Perceived Discrimination and Coping with Substance Use Among Asian Americans During the COVID-19 Pandemic (Preprint)

Abstract

Race/ethnicity-related discrimination against Asian Americans increased during the COVID-19 pandemic. Previous studies have found an association between experiences of discrimination and use of alcohol and other drugs (AOD) as a form of coping.

This study aims to evaluate the proportion of race/ethnicity-related discrimination and coping with AOD and evaluate the association of stress because of race/ethnicity-related discrimination and other stressors and coping with AOD among Asian Americans during the pandemic.

We use data from the Asian American and Native Hawaiian/Pacific Islander (AA & NH/PI) COVID-19 Needs Assessment Project, a nationally representative study of Asian Americans and NH/PI in the United States (n = 3,159) that was conducted from January to April 2021. Three AOD outcomes related to coping with the stresses of the COVID-19 pandemic were examined: using tobacco, drinking alcohol, and using marijuana or cannabidiol. Our primary independent variables were stress related to racial/ethnic discrimination, whether discrimination during the COVID-19 pandemic impacted their families, and a five-item “Coronavirus Racial Bias Scale”. We also examined the role of the number of other COVID-19 stressors aside from racial/ethnic discrimination. Binary logistic regression was used to examine the association between each AOD outcome, discrimination, and other COVID-19 stressors accounting for sociodemographic factors, physical and mental health, and survey medium. Analyses were weighted to be representative of the entire Asian American population in the U.S.

Most Asian Americans used alcohol to cope with the stressors of the COVID-19 pandemic (13.0%) while tobacco and marijuana use were similar (4.3% and 4.1%, respectively). About 24% of Asian Americans reported that racial/ethnic discrimination was the greatest source of stress from the COVID-19 pandemic. Furthermore, about 24% of Asian Americans reported that discrimination impacted their families. There was heterogeneity in the association of each AOD substance with discrimination. In fully adjusted models, racial/ethnic discrimination was not associated with AOD use. However, reporting more of COVID-19 stressors (aside from racial/ethnic discrimination) was associated with greater AOD use for each AOD outcome.

Asian Americans reported using AOD to cope with stress during the pandemic. However, the primary motivation of using AOD to cope with stress was related to other non-racially/ethnically based stressors. Future studies need to further examine how different subgroups within the Asian American population are experiencing discrimination and how its related to use of AOD.