skip to main content


Title: Mental health during the COVID-19 pandemic: Impacts of disease, social isolation, and financial stressors
Background

Although research shows that the Covid-19 pandemic has led to declines in mental health, the existing research has not identified the pathways through which this decline happens.

Aims

The current study identifies the distinct pathways through which COVID-induced stressors (i.e., social distancing, disease risk, and financial stressors) trigger mental distress and examines the causal impact of these stressors on mental distress.

Methods

We combined evidence of objective pandemic-related stressors collected at the county level (e.g., lack of social contact, infection rates, and unemployment rates) with self-reported survey data from over 11.5 million adult respondents in the United States collected daily for eight months. We used mediation analysis to examine the extent to which the objective stressors influenced mental health by influencing individual respondents’ behavior and fears.

Results

County-level, day-to-day social distancing predicted significantly greater mental distress, both directly and indirectly through its effects on individual social contacts, worries about getting ill, and concerns about finances. Economic hardships were indirectly linked to increased mental distress by elevating people’s concerns about their household’s finances. Disease threats were both directly linked to mental distress and indirectly through its effects on individual worries about getting ill. Although one might expect that social distancing from people outside the home would have a greater influence on people who live alone, sub-analyses based on household composition do not support this expectation.

Conclusion

This research provides evidence consistent with the thesis that the COVID-19 pandemic harmed the mental well-being of adults in the United States and identifies specific stressors associated with the pandemic that are responsible for increasing mental distress.

 
more » « less
Award ID(s):
2001851 1952085
NSF-PAR ID:
10469269
Author(s) / Creator(s):
; ;
Editor(s):
Nabi, Mohammad Hayatun
Publisher / Repository:
PLOS
Date Published:
Journal Name:
PLOS ONE
Volume:
17
Issue:
11
ISSN:
1932-6203
Page Range / eLocation ID:
e0277562
Format(s):
Medium: X
Sponsoring Org:
National Science Foundation
More Like this
  1. Kwon, Young Dae (Ed.)
    Despite the profound health and economic implications of Covid-19, there is only limited knowledge to date about the role of economic concerns, health worries and social distancing for mental health outcomes during the pandemic. We analyze online survey data from the nationally representative “Understanding America Study” (UAS) covering the period of March 10-31st 2020 (sample size: 6,585). Mental health is assessed by the validated PHQ-4 instrument for measuring symptoms of depression and anxiety. About 29% (CI:27.4-.30.4%) of the US adult population reported some depression/anxiety symptoms over the study period, with symptoms deteriorating over the month of March. Worsening mental health was most strongly associated with concerns about the economic consequences of the pandemic, while concerns about the potential implications of the virus for respondents’ own health and social distancing also predicted increases in symptoms of depression and anxiety during the early stages of the pandemic in the US, albeit less strongly. Our findings point towards the possibility of a major mental health crisis unfolding simultaneously with the pandemic, with economic concerns being a key driving force of this crisis. These results highlight the likely importance of economic countermeasures and social policy for mitigating the impact of Covid-19 on adult mental health in the US over and above an effective public health response. 
    more » « less
  2. Importance

    Marked elevation in levels of depressive symptoms compared with historical norms have been described during the COVID-19 pandemic, and understanding the extent to which these are associated with diminished in-person social interaction could inform public health planning for future pandemics or other disasters.

    Objective

    To describe the association between living in a US county with diminished mobility during the COVID-19 pandemic and self-reported depressive symptoms, while accounting for potential local and state-level confounding factors.

    Design, Setting, and Participants

    This survey study used 18 waves of a nonprobability internet survey conducted in the United States between May 2020 and April 2022. Participants included respondents who were 18 years and older and lived in 1 of the 50 US states or Washington DC.

    Main Outcome and Measure

    Depressive symptoms measured by the Patient Health Questionnaire-9 (PHQ-9); county-level community mobility estimates from mobile apps; COVID-19 policies at the US state level from the Oxford stringency index.

    Results

    The 192 271 survey respondents had a mean (SD) of age 43.1 (16.5) years, and 768 (0.4%) were American Indian or Alaska Native individuals, 11 448 (6.0%) were Asian individuals, 20 277 (10.5%) were Black individuals, 15 036 (7.8%) were Hispanic individuals, 1975 (1.0%) were Pacific Islander individuals, 138 702 (72.1%) were White individuals, and 4065 (2.1%) were individuals of another race. Additionally, 126 381 respondents (65.7%) identified as female and 65 890 (34.3%) as male. Mean (SD) depression severity by PHQ-9 was 7.2 (6.8). In a mixed-effects linear regression model, the mean county-level proportion of individuals not leaving home was associated with a greater level of depression symptoms (β, 2.58; 95% CI, 1.57-3.58) after adjustment for individual sociodemographic features. Results were similar after the inclusion in regression models of local COVID-19 activity, weather, and county-level economic features, and persisted after widespread availability of COVID-19 vaccination. They were attenuated by the inclusion of state-level pandemic restrictions. Two restrictions, mandatory mask-wearing in public (β, 0.23; 95% CI, 0.15-0.30) and policies cancelling public events (β, 0.37; 95% CI, 0.22-0.51), demonstrated modest independent associations with depressive symptom severity.

    Conclusions and Relevance

    In this study, depressive symptoms were greater in locales and times with diminished community mobility. Strategies to understand the potential public health consequences of pandemic responses are needed.

     
    more » « less
  3. null (Ed.)
    Abstract Background Encounters with rats in urban areas increase risk of human exposure to rat-associated zoonotic pathogens and act as a stressor associated with psychological distress. The frequency and nature of human-rat encounters may be altered by social distancing policies to mitigate the COVID-19 pandemic. For example, restaurant closures may reduce food availability for rats and promote rat activity in nearby residential areas, thus increasing public health risks during a period of public health crisis. In this study, we aimed to identify factors associated with increased perceived exposure to rats during a stay-at-home order, describe residents’ encounters with rats relevant to their health and well-being, and identify factors associated with increased use of rodent control. Methods Urban residents in Chicago, a large city with growing concerns about rats and health disparities, completed an online questionnaire including fixed response and open-ended questions during the spring 2020 stay-at-home order. Analyses included ordinal multivariate regression, spatial analysis, and thematic analysis for open-ended responses. Results Overall, 21% of respondents ( n  = 835) reported an increase in rat sightings around their homes during the stay-at-home order and increased rat sightings was positively associated with proximity to restaurants, low-rise apartment buildings, and rat feces in the home ( p  ≤ 0.01). Many respondents described feeling unsafe using their patio or yard, and afraid of rats entering their home or spreading disease. Greater engagement with rodent control was associated with property ownership, information about rat control, and areas with lower incomes ( p  ≤ 0.01). Conclusions More frequent rat encounters may be an unanticipated public health concern during periods of social distancing, especially in restaurant-dense areas or in low-rise apartment buildings. Rat presence may also limit residents’ ability to enjoy nearby outdoor spaces, which otherwise might buffer stress experienced during a stay-at-home order. Proactive rat control may be needed to mitigate rat-associated health risks during future stay-at-home orders. 
    more » « less
  4. null (Ed.)
    CONTEXT With the onset of the COVID-19 pandemic, and the resulting response from universities, engineering students find themselves in an unprecedented situation. In addition to stressors related to the curriculum, residential students across the United States are being asked to relocate away from campus and engage in distance learning. At the same time, social distancing requirements are limiting students’ ability to socialize, procure food and supplies, exercise, and remain employed and financially solvent. Some students will fall ill while others face the prospect of sick family members, and even deaths in the family. Prior research suggests that individuals living through this pandemic are likely to face stress, uncertainty, and fear that affects their mental health and academic performance for years to come. PURPOSE OR GOAL The purpose of this study was to understand the ways in which the COVID-19 pandemic is affecting engineering students’ mental wellness, specifically stress, and how the effects differ for different groups of students. The research questions addressed are: 1) What effects has the pandemic had on baseline stress levels, and how do those vary by demographic group? 2) What effects has the pandemic had on quality of life, such as sleep habits and financial security, and how do those vary by demographic group? METHODS An online survey was conducted in the United States in May and June of 2020. More than 800 4-year engineering students who represented many engineering disciplines and universities responded. The survey used a modified version of the Holmes-Rahe Social Readjustment Rating Scale, which is a widely used and validated instrument to measure the effects of certain life events on stress. The data was analysed to determine the average increase in stress levels for students resulting from COVID-19, and which demographic groups have seen the most negative impact. We also report on which stress-inducing life-events were experienced most. OUTCOMES Latinx individuals and international students report statistically significantly higher levels of stress than the baseline population. Engineering students from other historically excluded identities, however,are not facing statistically significantly worse stress than their peers from historically over represented identities. Veterans fare better than the majority population on this metric.The data also indicates that different groups are more likely to experience different negative life-events because of COVID. CONCLUSIONS No previous research has examined the impacts of a global pandemic on engineering student stress and mental wellness. Our findings show that stress and mental wellness need to be understood intersectionally and that some underrepresented groups are disproportionately impacted by COVID-19. Understanding the impacts on students can help universities strategize and allocate limited resources most effectively to support student success. KEYWORDS Mental wellness; COVID-19; stress 
    more » « less
  5. null (Ed.)
    Urban green spaces provide a range of environmental and health benefits, which may become even more critical during times of crisis such as the current COVID-19 pandemic. However, with a radical shift in mobility, additional concerns over safety, and access temporarily restricted during the implementation of social distancing policies, the experience and use of urban green spaces may be reduced. This is particularly concerning for densely populated cities like New York, considered the first U.S. epicenter or vanguard of the outbreak. To better understand the impact of COVID-19 on the perception and use of urban green spaces, we conducted a social survey during the early months of the Covid-19 pandemic in New York City (May 13 - June 15, 2020). The results of the survey show respondents continued to use urban green spaces during the pandemic and consider them to be more important for mental and physical health than before the pandemic began. However, the study revealed a pattern of concerns residents have about green space accessibility and safety, and found key differences between the concerns and needs of different populations, suggesting a crucial role for inclusive decision-making, support for additional management strategies, and urban ecosystem governance that reflect the differential values, needs and concerns of communities across the City. As urban centers face looming budget cuts and reduced capacity, this study provides some empirical evidence to illustrate the value of urban green spaces as critical urban infrastructure, and may have implications for funding, policy, and management, of urban green spaces in NYC, with potential applications to other cities, particularly during times of crisis. 
    more » « less