Multiracial individuals appear to be at higher risk for mental health problems; however, more research is needed to confirm these racial disparities among young adult college populations.
Methods:
We analyzed data from the Health Minds Study (N = 99728 young adult college students aged 18–34), collected online across 140 college campuses from September 2020 to June 2021. We used multivariable logistic regression to examine associations between multiracial identity and several mental health outcomes, including mental and behavioral health (depression, anxiety, languishing, perceived need, loneliness), self-injurious behaviors (non-suicidal self-injury, suicidal ideation, suicide plan, suicide attempt), and history of lifetime psychiatric disorders, adjusting for age and gender.
Results:
Almost a tenth of the weighted sample were multiracial. Multiracial students had greater odds of all mental and behavioral health outcomes, self-injurious behaviors (though only marginally significant for suicide attempt), and most lifetime psychiatric disorders.
Conclusion:
Multiracial young adult college students were more likely to have mental health problems than their monoracial counterparts, calling for targeted preventive interventions on college campuses to address these mental health disparities.
AlbujaA. F.SanchezD. T.GaitherS. E. (2019). Identity denied: Comparing American or White identity denial and psychological health outcomes among bicultural and biracial people. Personality and Social Psychology Bulletin, 45(3), 416–430. https://doi.org/10.1177/0146167218788553
2.
BakerR.BrickJ. M.BatesN. A.BattagliaM.CouperM. P.DeverJ. A.GileK. J.TourangeauR. (2013). Summary report of the AAPOR task force on non-probability sampling. Journal of Survey Statistics and Methodology, 1(2), 90–143.
3.
BaumeisterR. F.LearyM. R. (1995). The need to belong: Desire for interpersonal attachments as a fundamental human motivation. Psychological Bulletin, 117(3), 497.
4.
BenJ.KellyD.ParadiesY. (2020). Contemporary anti-racism: A review of effective practice. In SolomosJ. (Ed.), Routledge International Handbook of Contemporary Racisms (pp. 205–215). Routledge.
5.
BratterJ. L. (2018). Multiracial identification and racial gaps: A work in progress. The Annals of the American Academy of Political and Social Science, 677(1), 69–80.
6.
BratterJ. L.GormanB. K. (2011). Does multiracial matter? A study of racial disparities in self-rated health. Demography, 48(1), 127–152.
7.
BratterJ. L.KimbroR. T. (2013). Multiracial children and poverty: Evidence from the early childhood longitudinal study of kindergartners. Family Relations, 62(1), 175–189.
8.
BrunsmaD. L.DelgadoD.RockquemoreK. A. (2013). Liminality in the multiracial experience: Towards a concept of identity matrix. Identities, 20(5), 481–502.
9.
ChavezG. F.SanchezD. T. (2010). A clearer picture of multiracial substance use: Rates and correlates of alcohol and tobacco use in multiracial adolescents and adults. Race and Social Problems, 2(1), 1–18.
10.
ChenJ. A.StevensC.WongS. H.LiuC. H. (2019). Psychiatric symptoms and diagnoses among US college students: A comparison by race and ethnicity. Psychiatric Services, 70(6), 442–449.
11.
ChengC.-Y.LeeF. (2009). Multiracial identity integration: Perceptions of conflict and distance among multiracial individuals. Journal of Social Issues, 65(1), 51.
12.
CraigB. M.HaysR. D.PickardA. S.CellaD.RevickiD. A.ReeveB. B. (2013). Comparison of US panel vendors for online surveys. Journal of Medical Internet Research, 15(11), e260.
13.
DienerE.WirtzD.Biswas-DienerR.TovW.Kim-PrietoC.ChoiD.OishiS. (2009). New measures of well-being. In DienerE. (Ed.), Assessing well-being (pp. 247–266). Springer.
14.
FanW.YanZ. (2010). Factors affecting response rates of the web survey: A systematic review. Computers in Human Behavior, 26(2), 132–139.
15.
FelipeL. C.Garrett-WalkerJ. J.MontagnoM. (2022). Monoracial and multiracial LGBTQ+ people: Comparing internalized heterosexism, perceptions of racism, and connection to LGBTQ+ communities. Psychology of Sexual Orientation and Gender Diversity, 9(1), 1.
16.
FisherS.ReynoldsJ. L.HsuW.-W.BarnesJ.TylerK. (2014). Examining multiracial youth in context: Ethnic identity development and mental health outcomes. Journal of Youth and Adolescence, 43(10), 1688–1699.
17.
FrancoM.DurkeeM.McElroy-HeltzelS. (2021). Discrimination comes in layers: Dimensions of discrimination and mental health for multiracial people. Cultural Diversity and Ethnic Minority Psychology, 27, 343–353.
18.
FrancoM.KatzR.PickensJ.BrunsmaD. L. (2020). From my own flesh and blood: An exploratory examination of discrimination from family for Black/White Multiracial people. Qualitative Social Work, 19(2), 246–266.
19.
FrancoM.McElroy-HeltzelS. (2019). Let me choose: Primary caregiver cultural humility, racial identity, and mental health for multiracial people. Journal of Counseling Psychology, 66(3), 269–279. https://doi.org/10.1037/cou0000317
20.
FrodlT.O’KeaneV. (2013). How does the brain deal with cumulative stress? A review with focus on developmental stress, HPA axis function and hippocampal structure in humans. Neurobiology of Disease, 52, 24–37.
21.
GonlinV. (2022). Mixed-race ancestry ≠ multiracial identification: the role racial discrimination, linked fate, and skin tone have on the racial identification of people with mixed-race ancestry. Social Sciences, 11(4), 160.
22.
HallW. J.ChapmanM. V.LeeK. M.MerinoY. M.ThomasT. W.PayneB. K.EngE.DayS. H.Coyne-BeasleyT. (2015). Implicit racial/ethnic bias among health care professionals and its influence on health care outcomes: A systematic review. American Journal of Public Health, 105(12), e60–e76.
23.
HarrellC. J. P.BurfordT. I.CageB. N.NelsonT. M.ShearonS.ThompsonA.GreenS. (2011). Multiple pathways linking racism to health outcomes. Du Bois Review: Social Science Research on Race, 8(01), 143–157. http://journals.cambridge.org/abstract_S1742058X11000178
24.
HassenN.LoftersA.MichaelS.MallA.PintoA. D.RackalJ. (2021). Implementing anti-racism interventions in healthcare settings: A scoping review. International Journal of Environmental Research and Public Health, 18(6), 2993.
25.
HitlinS.Scott BrownJ.ElderG. H.Jr. (2006). Racial self-categorization in adolescence: Multiracial development and social pathways. Child Development, 77(5), 1298–1308.
26.
HughesM. E.WaiteL. J.HawkleyL. C.CacioppoJ. T. (2004). A short scale for measuring loneliness in large surveys: Results from two population-based studies. Research on Aging, 26(6), 655–672.
27.
HuynhV. W.RavalV. V.FreemanM. (2022). Ethnic-racial discrimination towards Asian Americans amidst COVID-19, the so-called “China” virus and associations with mental health. Asian American Journal of Psychology, 13(3), 259–269.
KeyesC. L. (2002). The mental health continuum: From languishing to flourishing in life. Journal of Health and Social Behavior, 43, 207–222.
30.
KroenkeK.SpitzerR. L. (2002). The PHQ-9: A new depression diagnostic and severity measure. Psychiatric Annals, 32(9), 509–515.
31.
KuentzelJ. G.ArbleE.BoutrosN.ChuganiD.BarnettD. (2012). Nonsuicidal self-injury in an ethnically diverse college sample. American Journal of Orthopsychiatry, 82(3), 291.
32.
LeeS.WatersS. F. (2021). Asians and Asian Americans’ experiences of racial discrimination during the COVID-19 pandemic: Impacts on health outcomes and the buffering role of social support. Stigma and Health, 6(1), 70.
33.
Leigh-HuntN.BagguleyD.BashK.TurnerV.TurnbullS.ValtortaN.CaanW. (2017). An overview of systematic reviews on the public health consequences of social isolation and loneliness. Public Health, 152, 157–171.
34.
ManiamJ.AntoniadisC.MorrisM. J. (2014). Early-life stress, HPA axis adaptation, and mechanisms contributing to later health outcomes. Frontiers in Endocrinology, 5, 73.
35.
MillerB.RocksS.CatalinaS.ZemaitisN.DanielsK.LondonoJ. (2019). The missing link in contemporary health disparities research: A profile of the mental and self-rated health of multiracial young adults. Health Sociology Review, 28(2), 209–227.
36.
MitchellS.WarrenE. (2022). Educational trajectories and outcomes of multiracial college students. Social Sciences, 11(3), 101.
37.
MuseusS. D.SariñanaS. A. L.RyanT. K. (2015). A qualitative examination of multiracial students’ coping responses to experiences with prejudice and discrimination in college. Journal of College Student Development, 56(4), 331–348.
38.
OhH.ZhouS.BanawaR. (2021). The mental health consequences of discrimination against Asian American/Pacific Islanders. Psychiatric Services, 72(11), 1359–1359.
ParadiesY.BenJ.DensonN.EliasA.PriestN.PieterseA.GuptaA.KelaherM.GeeG. (2015). Racism as a determinant of health: A systematic review and meta-analysis. PLoS One, 10(9), e0138511.
PaukerK.MeyersC.SanchezD. T.GaitherS. E.YoungD. M. (2018). A review of multiracial malleability: Identity, categorization, and shifting racial attitudes. Social and Personality Psychology Compass, 12(6), e12392.
44.
Paz GalupoM.TaylorS. M.ColeDJr. (2019). “I am double the Bi”: Positive aspects of being both bisexual and biracial. Journal of Bisexuality, 19(2), 152–168.
45.
ReeceR. L. (2019). Coloring racial fluidity: How skin tone shapes multiracial adolescents’ racial identity changes. Race and Social Problems, 11(4), 290–298.
46.
Reid MarksL.ThurstonI. B.KamodyR. C.Schaeffer-SmithM. (2020). The role of multiracial identity integration in the relation between racial discrimination and depression in multiracial young adults. Professional Psychology: Research and Practice, 51(4), 317.
47.
RogersL. O.RosarioR. J.PadillaD.FooC. (2021). “[I]t’s hard because it’s the cops that are killing us for stupid stuff”: Racial identity in the sociopolitical context of Black Lives Matter. Developmental Psychology, 57(1), 87.
48.
RosmondR.BjörntorpP. (2000). The hypothalamic–pituitary–adrenal axis activity as a predictor of cardiovascular disease, type 2 diabetes and stroke. Journal of Internal Medicine, 247(2), 188–197.
49.
SanchezD. T. (2010). How do forced-choice dilemmas affect multiracial people? The role of identity autonomy and public regard in depressive symptoms. Journal of Applied Social Psychology, 40(7), 1657–1677.
50.
SanchezD. T.GaitherS. E.AlbujaA. F.EddyZ. (2020). How policies can address multiracial stigma. Policy Insights from the Behavioral and Brain Sciences, 7(2), 115–122.
51.
ShihM.SanchezD. (2009). When race becomes even more complex: Toward understanding the landscape of multiracial identity and experiences. Journal of Social Issues, 65(1), 1.
52.
SpitzerR. L.KroenkeK.WilliamsJ. B.LöweB. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166(10), 1092–1097.
53.
SubicaA. M.AgarwalN.SullivanJ. G.LinkB. G. (2017). Obesity and associated health disparities among understudied multiracial, Pacific Islander, and American Indian adults. Obesity, 25(12), 2128–2136.
54.
SubicaA. M.WuL.-T. (2018). Substance use and suicide in Pacific Islander, American Indian, and multiracial youth. American Journal of Preventive Medicine, 54(6), 795–805.
55.
TabbK. M.GavinA. R.SmithD. C.HuangH. (2019). Self-rated health among multiracial young adults in the United States: Findings from the add health study. Ethnicity & Health, 24(5), 495–511.
56.
WangJ.MannF.Lloyd-EvansB.MaR.JohnsonS. (2018). Associations between loneliness and perceived social support and outcomes of mental health problems: A systematic review. BMC Psychiatry, 18(1), 1–16.
57.
WeyA.DavisJ.JuarezD. T.SentellT. (2018). Distinguishing between primary and secondary racial identification in analyses of health disparities of a multiracial population in Hawaii. Ethnicity & Health, 23(3),233–248.
58.
WilliamsD. R.JacksonP. B. (2005). Social sources of racial disparities in health. Health Affairs, 24(2), 325–334.
WooM.AustinS. B.WilliamsD. R.BennettG. G. (2011). Reconceptualizing the measurement of multiracial status for health research in the United States. Du Bois Review: Social Science Research on Race, 8(1), 25–36.
61.
ZhouS.BanawaR.OhH. (2021). The mental health impact of COVID-19 racial and ethnic discrimination against Asian American and Pacific Islanders. Frontiers in Psychiatry, 12, 708426.
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