ABSTRACT
Background. The COVID-19 pandemic has been associated with a decline in mental health status in the US, as well as reduced ability to seek mental health treatment. This study analyzed undertreatment of mental health during the pandemic to identify possible disparities and assess the need for interventions. Methods. Data were collected from Wave 3 (January 6-February 15, 2021) of the US Census COVID-19 Household Pulse online survey, designed to measure the ongoing impact of the pandemic. Microdata files were downloaded from the Census website and included N=185,201 respondents. Data was collected in both English and Spanish and consisted of a representative sample of US residents. Data were analyzed using χ 2 tests, with z-tests for more granular between-group comparisons. Results. When asked if they needed and received therapy due to mental health concerns, 81% of respondents did not need therapy and did not receive it. Some (2%) reported receiving therapy but needing more. However, 9% reported needing therapy but not receiving it. A similar proportion, 9%, reported having received adequate therapy from a mental health professional. Those who needed therapy but did not receive it were more likely than adequately treated respondents to express debilitating worry, anxiety, depression, and lack of interest/pleasure in doing things (all p< .05). These respondents were also more likely (vs. adequately treated respondents) to be younger, lower-income, racial/ethnic minorities, without health insurance, and food-insecure (all p< .05). Conclusion. Inadequate mental health treatment is a critical challenge, especially in the wake of COVID-19;Just as many respondents reported adequate mental health treatment as did needing additional mental health treatment. Respondents reporting undertreated mental health issues in this study were more likely to be vulnerable populations, many of whom have already been disproportionately impacted by the pandemic. Methods to expand accessible counseling capacity in economically feasible ways to limit these disparities should be further explored.
ABSTRACT
Background. The COVID-19 pandemic was associated with an array of social and economic events, influencing how the pandemic affected people of all genders. In particular, job losses surged during the COVID-19 pandemic, especially among women. We analyzed how the pandemic and rising job losses affected the mental health of unmarried women with and without children in order to identify possible health disparities, potential causal factors and opportunities for interventions. Methods. Data were collected from Wave 3 (January 6-February 15, 2021) of the US Census COVID-19 Household Pulse online survey designed to measure the impact of COVID-19. Microdata files were downloaded from the Census website and included N=13,940 never-married female respondents aged 25-54 years old. Data were analyzed using χ2 tests, with z-tests for more granular between-group comparisons. Results. When asked if they had felt anxiety in the past week, 31% of respondents without children in the household and 28% of those with children reported feeling anxiety nearly every day (p< .05). Among those who did not lose work during the pandemic, 24% of those without children felt anxiety nearly every day vs. 20% of those with children (p< .05). Among those who did experience pandemic-related job loss, 33% of those with children and 42% of those without children reported daily anxiety (p< .05). Conclusion. Overall, COVID-19 job loss was associated with higher levels of anxiety for never-married adult women. Notably, respondents without children expressed significantly higher levels of anxiety than respondents with children, and this difference was even greater when comparing those who had lost jobs during the pandemic. Reasons are being further researched but may be related to mothers' greater opportunities for social and community support, particularly when encountering difficult circumstances. These results have implications for the development of mental health programs serving women experiencing environmental stressors such as job loss, especially women without children who may not have the same mental health and community support.
ABSTRACT
Background. Institutional trust is a key component of the public health system's effectiveness. However, the COVID-19 pandemic highlighted gaps in institutional trust and hesitation. Analysis was conducted to understand correlates of institutional trust to inform communication strategies for the ongoing pandemic and future public health crises. Methods. The Roper Center for Public Opinion/ America's Voice Project Coronavirus Index conducted a US online survey February 22-April 5, 2021 and included questions about COVID-19 experiences, attitudes and behaviors. Respondents also indicated trust in each of four institutions to provide accurate information about COVID-19: federal government, state government, CDC and national public health officials. Scores were summed to create an Institutional Trust (IT) index: the top third was classified as "High IT," the middle third "Moderate IT" and the bottom third "Low IT." Data were analyzed using χ2 tests, with z-tests for more granular between-group comparisons. Results. Those with Low IT were significantly more likely than those with Moderate or High IT to be white, male, rural, politically conservative, married, and live with children under age 18. Low IT individuals were less likely to have been tested for COVID-19 themselves and less likely to know someone who had tested positive for COVID-19. However, Low IT respondents were more likely to have tested positive for COVID-19, even when controlling for their lower propensity to be tested. Low IT individuals were significantly more likely to have visited restaurants and stores in the past week and feel these activities posed no health risk;they also wore masks less often. Despite greater risk-taking, Low IT respondents were over five times more likely than High IT respondents to refuse the COVID-19 vaccine. Conclusion. Low IT was associated with higher COVID-19 vaccine hesitancy as well as behavior that, at the time data was collected, put people at higher risk of contracting COVID-19. Public health officials should prioritize the development of more effective communications towards Low IT populations. Traditional methods of establishing message credibility may require modification in order to encourage Low IT individuals to participate in behaviors that enhance public health.
ABSTRACT
BACKGROUND: The COVID-19 pandemic has had a disproportionate impact on people of color, particularly Blacks and Hispanics. Recent studies also demonstrate these groups are often less willing to receive the COVID-19 vaccine when it is available. We analyzed health information perceptions among older Blacks and Hispanics for insight on how to overcome this vaccine reluctance. METHOD: We analyzed survey data collected by The COVID Collaborative, a non-profit assemblage of researchers developed to address the COVID-19 pandemic. Data were collected in August 2020 through an online US survey of Hispanic and Black respondents. N= 364 Black respondents and N=54 Hispanic respondents were 60+ years old and were included in the analysis. RESULTS: Among the older (60+) Black and Hispanic respondents, just 25% and 35% were willing to receive a COVID-19 vaccine. 30% of older Blacks and 29% of older Hispanics reported complete trust in their doctor/healthcare team. This lack of trust may be due to perceived cultural insensitivity. Only 30% of older Blacks and 33% of older Hispanics felt their healthcare providers understood their cultural/ ethnic background. Less than half of older Blacks and Hispanics (45% and 48%) felt their healthcare providers explained things coherently. 87% of older Blacks and 85% of older Hispanics thought the vaccine would make them sick. CONCLUSIONS: Although older Blacks and Hispanics are at risk of contracting COVID-19, many are unwilling to receive the vaccine. This may be due to distrust in the healthcare system, exacerbated by perceptions of healthcare providers' lack of cultural sensitivity towards older Black and Hispanic patients. Improved communication about the vaccine is needed, as both groups believed the vaccine would get them sick and less than half felt their healthcare teams communicate clearly. Our findings have implications for improved cultural sensitivity and health communication.
ABSTRACT
Background: African-Americans suffer a disproportionate impact from COVID-19, comprising about 24% of deaths while representing 13% of the US population. We conducted a study to understand COVID-19's impact on African-Americans' health attitudes. Methods: In April 2020, we surveyed online a national sample of US adults on their health attitudes and behaviors before and after the COVID-19 outbreak. Comparisons were analyzed using chi-squared tests. Results: A total of 2,544 individuals completed the survey: 473 African- Americans, 282 Hispanics and 1,799 Caucasians responded. The mean ages of each group were 41.4 ± 11 years, 38.0 ± 11 years and 45.7 ± 13 years, respectively. Before COVID-19, African-Americans were least likely to report they had trust in science (53% vs. 68% for Hispanics and 77% for Caucasians;p< .01) and government (16% vs. 27% and 28%;p< .01). After COVID-19, the percentage of African-Americans who had trust in science and government fell further to 44% (p< .01) and 9% (p< .01), respectively, and remained significantly lower than the other two groups. Twice as many African-Americans vs. Caucasians stopped following science and health news after COVID-19 (9% vs. 4%, p< .01). The percentage of African-Americans who reported anxiety about their health rose from 30% pre-COVID to 53% after the outbreak (p< .01), and the percentage who reported anxiety about their family members' health rose from 35% to 61% (p< .01). Only 25% of African-Americans surveyed agreed that if they contracted COVID-19, they were confident they would get the healthcare needed. Conclusion: After COVID-19, African-Americans' trust in science and government fell and a meaningful percentage stopped following science and health news, possibly reducing access to important health information. The percentage of African- Americans reporting anxiety about the future, about their health and about their family members' health all increased significantly after COVID-19. Only a minority of African-Americans agreed they would get the needed healthcare if they contracted COVID-19. These findings have implications for the mental health and behavioral impacts of COVID-19 on African-Americans and for the development of health communications to high-disease-incidence populations.