Effect of perceived discrimination on depression and suicidal ideation during the COVID-19 pandemic: a large-scale, repeated-measures study in the All of Us Research Program
AbstractObjectiveThe COVID-19 pandemic has coincided with an increase in depressive symptoms as well as a growing awareness of health disparities and discrimination against racial and ethnic minority communities in the United States. Here, we examine the mental health impact of perceived discrimination during the pandemic in a large and diverse cohort of the All of Us Research Program.MethodsUsing repeated assessments of 62,651 participants in May to July of 2020, we fitted mixed-effects models to assess the effect of perceived discrimination on moderate to severe depression (Patient Health Questionnaire (PHQ)-9 ≥ 10) and suicidal ideation (PHQ-9 item 9 > 0), and applied inverse probability weights to account for non-random probabilities of completing the voluntary survey.ResultsPerceived discrimination was associated with an increased odds of depression (adjusted odds ratio (aOR) [95% CI]: 1.21 [1.20 -1.22]) and suicidal ideation (1.17 [1.16-1.18]). For depression, the effects were larger in earlier phases of the pandemic (interaction p=8.2×10−5), which varied by main reason for discrimination and self-reported race. Among those who identified race or ancestry as a primary reason for discrimination, Asian and Black participants had 24% and 17% increase in the odds of depression in May of 2020 (1.24 [1.17-1.31] and 1.17 [1.12-1.22]), respectively, versus a 3% and 7% increase in July (1.03 [0.96-1.10] and 1.07 [1.02-1.12]).ConclusionIn this large and diverse sample, increased levels of perceived discrimination were associated with higher odds of depression, particularly during the early phase of the pandemic among participants self-identifying as Asian or Black.