Asian American Adolescents’ Behavioral Health within the Context of Racism, Discrimination, and the COVID-19 Pandemic

Asian American youth are underrepresented in research on racism, discrimination, and adolescent health outcomes compared to their peers from other minoritized racial-ethnic groups. This invisibility is, in part, due to the “model minority” stereotype that portraits Asian Americans as high-achieving and well-behaved, erroneously suggesting that they do not require special attention in health disparity research ¹. However, studies that do examine Asian American adolescents suggest that they are more likely than other racial-ethnic groups to experience racial-ethnic discrimination perpetrated by peers or at school ^2,3. These experiences have been exacerbated since the COVID-19 pandemic, when the United States witnesses a surge of anti-Asian sentiments and hate crimes that have significantly affected Asian American communities including its young members ^4,5. An emerging body of scientific evidence has begun to document the detrimental impacts of racism and discrimination on the mental health outcomes of Asian American adolescents ^5–7.

Despite the growing attention to discrimination against Asian American adolescents, there remains a notable gap in research regarding its impact on behavioral health outcomes, such as delinquency, gang involvement, substance use, and risky sexual behaviors. A recent meta-analytic review shows that, among 371 studies investigating the influence of racial-ethnic discrimination on adolescents’ mental, academic, and behavioral health outcomes, only 37 studies focused specifically on Asian American adolescents and 7 studies (less than 2%) examined their behavioral health outcomes (mostly by delinquency) ⁸. While Asian American adolescents tend to show lower levels of behavioral issues than other racial-ethnic groups overall, a small body of work has identified substantial variations within this population. These variations encompass substance use ⁹, gang involvement ¹⁰, school violence ¹¹, and sexual behaviors ¹², influenced by factors such as gender, ethnicity, generational status, and sexual orientation. This evidence underscores a clear need to understand Asian American adolescents’ behavioral health outcomes, as well as relevant risk and resilience factors.

The study by Lu et al. in this issue addresses this gap in the literature by attending to Asian American adolescents’ involvement in interpersonal violence, specifically victimization and perpetration of bullying and teen dating violence. Using data from 344 Asian American adolescents participating in a randomized trial of a school-based violence prevention program in urban southeast Texas, the study showed that adolescents who reported racial discrimination in 2020 (compared to those who did not) were more likely to report both victimization and perpetration of interpersonal violence cross-sectionally; they were also more likely to report bullying victimization and teen dating violence perpetration one-year later. These findings offer initial evidence linking experiences of racial discrimination to a heightened risk of interpersonal violence among Asian American adolescents. The findings are particularly meaningful within the context of a school-based violence prevention program. Existing research indicates that anti-bullying programs that primarily target general bullying behaviors, without addressing issues related to racism and stigma, tend to be more effective at reducing bullying victimization for White students but not for racial-ethnic minority students ¹³. The current findings add to this work by highlighting the need to address Asian American adolescents’ experiences of racial discrimination in these violence prevention efforts.

The study also represents an initial step towards documenting the long-term impacts of racial discrimination experienced by Asian American adolescents during the COVID-19 pandemic. Despite the emerging research attention on this population since the pandemic’s onset ^5,6, there is limited evidence regarding how the experiences of Asian American youth change over time and how these pandemic-related experiences may continually impact their health. As an exception, a recent study shows that Chinese American parents and youth reported more direct discrimination and poorer mental health during the second year of the pandemic than the first year ⁷, underscoring the enduring challenges faced by Asian American communities. Moreover, future research is imperative to identify effective strategies employed by schools, communities, and policies that can promote resilience and long-term health among Asian American adolescents in the post-pandemic era.

The investigation of racial discrimination and interpersonal violence requires careful conceptual and methodological considerations, as the two constructs can be related to each other through co-occurrence, shared motives, or bidirectional associations. Lu et al. attended to this issue by clarifying conceptual distinctions between the two constructs. For example, interpersonal violence is characterized by its violent and intentional nature, driven by multiple motives. In contrast, racial discrimination can manifest in non-violent forms and may occur unintentionally, targeting individuals based on their race, ethnicity, or skin color. The authors also outlined the theoretical foundations underpinning their investigation, which is a commendable effort. However, they also acknowledged measurement limitations (e.g., racial discrimination was assessed by single items, motives of interpersonal violence were not assessed) that preclude a more nuanced understanding of the interrelations between racial discrimination and interpersonal violence. Beyond addressing these measurement issues, future research could enhance its methodologies by examining mediating mechanisms, alternative directionalities, or bidirectional effects using longitudinal data, or capturing youth lived experiences using mixed methods. These efforts will contribute to a more robust and comprehensive understanding of racial discrimination and behavioral health among Asian American adolescents.

Moving forward, another important area ripe for investigation is the heterogeneity within Asian American youth populations. Asian American communities are highly diverse in terms of language, ethnicity, culture, religion, immigration history, generational status, socioeconomic status, and sexual orientation, among other factors ¹. Similarly, Asian American adolescents’ experiences of discrimination are multifaceted. For instance, Chinese Americans may be particularly targeted by xenophobia and COVID-19 related discrimination since the pandemic ⁷; Southeast Asians often need to navigate stereotypes associated with gang involvement ¹⁰; Asian American sexual minority youth are confronted with intersectional stigma stemming from their multiplicatively marginalized identities ⁹. Furthermore, various Asian American subgroups have distinct cultures, religions, and norms around health behaviors such as drinking ¹⁴ and dating ¹⁵. This multi-layered diversity underscores the importance of carefully considering the unique developmental contexts within various Asian American groups, and much more science is needed to unpack the complex ways in which racism and discrimination shape the behavioral health outcomes of Asian American adolescents.