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      Ethno-cultural disparities in mental health during the COVID-19 pandemic: a cross-sectional study on the impact of exposure to the virus and COVID-19-related discrimination and stigma on mental health across ethno-cultural groups in Quebec (Canada)

      research-article
      , PhD, , MScPH candidate, , ScD, , MScPH candidate, , PhD, , PhD, , MD
      BJPsych Open
      Cambridge University Press
      Pandemic, mental health, sociocultural factors, discrimination and stigma, exposure to virus

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          Abstract

          Background

          Although social and structural inequalities associated with COVID-19 have been documented since the start of the pandemic, few studies have explored the association between pandemic-specific risk factors and the mental health of minority populations.

          Aims

          We investigated the association of exposure to the virus, COVID-19-related discrimination and stigma with mental health during the COVID-19 pandemic, in a culturally diverse sample of adults in Quebec (Canada).

          Method

          A total of 3273 residents of the province of Quebec (49% aged 18–39 years, 57% women, 51% belonging to a minority ethno-cultural group) completed an online survey. We used linear and ordinal logistic regression to identify the relationship between COVID-19 experiences and mental health, and the moderating role of ethno-cultural identity.

          Results

          Mental health varied significantly based on socioeconomic status and ethno-cultural group, with those with lower incomes and Arab participants reporting higher psychological distress. Exposure to the virus, COVID-19-related discrimination, and stigma were associated with poorer mental health. Associations with mental health varied across ethno-cultural groups, with exposed and discriminated Black participants reporting higher mental distress.

          Conclusions

          Findings indicate sociocultural inequalities in mental health related to COVID-19 in the Canadian context. COVID-19-related risk factors, including exposure, discrimination and stigma, jeopardise mental health. This burden is most noteworthy for the Black community. There is an urgent need for public health authorities and health professionals to advocate against the discrimination of racialised minorities, and ensure that mental health services are accessible and culturally sensitive during and in the aftermath of the pandemic.

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          Most cited references38

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          Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019

          Key Points Question What factors are associated with mental health outcomes among health care workers in China who are treating patients with coronavirus disease 2019 (COVID-19)? Findings In this cross-sectional study of 1257 health care workers in 34 hospitals equipped with fever clinics or wards for patients with COVID-19 in multiple regions of China, a considerable proportion of health care workers reported experiencing symptoms of depression, anxiety, insomnia, and distress, especially women, nurses, those in Wuhan, and front-line health care workers directly engaged in diagnosing, treating, or providing nursing care to patients with suspected or confirmed COVID-19. Meaning These findings suggest that, among Chinese health care workers exposed to COVID-19, women, nurses, those in Wuhan, and front-line health care workers have a high risk of developing unfavorable mental health outcomes and may need psychological support or interventions.
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            Racial Differences in Physical and Mental Health: Socio-economic Status, Stress and Discrimination.

            This article examines the extent to which racial differences in socio-economic status (SES), social class and acute and chronic indicators of perceived discrimination, as well as general measures of stress can account for black-white differences in self-reported measures of physical and mental health. The observed racial differences in health were markedly reduced when adjusted for education and especially income. However, both perceived discrimination and more traditional measures of stress are related to health and play an incremental role in accounting for differences between the races in health status. These findings underscore the need for research efforts to identify the complex ways in which economic and non-economic forms of discrimination relate to each other and combine with socio-economic position and other risk factors and resources to affect health.
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              COVID-19 and Racial/Ethnic Disparities

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                Author and article information

                Journal
                BJPsych Open
                BJPsych Open
                BJO
                BJPsych Open
                Cambridge University Press (Cambridge, UK )
                2056-4724
                January 2021
                09 December 2020
                : 7
                : 1
                : e14
                Affiliations
                [1]Division of Social and Cultural Psychiatry, McGill University , Canada
                [2]Department of Epidemiology, Biostatistics, and Occupational Health, McGill University , Canada
                [3]Division of Social and Cultural Psychiatry, McGill University , Canada
                [4]Department of Epidemiology, Biostatistics, and Occupational Health, McGill University , Canada
                [5]School of Psychology (Clinical), University of Ottawa , Canada
                [6]UNESCO co-Chair on Prevention of Radicalisation and Violent Extremism, Concordia University , Canada
                [7]Division of Social and Cultural Psychiatry, McGill University , Canada
                Author notes
                Correspondence: Diana Miconi. Email: diana.miconi@ 123456mail.mcgill.ca
                Author information
                https://orcid.org/0000-0002-7088-1646
                https://orcid.org/0000-0003-3628-6904
                Article
                S2056472420001465
                10.1192/bjo.2020.146
                7844156
                33295270
                72da3db3-c04f-4da9-adf7-7de5f9e8ed28
                © The Author(s) 2020

                This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 03 August 2020
                : 28 October 2020
                : 11 November 2020
                Page count
                Tables: 5, References: 45, Pages: 10
                Categories
                General Adult
                Papers

                pandemic,mental health,sociocultural factors,discrimination and stigma,exposure to virus

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