COVID-19 Racial Discrimination and Substance Use among Asian Americans by Gender.

OBJECTIVES

The COVID-19 pandemic was accompanied by a surge in anti-Asian racial discrimination in the United States. To date, there has not been a study that examined the role of gender among Asian Americans (AAs) during the pandemic and its associations with racial discrimination and substance use. This study examined the relationship between COVID-19-related discrimination and substance use behaviors among AAs and investigated the moderating role of gender.

METHODS

We used survey data from N = 1,052 AA Chinese, Filipino/a/x, and South Asian adults (Mage = 36.58, women = 69%) collected in May 2022. COVID-19-related discrimination was measured across three dimensions: direct overt-, direct subtle-, and vicarious discrimination. Substance use outcomes included past-year frequency of alcohol, tobacco/nicotine, cannabis, and other illicit substance use. Ordinal logistic regression models examined main effects and gender interactions.

RESULTS

Overall, COVID-19 racial discrimination was significantly associated with increased odds of all substance use: alcohol (OR = 1.72), tobacco/nicotine (OR = 1.77), cannabis (OR = 1.85), and other illicit substances (OR = 2.88). Direct overt discrimination demonstrated the strongest associations across all substances. Gender significantly moderated the discrimination-substance use relationship for alcohol and cannabis, with men showing stronger associations (alcohol interaction OR = 1.46; cannabis interaction OR = 1.68). Marginal effects revealed that men experienced consistently larger probability increases in substance use across all discrimination types compared to women.

CONCLUSION

COVID-19-related racial discrimination is robustly associated with substance use among AAs, with AA men demonstrating particular vulnerability to alcohol and cannabis use following discriminatory experiences. Results underscore the need for gender-specific, culturally tailored interventions addressing discrimination-related substance use in AA populations.