Two Epidemics and a Pandemic: The Collision of Prescription Drug Misuse and Racism during COVID-19

The present study investigated the relationship between perceived racial discrimination and prescription drug misuse (PDM) among Asian, Black, and Latinx Americans during the COVID-19 crisis. U.S. racial/ethnic minorities may have been uniquely affected by two national and one global pandemic: the opioid crisis, racism, and COVID-19. Opioid death rates increased among many groups prior to the pandemic. This country witnessed an increase in racialized acts against people of color across the spectrum in the spring and summer months of the world's COVID-19 outbreak. While studies have shown a clear link between perceived racial discrimination and substance abuse outside of the global pandemic, no identified studies have done so against the backdrop of a global health pandemic. Separate hierarchical regressions revealed a significant association between perceived racial discrimination and PDM for Black Americans, Asian Americans, and Latinx individuals. Findings build on the scant literature on PDM in diverse samples and establish a relationship between perceived racial discrimination and PDM, as previously identified for other abused substances. Future post-pandemic substance misuse interventions should consider the influence of perceived racial discrimination as they help individuals recover from the aftermath of this stressful trifecta.

The Effects of Perceived Racial/Ethnic Discrimination on Substance Use Among Youths Living in the Cherokee Nation

We examined frequency and intensity of racial/ethnic discrimination and the longitudinal relationship to substance use. The sample included (N = 1,421) American Indian, American Indian and White, and White adolescents. A high frequency of perceived racial discrimination was associated with an increased risk for heavy alcohol use, prescription drug misuse, and other illicit drug use. Experiences of perceived racial discrimination high in intensity were associated with further increased risk of prescription drug misuse and other illicit drug use. Race/ethnicity did not moderate the relationship between perceived racial discrimination and substance use. Interventions targeting the deleterious effects of racial discrimination may need to be designed to account for both the environment and the individual.

Effect of perceived racial discrimination on self-care behaviors, glycemic control, and quality of life in adults with type 2 diabetes

OBJECTIVE

This study used a large sample size of black and white patients with type 2 diabetes to investigate the influence of perceived racial discrimination on biologic measures (glycemic control, blood pressure, and LDL cholesterol), the mental component of quality of life (MCS), and health behaviors known to improve diabetes outcomes.

METHODS

602 patients were recruited from two adult primary care clinics in the southeastern United States. Linear regression models were used to assess the associations between perceived racial discrimination, self-care, clinical outcomes, MCS, adjusting for relevant covariates. Race-stratified models were conducted to examine differential associations by race.

RESULTS

The mean age was 61 years, with 64.9 % non-Hispanic black, and 41.6 % earning less than $20,000 annually. Perceived discrimination was significantly negatively associated with MCS (β = -0.56, 95 % CI -0.90, 0.23), general diet (β = -0.37, CI -0.65, -0.08), and specific diet (β = -0.25, CI -0.47, -0.03). In African Americans, perceived discrimination was significantly associated with higher systolic blood pressure (β = 10.17, CI 1.13, -19.22). In Whites, perceived discrimination was significantly associated with lower MCS (β = -0.51, CI -0.89, -0.14), general diet (β = -0.40, CI -0.69, -0.99), specific diet (β = -0.25, CI -0.47, -0.03), and blood glucose testing (β = -0.43, CI -0.80, -0.06).

CONCLUSIONS

While no association was found with biologic measures, perceived discrimination was associated with health behaviors and the MCS. In addition, results showed a difference in influence of perceived discrimination by race.

Association of perceived racial discrimination with eating behaviors and obesity among participants of the SisterTalk study

The purpose of this study was to assess the association of perceived racial discrimination with emotional eating behaviors, weight status, and stress levels among obese African-American women, who volunteered to enter a weight control study (SisterTalk) in the New England region of the United States. The sample of women was taken from the baseline data of participants in SisterTalk, a randomized, controlled trial of a cable TV-delivered weight control program. Using the Krieger instrument, telephone and in-person surveys were used to assess perceived discrimination, emotional eating behaviors, and stress. Height and weight were measured to calculate BMI in order to assess weight status. ANOVA models were constructed to assess the association of discrimination with demographics. Correlations were calculated for discrimination, stress, emotional eating, and weight variables. ANOVA models were also constructed to assess discrimination with emotional eating, after adjusting for appropriate demographic variables. Perceived discrimination was associated with education and stress levels but was not associated with weight status (BMI). The frequency of eating when depressed or sad, and eating to manage stress, were both significantly higher among women who reported higher perceived discrimination and higher stress levels. Discrimination may contribute to stress that leads to eating for reasons other than hunger among African-American women, although the causal direction of associations cannot be determined with cross sectional data. Associations of discrimination with weight status were not found, although it is likely that emotional eating behaviors related to perceived discrimination are unhealthy. Future research should examine these relationships more closely in longitudinal studies.