence. In her spare time, she is a fencer with the University of Toronto Varsity Fencing team and the Canadian Fencing Federation.

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