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Ormiston et al

Original Paper

Association Between Discrimination and Depressive Symptoms
Among Hispanic or Latino Adults During the COVID-19 Pandemic:
Cross-Sectional Study
Cameron K Ormiston1,2*, BS; Kevin Villalobos1*, BS; Francisco Alejandro Montiel Ishino3*, CPH, MPH, PhD; Faustine
Williams1*, MPH, PhD
1National Institute on Minority Health and Health Disparities, National Institutes of Health, Rockville, MD, United States

2

Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, United States

3

National Institute of Environmental Health Sciences, National Institutes of Health, Durham, NC, United States*

all authors contributed equally

Corresponding Author:
Cameron K Ormiston, BS
National Institute on Minority Health and Health Disparities
National Institutes of Health11545 Rockville Pike
Rockville, MD, 20852
United States
Phone: 1 301 827 2727
Email: cameron.ormiston@icahn.mssm.edu

Abstract
Background: Discrimination and xenophobia toward Hispanic and Latino communities increased during the COVID-19
pandemic, likely inflicting significant harm on the mental health of Hispanic and Latino individuals. Pandemic-related financial
and social instability has disproportionately affected Hispanic and Latino communities, potentially compounding existing disparities
and worsening mental health.
Objective: This study aims to examine the association between discrimination and depressive symptoms during the COVID-19
pandemic among a national sample of Hispanic and Latino adults.
Methods: Data from a 116-item web-based nationally distributed survey from May 2021 to January 2022 were analyzed. The
sample (N=1181) was restricted to Hispanic or Latino (Mexican or Mexican American, Puerto Rican; Cuban or Cuban American,
Central or South American, and Dominican or another Hispanic or Latino ethnicity) adults. Depression symptoms were assessedusing the 2-item Patient Health Questionnaire. Discrimination was assessed using the 5-item Everyday Discrimination Scale. A
multinomial logistic regression with a block entry model was used to assess the relationship between discrimination and thelikelihood of depressive symptoms, as well as examine how controls and covariates affected the relationship of interest.
Results: Mexican or Mexican American adults comprised the largest proportion of the sample (533/1181, 45.13%), followed
by Central or South American (204/1181, 17.3%), Puerto Rican (189/1181, 16%), Dominican or another Hispanic or Latino
ethnicity (172/1181, 14.6%), and Cuban or Cuban American (83/1181, 7.03%). Approximately 31.26% (367/1181) of the sample
had depressive symptoms. Regarding discrimination, 54.56% (634/1181) reported experiencing some form of discrimination.
Compared with those who did not experience discrimination, those who experienced discrimination had almost 230% higher
odds of depressive symptoms (adjusted odds ratio [AOR] 3.31, 95% CI 2.42-4.54). Also, we observed that sociodemographic
factors such as age and gender were significant. Compared with participants aged 56 years and older, participants aged 18-35
years and those aged 36-55 years had increased odds of having depressive symptoms (AOR 3.83, 95% CI 2.13-6.90 and AOR
3.10, 95% CI 1.74-5.51, respectively). Women had higher odds of having depressive symptoms (AOR 1.67, 95% CI 1.23-2.30)
than men. Respondents with an annual income of less than US $25,000 (AOR 2.14, 95% CI 1.34-3.41) and US $25,000 to lessthan US $35,000 (AOR 1.89, 95% CI 1.17-3.06) had higher odds of depressive symptoms than those with an annual income of
US $50,000 to less than US $75,000.
Conclusions: Our findings provide significant importance especially when considering the compounding, numerous socioeconomic
challenges stemming from the pandemic that disproportionately impact the Hispanic and Latino communities. These challenges

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include rising xenophobia and tensions against immigrants, inadequate access to mental health resources for Hispanic and Latino
individuals, and existing hesitations toward seeking mental health services among this population. Ultimately, these findings canserve as a foundation for promoting health equity.
(JMIR Form Res 2024;8:e48076) doi: 10.2196/48076
KEYWORDS
depressive symptoms; everyday discrimination; COVID-19 pandemic; Hispanic and Latino; immigrant health

Introduction
Mental health conditions are a major public health concern in
the United States, with 20% of US adults (ie, 52.9 million
people) experiencing mental illness annually [1]. Risk factors
for mental health conditions include having chronic diseases,
experiencing homelessness, financial and food insecurity,
substance use, racism and discrimination, and stressful life
events [2-5]. The prevalence of mental health conditions also
varies by sociodemographic factors such as gender, race andethnicity, and income [2,6-9]. Although data suggest that racialand ethnic minorities have lower rates of mental healthconditions than White individuals, these trends may be a resultof higher rates of misdiagnosis or underdiagnosis of mental
health conditions among non–White populations [6,10,11].
Furthermore, the impact of mental health symptoms is more
far-reaching and drastic among racial and ethnic minoritizedcommunities [6,10]. Despite having a lower lifetime risk formood and anxiety disorders, Hispanic and non-Hispanic Black
adults are more likely to have persistent disorders thannon-Hispanic White adults [12].
In addition, barriers to mental health care access are more
pronounced among racial and ethnic minoritized communities.
For example, disability burden due to inadequate mental healthservices and unmet needs are disproportionately higher among
racial and ethnic minorities [13]. Among adults with moderateor severe anxiety or depression in 2019, 53% of Black adults
and 40% of Hispanic adults reported that they were not receiving
treatment [14]. Lower use and poorer access to psychologicalservices among underrepresented and underserved racial andethnic groups (eg, Black and African American communities;
Hispanic and Latino communities) stem from socioeconomic
inequities that are compounded by stigma, financial barriers,
structural racism, and lack of representation in health care
[5,10,15,16]. Moreover, historical and current discrimination,
as well as abuse by the health care system, discordance between
providers and patients, and lack of cultural humility and empathy
among providers perpetuates apprehension to seek care andworsens mental health care access and use [5,10,15,16].
The COVID-19 pandemic has had especially drastic mental
health consequences, with the prevalence of depression andanxiety being nearly 4-fold higher during the pandemic (2020)
than before (2019) [17]. Concurrent with the increase in mental
health burden in the United States was an increase inanti-immigrant sentiment and misinformation, racism,discrimination, exploitation, and xenophobia targeted toward
Hispanic and Latino groups [18]. Exclusion of immigrants, 44%of whom are Hispanic or Latino (ie, two-thirds of Hispanic andLatino individuals in the United States are born outside thehttps://formative.jmir.org/2024/1/e48076

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United States), from COVID-19 relief bills has likely further
entrenched inequities for immigrant, Hispanic, and Latino
communities in the United States [19,20]. Moreover, Hispanicand Latino communities have been disproportionately affectedby COVID-19, having higher rates of COVID-19 infection,
hospitalization, and mortality [19,21]. Data on layoffs due tothe pandemic also show that Hispanic and Latino adults had thehighest probability of being laid off compared with their Black,
Asian, and White counterparts [22]. Thus, the increase indiscrimination toward Hispanic and Latino groups combinedwith preexisting low psychological service use rates andworsening financial and social disparities is likely to have major,
synergistic effects on the acute and long-term mental health of
the Hispanic and Latino community. In fact, data as recent as
February 2023 from the Household Pulse Survey show that
Hispanic or Latino adults have the highest prevalence ofdepressive symptoms among all racial and ethnic groups [23].
Hispanic and Latino adults also reported a higher prevalenceof depressive symptoms and a higher unmet need for mental
health services compared with non-Hispanic Asian,non-Hispanic Black, and non-Hispanic White adults during the
pandemic (March 2020, December 2020, and January 2021)[4,17,24,25]. Moreover, a prepandemic meta-analysis of 333
studies reported that discrimination may incur greater mental
health tolls for Latino adults compared to other racial and ethnic
groups, indicating that recent increases in discrimination may
have particularly drastic effects on Hispanic and Latino
psychological outcomes [26].
Importantly, the heterogeneity of the US Hispanic or Latino
population must be considered, with prepandemic researchshowing differences in psychological distress, depression, andanxiety across acculturation and Hispanic or Latino ethnicity[27-32]. However, it remains to be seen whether thesedifferences are present during the pandemic. To address theseknowledge gaps, we examined the association of discriminationand depressive symptoms during the COVID-19 pandemic
among a national sample of Hispanic and Latino adults that was
further analyzed by Hispanic or Latino ethnicity group. We
hypothesize that (1) discrimination will be associated withhigher odds of depressive symptoms and (2) differences will
be observed in the odds of depressive symptoms across Hispanic
or Latino ethnicity group.

Methods
Study Participants
Data from “Understanding the Impact of the Novel Coronavirus(COVID-19) and Social Distancing on Physical andPsychosocial (Mental) Health and Chronic Diseases” wereanalyzed. This was a 116-item web-based survey that was
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nationally distributed in the United States from May 2021 toJanuary 2022. Qualtrics, LLC conducted recruitment and survey
distribution using a national survey panel. The survey was inEnglish only. For more details, see the study by Montiel Ishino
et al [33]. Analysis was restricted to Hispanic or Latino (ie,Mexican or Mexican American; Puerto Rican, Cuban or Cuban
American, Central or South American, and Dominican or
another Hispanic or Latino ethnicity) adults, which included
both foreign-born and US-born groups. The final sample size
was 1181.

Outcome Variable: Depressive Symptoms
Depressive symptoms were assessed using the Patient Health
Questionnaire-2 [34]. Two items were used to assess whether“Over the last 2-week period how often were you bothered by
the following problems?”: (1) “Little interest or pleasure indoing things”; and (2) Feeling down, depressed or hopeless.”
Responses to these items included (1) “not at all” for a score of0; (2) “several days” for a score of 1; (3) “more than half thedays” for a score of 2; and (4) “nearly every day” for a score of
3. Scores were summed for a range of 0-6, where a score of 0-2(reference category) indicates no depressive symptoms and ascore of 3 or more indicates present depressive symptoms [34].
The Patient Health Questionnaire-2 has been validated by bothSpanish- and English-speaking Hispanic and Latino adults[34-37].

Predictor Variable: Everyday Discrimination
The short version of the Everyday Discrimination Scale wasused [38]. Items of the short version assessed whether “In yourday-to-day life how often have any of the following things
happened to you?”: (1) You are treated with less courtesy or
respect than other people. (2) You receive poorer service thanother people at restaurants or stores. (3) People act as if they
think you are not smart. (4) People act as if they are afraid ofyou. (5) You are threatened or harassed. Responses to the 5
items were (1) never; (2) monthly to weekly; and (3) multiple
times a week to daily. A composite score was created to compare
participants who had never experienced any discrimination withthose with experiences of discrimination.

Acculturation and Sociodemographic Covariates andControls
All items were self-reported. Acculturation factors included
years in the United States (ie, less than 10 years and 10 or more
years) and English-speaking proficiency level (ie, none or poor,
fairly well, well, or very well). Self-reported sociodemographic
factors included the following: age group (ie, 18-35 years, 36-55
years, and 56 years of age and older); gender (ie, man, woman,
and another gender category that included responses fornonbinary, transgender, or responses provided through fill inthe blank); marital status (ie, divorced or separated, married orliving with a partner, never been married, or widowed);educational attainment (ie, categorized by self-reported highest
schooling that included less than high school, did not attend
school, elementary level education, more than elementary tohttps://formative.jmir.org/2024/1/e48076

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Ormiston et al
junior high school, or some high school; high school diploma
or GED; some college or vocational or technical schooling;bachelor’s degree; and master’s degree or above that includes
doctoral, professional, or postgraduate degree); and annual
household income (ie, US <$25,000, US $25,000 to US $34,999,
US $35,000 to US $49,999, US $50,000 to US $74,999, andUS ≥$75,000).

Statistical Analysis
We used a multinomial logistic regression with a block entry
model to assess the relationship between discrimination and thelikelihood of depressive symptoms, as well as to examine how
controls and covariates affected the relationship of interest. All
findings are reported in odds ratios (ORs) or adjusted odds ratios(AORs) using 95% CI and P value at ≤.05 statistical level ofsignificance. All analyses were conducted using Stata/MP(version 16.1; StataCorp).

Ethical Considerations
The NIH Intramural Research Program institutional review
board, Human Research Protection Program, and Office of
Human Subjects Research Protections reviewed this study’s
research protocol, determined that our protocol did not involve
human participants and granted an exemption on December 23,
2020 (IRB#000308). For full information on ethicalconsiderations for this study, see the study by Ishino et al [33].
Qualtrics recruited participants, and web-based informed consent
was obtained from each participant prior to filling out the survey.
Participants were assured that responses were confidential andwere reminded that the study was voluntary, and they could opt
out of the survey or skip any questions without repercussions.
All answers were kept confidential, and no personal identifiers
were shared with the National Institute on Minority Health and
Health Disparities research team, which participants were also
made aware of. A US $10 gift card was given to each participant
after the completion of their survey, which took approximately
30 minutes to complete.

Results
Sample Characteristics
The largest subpopulation among the sample was Mexican or
Mexican American (533/1181, 45.13%), followed by Central
or South American (204/1181, 17.3%), Puerto Rican (189/1181,16%), Dominican or another Hispanic or Latino ethnicity(172/1181, 14.6%), and Cuban or Cuban American (83/1181,
7.03%; Table 1). Depressive symptoms were reported in 31.26%(367/1181) of the sample and 54.56% (634/1181) reported
experiencing some form of discrimination. Most of theparticipants reported living in the United States for 10 years ormore (900/1181, 76.53%), spoke English very well (832/1181,
70.63%), were 18-35 years of age (541/1181, 49.54%), andwere women (728/1181, 61.75%). About a quarter ofparticipants (290/1181, 24.83%) reported having a householdincome of less than US $25,000 (Table 1).

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Table 1. Descriptive characteristics of the sample (N=1181)a.
Values, n (%)
Depressive symptoms
Present depressive symptoms

367 (31.26)

Discrimination
Experienced discrimination

634 (54.56)

Years in the United States≥10

900 (76.53)

English-speaking proficiency
None or poor

60 (5.09)

Fairly well

94 (7.98)

Well

192 (16.30)

Very well

832 (70.63)

Age (years)
18-35

541 (49.54)

36-55

366 (33.52)

56 and older

185 (16.94)

GenderAnother gender

32 (2.71)Man

419 (35.53)

Woman

728 (61.75)

Hispanic or Latino ethnicity
Central or South American

204 (17.27)

Cuban or Cuban American

83 (7.03)

Dominican or another Hispanic or Latino ethnicity

172 (14.56)

Mexican or Mexican American

533 (45.13)

Puerto Rican

189 (16)

Marital status
Divorced or separated

106 (9.01)

Married or living with a partner

617 (52.47)

Never been married

425 (36.14)

Widowed28 (2.38)

EducationLess than high school

36 (3.06)

High school or GEDb

368 (31.24)

Some college, vocational, or technical

364 (30.9)

Bachelor’s degree

280 (23.77)

Master’s degree or above

130 (11.04)

Household income (US $)<$25,000290 (24.83)$25,000 to <$35,000208 (17.81)$35,000 to <$50,000

190 (16.27)$50,000 to <$75,000235 (20.12)

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Values, n (%)≥$75,000a245 (20.98)

Some category values do not add to the total (N) due to missing numbers.

b

GED: General Education Development.

Multinomial Logistic Regression
Model 1 (the unadjusted model) found that there was asignificant relationship between discrimination and thelikelihood of depressive symptoms. In model 2, we then included
acculturation factors, where years in the United States were
found to be significant. In model 3, the comprehensive modelthat was selected for interpretation included the variables fromthe aforementioned models in addition to sociodemographic
variables. Compared with those who did not experience
discrimination, those who experienced discrimination had almost
230% higher odds of depressive symptoms (AOR 3.31, 95%
CI 2.42-4.54). In addition, we observed that sociodemographic

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factors such as age and gender were significant. Participants
aged 18-35 years of age and 36-55 years of age had increased
odds of having depressive symptoms (AOR 3.83, 95% CI
2.13-6.90 and AOR 3.10, 95% CI 1.74-5.51, respectively) whencompared with participants 56 years of age and older. Regarding
gender, women compared with men had higher odds of having
depressive symptoms (AOR 1.67, 95% CI 1.23-2.30).
Respondents with an annual income of less than US $25,000(AOR 2.14, 95% CI 1.34-3.41) and US $25,000 to less than US$35,000 (AOR 1.89, 95% CI 1.17-3.06) had higher odds ofdepressive symptoms than those with an annual income of US$50,000 to less than US $75,000 (Table 2).

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Table 2. ORa and CIs for associations between depressive symptoms and covariatesb.
Model 1, OR (95% CI)

Model 2, AORc (95% CI)

Model 3, AORc (95% CI)

Experienced discrimination

3.66 (2.78-4.82)d3.55 (2.69-4.70)

3.31 (2.42-4.54)

Experienced no discrimination

Reference

Reference

Reference

<10

N/Ae

1.46 (1.04-2.05)

1.34 (0.90-1.98)

≥10

N/A

Reference

Reference

None or poor

N/A

0.78 (0.41-1.46)

0.71 (0.34-1.49)

Fairly well

N/A

0.58 (0.34-0.99)

0.60 (0.34-1.08)

Well

N/A

0.89 (0.61-1.30)

1.04 (0.68-1.58)

Very well

N/A

Reference

Reference

18-35

N/A

N/A

3.83 (2.13-6.90)

36-55

N/A

N/A

3.10 (1.74-5.51)

56 and older

N/A

N/A

Reference

Another gender identity

N/A

N/A

1.50 (0.65-3.46)

Man

N/A

N/A

Reference

Woman

N/A

N/A

1.67 (1.23-2.30)

Central or South American

N/A

N/A

0.73 (0.43-1.22)

Cuban or Cuban American

N/A

N/A

1.44 (0.71-2.91)

Dominican or another Hispanic or Latino ethnicity

N/A

N/A

Reference

Mexican or Mexican American

N/A

N/A

1.01 (0.66-1.55)

Puerto Rican

N/A

N/A

1.22 (0.72-2.05)

Divorced or separated

N/A

N/A

1.05 (0.60-1.84)

Married or living with a partner

N/A

N/A

0.99 (0.71-1.38)

Never been married

N/A

N/A

Reference

Widowed

N/A

N/A

1.72 (0.58-5.09)

Less than high school

N/A

N/A

0.77 (0.29-2.00)

High school or general educational diploma

N/A

N/A

1.22 (0.70-2.14)

Some college, vocational, or technical

N/A

N/A

1.06 (0.62-1.83)

Bachelor’s degree

N/A

N/A

0.71 (0.41-1.23)

Master’s degree or above

N/A

N/A

Reference<$25,000

N/A

N/A

2.14 (1.34-3.41)$25,000 to <$35,000

N/A

N/A

1.89 (1.17-3.06)$35,000 to <$50,000

N/A

N/A

1.35 (0.83-2.20)$50,000 to <$75,000

N/A

N/A

Reference

Discrimination

Years in the United States

English-speaking proficiency

Age (years)

Gender

Hispanic or Latino ethnicity

Marital status

Education

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Ormiston et al
Model 1, OR (95% CI)

Model 2, AORc (95% CI)

Model 3, AORc (95% CI)

N/A

N/A

1.44 (0.89-2.33)

OR: odds ratio.

b

Covariates included years in the United States, English-speaking proficiency level, age, gender, marital status, educational attainment, and annual
household income.
c

AOR: adjusted odds ratio.

dValues in italics indicate statistical significance level at P≤.05.

e

N/A: not applicable.

Discussion
Principal Findings
We found a significant association between discrimination anddepressive symptoms that persisted after adjusting foracculturation and sociodemographic factors, indicating that
discrimination cannot be overlooked among Hispanic and Latino
communities during the pandemic. This relationship isparticularly important given discrimination’s role in perpetuating
systemic inequities and socioeconomic disparities [39]. For
instance, research predating the pandemic reported that
discrimination toward Latino communities significantly limits
job opportunities, income, housing, and education [40,41].
Discrimination has also been shown to increase substance use
disorders, chronic disease, and blood pressure [42]. All these
discrimination-related adverse life and health outcomes wererisk factors for poor physical and mental health during the
pandemic [43]. Thus, when placing our findings in the context
of a pandemic that has caused greater financial and social
instability for racial and ethnic minoritized communities, theneed to address the deleterious effects of discrimination on themental health of Hispanic and Latino communities is urgently
salient. Ultimately, our findings mirror research showing that
discrimination is associated with depressive symptoms and otheradverse psychological outcomes both predating [26,40,42,44]
and during the COVID-19 pandemic [45-47].
Contrary to our hypothesis, we did not find differences in theodds of depressive symptoms by Hispanic or Latino subgroup.
This may be because we adjusted for sociodemographic andmigration factors, which have been shown to attenuate
differences in anxiety and psychiatric disorders by Hispanic or
Latino subgroup [48,49]. Furthermore, our findings may be anindication that the pandemic was detrimental to mental healthirrespective of subgroup given the prevalence of discriminationand depressive symptoms was exceedingly high and similar
across all subgroups. Thus, future research should examine
whether discrimination impacts depression symptoms differently
by Hispanic or Latino subgroup during the pandemic andbeyond. For instance, Held and Lee’s [49] study about
discrimination and mental health among Latino adults reported
that discrimination was more likely to have an effect on theodds of having a psychiatric disorder among Mexican adults
than among Puerto Rican adults, and there was no difference
between Cubans and Puerto Ricans. However, no further
investigation or comparison regarding other Hispanic or Latino
subgroups was performed.

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This study also found that younger respondents (18-35 and36-55 years of age) were more likely to report depression
symptoms than older respondents (56 years of age and older).
This finding is discordant with prepandemic literature, which
has typically reported a higher risk of depression and levels of
distress among older Latino adults [50]. Explanations for thesetrends lie within the longer time spent in the United States being
linked with loss of cultural values that may be protective against
depression and distress, and longer exposure to discrimination
and acculturative stress [50,51]. Our findings align with previous
research conducted during the pandemic, which has shown aconsistent pattern in the United States of an inverse relationshipbetween age and mental health symptoms, including
psychological distress and depressive disorder [52,53].
Furthermore, a web-based study using a national sample of 124
Hispanic and Latino adults found that younger age wasassociated with poorer overall mental health during the
COVID-19 pandemic [54]. These findings may be explainedby younger Latino individuals (younger than 50 years) being
more likely to report experiencing discrimination during the
pandemic, according to a March 2021 report from the Pew
Research Center, which may translate to greater odds of mental
health symptoms [55].
In our study, women had higher odds of depressive symptoms
than men, which is consistent with prior studies [53,56-59].
Multiple explanations for this association exist, including Latina
women having greater internalizing behaviors (ie, anxiety andmood disorders), psychological distress, depressive responses
to discrimination and family conflict, and experiencing greaterlevels of acculturative stress than Latino men [56-58,60].
Furthermore, traditional Latino cultural values such as machismo
and marianismo may increase the odds of depressive symptoms
among Latina women compared with men [59]. In addition,
discrimination is linked to greater family conflict among Latino
adults, although whether gender modifies this association is
unclear and requires further study [61]. These pathways for
distress and depression may be exacerbated during the pandemic,
especially given that Hispanic and Latino families have faced
significantly more economic and health-related hardships than
Asian and White families across the income spectrum [62].
Also, among Hispanic and Latina parents, women more thanmen report childcare during the pandemic as being very orsomewhat difficult, suggesting that the burden of family
responsibilities and childcare may be higher among Latina
women [63]. Furthermore, Latina women are overrepresented
in unemployment and layoffs during the pandemic, which islikely to worsen financial instability and inequities [22,64]. The
disproportionate burdens of stressors and risk factors may
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manifest into worse depressive symptoms among Latina womenas seen in our study. Finally, this study found that individuals
with lower income had increased odds of depressive symptoms,
which is consistent with prior research showing thatlower-income groups are more affected by national financial
and public health crises [65-67]. Low-income Latino individuals
also face numerous structural and systemic barriers towell-being, such as segregation, food deserts, limited job
opportunities, and overcrowded housing—all of which cancontribute to worse mental health [68-70]. Moreover,
low-income and Latino communities have a heightened risk of
COVID-19 incidence and severe symptoms [21,68,71]. Thus,
this constellation of factors may also contribute to their higher
odds of depressive symptoms.

Limitations
Given this study is cross-sectional, directionality and causality
cannot be established. Also, Dominicans and individuals who
indicate “Another Hispanic, Latino, or Spanish origin” werecombined due to small sample sizes. Thus, the association
between discrimination and depressive symptoms among
Dominicans could not be elucidated and may be obscured. In
addition, the survey was conducted in English and web-based
only, meaning individuals with limited English proficiency or
who do not have access to the internet may not be captured andOrmiston et al
are underrepresented. Another limitation is the survey wasadministered over a 6-month period when vaccines became
more available and some restrictions were lifted, meaning
answer choices may differ depending on when the survey wascompleted. It should also be noted that the 5-item Everyday
Discrimination Scale has not been previously validated among
Hispanic and Latino adults, which may affect our results.

Conclusions
Using a national sample of Hispanic and Latino adults, we foundthat discrimination was associated with depressive symptoms
during the COVID-19 pandemic. We further found elevatedodds of depressive symptoms among women, individuals
younger than 56 years, and lower-income adults—highlighting
potentially at-risk groups. Our results hold significant relevancedue to the numerous pandemic-related socioeconomic crisesthat disproportionately impact Latino communities, increased
xenophobia and tension toward immigrants, inadequate
resources to address mental health care demands among
Hispanic and Latino communities, and existing hesitancy inaccessing mental health services in these communities. The
findings of this study serve as compelling evidence of the poor
depression outcomes experienced by Hispanic and Latino
communities. This study can serve as an important foundational
step in promoting health equity for these at-risk groups.

Acknowledgments
The efforts of CKO, KV, and FW were supported by the Division of Intramural Research, the National Institute on Minority
Health and Health Disparities, and the National Institutes of Health (NIH). FAMI was supported by the National Institute ofEnvironmental Health Sciences and the NIH. The content is solely the responsibility of the authors and does not necessarilyreflect the views of the NIH.

Data Availability
The data are available by requesting FW per the new NIH Data Management and Sharing Agreement plan.

Authors' Contributions
Authors CKO (cameron.ormiston@icahn.mssm.edu) and FW (faustine.williams@nih.gov) are co-corresponding authors for thisarticleConflicts of Interest
None declared.

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Abbreviations
AOR: adjusted odds ratio
OR: odds ratio

Edited by A Mavragani; submitted 11.04.23; peer-reviewed by K Nelson; comments to author 16.03.24; revised version received
04.04.24; accepted 09.04.24; published 06.06.24
Please cite as:
Ormiston CK, Villalobos K, Montiel Ishino FA, Williams F
Association Between Discrimination and Depressive Symptoms Among Hispanic or Latino Adults During the COVID-19 Pandemic:
Cross-Sectional StudyJMIR Form Res 2024;8:e48076
URL: https://formative.jmir.org/2024/1/e48076
doi: 10.2196/48076
PMID:©Cameron K Ormiston, Kevin Villalobos, Francisco Alejandro Montiel Ishino, Faustine Williams. Originally published in JMIR
Formative Research (https://formative.jmir.org), 06.06.2024. This is an open-access article distributed under the terms of theCreative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution,and reproduction in any medium, provided the original work, first published in JMIR Formative Research, is properly cited. The
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