Wael Al-Delaimy: Arab Americans had stress and mental health challenges before the pandemic piled on more

In light of events following the death of George Floyd at the hands of police…

Wael Al-Delaimy: Arab Americans had stress and mental health challenges before the pandemic piled on more

In light of events following the death of George Floyd at the hands of police officers, our nation’s attention turned towards discrimination and bias against Blacks. Structural discrimination and inequity extend beyond skin color, however, to attributes of faith, immigrant status, gender, ethnicity and others. Since Sept. 11, 2001, Arab Americans in particular have suffered discrimination at work, at border entry points and by the FBI and other surveillance organizations that has adversely affected their mental well-being.

Discrimination and bullying of Arab Americans is especially severe if their features, names or dress identify them as such. Every identifiable ethnic Arab in this country has faced discrimination in one form or another. This harassment extends from young children in schools to adult professionals of both genders.

Arab Americans have been subjected to workplace discrimination, such as being fired or denied a promotion for no apparent reason. An Arab American academic colleague here in San Diego completely changed his Arab name to avoid discrimination.

A study titled Project Salaam surveyed Arab Americans and other ethnic groups from the Middle East region living in San Diego County, and found Arab Americans with the highest frequency of harassment and discrimination reports among all other ethnic groups surveyed in the study.

There were many instances of verbal harassment reported such as being told, “Go home, Arab,” or asked “Where’s your bomb?” Parents were cursed on the street while walking their children to school. Dirty looks were commonplace.

The study also found many instances of physical assault. One respondent said that a woman tried to hit his wife with a car. A cab driver reported being slapped by a customer. There was an example of vandalism — a car being damaged.

Arab Americans are under intensive surveillance by the FBI and other federal agencies. They are consistently selected for comprehensive screening at airports. When applying for Green Cards or citizenship, they are often scrutinized and delayed.

The scientific literature is very clear that these various forms of discrimination and harassment create major stress and undermine mental well-being. For Arab Americans, this is compounded by cultural reluctance to report discrimination, and stigma associated with mental illnesses or seeking mental health care that further delays healing and mental well-being creating a viscous cycle.

The impact of COVID-19 (SARS-CoV-2) on mental well-being is a major complication of this pandemic. For Arab Americans, as well as other communities of color, this is on top of pre-existing stress and poor mental well-being, in some cases complicated by high unemployment of unskilled workers resulting from the pandemic and limited capability to adapt to alternative employment options.

The pandemic is the start of what is to come when climate change and its associated health impacts become full-blown. Mental illnesses will be at the forefront of these health impacts. Unless health care organizations and practitioners prepare for and address this incoming tsunami of health consequences, they will be caught off-guard as they were with the pandemic. As Bill Gates recently said: “COVID-19 is awful. Climate change could be worse.”

Each community has its precipitators of discrimination, but they all have similar perpetrating factors of ignorance, cultural and ethnic superiority and absence of deterrents. This leads to stereotyping, implicit or explicit bias, marginalization and hate leading to all forms of discrimination in various settings. These are part of the root causes of disparity in health and mental well-being. Health care providers are not trained or prepared to address such disparity because of cultural barriers, as well as a lack of institutional resources and interest in addressing them in the communities that suffer the most.

The root causes of health disparity need to be addressed by every public and private institution, workplace, governing entity and individual. This effort must genuinely address structural discrimination and not only a patchwork of symbolic knee-jerk reactions to media reports of tragic incidents against one minority or another. Such effort must be systematically inclusive and long-term for generations to come regardless of ethnic, religious or other attributes. New mental health care approaches must be part of that effort. While doing that and listing the groups and communities that are being discriminated against and how to stop that cycle, do not forget Arab Americans.

Al-Delaimy is professor of public health at the University of California San Diego, Director of the Global Mental Health Initiative, and co-lead of a new initiative on Climate, Health Disparity, and Social Justice. He lives in Clairemont.