Racial/Ethnic Disparities in Vicarious and Direct COVID-19–Related Discrimination and Vigilance

INTRODUCTION: The high visibility of COVID-19–related discrimination underscores the importance of understanding the psychological harms associated with vicariously and directly experiencing such incidents. In this observational study, both vicariously and directly experienced COVID-19–related discrimination and their association with heightened concerns about discrimination and vigilance were examined in U.S. adults who use commercial tobacco. METHODS: Data were from a nationally representative sample of adults who currently or formerly used commercial tobacco products (N=1,700; mean age=43 years) from an online survey panel administered in January–February 2021 (analyzed in 2021–2022). Participants reported vicariously and directly experienced COVID-19–related discrimination, concern about experiencing such discrimination, and heightened vigilance. Weighted multivariable linear and logistic regression models were used to examine the associations among these variables. RESULTS: Overall, 69% of individuals reported exposure to vicarious COVID-19–related discrimination, and 22% reported directly experiencing COVID-19–related discrimination. Asian, Hispanic, and Black individuals reported higher levels of concern and vigilance than White individuals (p<0.05). Vicariously and directly experienced COVID-19–related discrimination was independently associated with concern about experiencing COVID-19–related discrimination in the entire sample and within each racial and ethnic group (p<0.05). This concern was associated with increased vigilance (p<0.05) and was stronger in those exposed to vicarious COVID-19–related discrimination than in those who were not (p<0.05). CONCLUSIONS: COVID-19–related discrimination may undermine the psychological well-being of those who are exposed to it vicariously as well as those who experience it directly and may also make individuals feel vulnerable and unsafe. Interventions to prevent and reduce the impact of COVID-19–related discrimination may have wide-reaching societal benefits.