COVID-19 Pandemic
Racial and ethnic differences in the associations between COVID-19 stigma and mental health in a population-based study of adults with SARS-CoV-2 infection Soomin Ryu* Soomin Ryu Paula Guro Jana L. Hirschtick Robert Orellana Nancy L. Fleischer
Introduction: Many individuals with COVID-19 faced stigmatization, which may contribute to poor health. However, few studies have explored the relationship between COVID-19 stigma and health and even less is known about intersectional stigma, which means having multiple stigmatized social identities simultaneously. This paper examines associations between COVID-19 stigma and mental health overall and by race and ethnicity.
Methods: Using a population-based probability sample of Michigan adults with confirmed SARS-CoV-2 infection between March 2020 and February 2022, we captured COVID-19 stigma based on (1) perceived COVID-19 stigma, (2) fear of COVID-19 disclosure to friends or family, and (3) fear of COVID-19 disclosure at work. We assessed associations between the three COVID-19 stigma measurements with symptoms for depressive and anxiety symptoms using modified Poisson regression with robust standard errors and adjusting for confounding factors.
Results: Individuals who perceived COVID-19 stigma had a higher prevalence of depressive (aPR: 1.38, 95% CI: 1.17−1.62) and anxiety symptoms (aPR: 1.41, 95% CI: 1.22−1.62) than individuals who did not perceive stigma. Moreover, individuals who were afraid to disclose their COVID-19 diagnosis to friends or family or at work had a higher prevalence of depressive and anxiety symptoms than those who were not. These associations were more pronounced among racial and ethnic minoritized individuals than among non-Hispanic White individuals.
Discussion: COVID-19 stigma was associated with higher prevalence of depressive and anxiety symptoms. This association was greater for racial and ethnic minoritized individuals, possibly due to the intersection of disease stigma and race and ethnicity. Continuing to monitor the long-term effects of COVID-19 stigma on mental health, particularly among racial and ethnic minoritized populations, will provide useful insight and lessons for future pandemics.