Look behind the numbers when reporting on the pandemic’s mental health toll on people of color

The COVID-19 pandemic wreaked havoc on the nation’s mental health. While no one study can capture the pain of those who dealt with loss, sickness, loneliness, financial struggles and other stressors, research continues to try to quantify the mental anguish.

However, journalists should take data on the pandemic’s mental health toll on people of color with a grain of salt.

A recent analysis from the Research and Insights team at athenahealth, a healthcare technology company, sought to examine the pandemic’s unequal impact on mental health by looking at de-identified data from more than 24 million patient visits to primary care providers within the athenahealth network between May and December of 2020.

The analysis found that women were twice as likely as men to receive a diagnosis of anxiety or depression from their primary care provider. Patients with chronic conditions were also more likely to be diagnosed with anxiety or depression. Among patients with four or more chronic illnesses, 9.7% were diagnosed with anxiety, and 7.6% with depression. Those with no chronic illness had anxiety and depression diagnoses rates of less than 2%.

Surprisingly, white patients were diagnosed with both conditions at significantly higher rates than patients of color. “White patients received anxiety and depression diagnoses at rates of 7.2% and 4.7% percent, respectively, while Asian patients were only diagnosed at rates of 2.2%(anxiety) and 1.5% (depression),” writes Chris Hayhurst for athenahealth.

Taking this data at face value and assuming it implies that people of color within athenahealth’s network experienced fewer mental health challenges than their white counterparts during the pandemic erases what we already know about the pandemic’s disproportionate impact on communities of color, and about mental health stigma and historic barriers to health care access.

Factors such as discrimination, health care access and use, occupation and housing were “associated with more COVID-19 cases, hospitalizations, and deaths in areas where racial and ethnic minority groups live, learn, work, play, and worship,” according to the Centers for Disease Control and Prevention (CDC).

A June 2020 CDC survey  shows U.S. adults in general reported considerably higher levels of mental health struggles than the athenahealth analysis found. More than 40% of CDC respondents reported at least one mental health symptom associated with pandemic-related illness, death, trauma, or stress. Racial and ethnic minorities, younger adults, essential workers, and unpaid adult caregivers reported disproportionately worse mental health outcomes and increased substance use. The percentage of respondents who reported having seriously considered suicide within 30 days of completing the survey was dramatically higher among those aged 18-24 (25.5%), minority racial/ethnic groups (18.6% of Hispanics, 15.1% of non-Hispanic Black respondents), unpaid caregivers for adults (30.7%), and essential workers (21.7%).

This shouldn’t come as a surprise. According to the National Alliance on Mental Illness, Latinx communities experience disparities in access to and quality of mental health treatment. Mental Health America details how language barriers, stigma, religious intolerance and other factors leave Asian American and Pacific Islander communities three times less likely to seek mental health treatment or help than their white counterparts in the U.S. Mental health stigma and lack of access to quality health care prevented many Black Americans from seeking care for mental health issues long before the pandemic. 

Journalists might take the athenahealth findings as an opportunity to consider what is and isn’t being said inside primary care visits, if these visits happen at all for certain individuals, and what factors are keeping people of color in their communities from seeking help for mental health.

Meanwhile, movements such as Black Lives Matter and Stop Asian Hate remind us that communities of color have continued experiencing trauma and anxiety from racialized violence and injustice throughout the pandemic.

Janvi Nerurkar, quantitative research manager on the athenahealth Research and Insights team, noted the limitations of the data in capturing the mental health burden of patients of color. “I think I was expecting to see differences in these demographic groups, but I never thought they’d be to this magnitude,” Nerurkar said in an athenahealth blog post. “It kind of hits home for me. It makes me wonder what else we could be doing to destigmatize mental health conditions.”