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Vicarious Racism, Direct Racism, and Mental Health Among Racialized Minority Healthcare Workers

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Abstract

Background

Racism-related stress is a root cause of racial and ethnic disparities in mental health outcomes. An individual may be exposed to racism directly or vicariously by hearing about or observing people of the same racial and/or ethnic group experience racism. Although the healthcare setting is a venue by which healthcare workers experience both direct and vicarious racism, few studies have assessed the associations between direct and vicarious racism and mental health outcomes among healthcare workers.

Methods

In this cross-sectional study, we assessed the relationships between direct and vicarious racism and symptoms of posttraumatic stress, depression, and anxiety among healthcare workers in the USA in 2022.

Results

Our sample consisted of 259 healthcare workers identifying as a racialized minority, including 68 (26.3%) who identified as mixed-race, 61 (23.6%) East Asian, 36 (13.9%) Black, 33 (12.7%) South Asian, 22 (8.5%) Southeast Asian, 21 (8.1%) Middle Eastern/North African, and 18 (6.9%) another race. The mean age was 37.9 years (SD 10.1). In multivariable linear regression models that adjusted for demographics, work stressors, and social stressors, we found that increased reporting of vicarious racism was associated with greater symptoms of anxiety (B = 0.066, standard error = 0.034, p = .049). We did not identify significant relationships between vicarious and direct racism and symptoms of posttraumatic stress or depression in the fully adjusted models.

Conclusions

Our findings should be considered by academic health systems to mitigate the negative impact of racism on healthcare workers’ mental health.

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Data Availability

The data that support the findings of this study are available on request from the corresponding author (RH, rachel.hennein@yale.edu).

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Funding

RH and SL received funding support from Yale University’s COVID-19 Response Coordination Team. RH received funding support from the National Institutes of Health Medical Scientist Training Program (Training Grant T32GM007205).

Author information

Authors and Affiliations

  1. Department of Epidemiology of Microbial Diseases, Yale School of Public Health, 60 College St, New Haven, CT, USA

    Rachel Hennein

  2. Yale School of Medicine, New Haven, CT, USA

    Rachel Hennein

  3. Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA

    Max Jordan Nguemeni Tiako

  4. Department of Psychology, University of Maryland, College Park, MD, USA

    Jessica Bonumwezi

  5. Department of Psychology, Montclair State University, Montclair, NJ, USA

    Petty Tineo

  6. Department of Emergency Medicine, New York University Grossman School of Medicine, New York, NY, USA

    Dowin Boatright

  7. Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA

    Cindy Crusto

  8. Department of Psychology, University of Pretoria, Pretoria, South Africa

    Cindy Crusto

  9. Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA

    Sarah R. Lowe

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Contributions

All the authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by RH and SRL. The first draft of the manuscript was written by RH and all the authors commented on previous versions of the manuscript. All the authors read and approved the final manuscript.

Corresponding author

Correspondence to Rachel Hennein.

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Ethics Approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Yale University.

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Informed consent was obtained from all individual participants included in the study.

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Not applicable.

Competing Interests

The authors declare no competing interests.

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Appendix

Appendix

Table 4

Table 5

Table 6

Table 4 Hierarchical linear regression model predicting symptoms of posttraumatic stress
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Table 5 Hierarchical linear regression model predicting symptoms of depression
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Table 6 Hierarchical linear regression model predicting symptoms of anxiety
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Hennein, R., Tiako, M.J.N., Bonumwezi, J. et al. Vicarious Racism, Direct Racism, and Mental Health Among Racialized Minority Healthcare Workers. J. Racial and Ethnic Health Disparities (2023). https://doi.org/10.1007/s40615-023-01844-7

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