Studying the link between discrimination and depressive symptoms
Younga “Heather” Lee, PhD Postdoctoral Research Fellow, Massachusetts General Hospital, Harvard Medical School, Broad Institute of MIT and Harvard
Smoller Laboratory, Psychiatric & Neurodevelopmental Genetics Unit, Center for Genomic Medicine
Project overview
A growing body of literature has begun to calculate the far-reaching health and economic consequences of the COVID-19 pandemic on the U.S. population. Communities affected by structural racism—particularly Asian, Black, Hispanic or Latino, American Indian and Alaska Native, and Pacific Islander populations—have borne an unequal burden of these consequences. These communities have experienced higher rates of unemployment, food and housing insecurity, reduced access to health care, and poorer health outcomes during the COVID-19 pandemic. In the Smoller Laboratory at Massachusetts General Hospital (MGH), a team led by postdoctoral research fellow Younga “Heather” Lee, PhD hypothesized that experiencing discrimination during the pandemic would be associated with moderate to severe depression and/or suicidal ideation. They used data from the All of Us Research Program, drawn primarily from the COVID-19 Participant Experience (COPE) surveys, to test this hypothesis. The data demonstrated that, within the participant cohort, discrimination was associated with both depressive symptoms and suicidal ideation. The team has recently published their results and is pursuing additional studies examining additional risk and protective factors of mental health conditions during the pandemic such as the effects of social support on depression.
The topic of discrimination is something Dr. Lee has learned more about personally and professionally since emigrating from South Korea to the U.S. for college 11 years ago. Having grown up in a largely homogenous culture, racism and racial discrimination, as they can be experienced in the U.S., were initially abstract concepts to her. But as a pre-medical student majoring in psychology at New York University, she began to examine these issues more deeply, as she sought to understand why communities historically underrepresented in biomedical research (including her own) underutilize mental health treatment.
In her sophomore year of college, Dr. Lee started working with Dr. Sidney Hankerson on investigating socio-ecological factors that contribute to mental health inequities and developing a novel, church-based intervention with a focus on engaging Black men in depression care. Through this collaboration, she learned more about the vast inequities in mental health in the U.S., particularly across racial and ethnic lines, which she has remained interested in throughout her research career. These inequities have been brought into sharper focus during the pandemic, creating an even more personal connection to her work.
As an Asian person, I had been hearing a lot about hate crimes targeting AAPI individuals throughout the pandemic, and there were times I felt fearful myself. When I saw discrimination measured as part of the COPE survey, I felt I had to examine this in my work.
– Heather Lee, PhD
Key benefits of All of Us data and resources
Dr. Lee describes the All of Us dataset as a living organism that continues to evolve. To ensure her team is able to make the best use of the data available to them, she frequently turns to the Workbench User Support Hub, including the Community Support Forum, the Help Desk, and training tools such as Featured Workspaces.
“It’s really helpful that the support team has been releasing such thorough documentation on what has changed. I’ve always referred to that as the best resource I can go to.”
– Heather Lee, PhD
Dr. Lee and her team have also found and collaborated with fellow researchers through the workbench, and have given demonstrations of their research on the platform to other registered users. As the program works to expand opportunities for cross-team collaboration, feedback from researchers who have shared research interests, like Dr. Lee, is critical to shaping new collaboration tools.
Dr. Lee also acknowledges how rare it is for researchers to be able to examine potential variations in the etiology of mental health conditions across racial and ethnic groups in the same dataset. They credit the size and diversity of All of Us for enabling new discoveries of factors that contribute to mental health inequities. In particular, Dr. Lee noted she was pleasantly surprised to see how large a portion of the All of Us cohort self-identified as Asian relative to most existing biomedical studies. Between the diversity of the dataset and the existence of a detailed discrimination module within the COPE survey, Dr. Lee’s team was able to identify and detect the statistically significant association between discrimination and depressive symptoms among participants self-identifying as Asian during the COVID-19 pandemic.
When I saw discrimination measured as part of the COPE survey, I felt I had to examine this, especially with so many communities being impacted. To my knowledge, there hasn’t been any other study on this scale with repeated measurements of both discrimination and mental health outcomes during the COVID-19 pandemic.
– Heather Lee, PhD
Long-term vision
The Smoller Lab sits within the Psychiatric & Neurodevelopmental Genetics Unit of The Center for Genomic Medicine at MGH and Harvard Medical School. Given this, Dr. Lee and her team are already beginning to explore what the new genomics data in the All of Us dataset can tell them about the genetic underpinnings of mental health conditions in diverse populations. They hope to learn more about how the intersection of genomics and life circumstances impacts experiences of mental health consequences differently across populations.
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