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

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.

Coronavirus disease 2019 pandemic associated with anxiety and depression among Non-Hispanic whites with chronic conditions in the US

“…Studies conducted during the pandemic period also support such findings. ( Goldmann et al , 2021 ; Owens and Saw, 2021 ) A US study using the same tool used in our study to measure anxiety and depression reported that during the COVID-19 pandemic, anxiety/depression was lower among NHB compared to NHW individuals. ( Goldmann et al , 2021 ) Another US study conducted during the COVID-19 pandemic using data from Understanding American Study also reached similar findings.…”

“…As stated in the introduction, studies have reported mixed results on the association of race/ethnicity to depression and anxiety. ( Goldmann et al , 2021 ; Owens and Saw, 2021 ) McGuire et al reported that, in general, people of color had similar or better mental health compared to NHWs. ( McGuire and Miranda, 2008 ) However, this study was conducted before COVID-19.…”

“…Furthermore, the differential effects of COVID-19 among individuals of different races/ethnicities may also contribute to varying rates of anxiety and depression among these groups. ( Goldmann et al , 2021 ; McKnight-Eily et al , 2021 ; Goldmann et al , 2021 ; Owens and Saw, 2021 ) Some studies reported higher anxiety/depression among Non-Hispanic White (NHW) than people of color. ( Goldmann et al , 2021 ; Owens and Saw, 2021 ) Whereas other studies showed higher stress levels among Hispanic populations during the pandemic than their NHW counterparts.…”

“…( Goldmann et al , 2021 ; McKnight-Eily et al , 2021 ; Goldmann et al , 2021 ; Owens and Saw, 2021 ) Some studies reported higher anxiety/depression among Non-Hispanic White (NHW) than people of color. ( Goldmann et al , 2021 ; Owens and Saw, 2021 ) Whereas other studies showed higher stress levels among Hispanic populations during the pandemic than their NHW counterparts. ( McKnight-Eily et al , 2021 ; Bui et al , 2021 ) While those with chronic conditions have higher rates of anxiety and depression, it is not known how different race/ethnic groups are affected by anxiety and depression in the presence of chronic conditions.…”

Comparison of the Mental Health Impact of COVID-19 on Vulnerable and Non-Vulnerable Groups: A Systematic Review and Meta-Analysis of Observational Studies

“…Although excluded because they did not meet the inclusion criteria for this review there are also recent studies investigating the mental health of other vulnerable populations, such as racial/ethnic minorities [81] and people with physical disabilities [82]. In the future, in the context of COVID-19, the mental health of these vulnerable populations needs to be investigated more specifically through comparison with an ethnically mainstream or physically healthy control group.…”