A hypothetical intervention to reduce inequities in anxiety for Multiracial people: simulating an intervention on childhood adversity.

Multiracial people report higher mean Adverse Childhood Experiences (ACEs) scores and prevalence of anxiety than other racial groups. Studies using statistical interactions to estimate racial differences in ACEs-anxiety associations do not show stronger associations for Multiracial people. Using data from Waves 1 (1995-97) through 4 (2008-09) of the National Longitudinal Study of Adolescent to Adult Health (Add Health), we simulated a stochastic intervention over 1,000 resampled datasets to estimate the race-specific cases averted per 1,000 of anxiety if all racial groups had the same exposure distribution of ACEs as Whites. Simulated cases averted were greatest for the Multiracial group, (median = -4.17 cases per 1,000, 95% CI: -7.42, -1.86). The model also predicted smaller risk reductions for Black participants (-0.76, 95% CI: -1.53, -0.19). CIs around estimates for other racial groups included the null. An intervention to reduce racial disparities in exposure to ACEs could help reduce the inequitable burden of anxiety on the Multiracial population. Stochastic methods support consequentialist approaches to racial health equity, and can encourage greater dialogue between public health researchers, policymakers, and practitioners.

Asking MultiCrit Questions: A Reflexive and Critical Framework to Promote Health Data Equity for the Multiracial Population.

Policy Points Health equity work primarily centers monoracial populations; however, the rapid growth of the Multiracial population and increasingly clear health disparities affecting the people in that population complicate our understanding of racial health equity. Limited resources exist for health researchers and professionals grappling with this complexity, likely contributing to the relative dearth of health literature describing the Multiracial population. We introduce a question-based framework built on core principles from Critical Multiracial Theory (MultiCrit) and Critical Race Public Health Praxis, designed for researchers, clinicians, and policymakers to encourage health data equity for the Multiracial population.

Neighborhood Safety and Neighborhood Police Violence Are Associated with Psychological Distress among English- and Spanish-Speaking Transgender Women of Color in New York City: Finding from the TURNNT Cohort Study.

Transgender women of color (TWOC) experience high rates of police violence and victimization compared to other sexual and gender minority groups, as well as compared to other White transgender and cisgender women. While past studies have demonstrated how frequent police harassment is associated with higher psychological distress, the effect of neighborhood safety and neighborhood police violence on TWOC's mental health is rarely studied. In this study, we examine the association between neighborhood safety and neighborhood police violence with psychological distress among TWOC. Baseline self-reported data are from the TURNNT ("Trying to Understand Relationships, Networks and Neighborhoods among Transgender Woman of Color") Cohort Study (analytic n = 303). Recruitment for the study began September 2020 and ended November 2022. Eligibility criteria included being a TWOC, age 18-55, English- or Spanish-speaking, and planning to reside in the New York City metropolitan area for at least 1 year. In multivariable analyses, neighborhood safety and neighborhood police violence were associated with psychological distress. For example, individuals who reported medium levels of neighborhood police violence had 1.15 [1.03, 1.28] times the odds of experiencing psychological distress compared to those who experienced low levels of neighborhood police violence. Our data suggest that neighborhood safety and neighborhood police violence were associated with increased psychological distress among TWOC. Policies and programs to address neighborhood police violence (such as body cameras and legal consequences for abusive officers) may improve mental health among TWOC.

A study of hospitalized COVID-19 patients with AKI in a setting of multiracial developing country.

BACKGROUND: The commonest indication for hospitalization in COVID-19 patients is hypoxemia or severe respiratory symptoms. However, COVID-19 disease may result in extrapulmonary complications including kidney-related pathology. The reported incidence of renal involvement related to COVID infection varies based on geographical location. OBJECTIVE: This study aimed to assess the incidence rate of AKI in hospitalized COVID-19 patients and identify risk factors and prognostic predictors. METHOD: In this retrospective study, we recruited hospitalized COVID-19 patients from January 2021 until June 2021 at the University Malaya Medical Center. The inclusion criteria were hospitalized for ≥ 48 h with confirmed COVID-19 infection and at least 18 years old. Patient demographic and clinical data were collected from electronic medical records. The staging of AKI was based on criteria as per KDIGO guidelines. RESULTS: One thousand five hundred twenty-nine COVID patients fulfilled the inclusion criteria with a male-to-female ratio of 759 (49.6%) to 770 (50.3%). The median age was 55 (IQR: 36-66). 500 patients (32.7%) had diabetes, 621 (40.6%) had hypertension, and 5.6% (n = 85) had pre-existing chronic kidney disease (CKD). The incidence rate of AKI was 21.1% (n = 323). The percentage of COVID patients in different AKI stages of 1,2 and 3 were 16.3%, 2.1%, and 2.7%, respectively. Fifteen hospitalized patients (0.98%) required renal replacement therapy. 58.8% (n = 190) of AKI group had complete recovery of kidney function. Demographic factors included age (p < 0.001), diabetes (p < 0.001), hypertension (p < 0.012), CKD (p < 0.001), and vaccination status (p = 0.042) were associated with an increased risk of developing AKI. We found that the AKI cohort had statistically significant lower platelet counts and higher ferritin levels than the non-AKI cohort. AKI is a risk predictor of prolonged hospitalization (p < 0.001) and higher mortality rates (P < 0.001). CONCLUSION: AKI is a common clinical complication among hospitalized COVID-19 patients. The etiology of AKI is multifactorial and may have an adverse impact on patient morbidity and mortality.

Incorporating multiracial and multiethnic experiences into genetic counseling practice and research: A necessary opportunity.

The conflation of race and genetic ancestry can have harmful consequences. Biological conceptualizations of race have long been used to justify inequities and distract from social structures that afford opportunities to some that are unjustly denied to others. Despite recent efforts within the scientific community to distinguish between the sociopolitical constructs of race and ethnicity and the biological constructs of genetic ancestry and genetic similarity, their conflation continues to influence genomic research and its translation into clinical care. One overlooked aspect of this problematic conflation is the extent to which discrete monoracial and monoethnic categorization systems persist and perpetuate unequal benefit-sharing in the clinical translation of genomic technologies. In genetic service delivery, reliance on discrete racial and ethnic categories undermines the clinical translation of genomic technologies for large segments of the global population. For multiracial and multiethnic individuals, who have complex identities that defy discrete categorization systems, the potential benefits of genomic discoveries are especially elusive. Scholars have recently begun to call for the inclusion of multiracial, multiethnic, and admixed individuals in race, ethnicity, and ancestry frameworks in genetics and genomics. However, little work has been done to explore and address the unique challenges and opportunities posed by multiracial/multiethnic individuals in genetic counseling specifically. We discuss how conceptualizing diversity along discrete racial and ethnic lines perpetuates inequitable patient care and limits efforts to increase inclusion and belonging within genetic counseling. Moreover, we argue that ongoing efforts to mitigate racial inequity must actively challenge the paradigm of monoracial and monoethnic categories to accomplish their goal.

Multiracial Reading the Mind in the Eyes Test (MRMET): An inclusive version of an influential measure.

Can an inclusive test of face cognition meet or exceed the psychometric properties of a prominent less inclusive test? Here, we norm and validate an updated version of the influential Reading the Mind in the Eyes Test (RMET), a clinically significant neuropsychiatric paradigm that has long been used to assess theory of mind and social cognition. Unlike the RMET, our Multiracial Reading the Mind in the Eyes Test (MRMET) incorporates racially inclusive stimuli, nongendered answer choices, ground-truth referenced answers, and more accessible vocabulary. We show, via a series of large datasets, that the MRMET meets or exceeds RMET across major psychometric indices. Moreover, the reliable signal captured by the two tests is statistically indistinguishable, evidence for full interchangeability. We thus present the MRMET as a high-quality, inclusive, normed and validated alternative to the RMET, and as a case in point that inclusivity in psychometric tests of face cognition is an achievable aim. The MRMET test and our normative and validation data sets are openly available under a CC-BY-SA 4.0 license at osf.io/ahq6n.

Video telehealth emotional awareness and expression therapy for older U.S. military veterans with chronic pain: A pilot study.

OBJECTIVES: Emotional Awareness and Expression Therapy (EAET) targets trauma and emotional conflict to reduce or eliminate chronic pain, but video telehealth administration is untested. This uncontrolled pilot assessed acceptability, feasibility, and preliminary efficacy of group-based video telehealth EAET (vEAET) for older veterans with chronic musculoskeletal pain. METHODS: Twenty veterans were screened, and 16 initiated vEAET, delivered as one 60-minute individual session and eight 90-minute group sessions. Veterans completed posttreatment satisfaction ratings and pain severity (primary outcome), pain interference, anxiety, depression, functioning, social connectedness, shame, and anger questionnaires at baseline, posttreatment, and 2-month follow-up. RESULTS: Satisfaction was high, and veterans attended 7.4 (SD = 0.6) of 8 group sessions; none discontinued treatment. Veterans attained significant, large reductions in pain severity from baseline to posttreatment (p < .001, Hedges' g = -1.54) and follow-up (p < .001, g = -1.20); 14 of 16 achieved clinically significant (≥ 30%) pain reduction, and 3 achieved 90-100% pain reduction. Secondary outcomes demonstrated significant, medium-to-large improvements. CONCLUSIONS: In this small sample, vEAET produced better attendance, similar benefits, and fewer dropouts than in-person EAET in prior studies. Larger, controlled trials are needed. CLINICAL IMPLICATIONS: Group vEAET appears feasible and highly effective for older veterans with chronic pain.

"That's what we think of as activism": Solidarity through care in queer Desi diaspora.

This article examines a framing of solidarity as both activism and community care work in diasporic South Asian (sometimes referred to as "Desi") communities in the US and the UK. From the vantage point of the researcher as a pansexual Indian-American activist herself, this article draws conclusions based on ethnographic research and interviews conducted with lesbian, gay, queer, and trans activists during the height of the COVID-19 pandemic and Black-led uprisings against police and state violence in the US and the UK. These conversations and this article particularly examine the participation of Desi activists and their peers in these movements, and their explorations of different modes of solidarity, from joint struggle to allyship to coconspiratorship and community transformation. They ultimately argue that queerness in Desi diaspora fosters solidarity through care that nurtures relationships across and between the diverse groups that make up LGBTQ + communities and the Desi diaspora, as well as between Desi, Black, and other racialized and diasporic communities. By examining lesbian, gay, trans, and broadly queer South Asian activists' relationships to each other and to other racialized groups in struggle, this article conceptualizes a framing of solidarity and Black and Brown liberation together that transcends difference, transphobia and TERFism, and anti-Blackness through centering kinship and care. Through the intimacies borne out of months and years on the frontlines of struggle together, this article argues that deepening an understanding of activism, kinship, and care together in Desi diasporic organizing is key to building a solidarity that imagines and moves toward new and liberated worlds.

The Multiracial-Black Socialization Model: Conceptualizing racial socialization in Multiracial-Black families.

Scholars have spent the last four decades expanding the theoretical understanding of parental racial socialization-or parent-child communication about race. What is largely absent from existing conceptualizations, however, is a consideration for how the practice manifests in Multiracial families. The interracial structure of Multiracial families complicates racial socialization in ways that are not being captured in empirical research due to the overreliance on universal frameworks. It is imperative that we close this theoretical gap as the proportion of Multiracial families in the United States is expanding at record rates. Accordingly, we present the Multiracial-Black Socialization Model (MRB-SM) in this paper. The MRB-SM is designed explicitly for Multiracial-Black families, one of the fastest-growing sub-groups of Multiracial families. The model builds upon the strengths of universal socialization theories by outlining the content, process, and context components of racial socialization in Multiracial-Black families. The implications for research are discussed.

Assessing the Prevalence Rates of Internalizing Symptomatology Among Multiracial Adolescents in the United States: A Systematic Review.

This systematic review aimed to investigate the prevalence of internalizing symptomatology among Multiracial adolescents in the United States and to report on the methods utilized to measure Multiracial race and internalizing symptoms. A comprehensive search was conducted in Ovid MEDLINE, Embase, APA PsycInfo, and Web of Science Core Collection. The search was confined to peer-reviewed studies reporting the prevalence of any internalizing symptom among Multiracial adolescents between 10 and 24 years in the United States. Study selection, data abstraction, and quality assessments were managed by four team members. Between 2000 and 2023, nine studies provided prevalence estimates and used various methods to measure Multiracial race and internalizing symptoms. Prevalence estimates displayed considerable variability depending on symptom examined and measurement method utilized. For all internalizing symptomatology, estimates ranged between 7.5 and 55.2%; for depressive symptomatology, estimates ranged between 12.8 and 51.0%. No information on the prevalence of anxiety symptoms alone were provided. This review represents a pioneering attempt to report the prevalence of internalizing symptomatology among Multiracial adolescents in the United States, revealing significant gaps in current knowledge and methodological inconsistencies in the field. There exists a need for more comprehensive epidemiological research with this growing population.

Impact of Racial Categorization on Effect Estimates: An HIV Stigma Analysis.

Suboptimal racial categorization potentially introduces bias in epidemiologic analysis and interpretation, making it difficult to appropriately measure factors leading to racial health disparities. As part of an analysis focused on predictors of experiencing human immunodeficiency status (HIV)-related stigma among men who have sex with men living with HIV in San Francisco, we struggled with the most appropriate ways to categorize people who reported more than 1 racial identity, and we aimed to explore the implications of different methodological choices in this analysis. We fitted 3 different multivariable linear regression models, each utilizing a different approach to racial categorization: the "multiracial," "othering," and "hypodescent" models. We estimated an adjusted risk difference in mean score for reported frequency of experiencing HIV-related stigma on a 4-point scale, adjusting for age, race, gender identity, injection history, housing, mental health concerns, and viral load. Use of a hypodescent model for racial categorization led to a shift in the point estimate through the null for Blacks/African Americans, and it improved precision for that group. However, it obscured the association of increased stigma and race for multiracial people, compared with monoracial counterparts. We conclude that methodological decisions related to racial categorization of participants can dramatically affect race-related study findings in predictor regression models.

Beyond the Boundaries: Exploring the Identity-Related Experiences of Biracial/Multiracial and Bisexual Adults.

Most prior bisexual research takes a monolithic approach to racial identity, and existing racial/ethnic minority research often overlooks bisexuality. Consequently, previous studies have rarely examined the experiences and unique health needs of biracial/multiracial and bisexual individuals. This exploratory qualitative study investigated the identity-related experiences of biracial/multiracial and bisexual adults within the context of health and well-being. Data were collected through 90-min semi-structured telephone interviews. Participants were recruited through online social network sites and included 24 adults between ages 18 and 59 years. We aimed to explore how identity-related experiences shape biracial/multiracial and bisexual individuals' identity development processes; how biracial/multiracial and bisexual individuals negotiate their identities; how the blending of multiple identities may contribute to perceptions of inclusion, exclusion, and social connectedness; and how biracial/multiracial and bisexual individuals may attribute positive and negative experiences to their identities. Interview transcripts were analyzed using an inductive thematic approach. Analysis highlighted four major themes: passing and invisible identities, not measuring up and erasing complexity, cultural binegativity/queerphobia and intersectional oppressions, and navigating beyond boundaries. Our findings imply promoting affirmative visibility and developing intentional support networks may help biracial/multiracial and bisexual individuals cultivate resiliency and navigate sources of identity stress. We encourage future research to explore mental health and chronic stress among this community.

Adverse childhood experiences and mental health conditions among multiracial adolescents.

OBJECTIVE: The objective of this study was to verify the factor structure of the household dysfunction type of ACE using data from the National Survey of Children's Health (NSCH), and then examine whether household dysfunction (measured as a latent construct) was associated with mental health conditions among multiracial adolescents. DESIGN: We used cross-sectional data collected in 2016 from caregivers who completed the NSCH and analyzed data from a subpopulation of adolescents (12-17) who reported more than one race (n = 1,231). Mplus 8.4 was used to conduct confirmatory factor analysis and probit models from a structural equation modeling framework. RESULTS: Results from this study indicated that the household dysfunction type of ACE, as a latent construct, had good model fit and was significantly associated with depression [standardized coefficient [B] = .50, 95% confidence interval [CI] .36, .65], anxiety [B = .61, 95% CI .48, .73], behavior problems [B = .58, 95% CI .44, .72], and ADHD [B = .54, 95% CI .38, .69] for multiracial adolescents. CONCLUSIONS: Household dysfunction may result in adolescents being separated (physically or emotionally) from their caregivers, which may hinder adolescents' ability to establish or maintain one of the most important relationships needed to promote racial/ethnic identity development and mental health. Implications for advancements in theory and NSCH are presented.

Perceived monoracism and psychological adjustment of multiracial adults: The roles of racially diverse contexts and creating third space.

Across two studies, we examined whether racially diverse contexts in combination with creating a third (multiracial) space played a protective role in the association between perceived monoracism and psychological adjustment for multiracial adults. Study 1 participants (N = 263; 77.8% female, Mage = 32.16 years) were recruited from national multiracial organizations and completed an online cross-sectional survey in 2009. Study 2 participants (N = 1478; 56.2% female, Mage = 48.89 years) were recruited by the Pew Research Center and completed a nationally representative survey in 2015. Results indicated significant three-way interaction effects on psychological adjustment, with differential effects depending on the types of perceived monoracism. Specifically, when subjective racial diversity was high, creating a third space buffered against the deleterious effects of multiracial discrimination on distress, negative affect, and life satisfaction; while it exacerbated the link between perceived racial ambiguity and negative affect. This study provides empirical evidence for the importance of using an ecological framework when examining multiracial identity and experiences. Results also highlight the need to move beyond conceptualizing and measuring multiracial experiences as dichotomous risks or resiliencies. Rather, we should aim to understand multiracial experiences as either promoting or inhibiting across contexts, time, and individual characteristics.

Concordant and Discordant Patterns of Parental Racial Socialization among Biracial Black-White Adolescents: Correlates and Consequences.

Multiracial-Black youth are one of the fastest-growing populations in the U.S., but little is known about their racialized developmental experiences. This study uses Latent Profile Analysis to identify patterns of parental racial socialization among Biracial Black-White adolescents and explore whether those profiles relate to demographics and racial identity outcomes. The sample consisted of 330 Biracial Black-White adolescents living in the U.S. (67% boys; Mage = 14.8, SD = 1.5). The analysis yielded a four-profile solution based on (1) the frequency of socialization messages youth received and (2) the concordance of those messages across both of their parents (i.e., whether socialization frequency is similar or different between Black and white parents). Profile membership differed based on youth gender and racialized appearance (i.e., whether youth presented physically as Black, white, or racially ambiguous). Ultimately, adolescents in the profile with the highest frequency and concordance of parental racial socialization reported more adaptive racial identity attitudes including a sense of pride in being Black and Biracial. Youth in that profile also felt the most comfortable navigating the intersections of their racial identities, which coupled with racial pride has promising implications for their development and wellbeing.

Early Childhood Teachers of Color in New York City: heightened stress, lower quality of life, declining health, and compromised sleep amidst COVID-19.

Stress and well-being are known to influence the quality of teacher-student interactions, teachers' delivery of emotional and instructional support, and the social competence and executive function skills of young learners-dynamics that impact the education and development of young children. Even prior to COVID-19, 46% of teachers reported notably high levels of daily stress. Given the additional stressors associated with the pandemic, this multi-methods study explores the well-being of Latinx, Black, and multiracial early childhood teachers in New York City, where communities of Color have been particularly hard hit by COVID-19. Via an amalgamation of descriptive and interpretive approaches-a survey, time-use diaries, and qualitative interviews-this study documents early childhood teachers' experiences making sense of and negotiating the impacts of intersecting stressors on their stress, health, quality of life, and sleep amidst COVID-19. Survey findings show reduced well-being across measures among the early childhood teachers in the sample, while qualitative findings illustrate the many layers of challenges that teachers of Color faced during the pandemic. Time-use diaries show extremely high demands and long work hours associated with concerning lack of self-care and attention to mental health. Interviews elucidate how stress is layered across environmental, occupational, and racial factors. This study points to the need to attend to the well-being of Black, Latinx, and multiracial early childhood teachers in urban settings during and after COVID-19 recovery.

Racial discrimination, racial identity affiliation, and heavy alcohol use among multiracial individuals.

BACKGROUND: Alcohol use is disproportionately higher among multiracial than monoracial adults; yet, associated risk and protective factors are underexplored. The present study compared levels of experienced racial discrimination, racial identity affiliation, and heavy alcohol use among multiracial and monoracial adults and tested whether racial identity affiliation, experienced racial discrimination, and their interaction were significantly associated with heavy alcohol use among multiracial individuals. METHODS: We conducted secondary analyses of data from the National Epidemiologic Survey on Alcohol and Related Conditions-III. Participants are a nationally representative sample of all U.S. adults (N = 29,026; 56.4% female) and were interviewed for the study from 2012 to 2013. The sample includes 598multiracial individuals. RESULTS: Linear regression analyses showed that multiracial individuals experienced significantly greater racial discrimination than White (b = -1.26, 95% CI [-1.47, -1.05], p < 0.001) or Asian individuals (b = -0.30, 95% CI [-0.53, -0.06], p = 0.013) but less than Black individuals (b = 0.29, 95% CI [0.08, 0.50], p = 0.007). Furthermore, multiracial individuals reported less affiliation with their racial identity than Black (b = 4.92, 95% CI [4.23, 5.62], p < 0.001) or Asian individuals (b = 3.86, 95% CI [3.09, 4.63], p < 0.001) but did not differ significantly from White individuals. Logistic regression analysis showed that multiracial individuals were significantly more likely to report heavy drinking than Asian individuals (OR = 0.53, 95% CI [0.36, 0.78], p = 0.001) but did not differ significantly from White or Black individuals. Finally, experienced racial discrimination was significantly related to heavy alcohol use in multiracial adults (b = 0.11, 95% CI [0.01, 0.20], p = 0.031), though neither racial identity affiliation nor the interaction of racial identity affiliation with experienced racial discrimination were significantly related to heavy alcohol use. CONCLUSIONS: Our results suggest that multiracial individuals, as compared to other minoritized individuals who are monoracial, report high levels of experienced racial discrimination and heavy alcohol use and low levels of racial identity affiliation. Further understanding of the effects of racial identity affiliation and experienced racial discrimination on the risk for heavy alcohol use could help in the development of interventions aimed at reducing alcohol use disparities among multiracial individuals.

What Are You? A Biracial Physician on Nuanced Racism.

A patient shouts what he suspects is my racial background at my face. A colleague repeats a patient's racist remarks against me; I lurk in my whiteness to cope. A compliment about my Asianness lands as a racist devaluation of both sides of my heritage. The medical licensing board does not include my race on its registration form. Straddling the boundary of Asian and White as a biracial female psychiatrist, I struggle to handle exoticization, discriminatory assumptions, and subtle marginalization by patients and colleagues. I grapple with the privilege of light-skinned ethnic ambiguity vs the disrespect for having features deviating from the imagined physician appearance. In this piece, I introduce a nuanced dialog about race and advocate for recognition and inclusion of biracial and multiracial minority medical practitioners who defy oversimplified racial categories.

Gender, Generation, and Multiracial Identification in the United States.

Multiracial self-identification is frequently portrayed as a disproportionately female tendency, but previous research has not probed the conditions under which this relationship might occur. Using the 2015 Pew Survey of Multiracial Adults, we offer a more comprehensive analysis that considers gender differences at two distinct stages: reporting multiple races in one's ancestry and selecting multiple races to describe oneself. We also examine self-identification patterns by the generational locus of multiracial ancestry. We find that females are more likely to be aware of multiracial ancestry overall, but only first-generation females are more likely than their male counterparts to self-identify as multiracial. Finally, we explore the role of racial ancestry combination, finding that multiracial awareness and self-identification are likely gendered differently for different segments of the mixed-race population. This offers a more nuanced picture of how gender interacts with other social processes to shape racial identification in the United States.

Ethnic Identity, Perceived Discrimination, Substance Use and Misuse among Black-White Biracial Adults.

Background: Multiracial groups are projected to be the fastest growing segment of the U.S. population, more than tripling in size over the next four decades. Marginality Theory suggests that biracial individuals, a subgroup of multiracial, may experience heightened conflict with their ethnic identity due to having to negotiate between two distinct cultures. Research shows that changes in ethnic identity is associated with perceived discrimination, and both are associated with marijuana and alcohol use among multiracial groups. These relationships are sometimes stronger among multiracial individuals than monoracial. Limited research exists among specific biracial groups, such as Black-White biracial individuals, despite unique complexities related to ethnic identity. Research conducted among Black-White biracial individuals is often limited to youth samples and shows disproportionate rates of substance use. Objectives: Given the population increase and disparate substance use outcomes among Black-White biracial youth, it is essential to extend substance use and misuse research to Black-White biracial adults to see if similar disparities exist. The present study examined the direct effect of biracial ethnic identity on marijuana use and alcohol misuse, and indirect effects of perceived discrimination to these relationships among a sample of Black-White biracial adults (n = 195) using a 46-item self-report survey administered online via MTurk. Results: Results revealed that while ethnic identity alone was not associated with marijuana use or alcohol misuse, there were significant indirect relationships between ethnic identity, marijuana use, and alcohol misuse through perceived discrimination. Conclusions/Importance: Findings suggest that substance use interventions should seek to address coping with perceived discrimination among this population.