Asian Americans' Lived Experiences with and Perceptions of Social Stigma during COVID-19

It has been well documented that Asian Americans have experienced increased social stigmatization related to COVID-19 since Donald Trump began referring to the virus as the "Chinese virus" and "kung flu" in March 2020. Stigma has negative social and health impacts on minority communities, such as labeling, avoiding, shame, disgust, and social exclusion. The health impacts include both physical and mental illness, and the acceleration of health disparities. This study seeks to understand these lived experiences and subsequent coping strategies. Using focus groups, 17 Asian American participants were interviewed to understand their experiences with stigmatization during the pandemic. The findings reveal that stigmatized behavior and attitudes of others did not deter Asian Americans from following the COVID-19 related health guidelines, likely because perceived health threats were high. Consumer behaviors of Asian Americans also changed dramatically toward buying almost everything online (due to both the pandemic and personal safety). This behavioral decisioning provides insights into the complex motivations for adopting health behaviors, and, in this case, social distancing can double as a means by which to avoid people, for fear of becoming victims of stigmatization in public areas.

Adequacy of Existing Surveillance Systems to Monitor Racism, Social Stigma and COVID Inequities: A Detailed Assessment and Recommendations.

The populations impacted most by COVID are also impacted by racism and related social stigma; however, traditional surveillance tools may not capture the intersectionality of these relationships. We conducted a detailed assessment of diverse surveillance systems and databases to identify characteristics, constraints and best practices that might inform the development of a novel COVID surveillance system that achieves these aims. We used subject area expertise, an expert panel and CDC guidance to generate an initial list of N > 50 existing surveillance systems as of 29 October 2020, and systematically excluded those not advancing the project aims. This yielded a final reduced group (n = 10) of COVID surveillance systems (n = 3), other public health systems (4) and systems tracking racism and/or social stigma (n = 3, which we evaluated by using CDC evaluation criteria and Critical Race Theory. Overall, the most important contribution of COVID-19 surveillance systems is their real-time (e.g., daily) or near-real-time (e.g., weekly) reporting; however, they are severely constrained by the lack of complete data on race/ethnicity, making it difficult to monitor racial/ethnic inequities. Other public health systems have validated measures of psychosocial and behavioral factors and some racism or stigma-related factors but lack the timeliness needed in a pandemic. Systems that monitor racism report historical data on, for instance, hate crimes, but do not capture current patterns, and it is unclear how representativeness the findings are. Though existing surveillance systems offer important strengths for monitoring health conditions or racism and related stigma, new surveillance strategies are needed to monitor their intersecting relationships more rigorously.