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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.

Additional file 1: Supplemental Figure 1. The figure shows the mean score for protective behavior in individuals with different number of moles. Supplemental Table 1. Primary and Secondary Prevention Practices for Melanoma. Supplemental Table 2. Predictors of personal risk as revealed by multiple linear regression. Supplemental Table 3. Predictors of protective behavior as revealed by multiple linear regression. Supplemental Table 4. Predictors of melanoma knowledge as revealed by multiple linear regression. Supplemental Table 5. Predictors of the level of concern as revealed by multiple regression.