Socioeconomic status and well-being during COVID-19: A resource-based examination

The impact of the COVID-19 pandemic on the socioeconomic gradient of hypertension

The COVID-19 pandemic has brought into sharp focus the impact of socioeconomic factors on hypertension outcomes. This review examines the implications of the pandemic on the socioeconomic gradient of hypertension and explores the physiological and pathophysiological processes underlying this relationship. Changes in socioeconomic factors have disproportionately affected individuals with lower socioeconomic status, leading to adverse hypertension outcomes. The pandemic-related stressors, coupled with social isolation and disrupted daily routines, have contributed to elevated stress levels among individuals, particularly those with lower socioeconomic status. Equitable access to healthcare, enhancing health literacy and patient empowerment, and addressing social determinants of health are essential components of hypertension management strategies. By recognizing the specific challenges faced by individuals with lower socioeconomic status and implementing targeted interventions, public health efforts can help reduce the socioeconomic gradient of hypertension.

Effect of COVID-19 lockdowns on quality-of-life and health services access by socio-economic status in Australia

This study examined changes in physical and mental health quality-of-life and health services access before and after the onset of the COVID-19 pandemic among individuals of lower and higher socio-economic status (SES) in Australia. Difference-in-differences and logistic regression models were undertaken using data from the Household, Income and Labour Dynamics in Australia (HILDA) survey and government data on COVID-19 lockdowns between January 2020 and February 2021. Individuals from higher SES reported larger decreases in mental health quality-of-life scores than those from lower SES after the onset of the pandemic. Those from lower SES reported less disruption with any health services (24.2% vs 30.4%; OR = 0.68; p < 0.001), specifically dental services (8.2% vs 15.4%; OR = 0.51; p < 0.001) and allied health services (5.9% vs 8.5%; OR = 0.60; p < 0.001), compared with those from higher SES. Additional days under lockdown were associated with reduced access to all health services (OR = 1.19). Furthermore, long-term health conditions (higher SES: OR = 1.54) and scores indicative of poorer physical (lower SES: OR = 1.17; higher SES: OR = 1.07) and mental health (lower SES: OR = 1.16; higher SES: OR = 1.12) were associated with increased health services disruption. While individuals from higher SES were more likely than those from lower SES to experience greater relative declines in mental health and increased disruption with health services access, individuals with a greater apparent need for health services, regardless of SES, may have faced inequalities in accessing these services during the COVID-19 pandemic.

Mapping the well-being of Norwegian mothers during the COVID-19 pandemic

The COVID-19 pandemic had negative effects on many people's well-being and quality of life. In the present work, we focused on Norwegian mothers with elementary school children, and investigated whether their well-being, stress, and worries (and the relationships between them) changed across the early months of the pandemic. We collected data at two time points in 2020. In June 2020, 231 mothers (mean age = 40.09, SD = 6.22) responded to an online questionnaire in which they were asked to indicate their well-being, stress, and worries before the pandemic, during the lockdown (i.e., March 2020), and currently (i.e., June 2020). Of these 231 mothers, 97 (mean age = 40.58, SD = 5.66) answered the same questionnaire again in November 2020. Mothers' well-being was lower in November 2020 than before the pandemic (retrospectively reported). The age of the youngest child showed the strongest and most consistent relationship with mothers' well-being across all time points. In addition, we found that the stress mothers felt during the national lockdown in March 2020 was strongly associated with their well-being both during the lockdown and in June 2020. Finally, in November 2020, mothers' financial pandemic-related worries were negatively related to their well-being. Implications and suggestions for future research and for how societies can cope with future health-related crises are discussed.

Mental health among Hispanic college students during the COVID-19 pandemic: Concurrent and predictive effects of negative and positive COVID-19 changes

Objective: We generated items to assess COVID-19 changes among Hispanic college students and examined the concurrent and predictive effects of these changes vis-à-vis mental health. Participants: The sample consisted of 559 Hispanic first-year (69% women; age range 18-22; 88.1% U.S.-born; 84% Mexican/Mexican American) attending a public university in Texas. Methods: Students participated in a three-wave longitudinal online survey assessing stressors, COVID-19 changes, anxious and depressive symptoms, hope, and self-esteem. Results: Students experienced negative changes across six life domains as a result of the pandemic-related lockdowns: education; health; relationships; finances; social issues; death/loss. They also reported positive changes during the lockdowns. Negative changes were positively correlated with higher, and positive changes with lower, acculturative and perceived stress. Negative COVID-19 changes predicted lower mental health. Conclusions: Hispanic students experienced both negative and positive COVID-19 changes, which were related to their mental health. Results can guide research and decision-making during future pandemics.

Comprehensive Clustering Analysis and Profiling of COVID-19 Vaccine Hesitancy and Related Factors across U.S. Counties: Insights for Future Pandemic Responses

This study employs comprehensive clustering analysis to examine COVID-19 vaccine hesitancy and related socio-demographic factors across U.S. counties, using the collected and curated data from Johns Hopkins University. Utilizing K-Means and hierarchical clustering, we identify five distinct clusters characterized by varying levels of vaccine hesitancy, MMR vaccination coverage, population demographics, and political affiliations. Principal Component Analysis (PCA) was conducted to reduce dimensionality, and key variables were selected based on their contribution to cumulative explained variance. Our analysis reveals significant geographic and demographic patterns in vaccine hesitancy, providing valuable insights for public health strategies and future pandemic responses. Geospatial analysis highlights the distribution of clusters across the United States, indicating areas with high and low vaccine hesitancy. In addition, multiple regression analyses within each cluster identify key predictors of vaccine hesitancy in corresponding U.S. county clusters, emphasizing the importance of socio-economic and demographic factors. The findings underscore the need for targeted public health interventions and tailored communication strategies to address vaccine hesitancy across the United States and, potentially, across the globe.

Temporal dynamics of socioeconomic inequalities in depressive and anxiety symptoms during the COVID-19 pandemic: a scoping review

Background

The existence of socioeconomic inequalities in the prevalence of symptoms of depression and anxiety is widely acknowledged, and individuals from lower socioeconomic backgrounds tend to exhibit higher rates of symptoms. However, the direction in which the COVID-19 pandemic has influenced these disparities remains uncertain. We therefore aimed to systematically outline the available evidence on the temporal dynamics of socioeconomic inequalities in symptoms related to depression and anxiety during the COVID-19 pandemic across high-income countries.

Methods

A scoping review was conducted by searching the databases Embase, Scopus and PsycINFO. According to pre-defined eligibility criteria, two reviewers independently screened titles and abstracts as well as full texts of the compiled records. Data from the included studies were extracted using a standardised data-extraction form and analysed numerically and narratively. The scoping review followed the PRISMA-ScR guidelines.

Results

A total of 49 studies comprising 149 analyses of socioeconomic indicators in relation to symptoms of depression and anxiety were included. Despite heterogeneous study designs and results, there was a tendency of increasing (40.9%; n = 61) or persistent (38.2%; n = 57) inequality trends to the detriment of those in socially more disadvantaged positions. Increasing inequalities were most pronounced when income was used as a socioeconomic indicator. Groups with lower socioeconomic status appeared most vulnerable in the initial phase of the COVID-19 pandemic. Throughout the pandemic, dynamics were diverse, with persistent trends most frequently reported.

Conclusion

Overall, to the detriment of those with lower socioeconomic status, mental-health inequalities persisted or increased in most analyses. Continually monitoring socioeconomic inequalities over time is crucial, since this makes it possible to adapt prevention and intervention strategies to specific pandemic phases. Interventions targeting job security, income security and educational attainment could reduce mental-health inequalities. The results can contribute to preparedness plans for future pandemics and crises.

Socioeconomic Disadvantage and Youth Mental Health During the COVID-19 Pandemic Lockdown

Importance

Adolescence is a period in which mental health problems emerge. Research suggests that the COVID-19 lockdown may have worsened emotional and behavioral health.

Objective

To examine whether socioeconomic status was associated with mental health outcomes among youths during the COVID-19 pandemic.

Design, Setting, and Participants

The Adolescent Brain Cognitive Development (ABCD) Study is a multisite 10-year longitudinal study of youth neurocognitive development in the US. Recruitment was staggered where the baseline visit (ages 9 to 10 years) occurred from 2016 to 2018, and visits occurred yearly. The COVID-19 lockdown halted research collection during the 2-year follow-up visits (ages 11 to 12 years), but eventually resumed. As some youths already underwent their 2-year visits prior to lockdown, this allowed for a natural experiment-like design to compare prepandemic and intrapandemic groups. Thus, data were gathered from the 1-year follow-up (pre-COVID-19 lockdown for all youths) and the 2-year follow-up, of which a portion of youths had data collected after the lockdown began, to compare whether a period of near social isolation was associated with mental health symptoms in youths. The prepandemic group consisted of youths with a 2-year follow-up visit collected prior to March 11, 2020, and the intrapandemic group had their 2-year follow-up visit after lockdown restrictions were lifted.

Main Outcomes and Measures

Assessments included measures on income-to-needs ratio (INR; derived from total household income), the Child Behavior Checklist (a measure of mental health symptomology), and the Family Environmental Scale.

Results

The final sample included 10 399 youths; 3947 (52.3%) were male; 2084 (20.3%) were Latinx/Hispanic; 6765 (66.0%) were White; 4600 (44.2%) reported caregiver education levels below a 4-year college degree; and 2475 (26.2%) had INR either below 100% (indicating poverty) or between 100% and less than 200% (near poverty). Among youths in the intrapandemic group, worse mental health symptoms (eg, more total problems, greater depression, and greater anxiety) over time were associated with being from a household with higher socioeconomic status (eg, when comparing individuals who differed by 1 unit on INR between prepandemic and intrapandemic groups from 1-year to 2-year follow-up, their expected difference in total problems score was 0.79 [95% CI, 0.37-1.22]; false discovery rate-corrected P < .001).

Conclusions and Relevance

This cohort study found that the COVID-19 lockdown was associated with disproportionately negative mental health outcomes among youths from higher socioeconomic status backgrounds. Although this study does not shed light on the direct mechanisms driving these associations, it does provide some support for positive outcomes for youths. Future studies are needed to understand whether these associations persist over longer periods of time.

Prevalence of new onset erectile dysfunction among Damietta governorate men after contracting COVID-19

BACKGROUND

Several reports showed that sexual function was affected during and after the COVID-19 pandemic.

AIMS

The objective of the study was to demonstrate whether a realistic association exists between the COVID-19 pandemic and erectile dysfunction (ED) among a sampled Egyptian population in Damietta governorate.

METHODS

This cross-sectional study consisted of 330 adult males diagnosed with COVID-19 infection. They were categorized in three age groups (18-29, 30-39, and 40-50 years, respectively). COVID-19-confirmed cases were assessed by the Arabic version of the International Index of Erectile Function questionnaire (IIEF) scores.

RESULTS

The prevalence of ED according to the IIEF was 55.1%. The ED was categorized into mild ED which represents 25.8% of the patients, mild to moderate which represents 22.4% of the patients, moderate which represents 7% of the patients, and severe which represents 0% of the patients. We found a significant negative correlation between the age of the patients and the IIEF score. Also, we found an association between the severity of COVID-19 infection and the IIEF score.

CONCLUSION

An association of new-onset ED in men who suffered COVID-19 infection was established. This may be due to virus-induced endothelial cell dysfunction; however, an underlying mechanism and causation have not yet been clearly elucidated. While it appears that COVID-19 infection may be a risk factor for ED, additional research is needed to establish causality.

The relation between economic stressors and higher education students' mental health during the initial outbreak of the COVID-19 pandemic

AIMS

The COVID-19 pandemic has had a large impact on the financial situation of higher education students, disproportionately affecting students with a low socioeconomic status (SES). This raises the question of whether economic stressors related to COVID-19 have aggravated existing socioeconomic inequalities in mental health. This study examined the relationship between economic stressors and students' depressive symptoms, and the role of students' SES and countries' socioeconomic conditions.

METHODS

Data from the COVID-19 International Student Well-being Study was used for multilevel analyses, with depressive symptoms as dependent variable. Three indicators measured SES: educational level of the parents, ability to borrow money from their social network, and struggling with financial resources prior to COVID-19.

RESULTS

Students with a low SES had more depressive symptoms, and those not able to borrow money and with parents without higher education were more exposed to a deterioration in their financial situation. Both economic stressors (reduction in working hours and a deterioration of their financial situation) were positively related to depressive symptoms. In addition, the positive relationship between a decrease in working hours and depressive symptoms was stronger in countries with a higher unemployment rate.

CONCLUSIONS

We observed socioeconomic inequalities in students' mental health, which, in part, can be ascribed to a larger exposure to the economic stressors related to COVID-19 among students' with a low SES. The macroeconomic context also played a role, as the impact of a reduction in working hours on depressive symptoms was stronger in countries with poor economic conditions.

Factors Associated With Negative Life Changes due to COVID-19 Among Older Adults Residing in an Urban Low-Income Neighborhood in Korea: Focused on Gendered Differences

This study examined negative life changes due to coronavirus disease of 2019 (COVID-19) and its correlates in a sample of community-dwelling older adults from a low-income urban city in Korea, focusing on gendered differences. Negative life changes due to COVID-19 were categorized into four domains: behavioral/physical, psychosocial, goal-seeking, and control/freedom. Being female, not receiving basic livelihood security, and dissatisfaction with housing situation were significantly associated with negative life changes during the pandemic. Gender-stratified analyses revealed that most within-gender social disparities associated with changes due to COVID-19 occurred in older women. The odds of experiencing negative changes were higher among working women and those receiving security income aid. In low-income urban communities, those who were previously socially and economically active perceived more negative changes owing to the pandemic. The contribution of gender to negative life changes should be considered to effectively alleviate concerns among older adults during pandemics.

A systematic review on the relationship between socioeconomic conditions and emotional disorder symptoms during Covid-19: unearthing the potential role of economic concerns and financial strain

BACKGROUND

Covid-19 has disrupted the lives of many and resulted in high prevalence rates of mental disorders. Despite a vast amount of research into the social determinants of mental health during Covid-19, little is known about whether the results are consistent with the social gradient in mental health. Here we report a systematic review of studies that investigated how socioeconomic condition (SEC)-a multifaceted construct that measures a person's socioeconomic standing in society, using indicators such as education and income, predicts emotional health (depression and anxiety) risk during the pandemic. Furthermore, we examined which classes of SEC indicators would best predict symptoms of emotional disorders.

METHODS

Following PRISMA guidelines, we conducted search over six databases, including Scopus, PubMed, etc., between November 4, 2021 and November 11, 2021 for studies that investigated how SEC indicators predict emotional health risks during Covid-19, after obtaining approval from PROSPERO (ID: CRD42021288508). Using Covidence as the platform, 362 articles (324 cross-sectional/repeated cross-sectional and 38 longitudinal) were included in this review according to the eligibility criteria. We categorized SEC indicators into 'actual versus perceived' and 'static versus fluid' classes to explore their differential effects on emotional health.

RESULTS

Out of the 1479 SEC indicators used in these 362 studies, our results showed that 43.68% of the SEC indicators showed 'expected' results (i.e., higher SEC predicting better emotional health outcomes); 51.86% reported non-significant results and 4.46% reported the reverse. Economic concerns (67.16% expected results) and financial strains (64.16%) emerged as the best predictors while education (26.85%) and living conditions (30.14%) were the worst.

CONCLUSIONS

This review summarizes how different SEC indicators influenced emotional health risks across 98 countries, with a total of 5,677,007 participants, ranging from high to low-income countries. Our findings showed that not all SEC indicators were strongly predictive of emotional health risks. In fact, over half of the SEC indicators studied showed a null effect. We found that perceived and fluid SEC indicators, particularly economic concerns and financial strain could best predict depressive and anxiety symptoms. These findings have implications for policymakers to further understand how different SEC classes affect mental health during a pandemic in order to tackle associated social issues effectively.

Pandemic stressors and mental health indicators in eight countries

PURPOSE

The Covid-19 pandemic has exacted a significant physical, financial, social, and emotional toll on populations throughout the world. This study aimed to document the association between pandemic stressors and mental health during the pandemic across countries that differ in cultural, geographic, economic, and demographic factors.

METHODS

We administered an online survey randomly in Brazil, China, Germany, Egypt, India, Indonesia, Nigeria, and the United States from September 2020 to November 2020. This survey included questions on Covid-19-related stressors as well as the Patient Health Questionnaire-2 and the Primary Care PTSD Checklist to screen for depression and post-traumatic stress disorder (PTSD) symptoms, respectively. We performed bivariable and multivariable regression analyses to assess the prevalence and odds ratios of overall depression symptoms and probable PTSD and in relation to stressors across countries.

RESULTS

Among 8754 respondents, 28.9% (95% CI 27.5-30.0%) experienced depression symptoms, and 5.1% (95% CI 4.5-6.0%) experienced probable PTSD. The highest prevalence of depression symptoms was in Egypt (41.3%, 95% CI 37.6-45.0%) and lowest in the United States (24.9%, 95% CI 22.3-27.7%). The highest prevalence of probable PTSD was in Brazil (7.3%, 95% CI 5.6-9.4%) and the lowest in China (1.2%, 95% CI 0.7-2.0%). Overall, experiencing six or more Covid-19-related stressors was associated with both depression symptoms (OR 1.90, 95% CI 1.46-2.48) and probable PTSD (OR 13.8, 95% CI 9.66-19.6).

CONCLUSION

The association between pandemic related stressors and the burden of adverse mental health indicators early in the Covid-19 pandemic transcended geographic, economic, cultural, and demographic differences between countries. The short-term and long-term impacts of the pandemic on mental health should be incorporated in efforts to tackle the consequences of Covid-19.

Assets and depression in U.S. adults during the COVID-19 pandemic: a systematic review

PURPOSE

Mental health is shaped by social and economic contexts, which were altered during the COVID-19 pandemic. No study has systematically reviewed the literature on the relation between different assets and depression during the COVID-19 pandemic.

METHODS

We conducted a systematic review of the literature on financial (e.g. income/savings), physical (e.g., home ownership), and social (e.g., marital status, educational attainment) assets and depression in U.S. adults. For each asset type, we created binary comparisons to report on the direction of the relationship and described if each study reported insignificant, positive, negative, or mixed associations.

RESULTS

Among the 41 articles identified, we found that income was the most studied asset (n=34), followed by education (n=25), marital status (n=18), home ownership (n=5), and savings (n=4). 88%, 100%, and 100% of articles reported a significant association of higher income, home ownership, and higher savings, respectively, with less depression. The association between marital status and education with depression was more nuanced: 72% (13 of 18) studies showed that unmarried persons had greater risk of depression than married or cohabitating persons and 52% (13 of 25) of studies reported no significant difference in depression across educational groups.

CONCLUSION

This work adds to the literature a deeper understanding of how different assets relate to depression. In the context of largescale traumatic events, policies that maintain and protect access to social, physical, and financial assets may help to protect mental health.

Associations Between Psychopathological Symptom Severity Amid the Pandemic and the Childhood Sociodemographic Environment

It is well-documented that childhood socioeconomic status (SES) is associated with various health conditions in adulthood. Here, we examine the extent to which childhood SES is associated with COVID-19 pandemic anxiety and depression. Participants (n = 212), recruited from Amazon Mechanical Turk, were assessed for depression and anxiety in February 2022 for both the current context and retrospective self-perceived early pandemic depression and anxiety (April 2020). Participants also reported childhood SES and current demographics. Consistent with predated findings, we show a strong, positive correlation between depression and anxiety under both conditions. Paternal unemployment in childhood was associated with increased anxiety, while maternal occupation was not. High household education in childhood was generally associated with greater anxiety and depression, similar to past studies examining education levels and depression. However, the shift from high school to post-secondary degrees (trade school and associate's) was associated with decreased anxiety and depression, which may reflect "essential work" careers, therefore indicating a dualism. Growing up in crowded, de-individualized spaces was associated with lower anxiety and depression, suggesting better conditioning for the imposition of COVID-19 quarantines. Pandemic-related unemployment was associated with an increase in anxiety and depression. Strong political views, regardless of ideology, were associated with increased anxiety. Finally, participants in our cohort perceived their mental health to be worse in the early pandemic for anxiety and depression, up 6.6% and 7.9%, respectively. Our work suggests a complex relationship between SES, demographics, and anxiety and depression during the pandemic. These findings emphasize the importance of exploring the dynamics between early SES and mental health in adulthood, particularly during extended societal stressors.

Emotionally intelligent school leadership predicts educator well-being before and during a crisis

We examined the role of educator perceptions of school leader emotion regulation (ER) and emotional support (ES) in educator well-being during a typical year and during the COVID-19 pandemic. Based on emotion contagion theory, leaders' (in)ability to regulate their own emotions may trigger ripple effects of positive or negative emotions throughout their organizations, impacting staff well-being. Additionally, based on conservation of resources theory, when experiencing psychologically taxing events, skillful emotional support provided by leaders may help to replenish staff's depleted psychological resources, promoting staff well-being. In two national studies, a cross-sectional (NStudy 1 = 4,847) and a two-wave study (NStudy 2 = 2,749), we tested the association between United States preK-12 educator perceptions of school leaders' ER and ES with educator well-being before and during the COVID-19 pandemic, employing structural equation modeling and multilevel modeling. In Studies 1 and 2, educator reports of their leaders' ER and ES skills predicted greater educator well-being, including higher positive affect and job satisfaction and lower emotional exhaustion and turnover intentions. In moderation analyses, perceived leader ER predicted well-being about equally among educators facing severe versus mild health impacts from COVID-19. In contrast, perceived leader ES was more strongly associated with educator well-being for some outcomes in those severely versus mildly impacted by COVID-19 illness and death. Leader ER played a role in the well-being of everyone, whereas leader ES was more predictive of well-being for those severely impacted by a crisis. Regarding implications for policy and practice, efforts to promote well-being among educators may be enhanced when combined with efforts to develop school leaders' ER and ES skills, especially in times of crisis. Accordingly, school districts should consider the value of investing in systematic, evidence-based emotion skills training for their leaders.

The association between the sense of control and depression during the COVID-19 pandemic: a systematic review and meta-analysis

Introduction

High levels of depression and low sense of control have been reported during the COVID-19 pandemic. The removal of typical freedoms through public health restrictions may have played an important role. The aim of this review was to examine data collected during the pandemic and (1) estimate the strength of the association between sense of control and depression, (2) examine whether the different types of control measures affected the strength of the association, and (3) whether this changed as a function of pandemic indicators.

Methods

We conducted a systematic review and meta-analysis of studies published in English between December 2019 and November 2022. A total of 993 articles were identified, of which 20 were included in the review and 16 in the meta-analysis after conducting a quality assessment using the standard NIH tool.

Results

The control-depression association gave a bias-independent pooled effect size of r = .41, and grew stronger over the 130 weeks covered by this review but did not change as a function of local COVID incidence rates. Subgroup analyses showed that external and overall control were more strongly related to depression than internal control.

Discussion

These findings emphasize that external factors are important to the sense of control and the importance of preserving the sense of control in situations where the removal of personal freedoms is necessary, such as public health emergencies.

The relationship between childhood socioeconomic status and depression level in older adults: the mediating role of adult socioeconomic status and subjective well-being

BACKGROUND

There is a causal link between childhood socioeconomic status and health status in adulthood and beyond. It's vital to comprehend the relationship between childhood socioeconomic status and mental health among older Chinese individuals from the current generation who have undergone significant social changes in China. This understanding is critical to foster healthy demographic and social development in China.

METHODS

Using data from the 2020 China Family Panel Studies, we investigate the relationship between childhood socioeconomic status and depression in older adults. Additionally, we examine the mediating role of adult socioeconomic status and subjective well-being.

RESULTS

1) Childhood socioeconomic status of Chinese older adults differences by region of residence, while depression levels differences by gender, region of residence, and marital status. 2) Adult socioeconomic status mediated the relationship between childhood socioeconomic status and depression in older adults. 3) Adult socioeconomic status and subjective well-being had a chain-mediated role in the relationship between childhood socioeconomic status and depression in older adults.

CONCLUSIONS

In terms of childhood socioeconomic status, older adults in urban regions were significantly higher than those in rural regions. As for depression level, female older adults were more depressed than males; married older people have the lowest depression levels, while unmarried and widowed older people have higher depression levels; older adults in rural regions had higher depression levels than those in urban regions. Evidence from our study further suggests that childhood socioeconomic status can suppress the depression level in older adults through adult socioeconomic status; it can also further reduce the depression level in older adults through the chain mediation of adult economic status affecting subjective well-being. As depression is more prevalent among older individuals with a lower childhood socioeconomic status, it is vital to prioritize the extensive impact of childhood socioeconomic status as a distal factor and investigate "upstream" solutions to enhance childhood socioeconomic status and reduce the gap during the early years of life.

Examining associations between social vulnerability indices and COVID-19 incidence and mortality with spatial-temporal Bayesian modeling

This study compares two social vulnerability indices, the U.S. CDC SVI and SoVI (the Social Vulnerability Index developed at the Hazards Vulnerability & Resilience Institute at the University of South Carolina), on their ability to predict the risk of COVID-19 cases and deaths. We utilize COVID-19 cases and deaths data for the state of Indiana from the Regenstrief Institute in Indianapolis, Indiana, from March 1, 2020, to March 31, 2021. We then aggregate the COVID-19 data to the census tract level, obtain the input variables, domains (components), and composite measures of both CDC SVI and SoVI data to create a Bayesian spatial-temporal ecological regression model. We compare the resulting spatial-temporal patterns and relative risk (RR) of SARS-CoV-2 infection (COVID-19 cases) and associated death. Results show there are discernable spatial-temporal patterns for SARS-CoV-2 infections and deaths with the largest contiguous hotspot for SARS-CoV-2 infections found in the southwest of the Indianapolis metropolitan area. We also observed one large contiguous hotspot for deaths that stretches across Indiana from the Cincinnati area in the southeast to just east and north of Terre Haute (southeast to west central). The spatial-temporal Bayesian model shows that a 1-percentile increase in CDC SVI was significantly (p ≤ 0.05) associated with an increased risk of SARS-CoV-2 infection by 6 % (RR = 1.06, 95 %CI = 1.04 -1.08). Whereas a 1-percentile increase in SoVI was significantly predicted to increase the risk of COVID-19 death by 45 % (RR = 1.45, 95 %CI =1.38 - 1.53). Domain-specific variables related to socioeconomic status, age, and race/ethnicity were shown to increase the risk of SARS-CoV-2 infections and deaths. There were notable differences in the relative risk estimates for SARS-CoV-2 infections and deaths when each of the two indices were incorporated in the model. Observed differences between the two social vulnerability indices and infection and death are likely due to alternative methodologies of formation and differences in input variables. The findings add to the growing literature on the relationship between social vulnerability and COVID-19 and further the development of COVID-19-specific vulnerability indices by illustrating the utility of local spatial-temporal analysis.

The effects of socioeconomic status on personality development in adulthood and aging

INTRO

The current study examined the effects of adulthood socioeconomic status (SES) on levels of and changes in the Big Five personality traits domains and nuances in adulthood and during aging. We also tested whether the relations between adulthood SES and personality traits differed by childhood SES and age.

METHODS

Data were drawn from three longitudinal studies: the Swedish Adoption/Twin Study of Aging (SATSA, N = 2000), the Midlife in the United States (MIDUS, N = 6428), and the Health and Retirement Study (HRS, N = 23,238).

RESULTS

Using the latent growth models, across samples, we found associations between high SES and low levels of neuroticism and high levels of extraversion, openness, and conscientiousness. The effects of SES on changes in personality traits were mainly observed in the aging sample of HRS. In general, a similar pattern was observed at the nuance level. Analyses of the moderating effects of age suggested some evidence for the increasingly important role of SES in levels of and changes in personality traits in older ages.

CONCLUSION

The findings support SES as a source that partially accounts for individual differences in personality traits level. Some evidence was found for the relations between SES and changes in personality traits in old age.

Hidden work, frustration and multiple layers of occupational health in emergency situations: a longitudinal study during the COVID-19 pandemic

This study examines the effects of the COVID-19 pandemic over time. Specifically, we derive from the organizational model of frustration to propose and test a model of pandemic-induced hidden work affecting employees' emotional responses of frustration along with behavioral responses and outcomes with respect to occupational health. We thereby develop a concept of multiple layers of occupational health that spans across stress, satisfaction with work-life balance (SWLB), burnout, subjective well-being, and physical health. Based on a longitudinal web-based survey of 198 working professionals conducted at seven points in time (1,143 data points, with 118 fully completed responses across all time points) for a wide range of industries in 2020, the study tests the proposed relationships using random coefficient modeling. The results show that COVID-19-situation-induced hidden work invokes emotional responses of frustration, which in turn influence outcomes referring to multiple layers of occupational health-positively affecting stress and burnout, and negatively influencing SWLB, subjective well-being, and physical health. Implications for research and practice are discussed.

Domestic firearm violence against women (2018-2021)

Background

Over 50 % of US female homicides occur during domestic violence, with half involving firearms. Public health measures to control COVID-19 may have isolated individuals with abusive partners at a time when firearm sales and new firearm ownership surged. This study sought to evaluate trends in domestic firearm violence (DFV) over time, hypothesizing that rates of DFV increased in the wake of COVID-19.

Materials and methods

A retrospective query of the Gun Violence Archive (2018-2021) was conducted for incidents of DFV. The primary outcome was the number of DFV-related shootings. Statistical testing, including one-way and two-way ANOVAs, was performed to compare monthly rates of DFV over time and to compare DFV per 100,000 women in states with strong versus weak gun laws.

Results

Average monthly DFV incidents rose nationwide during this study's time period, though injuries and fatalities did not. States with weaker gun laws had increased incidents, deaths, and injuries from 2018 to 2021 (all p<0.05). In a two-way ANOVA, stronger gun laws were associated with fewer incidents of DFV when compared with weaker gun law states. We also found that the use of a long gun in DFV more often resulted in a victim's death when compared to a handgun (p<0.01).

Conclusion

DFV incidents increased over time. States with weaker gun laws bore the brunt of the violence, demonstrating that DFV may be curtailed through legislative efforts. Methods of injury prevention aimed at preventing and reducing domestic violence and improving firearm safety may curtail DFV.

Psychological Health Among Older Adults During and After Quarantine: A Multi-Method Study

OBJECTIVE

Depression among older adults is a growing problem. With aging being a risk factor for COVID-19 infection, depression in this population may have been exacerbated. This study aimed to describe experiences and changes in depressive symptoms and well-being of older adults during and after the COVID-19 first wave in Spain.

METHODS

The study used a multi-method design. Participants self-reported depressive symptoms (Geriatric Depression Scale) and well-being (Cantril Ladder of Life). Participants were asked about changes in depressive symptoms or well-being during quarantine. If a change was perceived, they were asked to describe the change. In addition, the Patient Global Impression of Change scale was used. Both quantitative and qualitative analyses were performed on the data.

RESULTS

111 participants (mean age: 71±5 years; 76% women) completed the study. Sixty-three percent reported mild and 2% reported major depressive symptoms. Nearly half (47.7%) reported changes in depressive symptoms during the lockdown. While 37% reported feeling better during the lockdown, about 11% reported depressive symptoms were worse now compared with during the lockdown. 60% reported worsening well-being during the quarantining period. The qualitative analysis revealed 2 main themes: (1) psychological discomfort (mood deflection, fear/worries, and boredom/inactivity) and (2) social issues (inability to go out, missing family members and others).

CONCLUSIONS

Worsening depressive symptoms and lowering of well-being were noticed in this sample of older adults during and post-COVID lockdowns. Evaluation of mental health in the primary care setting and providing referrals for mental health services is essential for older adults who experienced COVID-19-related lockdowns.

Parents' attitudes regarding their children's play during COVID-19: Impact of socioeconomic status and urbanicity

Objectives

The COVID-19 pandemic has had a profound impact on the daily routines of parents and children. This study explored the influence of socioeconomic status (SES) and urbanicity on parents' attitudes toward their children's active play opportunities 6 months and 1.5 years into COVID-19.

Methods

A sample of 239 Ontario parents of children aged 12 and younger completed two online surveys (August-December 2020; 2021) to assess parents' intentions, beliefs, and comforts concerning their child's eventual return to play, in addition to various sociodemographic and physical activity variables. Descriptive analyses were run as well as an exploratory factor analysis (EFA) was conducted to group the 14 attitude items into subscales for analysis, to ensure reliability and validity of attitude measures.

Results

In general, parents in communities with more urban features (e.g., densely populated areas), single-parents, full-time employed parents, and parents with lower-incomes were more hesitant to return their children to active play during the pandemic.

Conclusion

Findings from this work highlight SES and urbanicity disparities that continue to exist during COVID-19.

Risk perceptions of individuals living in single-parent households during the COVID-19 crisis: examining the mediating and moderating role of income

The COVID-19 crisis had severe social and economic impact on the life of most citizens around the globe. Individuals living in single-parent households were particularly at risk, revealing detrimental labour market outcomes and assessments of future perspectives marked by worries. As it has not been investigated yet, in this paper we study, how their perception about the future and their outlook on how the pandemic will affect them is related to their objective economic resources. Against this background, we examine the subjective risk perception of worsening living standards of individuals living in single-parent households compared to other household types, their objective economic situation based on the logarithmised equivalised disposable household incomes and analyse the relationship between those indicators. Using the German SOEP, including the SOEP-CoV survey from 2020, our findings based on regression modelling reveal that individuals living in single-parent households have been worse off during the pandemic, facing high economic insecurity. Path and interaction models support our assumption that the association between those indicators may not be that straightforward, as there are underlying mechanisms-such as mediation and moderation-of income affecting its direction and strength. With respect to our central hypotheses, our empirical findings point toward (1) a mediation effect, by demonstrating that the subjective risk perception of single-parent households can be partly explained by economic conditions. (2) The moderating effect suggests that the concrete position at the income distribution of households matters as well. While at the lower end of the income distribution, single-parent households reveal particularly worse risk perceptions during the pandemic, at the high end of the income spectrum, risk perceptions are similar for all household types. Thus, individuals living in single-parent households do not perceive higher risks of worsening living standards due to their household situation per se, but rather because they are worse off in terms of their economic situation compared to individuals living in other household types.

Can psychological distress account for the associations between COVID-19 vaccination acceptance and socio-economic vulnerability?

Socially disadvantaged individuals and communities consistently showed lower COVID-19 vaccination acceptance. We aimed to examine the psychological mechanisms that could explain such vaccination disparities. This study used data from serial population-based surveys conducted since the COVID-19 vaccination programme being launched in Hong Kong (N = 28,734). We first assessed the correlations of community-level and individual-level social vulnerability with COVID-19 vaccination acceptance. Structural equation modelling (SEM) was then conducted to test whether psychological distress measured by PHQ-4 can account for the associations between participants' socio-economic vulnerability and COVID-19 vaccination acceptance. The third part analysis examined whether perceived negativity of vaccine-related news and affect towards COVID-19 vaccines accounted for the association between psychological distress and COVID-19 vaccination. Communities with higher social vulnerability scores and participants who had more vulnerable socio-economic status showed lower COVID-19 vaccination acceptance. Individuals with more vulnerable socio-economic status reported higher psychological distress, which lowered COVID-19 vaccination acceptance. Furthermore, higher psychological distress was associated with lower vaccination acceptance through its psychological mechanisms of processing vaccine-related information. We proposed a renewed focus on tackling psychological distress rather than merely increasing vaccine accessibility in more socio-economic-disadvantaged groups for promoting COVID-19 vaccination acceptance.

Deepening Depression in Women Balancing Work-Life Responsibilities and Caregiving during the COVID-19 Pandemic: Findings from Gender-Specific Face-to-Face Street Interviews Conducted in Italy

PURPOSE

This study investigated the impact of the COVID-19 pandemic on mental health, quality of life, and family functioning in a sample of the general female population, exploring difficulties encountered in managing family and work responsibilities and burden of care when taking care of a loved one. This study was, moreover, aimed at investigating factors capable of influencing severe depressive symptomatology in the context of socio-demographics, traumatic events, individual vulnerability, and family functioning.

METHOD

The sampling method used in this research was non-probability sampling. The survey took place during a Hospital Open Weekend (8-10 October 2021) organized by the National Gender Observatory on Women's Health "Fondazione Onda" on the occasion of the World Mental Health Day.

RESULTS

A total of 211 women were interviewed (mean age = 35.6, 53% living alone, more than 15% with financial difficulties, 47% exposed to the 2009 L'Aquila earthquake). More than 50% of the sample reported a higher complexity in managing their lives during the COVID-19 pandemic compared to their previous routine, with no statistically significant differences between working women and non-workers, although the latter obtained higher scores for depressive symptomatology and poorer quality of life. Compared to non-caregivers, female caregivers (22.3%) in charge of the care of loved ones affected by physical (10.9%) or psychiatric disabilities (11.4%) complained of a poorer quality of life, especially in general health perception (p = 0.002), physical function (p = 0.011), role limitations related to physical problems (p = 0.017), bodily pain (p = 0.015), mental health (p = 0.004), and social functioning (p = 0.007). Women caring for people affected by mental disorders seemed to experience a more significant worsening in vitality (p = 0.003) and social functioning (p = 0.005). Approximately 20% of the total sample reported severe depressive symptomatology. Previous access to mental health services (O.R. 10.923; p = 0.000), a low level of education (O.R. 5.410; p = 0.021), and difficulties in management of everyday lives during the COVID-19 pandemic (O.R. 3.598; p = 0.045) were found to be the main variables predictive of severe depressive psychopathology. Old age, good problem-solving skills, and ability to pursue personal goals were identified as protective factors.

CONCLUSIONS

The COVID-19 pandemic underlined the need for support amongst emotionally vulnerable women with pre-existing mental health conditions, partly reflecting the cumulative effects of traumas.

Socioeconomic Status and Students' Mental Health during the COVID-19 University Closure: Mediating Roles of Perceived Social Support and Self-Efficacy

Despite the need for urgent actions in response to the exacerbated inequalities in mental health resulting from the COVID-19 pandemic, there remains a significant gap in research into the relationships and underlying mechanisms between socioeconomic status (SES) and various mental health outcomes among students during the COVID-19 university closure. With a sample of 839 students from a university in Lanzhou, the capital city of China's Gansu Province, which was closed during the 2022 autumn semester due to the COVID-19 outbreak, this study examined the relationships between SES and both the negative and positive mental health outcomes, with a particular inquiry into the mediating roles of perceived social support and self-efficacy. The results show that SES had significant and negative total associations with psychological distress (β = -0.119, p < 0.001) and loneliness (β = -0.132, p < 0.001), while having significant and positive total associations with life satisfaction (β = 0.90, p < 0.01) and affective well-being (β = 0.108, p < 0.01). Moreover, perceived social support and self-efficacy independently and sequentially mediated the associations between SES and various mental health outcomes. Research implications for the design and improvement of university measures to reduce the socioeconomic inequalities in students' mental health are also discussed.

Changes in anxiety and depression in patients with different income levels through the COVID-19 pandemic

BACKGROUND

Lower socioeconomic status is known to be associated with high mental health burden, there have been few epidemiological studies showing how socioeconomic status has modified the effect of COVID-19 on anxiety and depression.

METHODS

We analyzed data from the National Health Interview Survey in the United States between 2019 and 2021 and used respondents with a documented income-to-poverty ratio as a measure of income level (n = 79,468). We used frequency of medication use and self-reported frequency of anxious and depressive episodes as the main outcome measures. We performed a multivariable logistic regression with a two-way interaction term between income and survey year.

RESULTS

We found a statistically significant worsening of depression and anxiety metrics in respondents with higher income levels from 2019 to 2021. We did not observe a significant change in anxiety and depression metrics for low-income respondents over the same period.

LIMITATIONS

The data from the NHIS survey is limited primarily by sampling bias (response rate of 50.7 % in 2021), as well as the self-reported nature of the one of the outcome measures.

CONCLUSION

These findings suggest that, within the limits of the National Health Interview Survey, mental health outcomes were worse but stable in a socioeconomically disadvantaged demographic between 2019 and 2021. In a higher socioeconomic bracket, mental health outcomes were less severe than the disadvantaged demographic but were worsening at a greater rate.

Risk Perception and Public Pandemic Fatigue: The Role of Perceived Stress and Preventive Coping

Purpose

This study explores the status of pandemic fatigue, predictors, and their mechanisms of action based on a stress-response framework and a parallel model of future-oriented response.

Patients and methods

Study 1 investigated 8426 Chinese adult residents' understanding of and willingness to cooperate with the pandemic prevention and control policies and Study 2 surveyed 1635 Chinese residents on their activeness of pandemic prevention and control (APPC), pandemic risk perception, perceived stress, and future-oriented coping.

Results

Study 1 found that public understanding of and willingness to cooperate with prevention policies were significantly lower in 2022 than in 2020 and 2021. Study 2 found that risk perception negatively predicted the APPC; perceived stress and preventive coping significantly mediated the relationship between risk perception and APPC; but perceived stress and proactive coping did not significantly mediate the relationship between risk perception and APPC.

Conclusion

This revealed an increase in public fatigue in the third year of the pandemic. Pandemic fatigue can be predicted by pandemic risk perception, but the direct pathway of action is not significant and requires the mediation of perceived stress and preventive coping.

Monitoring the Relationship between Social Network Status and Influenza Based on Social Media Data

BACKGROUND

This article aims to analyze the relationship between user characteristics on social networks and influenza.

METHODS

Three specific research questions are investigated: (1) we classify Weibo updates to recognize influenza-related information based on machine learning algorithms and propose a quantitative model for influenza susceptibility in social networks; (2) we adopt in-degree indicator from complex networks theory as social media status to verify its coefficient correlation with influenza susceptibility; (3) we also apply the LDA topic model to explore users' physical condition from Weibo to further calculate its coefficient correlation with influenza susceptibility. From the perspective of social networking status, we analyze and extract influenza-related information from social media, with many advantages including efficiency, low cost, and real time.

RESULTS

We find a moderate negative correlation between the susceptibility of users to influenza and social network status, while there is a significant positive correlation between physical condition and susceptibility to influenza.

CONCLUSIONS

Our findings reveal the laws behind the phenomenon of online disease transmission, and providing important evidence for analyzing, predicting, and preventing disease transmission. Also, this study provides theoretical and methodological underpinnings for further exploration and measurement of more factors associated with infection control and public health from social networks.

Were we happy and we didn't know it? A subjective dynamic and financial assessment pre-, during and post-COVID-19

The COVID-19 pandemic has brought many changes into people's lives. Fear, job insecurity, changes in their financial stability, concerns about their future lives have changed the entire lives of people and have affected the cognitive well-being of individuals. The purpose of the present analysis is to measure how the COVID-19 pandemic, along with financial factors, has affected the perceived level of well-being of individuals. We are also interested whether there are differences between life before COVID-19, life now with COVID-19, and life after the COVID-19 pandemic, in terms of future expectations. To address this objective, we performed an ANOVA approach and a GLM estimate on repeated measures for a large sample (1572 respondents) from 43 worldwide countries, during the period May 2020 and July 2021. Our results show that financial factors reflected by both the size of income and changes in personal or family income affect the levels of happiness. Robustness checks using stress as an alternative estimator for happiness have consolidated our results. Additionally, we find that well-being during COVID-19 compared to the previous period decreased, while in future, people expect to be happier, but not more than in the past when they did not know about the existence of this virus. This is one of the first studies to investigate the relationship between happiness and income before, during, and after COVID-19. These findings are important for policymakers to improve the conditions of living in the areas of health and financial stability.

Associations Between Children's Emotion Regulation, Mindful Parenting, Parent Stress, and Parent Coping During the COVID-19 Pandemic

Stress among parents has increased during the COVID-19 pandemic. Research prior to the pandemic indicates that parents of children who struggle with emotion regulation (ER) and who themselves are less mindful report more stress and diminished coping abilities. We know little, however, about these associations in the context of COVID-19. To prevent COVID-related deteriorations in parent well-being and child outcomes and to support parents during this potentially challenging time, it is important to understand the factors that are associated with increased stress as well as adaptive coping. This paper discusses the association between children's ER, mindful parenting (MP), parent stress, and parents' coping with parenting during the pandemic in a sample of 217 caregivers of school-aged children (91.0% mothers). Results indicated that children's ER was associated with parents' self-reported coping with parenting in the pandemic but was not associated with increased stress. Further, MP moderated the association between children's ER and coping, such that parents who were the most mindful and had children with better ER skills reported significantly greater ability to cope with pandemic parenting. Coping was lower for other combinations of ER and mindful parenting. These findings contradict those from before COVID, suggesting the relationship between children's ER and parent outcomes may differ in the COVID-19 context, and offering insights into which parents may be most likely to struggle with coping with pandemic parenting.

COVID-19 and employee job performance trajectories: The moderating effect of different sources of status

This study investigates the impact of the COVID-19 pandemic on employee job performance trajectories, and further examines the moderating effects of different sources of status. Drawing from event system theory (EST), we propose that employee job performance decreases upon COVID-19 onset, but gradually increases during the postonset period. Furthermore, we argue that status from society, occupation, and workplace functions to moderate such performance trajectories. We test our hypotheses with a unique dataset of 708 employees that combines survey responses and job performance archival data over 21 consecutive months (10,808 observations) spanning the preonset, onset, and postonset periods of the initial encounter with COVID-19 in China. Utilizing discontinuous growth modeling (DGM), our findings indicate that the onset of COVID-19 created an immediate decrease in job performance, but such decrease was weakened by higher occupation and/or workplace status. However, the postonset period resulted in a positive employee job performance trajectory, which was strengthened for employees with lower occupational status. These findings enrich our understanding of COVID-19's impact on employee job performance trajectories, highlight the role of status in moderating such changes over time, and also provide practical implications to understand employee performance when facing such a crisis.

The effects of the pandemic on mental health in persons with and without a psychiatric history

BACKGROUND

Prospective studies are needed to assess the influence of pre-pandemic risk factors on mental health outcomes following the COVID-19 pandemic. From direct interviews prior to (T1), and then in the same individuals after the pandemic onset (T2), we assessed the influence of personal psychiatric history on changes in symptoms and wellbeing.

METHODS

Two hundred and four (19-69 years/117 female) individuals from a multigenerational family study were followed clinically up to T1. Psychiatric symptom changes (T1-to-T2), their association with lifetime psychiatric history (no, only-past, and recent psychiatric history), and pandemic-specific worries were investigated.

RESULTS

At T2 relative to T1, participants with recent psychopathology (in the last 2 years) had significantly fewer depressive (mean, M = 41.7 v. 47.6) and traumatic symptoms (M = 6.6 v. 8.1, p < 0.001), while those with no and only-past psychiatric history had decreased wellbeing (M = 22.6 v. 25.0, p < 0.01). Three pandemic-related worry factors were identified: Illness/death, Financial, and Social isolation. Individuals with recent psychiatric history had greater Illness/death and Financial worries than the no/only-past groups, but these worries were unrelated to depression at T2. Among individuals with no/only-past history, Illness/death worries predicted increased T2 depression [B = 0.6(0.3), p < 0.05].

CONCLUSIONS

As recent psychiatric history was not associated with increased depression or anxiety during the pandemic, new groups of previously unaffected persons might contribute to the increased pandemic-related depression and anxiety rates reported. These individuals likely represent incident cases that are first detected in primary care and other non-specialty clinical settings. Such settings may be useful for monitoring future illness among newly at-risk individuals.

Perceived School Fairness and Willingness to Report Bias-Based Bullying Among Youth During COVID-19 Pandemic

BACKGROUND

As COVID-19 has let many students into remote learning environments and exacerbated inequality among marginalized individuals, there is a growing concern about Bias-Based Bullying (BBB) in online spaces among school-aged youths. Learning modality and perceived school fairness may affect youth's likelihood of reporting BBB.

METHODS

Data were collected as part of "No Place For Hate" (NPFH) project, which was conducted by an equity office of a school district. A sample of middle and high school students (N = 1117) in the school district was used as an analytic sample. We conducted a series of independent samples t tests and calculated a hierarchical stepwise multivariate regression model to examine the proposition.

RESULTS

Results demonstrated that students in fully remote modality reported slightly higher levels of witnessing BBB (t = 2.29, p < .05), lower perceived school fairness (t = -2.94, p < .01), and higher levels of likelihood of reporting BBB (t = 2.31, p < .05). Results of the regression model showed that perceived school fairness was positively associated with likelihood of reporting BBB, even when considering the influences of sociodemographic characteristics, learning modality, and experience of witnessing BBB.

CONCLUSIONS

Findings of this study suggest that learning modality and perceived school fairness can meaningfully explain witnesses' likelihood of reporting BBB. Additional research should continue investigating how schools can encourage students to increase their likelihood of reporting and adopt the bystander response of reporting against BBB at school to ensure school health and safety.

The association of families' socioeconomic and demographic characteristics with parents' perceived barriers to returning to youth sport following the COVID-19 pandemic

Developmentally appropriate sport contexts have the potential to positively influence young people's physiological, psychological, and social outcomes. However, little is known about how families returned to sport in the wake of COVID-19-related restrictions or how socioeconomic and demographic factors influenced parents' perceptions of barriers to returning. A nationally representative sample (N = 6183) of American youth sport parents completed a questionnaire in which they provided demographic information and answered questions related to the barriers they perceived in returning to sport, such as the risk of their child getting sick. Structural equation modeling was used to examine the relationships among a range of socioeconomic and demographic factors and these barriers to returning. Results suggest that parents from racially minoritized and urban neighborhoods held higher levels of concern over health-related and practical barriers to returning to sport. Findings highlight the importance of designing available, equitable, and appropriate youth sport contexts.

Prevalence of depressive symptoms in U.S. adults during the COVID-19 pandemic: A systematic review

The COVID-19 pandemic has led to a worsening of mental health among U.S. adults. However, no review to date has synthesized the overall prevalence of population depressive symptoms in the U.S. over the COVID-19 pandemic. We aimed to document the population prevalence of depressive symptoms and psychological distress across time since the start of the COVID-19 pandemic, both to identify patterns that emerged in the literature and to assess the data sources, methods, sampling, and measurement used to examine population mental health during the pandemic. In a systematic review of the peer review literature, we identified 49 articles reporting 88 prevalence points of depressive symptoms and related constructs in nationally representative samples of U.S. adults from March 2020 to June 2021. First, we found that the average prevalence of poor mental health across studies was 12.9% for severe depression, 26.0% for at least moderate depression, and 36.0% for at least mild depression. Second, we found that women reported significantly higher prevalence of probable depression than men in 63% of studies that reported depression levels by gender and that results on statistically significant differences between racial and ethnic groups were mixed. Third, we found that the 49 articles published were based on 12 studies; the most common sources were the Household Pulse Survey (n = 15, 31%), the AmeriSpeak panel (n = 8, 16%), the Qualtrics panel (n = 8, 16%), and the Understanding America Study (n = 5, 10%). Prevalence estimates varied based on mental health screening instruments and cutoffs used. The most commonly used instruments were the Patient Health Questionnaire (PHQ) (n = 36, 73%) and the Kessler (n = 8, 16%) series. While the prevalence of population depression varied over time depending on the survey instruments, severity, and constructs reported, the overall prevalence of depression remained high from March 2020 through June 2021 across instruments and severity. Understanding the scope of population mental health can help policymakers and providers address and prepare to meet the ongoing and future mental health needs of U.S. adults in the post-COVID-19 context and beyond.

Cross-cultural equivalence of parental ratings of child difficulties during the pandemic: Findings from a six-site study

OBJECTIVES

The Strengths and Difficulties Questionnaire (SDQ) has been shown to be invariant across informants, developmental stage and settings, but tests of cross-cultural equivalence are limited to adolescents' self-reports. The COVID-19 pandemic makes this gap particularly pertinent, given the need to understand whether distinct government approaches (e.g., school closures) are uniquely associated with variability in children's psychosocial outcomes and the reliance on parents' ratings for young children.

METHODS

Within a Confirmatory Factor Analysis framework, we tested the cross-cultural measurement invariance of the SDQ across six countries: Australia, China, Italy, Sweden, the United Kingdom and USA, using a sample of 1761 parents of 3- to 8-year-olds (M = 5.76, SD = 1.09).

RESULTS

A five-factors model showed good fit to the data and partial cross-cultural scalar invariance. In this sample, Swedish parents reported the fewest peer problems (Cohen's d = 0.950) and the highest prosocial scores (Cohen's d = 0.547), whilst British parents reported the greatest child emotional (Cohen's d = 0.412) and hyperactivity problems (Cohen's d = 0.535).

CONCLUSIONS

The present results indicate that the parent-version of the SDQ is appropriate for use and comparison across different contexts during the pandemic.

Time trends in mental health indicators in Germany's adult population before and during the COVID-19 pandemic

Background

Times of crisis such as the COVID-19 pandemic are expected to compromise mental health. Despite a large number of studies, evidence on the development of mental health in general populations during the pandemic is inconclusive. One reason may be that representative data spanning the whole pandemic and allowing for comparisons to pre-pandemic data are scarce.

Methods

We analyzed representative data from telephone surveys of Germany's adults. Three mental health indicators were observed in ~1,000 and later up to 3,000 randomly sampled participants monthly until June 2022: symptoms of depression (observed since April 2019, PHQ-2), symptoms of anxiety (GAD-2), and self-rated mental health (latter two observed since March 2021). We produced time series graphs including estimated three-month moving means and proportions of positive screens (PHQ/GAD-2 score ≥ 3) and reports of very good/excellent mental health, as well as smoothing curves. We also compared time periods between years. Analyses were stratified by sex, age, and level of education.

Results

While mean depressive symptom scores declined from the first wave of the pandemic to summer 2020, they increased from October 2020 and remained consistently elevated throughout 2021 with another increase between 2021 and 2022. Correspondingly, the proportion of positive screens first decreased from 11.1% in spring/summer 2019 to 9.3% in the same period in 2020 and then rose to 13.1% in 2021 and to 16.9% in 2022. While depressive symptoms increased in all subgroups at different times, developments among women (earlier increase), the youngest (notable increase in 2021) and eldest adults, as well as the high level of education group (both latter groups: early, continuous increases) stand out. However, the social gradient in symptom levels between education groups remained unchanged. Symptoms of anxiety also increased while self-rated mental health decreased between 2021 and 2022.

Conclusion

Elevated symptom levels and reduced self-rated mental health at the end of our observation period in June 2022 call for further continuous mental health surveillance. Mental healthcare needs of the population should be monitored closely. Findings should serve to inform policymakers and clinicians of ongoing dynamics to guide health promotion, prevention, and care.

Daily expression of workaholism and family outcomes: The buffering and magnifying effects of economic resources

Workaholism is increasingly recognized as a potential threat to occupational health. Although most research has conceptualized workaholism as a trait, some research suggests that it may also fluctuate from day to day. Moreover, the effects of the dynamic properties of workaholism on work and family outcomes may be contingent on one's economic situation. Therefore, the aim of the present study was to test the interactive effect of workday workaholism and economic resources on nightly work-family conflict and family engagement. Using experience sampling methodology, we demonstrated that workaholism fluctuates from one day to the next and has detrimental short-term effects on work-family conflict. Additionally, our findings indicated that the interaction between workday workaholism and perceived income adequacy predicted both nighty work-family conflict and family engagement. While the association between workday workaholism and work-family conflict was stronger for those who experienced low income adequacy, the relationship between workaholism and family engagement was stronger for those who exhibited high income adequacy. Similarly, job security buffered the effect of workaholism on work-family conflict. We discuss the theoretical and practice implications of this study as well as recommend future research directions.

Exploring the impact of COVID-19 pandemic on Americans time use related subjective wellbeing

In this study, the most recent American Time Use Surveys containing reported activity-based emotions and sensations information before (10,378 respondents in 2013) and during (6,902 respondents in 2021) the COVID-19 pandemic are used to assess if time use related individuals' subjective wellbeing (SWB) decreased in the pandemic. Given that the coronavirus has been shown to strongly influence activity decisions and social interactions, sequence analysis is applied to find daily time allocation patterns and changes in daily time allocation. Then, those derived daily patterns and other activity-travel factors, as well as social and demographic, temporal, spatial, and other contextual characteristics are added as explanatory variables in regression models of SWB measures. This provides a holistic framework of exploring the direct and indirect effects (via activity-travel schedules) of the recent pandemic on SWB while controlling for contexts such as the life assessments, daily schedule of activities, and living environment. The results show that respondents in the COVID year reported a new time allocation pattern that has a substantial amount of time at home, and they experienced more negative emotions. Three relatively happier daily patterns in 2021 contained substantial amounts of outdoor and indoor activities. In addition, no significant correlation was observed between metropolitan areas and individuals' SWB in 2021. However, comparisons among states show Texas and Florida residents experienced more positive wellbeing presumably due to fewer COVID-related restrictions.

Positive distraction in daily activities as a predictor of good coping: A "day in the life" during the COVID-19 pandemic

Introduction

The early part of the coronavirus pandemic (COVID-19) was a chronic stressor that led to decreased life satisfaction, increased psychopathology, and decreased social interaction, making it important to study coping strategies that stimulate increases in emotional well-being. Previous research has demonstrated that disengagement coping may be beneficial in scenarios where engagement coping is too difficult or not possible. We hypothesized that disengagement coping would be related to good emotional well-being (high positive emotions and/or perceived control, lower negative emotions and/or stress), with distraction (taking a break from a stressor) related to better emotional well-being than is avoidance (avoiding thoughts and feelings associated with a stressor).

Methods

Using a daily reconstruction method that represents a "day in the life" of people in the United States during the early stages of the COVID-19 pandemic, we assessed people's (N = 329) activities, their intention to distract from or avoid the stressor during these activities, emotions, and thoughts about and motivation to deal with COVID.

Results

Between-subjects' analyses revealed that habitual distraction did not predict any outcomes, while habitual avoidance related to poorer emotional well-being. Within-subject analyses, however, demonstrated that engaging in distraction (and to a smaller extent, avoidance) was associated with better concurrent emotional well-being and less thinking about COVID. Furthermore, the intent to distract/avoid was more reliable in predicting emotional outcomes than was the activity type.

Conclusion

These findings suggest that disengagement from stress can be an adaptive coping behavior during global pandemics and possibly other chronic stressors with similar attributes.

Patterns and predictors of adolescent life change during the COVID-19 pandemic: a person-centered approach

The present study investigated patterns of adolescent life changes across multiple life domains and utilized a holistic-interactionistic perspective to examine their individual, familial, and societal correlates with a sample of 2544 Chinese parent-adolescent dyads. Adolescents were aged from 10 to 19 years old (50.16% girls). Latent profile analysis revealed five life change profiles, including three improved profiles at various degrees, one unchanged profile, and one worsened profile. The majority of adolescents had an improved or unchanged life. Multinomial logistic regression analyses found that most of the individual, familial, and societal factors predicted the group memberships. Notably, parent-adolescent conflict was a significant factor that predicted memberships of all patterns. These findings show the resilience of adolescents and indicate the need for policies and interventions that consider the holistic nature of adolescents' person-context system, especially during a global crisis such as the COVID-19 pandemic.

Financial and Work Burden, Psychosocial Functioning, and Family Interactions During the COVID-19 Pandemic in Indonesia: Effects on Child Outcomes

The COVID-19 pandemic has profoundly affected all aspects of family life worldwide. This study aimed to examine the effects of several family factors on child outcomes during the pandemic in Indonesia, a country with approximately 260 million people. A range of child maladjustment and child competency variables were examined, along with a set of associated variables, including family income, psychosocial functioning, and family interactions, which were modelled via Structural Equation Modelling to understand the interrelationships between variables associated with child adjustment. Using an online survey, a total of 354 parents with at least one typically developing child between the age of 2 and 10 years participated in this study. Results showed that psychosocial functioning and family interactions appeared as successive mediators between family income, financial and work burden, and child adjustment. This study highlights some key concerns to support children's and families' wellbeing during the pandemic in Indonesia.

Stressful Events, Psychological Distress and Well-Being during the Second Wave of COVID-19 Pandemic in Spain: A Gender Analysis

The present study investigates gender differences in stressful events, psychological distress and well-being during the second wave of COVID-19 in Spain, analyzing women's and men's risk and resilience factors for psychological distress and for well-being. Participants were 1758 individuals from the general population, 50.8% women, aged between 18 and 79 years. Women and men did not differ in age, number of children, educational level, occupation or marital status. The participants were assessed by seven self-report questionnaires and scales. The results revealed that women experienced more psychological distress, more negative feelings, more stressful events related to the COVID-19 pandemic, more social support, and lower thriving and self-esteem than men. Multiple regression analyses showed that, in the case of women and men as well, self-esteem was the most important predictor of higher well-being and lower psychological distress and negative feelings while more COVID-19 pandemic-related stressful events were associated with higher psychological distress and lower well-being. Another important predictor of greater well-being for either gender was social support while unemployment was associated with lower well-being. In women and men, a higher educational level was associated with greater psychological distress and negative feelings; the male sample revealed that psychological distress was also connected to younger age while in women it was associated with lower instrumental social support. The results suggest that gender plays an important role in the mental health effects of the COVID-19 pandemic, with the risk being higher for women than for men.

Fear of COVID-19 and Subjective Well-Being: Sequential Mediating Role of Cognitive Flexibility and Psychological Resilience

The negative relationship between fear of COVID-19 and well-being has been revealed over the last years. However, the potential variables that affect this relationship need to be studied. This study examines the sequential mediating role of cognitive flexibility and psychological resilience in the relationship between fear of COVID-19 and subjective well-being. Six hundred and eight participants (339 females and 269 males, aged between 18-79 years) completed the Fear of COVID-19 Scale, the Brief Resilience Scale, the Cognitive Flexibility Inventory, the Positive and Negative Affect Schedule, and the Satisfaction with Life Scale online. The path analysis was conducted using PROCESS macro in the study. The sequential mediation analyses show that the control dimension of cognitive flexibility and psychological resilience fully mediate the relationship between fear of COVID-19 and subjective well-being. In other words, fear of COVID-19 indirectly affects subjective well-being via the control dimension of cognitive flexibility and psychological resilience. In order to restrain the adverse effects of COVID-19, individuals’ cognitive flexibility and psychological resilience levels should be increased to enhance their well-being.

Worrying About Finances During COVID-19: Resiliency Enhances the Effect of Worrying on Both Proactive Behavior and Stress

Amidst the COVID-19 pandemic and resulting economic instability, many people are contending with financial insecurity. Guided by Conservation of Resources Theory (Hobfoll, American Psychologist 44:513-524, 1989; Hobfoll et al., Annual Review of Organizational Psychology and Organizational Behavior 5:103-128, 2018), the current research explores the consequences of experiencing financial insecurity during a pandemic, with a focus on individuals who report relatively higher rates of financial insecurity, performance challenges, and stress during such experiences: working parents (American Psychological Association, 2022). This research also examines the role that personal resources, in the form of trait resiliency, play in the relationships between financial insecurity and behavioral and psychological outcomes including worrying, proactive behaviors, and stress. In a study of 636 working parents and their children, we find that financial insecurity heightens worrying, underscoring the threatening nature of the loss or anticipated loss of material resources. Worrying, in turn, promotes proactive behaviors at work-an effect that is more pronounced among high-resiliency individuals. However, worrying is also associated with elevated stress among high-resiliency individuals, providing support for a trait activation perspective (rather than buffering hypotheses) on ongoing, uncontrollable adversities. Taken together, our results help to (1) illuminate the impact of financial insecurity on work and well-being, (2) reveal a mechanism (i.e., worrying) that helps explain the links between financial insecurity and work and personal outcomes, and (3) expand our knowledge of the implications trait resiliency has for both psychological and behavioral reactions to ongoing crises.

Tough times at the top: Occupational status predicts changes in job satisfaction in times of crisis

How do individuals with a higher versus lower occupational status experience major, unexpected changes to their work life? The COVID-19 pandemic has disrupted most areas of work life and, thus, provides a unique opportunity to examine changes in work attitudes in response to a worldwide crisis. We predict that individuals with higher, but not with lower occupational status showed a decline in job satisfaction during the early stages of the COVID-19 pandemic in Germany (1st lockdown; March to May 2020), with subsequent recovery to initial job satisfaction levels. Based on role theory and social-psychological theories of hierarchical differentiation, we argue that, due to the profound work-related changes, individuals with higher (vs. lower) occupational status are more negatively affected in realizing their work goals and, thus, experience decreasing levels of job satisfaction. To test these predictions, we investigated trajectories of job satisfaction between December 2019 and August 2020 (7 measurement waves; N = 1583). Results of piece-wise growth curve models showed that individuals with higher occupational status showed a steeper decline in job satisfaction (followed by recovery) over time, whereas individuals with medium and lower occupational status did not experience a significant change in job satisfaction. In addition, we show that the decline in job satisfaction is moderated by perceived constraints at work associated with the pandemic among individuals with higher occupational status. Overall, these findings contribute to our understanding of the link between occupational status and job satisfaction in times of crisis.

The Impact of the COVID-19 Pandemic and Associated Control Measures on the Mental Health of the General Population : A Systematic Review and Dose-Response Meta-analysis

BACKGROUND

To what extent the COVID-19 pandemic and its containment measures influenced mental health in the general population is still unclear.

PURPOSE

To assess the trajectory of mental health symptoms during the first year of the pandemic and examine dose-response relations with characteristics of the pandemic and its containment.

DATA SOURCES

Relevant articles were identified from the living evidence database of the COVID-19 Open Access Project, which indexes COVID-19-related publications from MEDLINE via PubMed, Embase via Ovid, and PsycInfo. Preprint publications were not considered.

STUDY SELECTION

Longitudinal studies that reported data on the general population's mental health using validated scales and that were published before 31 March 2021 were eligible.

DATA EXTRACTION

An international crowd of 109 trained reviewers screened references and extracted study characteristics, participant characteristics, and symptom scores at each timepoint. Data were also included for the following country-specific variables: days since the first case of SARS-CoV-2 infection, the stringency of governmental containment measures, and the cumulative numbers of cases and deaths.

DATA SYNTHESIS

In a total of 43 studies (331 628 participants), changes in symptoms of psychological distress, sleep disturbances, and mental well-being varied substantially across studies. On average, depression and anxiety symptoms worsened in the first 2 months of the pandemic (standardized mean difference at 60 days, -0.39 [95% credible interval, -0.76 to -0.03]); thereafter, the trajectories were heterogeneous. There was a linear association of worsening depression and anxiety with increasing numbers of reported cases of SARS-CoV-2 infection and increasing stringency in governmental measures. Gender, age, country, deprivation, inequalities, risk of bias, and study design did not modify these associations.

LIMITATIONS

The certainty of the evidence was low because of the high risk of bias in included studies and the large amount of heterogeneity. Stringency measures and surges in cases were strongly correlated and changed over time. The observed associations should not be interpreted as causal relationships.

CONCLUSION

Although an initial increase in average symptoms of depression and anxiety and an association between higher numbers of reported cases and more stringent measures were found, changes in mental health symptoms varied substantially across studies after the first 2 months of the pandemic. This suggests that different populations responded differently to the psychological stress generated by the pandemic and its containment measures.

PRIMARY FUNDING SOURCE

Swiss National Science Foundation. (PROSPERO: CRD42020180049).

Effects of the COVID-19 pandemic and previous pandemics, epidemics and economic crises on mental health: systematic review

BACKGROUND

A rise in mental illness is expected to follow the COVID-19 pandemic, which has also been projected to lead to a deep global economic recession, further adding to risk factors.

AIMS

The aim of this review was to assess the impact of the COVID-19 pandemic and previous pandemics, epidemics and economic crises on mental health.

METHOD

Searches were conducted in PubMed, Web of Science, PsycINFO and Sociological Abstracts. We included studies of all populations exposed to the COVID-19 pandemic, and other similar pandemics/epidemics and economic crises, compared with non-exposed time periods or regions. The outcome was mental health.

RESULTS

The 174 included studies assessed mental health impacts of the COVID-19 pandemic (87 studies), 2008 economic crisis (84 studies) and severe acute respiratory syndrome (SARS) epidemic (three studies). Outcomes were divided into affective disorders, suicides, mental healthcare utilisation and other mental health. COVID-19 pandemic studies were of lesser quality than those for the economic crisis or SARS epidemic. Most studies for all exposures showed increases in affective disorders and other mental health problems. For economic crisis exposure, increases in mental healthcare utilisation and suicides were also found, but these findings were mixed for COVID-19 pandemic exposure. This is probably because of quarantine measures affecting help-seeking and shorter follow-ups of studies of COVID-19 pandemic exposure.

CONCLUSIONS

Our findings highlight the importance of available, accessible and sustainable mental health services. Also, socioeconomically disadvantaged populations should be particular targets of policy interventions during the COVID-19 pandemic.