The social patterning of vicarious discrimination: Implications for health equity

Differential associations between race-based traumatic stress and major, everyday, and vicarious racial discrimination among young adults of color

Race-based traumatic stress (RBTS) is a psychological response to racial discrimination among individuals with marginalized racial/ethnic identities, but the literature about how different forms of racial discrimination contribute to RBTS is lacking. We compared the effects of major, everyday, and vicarious racial discrimination on RBTS and evaluated the associations between ethnic-racial identity (ERI) and RBTS. Analyses used cross-sectional survey data from Black, Asian, and Latine young adults (N = 1,342, Mage = 25.9 years) collected in 2022. Demographic variables; major, everyday, and vicarious racial discrimination; ERI commitment and exploration; and RBTS were assessed. Hierarchical multiple regression was used to identify correlates of RBTS. Everyday, β = .37, p < .001; vicarious, β = .16, p < .001; and major racial discrimination, β = .16, p = .004, predicted RBTS. Neither ERI commitment nor ERI exploration was significantly associated with RBTS. Race did not moderate the associations between major, everyday, or vicarious discrimination and RBTS, highlighting that Black, Asian, and Latine young adults appear to be equally at risk. As most vicarious racial discrimination and RBTS research has focused on Black samples, we expand the literature by including Latine and Asian young adults. Our observation that vicarious racial discrimination was a similarly strong predictor of RBTS compared to everyday and major racial discrimination underscores the importance of its inclusion in research focused on discrimination and mental health. Taken together, clinical assessment should focus on questions related to diverse experiences of racial discrimination for individuals with marginalized racial identities.

Cardiovascular reactivity during conversations about discrimination is buffered by social support among U.S. Latines

Racial discrimination is conceptualized as an acute and chronic stressor. Like other acute stressors, lab-based studies demonstrate acute effects of discrimination-related stressors on stress-related cardiovascular outcomes, including total cardiac output, blood pressure, and indices of sympathetic and parasympathetic nervous system activity. Critically, it is important to understand how individual and social factors buffer the experience of race-related acute stress. The current study extends existing work by measuring cardiovascular indices of stress during conversations about racial/ethnic discrimination and examines the moderating role of social support. Latine/Hispanic participants (N = 97) talked about personal discrimination experiences with either a close other or a research assistant they had never previously met. Participants in both conditions exhibited cardiovascular reactivity indicative of stress during the conversation. Additionally, patterns of reactivity reflected a more adaptive stress response and recovery profile when participants talked about discriminatory experiences with a close other relative to a stranger (less parasympathetic withdrawal during the stressor and more parasympathetic rebound during recovery). These patterns are consistent with a stress buffering account of social support, which suggests social bonds and community-level support are critical to consider in interventions to mitigate the harms of experiencing discrimination and prevent chronic health disparities.

Associations between vicarious discrimination and mental health among young adult college students: Findings from the 2020-2021 Healthy Minds Study

BACKGROUND

Poor mental health among young adults in higher education is a growing concern. In recent years, the visibility of racism has sharply risen. Vicarious discrimination is defined as the secondhand witnessing of racism, and given society's increased accessibility to social media and the Internet, addressing indirect violence is urgently needed to inform anti-racism and mental health efforts. The current study examined associations between vicarious discrimination and mental health across a large sample of young college students in the United States.

METHODS

We analyzed data from the Healthy Minds Study (HMS; 2020-2021; N=130,566) and used multivariable logistic regression to examine whether past-year vicarious discrimination was associated with various mental health outcomes, adjusting for age, gender, race/ethnicity, and direct discrimination.

RESULTS

The sample was predominantly white (n=31,438, 63.66%) and female-identifying (n=34,313, 69.49%) with an average age of 21.1 years. Approximately 35.9% of the sample endorsed experiencing vicarious discrimination. Vicarious discrimination was associated with greater depression (OR:1.97; 95% CI: [1.86,2.09], p< 0.001), anxiety (OR:1.82; 95% CI: [1.72,1.92], p<0.001), languishing (OR:1.75; 95% CI: [1.65,1.87], p<0.001), perceived need for treatment (OR:2.24; 95% CI: [2.10,2.40], p<0.001), suicidal ideation (OR:1.86; 95% CI: [1.73,2.01], p<0.001), suicide plan (OR:1.91; 95% CI: [1.71,2.14], p<0.001), suicide attempt (OR:1.89; 95% CI: [1.51,2.36], p<0.001), self-injurious behavior (OR:2.0; 95% CI: [1.88,2.12], p<0.001), and loneliness (OR:1.67; 95% CI: [1.58,1.77], p<0.001).

DISCUSSION

Consistent with growing literature, vicarious discrimination was associated with poorer mental health among young college students. Additional research should investigate moderators, mediators, and interventions to support those who may be impacted indirectly by discrimination.

Intersectional discrimination and mental health inequalities: a qualitative study of young women's experiences in Scotland

BACKGROUND

In 2021, Scotland became the first UK country to launch a Women's Health Plan. This policy signals increasing commitment to broader ambitions surrounding gender equality in health. Research shows a connection between discrimination and health, representing a contributor to health inequalities. There remains sparse evidence on how certain groups experience discrimination that could be useful for policymaking. This research set out to address this evidence gap through exploring how discrimination shapes young women's experiences of mental health and inequalities in Scotland.

METHODS

We interviewed women aged 16-25 years (n=28), living in Scotland, UK, adopting an intersectional approach to recruitment and data analysis. We used a semi-structured topic guide to facilitate open discussion about discrimination and health. Transcripts were analysed by two researchers using Thematic Analysis and NVivo software.

FINDINGS

We identified three themes that illuminate intersectional discrimination and the impact on mental health. The first outlines how experiences of discrimination in school, work and public spaces (and the anticipation of such) creates stress leading to mental health problems, particularly for participants from ethnic minority groups. The second highlights the lack of support for mental health, both at structural and interpersonal levels, which was viewed by young women as a form of intersectional discrimination, largely because of their gender and age. Finally, we developed a mid-level theory termed the 'chain of dismissal' that displays that for both physical or mental health symptoms, young women's concerns are immediately "written off" as anxiety-related and in turn a natural attribute of young women. These themes show that discrimination has the potential to amplify mental health problems for young women and is a likely contributor to health inequalities.

CONCLUSIONS

Structural disadvantages such as racism intersect with gender and age to compound the experience of discrimination for marginalised young women. To improve mental health and reduce health inequalities for young women, multi-level approaches are needed, with strong consideration of how the structural and cultural landscape as well as assumptions made by healthcare professionals have critical implications for young women's health.

"Straight-acting white for same": In-person and online/app-based discrimination exposure among sexual minority men

This study quantitatively and qualitatively examined prevalence, frequency, and content of discrimination exposure among gay, bisexual and other sexually minoritized men (SMM) within sexual minority contexts. Participants were an online, U.S. national sample of 14,133 SMM who reported discrimination exposure within sexual minority contexts targeting: body type, race, sexual behavior, HIV status, gender expression, age, and income/employment. Quantitative analyses included prevalence percentages and frequencies and ANOVAs, t-tests, and correlations to examine frequency of discrimination exposure type across participant race/ethnicity, sexual identity, gender identity, HIV status, age, and income. Qualitative analyses included conventional content analysis of responses to an open-ended discrimination exposure item. Results showed that discrimination exposure was nearly universal (99%). Discrimination exposure frequency was lowest among White men and, other than for income/employment discrimination exposure, highest among Asian/Pacific Islander men. For several discrimination types, exposure frequency was highest among groups targeted by group-specific negative stereotypes (e.g., Black men were exposed to the most income/employment discrimination). Qualitative analyses highlighted specific exposures to discrimination targeting body type, race/ethnicity, gender identity, attractiveness, education, and intersections between forms of discrimination. Over 69% of write-in responses were relevant to online/app-based discrimination. Findings underscore the importance of examining individual and intersectional discrimination exposure targeting marginalized social positions within sexual minority communities, particularly in online/app contexts.