Sociodemographic Factors and Mental Health Outcomes During the COVID-19 Pandemic
It is well known that the COVID-19 pandemic has had a detrimental impact on individual and population health. However, research has just recently gained momentum on assessing the pandemic’s potential impact on mental health and observed sociodemographic disparities. This month, we will be reviewing three recent peer-reviewed articles on this subject matter and authors’ suggested recommendations to mitigate these disparities.
1. Psychological Distress Among Adults in the US
Researchers in a recent US cross-sectional study examined patterns of psychological distress by age, gender and other sociodemographic factors utilizing 21 waves of Household Pulse Survey (HPS) data collected by the US Census Bureau during the early stages of the COVID-19 pandemic (April and December 2020). Psychological distress is shaped by a combination of anxiety and depression and is described as disadvantaged social conditions, which generate a sense of powerlessness. A modified version of the two-item Generalized Anxiety Disorder (GAD-2) and the two-item Patient Health Questionnaire (PHQ-2), which collects information on symptoms over the last seven days, were utilized to measure anxiety and depression (i.e., psychological distress). The study sample size was 1,653,180. Statistically significant findings (p<.05) indicated age was inversely associated with psychological distress, with emerging adults (18 – 24 years) experiencing more than twice the rates of psychological distress than older adults (65 – 88 years). Furthermore, women experienced higher rates of psychological distress compared to men. Black and Asian individuals experienced lower rates of psychological distress compared to White individuals. As household income increased, psychological distress decreased. Individuals who lived alone with children experienced higher rates of psychological distress compared to individuals married with or without children.
Recommendation: Study researchers recommend leveraging study findings to inform policy on resource allocation to vulnerable social groups and propose that mitigating COVID-19 related psychological distress requires local efforts to reconstruct capacity for social reintegration and connection.
2. Psychotic Experiences Among US College Students
A US college student survey study was conducted during the 2020 fall semester to examine associations between seven COVID-19 dimensions (i.e., anxiety, racial/ethnic discrimination, financial distress, infections, illness of loved one, death of loved one, and caregiver) and 12-month psychotic experiences. A brief version of the World Health Organization Composite International Diagnostic Interview Psychosis Screen Analyses was used to measure psychotic experience. Analyses included data from 15,935 undergraduate and graduate students representing 28 colleges. Approximately 15% of the sample reported having a psychotic experience. Six of the seven dimensions (caregiver dimension being the exception) were significantly associated with psychotic experiences (p<0.01). Upon adjusting for age, gender, race/ethnicity, and international student status, multivariable logistic regression modeling revealed only COVID-19 anxiety (p=0.004), financial distress (p=0.010), and infection (p=0.011) dimensions were associated with psychotic experiences.
Recommendation: The authors postulate these findings could inform preventative interventions, such as telehealth, aimed at reducing the risk for psychosis during the pandemic among university students.
3. Stress and Protective Factors Among Postpartum Women in the US
Scientists in a US exploratory study examined associations between potential risk, protective factors, and psychological distress among postpartum women who gave birth during early stages of the COVID-19 pandemic (March – July 2020). The 80-item survey was electronically administered and included demographics, health information, and validated tools on stress (Perceived Stress Scale) and protective factors operationalized as resilience (Connor-Davidson resilience index) and mastery (Pearlin Mastery). Mastery is the extent to which an individual believes their life circumstances are under their control. The study included 885 postpartum women respondents aged 18 – 43 years who gave birth in the US between March and July 2020. Each US state was represented by at least one respondent. Of the 885 respondents, 15.3% were Black, Indigenous, or People of Color (BIPOC), 56.9% had an income greater than $70,000 USD, and 5.3% were single, widowed or divorced. Resilience and mastery protective traits were associated with lower stress levels (p<0.001). Higher income, full-time employment, and being in a relationship were associated with lower stress levels. Respondents whose infant was admitted to the NICU reported experiencing more stress than other respondents (p=0.038). BIPOC respondents experienced higher levels of stress (p=0.021) and lower resiliency (p=0.007). Single respondents showed higher levels of stress (p=0.003) lower rates of mastery (p=0.024) than women in relationships.
Recommendation: The authors suggest modifying care models to better support and provide resources to postpartum women during a pandemic, with interventions focusing on fostering resiliency and mastery.