A conditional indirect effect model of racism and depressive and anxiety symptoms by ethnicity among Asian Americans during the COVID-19 pandemic

The COVID-19 pandemic contributed to the rise in anti-Asian hate crimes, leading to adverse mental and physical health outcomes in Asian American communities and a growing need to better understand the detrimental effects of racism. This study aims to understand whether the indirect relationship between facing discrimination and depressive and anxiety symptoms through perceived danger is conditional on Asian ethnicity. We used data from the Asian American & Native Hawaiian/Pacific Islander COVID-19 Needs Assessment Project (n = 3071), employing multivariable linear regression models and path analysis to determine if ethnicity and perceived danger explained the relationship between facing discrimination and depressive and anxiety symptoms. We found that perceived danger indirectly explained about 9 % of the total effect in depressive symptoms and 12 % of the total effect in anxiety symptoms. We also found that facing discrimination yielded smaller increases of anxiety symptoms among Vietnamese and Cambodian individuals compared to other Asian ethnic groups. However, the indirect effect of facing discrimination and depressive and anxiety symptoms through perceived danger was the same across all ethnic groups, indicating no significant evidence for conditional indirect effects. These results suggest that interventions addressing perceived danger could reduce depressive and anxiety symptoms, and tailored approaches that account for distinct histories and identities may better address the effects of racism on various Asian ethnic groups. Future research directions include studies that incorporate longitudinal data to test for moderated mediation and alternative directional pathways.