State-level anti-Asian hate crimes and mental health among Asian and other racial groups in the US

Although racism and anti-Asian sentiments have been long-standing public health issues in the United States, evidence is lacking regarding anti-Asian hate crimes and their spillover effect on not only Asian populations but also other racial and ethnic populations. We aimed to investigate the association between state-level anti-Asian hate crimes and the individual mental health of Asians and how it varies by other race and ethnicity groups. This cross-sectional study analyzed data from 1,921,984 participants from the Behavioral Risk Factor Surveillance System survey and the Federal Bureau of Investigation Uniform Crime Reports between 2015 and 2021. We performed multivariable logistic regressions to obtain adjusted odds ratio (aOR) and 95% confidence interval (CI) for depression and poor mental health by state-level anti-Asian hate crimes rate per 10,000 population across different racial groups. Of the 1,921,984 participants (Asian 49,481 [2.6%], Hispanic 167,655 [8.7%], non-Hispanic Black 152,898 [8.0%], non-Hispanic White 1,496,965 [78%], and Others 81,985 [4.3%]), 364,636 (19%) reported a history of depression, and 640,675 (34%) reported at least one day of poor mental health in the past 30 days. State-level anti-Asian hate crime rates were associated with depression among Asian people (aOR [95%CI] = 1.41 [1.17–1.69]). The association was also observed among Hispanic (aOR [95%CI] = 1.73 [1.48–2.04]) and non-Hispanic White people (aOR [95%CI] = 1.12 [1.05–1.19]) but not among non-Hispanic Black people (aOR [95%CI] = 1.10 [0.85–1.43]). We observed the association with poor mental health only among Hispanics (adjusted OR [95%CI] = 1.28 [1.12 to 1.45]) accounting for individual-level and state-level covariates. Using a nationwide cohort of US adults, we found an association between state-level rates of hate crimes targeting Asian people and depression among Asian and non-Asian US adults. These findings suggest that such hate crimes may have an adverse impact on mental health, extending their reach beyond the direct victims.