Associations between experiences of racial discrimination across the life course and mental health: Exploring direct and indirect pathways

We aim to explore the association between racial discrimination across the life course on common mental disorders (CMD) during the COVID-19 pandemic, testing direct and indirect pathways. Cross-sectional data were obtained from the Evidence for Equality National Survey (Feb–Nov 2021, N = 8897 ethnic minority people aged 18–60). The survey measured experiences of racial discrimination across multiple domains and time periods. Path analyses were used to explore the associations between racial discrimination and CMD and the indirect associations via SARS-CoV-2 infection, financial concerns, loneliness and belonging. We find a clear dose–response relationship between experiences of racial discrimination over time and CMD. Compared to no reporting of experiences, chronic experiences of racial discrimination were associated with 2.91 times the odds of CMD (95%CI: 2.33–3.65; recent experiences only OR = 2.11, 1.67–2.67; past experiences only OR = 1.50, 1.16–1.92). Recent and chronic experiences of racial discrimination (but not past experiences) were also indirectly associated with CMD, via SARS-CoV-2 infection, greater financial concerns, greater feelings of loneliness and a reduced sense of belonging. These findings were consistent across all domains of racial discrimination, indicating that racial discrimination in any setting can negatively impact mental health. Anti-racist interventions which target the interconnected dimensions of racism are needed.