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Original article Associations of racial and ethnic discrimination with adverse changes in exercise and screen time during the COVID-19 pandemic in the United States
Tong Xia1orcid , Gilbert C. Gee2orcid , Jian Li3,4orcid , Xinyue Liu5orcid , Jin Dai6orcid , Lu Shi7orcid , Donglan Zhang8orcid , Zhuo Chen9,10orcid , Xuesong Han11orcid , Yan Li12orcid , Hongmei Li13orcid , Ming Wen14orcid , Dejun Su15orcid , Liwei Chen1orcid
Epidemiol Health 2022;e2023013
DOI: https://doi.org/10.4178/epih.e2023013 [Accepted]
Published online: January 28, 2023
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1Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, United States
2Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles, Los Angeles, United States
3Department of Environmental Health Sciences, Fielding School of Public Health, University of California Los Angeles, Los Angeles, United States
4School of Nursing, University of California Los Angeles, Los Angeles, United States
5Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, United States
6Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, United States
7Department of Public Health Sciences, Clemson University, Clemson, United States
8Division of Health Services Research, Department of Foundations of Medicine, New York University Long Island School of Medicine, Mineola, United States
9Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, United States
10School of Economics, Faculty of Humanities and Social Science, University of Nottingham Ningbo China, Ningbo, China
11Surveillance and Health Equity Science, American Cancer Society, Atlanta, United States
12Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, United States
13Department of Media, Journalism and Film, Miami University, Oxford, United States
14Department of Sociology, University of Utah, Salt Lake City, United States
15Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, United States
Corresponding author:  Liwei Chen, Tel: +1 4436298380, 
Email: cliwei86@ucla.edu
Received: 18 August 2022   • Revised: 31 December 2022   • Accepted: 5 January 2023
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Abstract

Objectives
During the coronavirus disease 2019 (COVID-19) pandemic, a growing prevalence of racial and ethnic discrimination occurred when many Americans struggled to maintain healthy lifestyles. This study investigated the associations of racial and ethnic discrimination with changes in exercise and screen time during the pandemic in the United States (US).
Methods
We included 2,613 adults who self-identified as non-Hispanic White, non-Hispanic Black, non-Hispanic Asian, or Hispanic from the Health, Ethnicity, and Pandemic (HEAP) study, a cross-sectional survey conducted among a nationally representative sample of US adults between October and November 2020. We assessed self-reported racial and ethnic discrimination by measuring COVID-19-related racial and ethnic bias and examined its associations with changes in exercise and screen time using multivariable logistic regression models. We analyzed data between September 2021 and March 2022.
Results
COVID-19-related racial and ethnic bias was associated with decreased exercise time among non-Hispanic Asian (odds ratio [OR]=1.46; 95% confidence interval [CI], 1.13–1.89) and Hispanic people (OR=1.91; 95% CI, 1.32–2.77), and with increased screen time among non-Hispanic Black people (OR=1.94; 95% CI, 1.33–2.85), adjusting for age, gender, education, marital status, annual household income, insurance, and employment status.
Conclusions
Racial and ethnic discrimination may have adversely influenced exercise and screen time changes among racial and ethnic minorities during the COVID-19 pandemic in the US. Further studies are needed to investigate the mechanisms through which racial and ethnic discrimination can impact lifestyles and to develop potential strategies to address racial and ethnic discrimination as a barrier to healthy lifestyles.

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