Daily Discrimination’s Link to Depression, Anxiety Varies by Race

A cross-sectional study found an association between discrimination and mental health across US adults.1

Discrimination presents itself in subtle, routine forms of mistreatment—less respect, microaggressions, or inferior services—and continues to be reinforced and upheld by structural and systemic factors. Approximately 31% of US adults have experienced ≥ 1 major incident of discrimination in their lifetime, such as not getting hired for an unjust reason or being prevented from moving into a neighborhood due to discriminatory actions. Among these individuals, 63% encounter discrimination daily.

Frequent discrimination increases the risk of psychological distress, depression, and anxiety, as well as heart conditions such as hypertension and cardiovascular disease. Marginalized groups—including women, certain racial and ethnic minorities (Asian, Black, Hispanic or Latino, Indigenous, and multiracial individuals), people with lower socioeconomic status, the LGBTQ community, and individuals with disabilities—experienced more health issues linked to discrimination.

Depression rates rose from 10% to 23% in women and 5.5% to 22% in men (2013–2023). Anxiety rates increased from 8% to 31% in women and 5% to 24% in men (2018–2023). Among Black adults, depression rose from 9% in 2013 to 21% in 2023, while anxiety jumped from 6% in 2018 to 27% in 2023.2,3,4

“Given these trends, it is important to investigate how discrimination is associated with mental health across a representative range of demographic groups,” wrote investigators, led by Monica L. Wang, ScD, from Boston University School of Public Health.1

Wang and colleagues conducted a cross-sectional study of 29,522 adults from the 2023 US National Health Interview Survey, weighted to represent a population of 258,237,552 US adults, to evaluate associations between discrimination and mental explore. Investigators wanted to explore how these associations may vary by race, ethnicity, and sex.

Primary outcomes included depression, measured with the Patient Health Questionnaire-2 scale, and anxiety, measured with the Generalized Anxiety Disorder-2 scale. The team looked for participants who had scores of ≥ 3 for both scales, indicating a positive screening.

The Everyday Discrimination Scale assessed discrimination exposure based on the frequency of discourtesy, poor service, being treated as unintelligent, being feared, and harassment. A summative scale and nominal variable categorized exposure levels as none, low, or high.

The sample had a mean age of 48.1 years and included 51.1% female, 62.2% non-Hispanic or non-Latino White, 17.5% Hispanic or Latino, 11.6% non-Hispanic or non-Latino Black, 6.2% non-Hispanic Asian, and 2.5% multiracial or other.

The study found each unit increase in discrimination exposure was linked to increased odds of a positive screening for depression (odds ratio [OR], 1.15; 95% confidence interval [CI], 1.12 – 1.17), anxiety (OR, 1.14; 95% CI, 1.12 – 1.16), and both depression and anxiety (OR, 1.19; 95% CI, 1.16 – 1.21).

Compared with no exposure to discrimination, low and high exposure to discrimination were associated with increased odds of a positive screening for depression (low exposure: OR, 2.20, 95% CI, 1.77 – 2.72; high exposure: OR, 5.39, 95% CI, 3.61 – 8.04), anxiety (low exposure: OR, 1.97, 95% CI, 1.66 – 2.33; high exposure: OR, 4.98, 95% CI, 3.59 – 6.91), and both depression and anxiety (low exposure: OR, 2.60, 95% CI, 2.13 – 3.18; high exposure: OR, 8.8, 95% CI, 6.44 – 12.14).

The analysis found that discrimination’s link to depression (P = .01) and to both depression and anxiety (P = .03) varied by race and ethnicity but not by sex.

The study also found that greater discrimination exposure correlated with a greater likelihood of a positive depression screening, with sharper increases among White, multiracial, and other race adults.

“Although our study’s results demonstrate that White adults experienced higher odds of positive screening results for depression with increasing levels of discrimination, this finding does not imply that exposure to discrimination is less significant for Asian, Black, Hispanic or Latino, and other racial and ethnic populations,” investigators clarified. “One potential explanation is that, after centuries of systemic racism and discrimination, individuals in these groups may have developed a form of resignation, passive acceptance, or normalization of these experiences, where prolonged exposure to discrimination may lead some groups to internalize its effects or develop coping mechanisms that mitigate the perceived effect.”

References

1. Wang ML, Narcisse MR. Discrimination, Depression, and Anxiety Among US Adults. JAMA Netw Open. 2025 Mar 3;8(3):e252404. doi: 10.1001/jamanetworkopen.2025.2404. PMID: 40152858.

2. Brody DJ, PrattLA, Hughes JP. Prevalence of depression among adults aged 20 and over: United States,20132016. NCHSDataBrief.2018;(303):1-8.

3. Anxiety and depression: household pulse survey. National Center for Health Statistics. Accessed August 22, 2024. https://www.cdc.gov/nchs/covid19/pulse/mental-health.htm

4. Goodwin RD, Weinberger AH, Kim JH, Wu M, Galea S. Trends in anxiety among adults in the United States, 2008-2018: rapid increases among young adults.JPsychiatrRes.2020;130:441-446.doi:10.1016/j.jpsychires. 2020.08.014