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. 2025 Jun;12(3):1700-1714.
doi: 10.1007/s40615-024-02000-5. Epub 2024 Apr 22.

Ethnic Identity Protects and Internalized Racism Harms Health and Coping in Asian Americans Following COVID-19 Discrimination: A Mixed-Methods Study

Emily R Nhan  1   2 , Aisha R Williamson-Raun  3   4 , Rachel Chan  3 , Joyce P Yang  3
Affiliations

Ethnic Identity Protects and Internalized Racism Harms Health and Coping in Asian Americans Following COVID-19 Discrimination: A Mixed-Methods Study

Emily R Nhan et al. J Racial Ethn Health Disparities. 2025 Jun.

Abstract

Mechanisms underlying the link between COVID-19 anti-Asian racial discrimination and psychological health are underexplored. This mixed-methods study examined the moderating effects of ethnic identity and internalized racism on the relationship between COVID discrimination and behavioral health outcomes among Asian Americans. We hypothesized that individuals with lower ethnic identity and higher internalized racism levels would demonstrate more adverse outcomes, including worsened psychological trauma and identity-avoidant behaviors, post-discrimination. Asian American participants (N = 215) responded to a Qualtrics survey, including qualitative and quantitative questions on COVID-related racism experiences, ethnic identity, internalized racism, trauma, and other subsequent effects. For qualitative analysis, participants were sorted into four subgroups defined by low- and/or high-ethnic identity and internalized racism scores, and we explored themes in participant reports of identity-related coping effects after racism. We additionally used hierarchical multiple regression analyses to quantitatively assess the moderating impact of ethnic identity and internalized racism on the relationship between COVID discrimination and trauma. Analyses revealed no moderating effects from the two identity variables. However, qualitative analyses identified themes of identity-promoting and identity-avoidant behavioral responses, and moderation analyses revealed that ethnic identity had a main effect on mitigating racial trauma, while internalized racism exacerbated both racial trauma and PTSD levels. This study identified ethnic identity and internalized racism as underlying causes to behavioral health outcomes for Asian Americans. Results offer mental health providers serving Asian clients insight into identity-related influences to help optimize culturally appropriate interventions and support initiatives of identity promotion to foster community engagement for this population.

Keywords: COVID-19; Discrimination; Ethnic identity; Internalized racism; PTSD; Racial trauma.

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Conflict of interest statement

Declarations. Ethics Approval: The University of San Francisco’s Institutional Review Board for Protection of Human Subjects reviewed and approved all study procedures (Protocol 1445). Consent to Participate: Prior to completing the Qualtrics survey, informed consent was obtained from all individual participants included in the study. Consent for Publication: Informed consent was obtained from all individual participants regarding publication of their data. Competing Interests: The authors declare no competing interests.

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