Background

During the COVID-19 pandemic, Asians/Asian Americans have experienced co-occurring threats of anti-Asian racism, economic challenges, and negative mental and physical health symptoms.

Objectives

We examined the co-occurrence of COVID-19-related anti-Asian discrimination and collective racism, economic stressors, and mental and physical health challenges for Asians/Asian Americans during the COVID-19 pandemic. We also examined Asian/Asian American subgroups associated with these threats.

Methods

Nationally representative data from the 2021 Asian American and Native Hawaiian/Pacific Islander COVID-19 Needs Assessment Project (unweighted N = 3,508) were used to conduct a latent profile analysis to identify unique typologies of the co-occurrence of these threats. We also conducted chi-square analyses to investigate subgroup differences by latent profile.

Results

We identified five distinct latent profiles: multi-threat impact, low impact, collective racism, health challenges, and economic/health challenges. Forty percent of Asians/Asian Americans were in the multi-threat impact profile, indicating high levels across COVID-19-related threats. Subgroup analyses revealed significant differences in profile membership. East Asians, US-born Asians/Asian Americans, and those aged 25-44 seemed to be particularly affected by the proposed syndemic; results also differed by income.

Conclusion

Asians/Asian Americans have experienced co-occurring and interrelated threats during COVID-19 that suggest the presence of a syndemic. Results from our study point to vulnerable Asian/Asian American subgroups and the need for targeted public health efforts to address racism, health challenges, and economic challenges in the context of COVID-19.

Background

Asian Americans (AAs) are experiencing increased rates of anti-Asian racism during COVID-19. Experiences of racism, whether personal or collective, constitute stress and psychosocial trauma that negatively impact mental and physical health.

Objectives

Examine subgroup differences in rates of personal experience of discrimination and COVID-related collective racism and how each is associated with mental and physical health for AAs.

Methods

Nationally representative data from the 2021 Asian American and Native Hawaiian/Pacific Islander COVID-19 Needs Assessment Project were used to estimate prevalence rates of discrimination and average COVID-related collective racism scores for AAs (unweighted N = 3478). We conducted logistic and linear regression models to examine subgroup differences by sociodemographic factors. We also conducted hierarchical logistic regression models to examine associations between racism and psychological distress and health decline.

Results

Twenty-four percent of AAs (95% CI: 21.6, 25.6) reported experiencing discrimination during the first year of the COVID-19 pandemic. Subgroup analyses revealed that Chinese, younger adults, and AAs who completed the survey in an Asian language were significantly more likely to experience discrimination compared to their counterparts. For COVID-related collective racism, subgroup analyses revealed that Chinese, women, and adults ages 25-44 were more likely to report experiences of collective racism compared to their counterparts. Both discrimination and collective racism were independently associated with negative mental and physical health.

Conclusion

Discrimination and COVID-related collective racism are associated with negative mental and physical health outcomes for AAs. Results point to vulnerable AA subgroups and the need for targeted public health efforts to address racism in the context of COVID-19.

A key component of the current framework for economic evaluation is the measurement and valuation of health outcomes using generic preference-based health-related quality-of-life (HRQoL) instruments. In 2015, a research synthesis reported the absence of conceptual and empirical research regarding the appropriateness of current preference-based instruments for people with aphasia-a disorder affecting the use and understanding of language-and suggested the development and validation of an accessible, pictorial variant could be an appropriate direction for further research. This paper describes the respective rationale and development process for each of three preliminary studies that have been undertaken to develop pictorial variants of two widely used preference-based HRQoL instruments (EQ-5D-3L and EQ-5D-5L). The paper also proposes next steps for this program of research, drawing on the lessons learned from the preliminary work and the demand for a pictorial preference-based instrument in the research community. Guidance for the use of the preliminary, pictorial instruments is also provided.

Rett syndrome (RTT) is a regressive neurodevelopmental disorder in girls, characterized by multisystem complications including gut dysbiosis and altered metabolism. While RTT is known to be caused by mutations in the X-linked gene MECP2, the intermediate molecular pathways of progressive disease phenotypes are unknown. Mecp2 deficient rodents used to model RTT pathophysiology in most prior studies have been male. Thus, we utilized a patient-relevant mouse model of RTT to longitudinally profile the gut microbiome and metabolome across disease progression in both sexes. Fecal metabolites were altered in Mecp2e1 mutant females before onset of neuromotor phenotypes and correlated with lipid deficiencies in brain, results not observed in males. Females also displayed altered gut microbial communities and an inflammatory profile that were more consistent with RTT patients than males. These findings identify new molecular pathways of RTT disease progression and demonstrate the relevance of further study in female Mecp2 animal models.