An examination of racial and ethnic disparities in mental health during the Covid-19 pandemic in the U.S. South

Emily Goldmann; Daniel Hagen; Estelle El Khoury; Mark Owens; Supriya Misra; Johannes Thrul

doi:10.1016/j.jad.2021.08.047

An examination of racial and ethnic disparities in mental health during the Covid-19 pandemic in the U.S. South

J Affect Disord. 2021 Dec 1:295:471-478. doi: 10.1016/j.jad.2021.08.047. Epub 2021 Aug 27.

Authors

Emily Goldmann¹, Daniel Hagen², Estelle El Khoury², Mark Owens³, Supriya Misra⁴, Johannes Thrul⁵

Affiliations

¹ Department of Epidemiology, New York University School of Global Public Health, 708 Broadway, 7th Floor, New York, NY 10003, USA. Electronic address: esg236@nyu.edu.
² Department of Epidemiology, New York University School of Global Public Health, 708 Broadway, 7th Floor, New York, NY 10003, USA.
³ Department of Political Science, College of Arts and Sciences, The University of Texas at Tyler, Tyler, TX, USA.
⁴ Department of Public Health, College of Health and Social Sciences, San Francisco State University, San Francisco, CA, USA.
⁵ Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA; Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA; Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia.

Abstract

Background: The mental health of racial/ethnic minority groups in the United States may be disproportionately impacted by the COVID-19 pandemic due to greater experience of peri-pandemic stressors. Yet, few studies have systematically examined racial/ethnic differences in mental health outcomes in this context.

Methods: Data came from the COVID-19 Southern Cities Study, a probability-based, cross-sectional study conducted in May/June 2020 among adults living in the metropolitan statistical areas of Atlanta, Austin, Dallas, Houston, and New Orleans. Unadjusted and adjusted associations between racial/ethnic identity and past-week depression and/or anxiety symptoms (Patient Health Questionnaire-2 score ≥ 3 or Generalized Anxiety Disorder-2 score ≥ 3), trouble sleeping, physical reactions when thinking about COVID-19, and self-rated worsened mental health due to the pandemic were estimated in separate logistic regression models.

Results: Over 30% of respondents reported depression and/or anxiety symptoms, 21% reported physical reactions, 25% had trouble sleeping, and 33% worsened mental health since the pandemic began. Adjusting for sociodemographic and health-related characteristics and pandemic-related stressors, odds of anxiety symptoms (odds ratio (OR) 0.53, 95% confidence interval (CI) 0.30-0.95) and worsened mental health (OR 0.58, 95% CI 0.36-0.94) were lower among non-Hispanic Black vs. non-Hispanic white respondents.

Limitations: No diagnostic assessments were used, and results may not be generalizable to later phases of the pandemic and the entire U.S. South.

Conclusions: Despite greater pandemic-related stressor experience, poor mental health outcomes were not more common among racial/ethnic minority individuals. However, interventions to reduce disparities in stressor experience and promote mental health are needed.

Keywords: COVID-19; Ethnicity; Mental health, Race; Stressors.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
COVID-19*
Cross-Sectional Studies
Ethnicity
Humans
Mental Health
Minority Groups
Pandemics*
SARS-CoV-2
United States / epidemiology