Differential changes in mental health and alcohol use after the 2016 presidential election by perceived discrimination and minority status in a sample of young adults

Background: According to minority stress theory, stigmatized minority groups may experience elevated levels of psychosocial stress and poor health outcomes due to factors including interpersonal and institutional discrimination and prejudice. During the 2016 presidential campaign, numerous inflammatory and/or threatening statements were made about racial/ethnic, immigrant, religious, and gender groups who have historically experienced discrimination in the United States. For these groups, the results of the presidential election may have functioned as a salient minority stressor. This study examined changes in depression and anxiety symptoms and alcohol use from months prior to the 2016 presidential election to months following the election in a sample of young adults being assessed monthly, and whether patterns differed according to perceived discrimination, immigrant status, and race/ethnicity.

Methods: A sample of 778 young adults 18 to 23 years-old from the greater Seattle, WA, area were assessed monthly as part of an ongoing longitudinal study of social role transitions and alcohol use. Participants were enrolled between January 2015 and January 2016. The Patient Health Questionnaire-2 item scale (PHQ-2), one item from the Generalized Anxiety Disorder (GAD-2) screen, and the Daily Drinking Questionnaire (DDQ) were used to assess monthly depression symptoms, anxiety symptoms, and typical number of drinks per week consumed, respectively. Outcomes were compared in the three months prior to (August to October 2016) and three months after (December 2016 to February 2017) the November general election.

Results: Generalized linear mixed effects models showed that depression and anxiety symptoms were higher, but typical drinking lower, in the months after the election compared to the months before. Increases in depression and anxiety symptoms were more precipitous for young adults reporting higher levels of perceived discrimination as reported by the Everyday Discrimination scale. A strong and statistically significant elevation in depression and anxiety was observed post-election among young adults who reported high levels of discrimination, but no significant elevation post-election was observed among those with low levels of discrimination. For alcohol use, there was a significantly weaker decline in alcohol use from pre- to post-election among immigrants compared to non-immigrants and minority racial/ethnic groups (Black, Hispanic, Arab) compared to Whites. Sensitivity analyses suggest these differential changes in mental health and alcohol use were not present in the corresponding months of the prior year.

Conclusions: Stigmatized minority young adults were found to be at particularly high risk of mental health problems and substance use in the wake of the 2016 presidential election. Findings may suggest that these populations are in need of support to address elevated distress and that population-level attention is warranted to address interpersonal and institutional discrimination.