From China to Here: Addressing the Impact of COVID-19 and Racism on Asian Americans and Pacific Islanders

The COVID-19 pandemic has starkly highlighted healthcare disparities caused in large part by discrimination and structural racism. For C-L psychiatrists, whose purview includes the systemic effects of medical illness, an understanding of the intersection of racism, mental health, and physical illness is crucial to providing high-quality care and educating our next generation of trainees.

Asian Americans and Pacific Islanders (AAPI) are the fastest-growing single ethnic group in the U.S. However, the role of how discrimination against AAPI has shaped healthcare outcomes and impacted the well-being of our patients, colleagues, and trainees during the pandemic has been relatively under-examined. Data suggest that AAPI may be at increased risk for healthcare disparities from COVID-19, including mortality, at least in some parts of the country. Proposed contributing factors, many of which are structural, include lack of outreach, language barriers, and living and work conditions among certain segments of the community of AAPI, as well as perpetuation of the “model minority” myth that AAPI are universally successful.

In addition, there has been a sharp increase in reported discrimination against AAPI throughout the pandemic. Studies have shown that discrimination is significantly related to increased anxiety, suicidal ideation, and psychological distress in AAPI. However, AAPI also have the lowest mental health services utilization rates in the country, so C-L psychiatrists may be in a unique position to address these concerns when AAPI seek medical care. Additionally, as with any form of discrimination, racism against AAPI can result in fear and anxiety among our trainees, who, if AAPI themselves, may be afraid to speak up about their feelings in the context of a historical pressure for many AAPI to assimilate into U.S. society.

In this workshop, we aim to provide C-L psychiatrists with a greater understanding of how COVID-19 and discrimination have impacted AAPI, which can help inform how they care for patients who are AAPI and educate and support their trainees in this area going forward. We will also discuss the significant interplay between COVID-19 and racism against AAPI, and strategies to mitigate the adverse effects of such.

Mark Bradley, MD, will outline the relevance of COVID-19 and discrimination against AAPI to C-L psychiatry. Peter Chin-Hong, MD, will discuss the epidemiology of COVID-19 in AAPI and potential contributors to healthcare disparities. William Hua, PhD, will describe the impact of COVID-19 on the mental health and well-being of AAPI, particularly during the pandemic. Miyuki Fukui, MD, will describe trainee perspectives and experiences regarding discrimination against AAPI in the context of C-L psychiatry. Kewchang Lee, MD, will discuss strategies to enhance the care of AAPI patients and related educational and mentorship experiences of C-L trainees, based on what has been learned from the pandemic.