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

J Racial Ethn Health Disparities. 2023 Nov 7. doi: 10.1007/s40615-023-01844-7. Online ahead of print.

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.

Keywords: Anxiety; Depression; Healthcare workers; Mental health; Posttraumatic stress; Racism; Vicarious racism.