Racism, Posttraumatic Stress Symptoms, and Racial Disparity in the U.S. COVID-19 Syndemic

Xiang Zhou, Viann N. Nguyen-Feng, Rachel Wamser-Nanney, Annett Lotzin

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


The COVID-19 syndemic, with a disproportionately higher adverse impact on communities of color (i.e., COVID-19 infection and death), will likely exacerbate the existing health disparities in trauma-related symptoms between people of color (POC) and White Americans. However, no studies have examined the racial disparity in posttraumatic stress symptoms (PTSS) during COVID-19. Grounded in ecological theory and racial trauma framework, we investigated racial disparity in PTSS and three possible mechanisms, 1) COVID stress, 2) direct racism, and 3) indirect racism, for these disparities using a large U.S. national sample. Results indicated that POC reported higher levels of PTSS than White Americans. The PTSS racial disparity was accounted more by direct and indirect racism than by the COVID-19-specific stressors, after controlling for age, gender, education, income, parent status, adverse childhood experiences (ACEs), and intimate partner violence (IPV). Additional fine-grained analyses for Hispanic/Latinx Americans, Black/African Americans, and Asian American and Pacific Islanders by and large corroborated the above findings. Our findings highlighted the deleterious impact of the ongoing racism pandemic on the POC community as a public health crisis in addition to the COVID-19 pandemic. Supplemental data for this article is available online at at http://doi:10.1080/08964289.2021.2006131.

Original languageEnglish (US)
Pages (from-to)85-94
Number of pages10
JournalBehavioral Medicine
Issue number2
StatePublished - 2022

Bibliographical note

Funding Information:
Financial support for this study was provided by startup funds allocated to X. Zhou from the College of Education, Purdue University and startup funds allocated to V. N. Nguyen-Feng from the College of Education and Human Service Professions, University of Minnesota, Duluth; and a Sustainable Development Goals Initiative Rapid Response Grant to V. N. Nguyen-Feng from the Global Programs and Strategy Alliance, University of Minnesota.

Publisher Copyright:
© 2022 Taylor & Francis Group, LLC.


  • COVID-19
  • disparity
  • ethnic-racial minority
  • racism
  • trauma

PubMed: MeSH publication types

  • Journal Article
  • Research Support, Non-U.S. Gov't


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