Factors Associated with Mental Health of Medicare Beneficiaries During the COVID-19 Pandemic.

OBJECTIVES: This study examined factors associated with the mental health of Medicare beneficiaries during the COVID-19 pandemic. METHODS: The Medicare Current Beneficiary Survey COVID-19 Supplement administered in the Fall of 2020 of beneficiaries aged ≥65 years was analyzed (n = 6,173). A survey-weighted logistic model, adjusted for socio-demographics and comorbidities, was performed to examine factors (e.g., accessibility of medical/daily needs, financial security, and social connectivity) associated with stress/anxiety. RESULTS: Of Medicare beneficiaries, 40.8% reported feeling more stressed/anxious during the pandemic. Factors that were associated with this increased stress/anxiety include the inability to get home supplies (95% CI [3.4%, 16.5%]) or a doctor's appointment (95% CI [1.7%, 20.7%]), feeling less financially secure (95% CI [23.1%, 33.2%]) or socially connected (95% CI [19.1%, 25.6%]), and being female (95% CI [7.2%, 12.2%]), when compared with their respective counterparts. Non-Hispanic blacks were less likely to report feeling more stressed/anxious than non-Hispanic whites (95% CI [-19.9%, -9.0%]). CONCLUSIONS: Our findings highlight that beneficiaries' mental health was adversely influenced by the pandemic, particularly in those who felt financially insecure and socially disconnected. CLINICAL IMPLICATIONS: It is warranted to screen at risk beneficiaries for stress/anxiety during Medicare wellness visits and advocate for programs to reduce those risk factors.

Food Insufficiency among Job-Loss Households during the Pandemic: The Role of Food Assistance Programs

During the early stages of the pandemic, many households experienced a loss of employment income, which worsened food insecurity and food insufficiency across the United States. This study aimed to examine whether food assistance programs (FAPs) significantly alleviated food insufficiency (FI) among job-loss households during the pandemic. The analysis was conducted with nationally representative survey data (n = 229,668) collected across 50 states and D.C. in 2020. Spatial analysis and logistic regression were applied to analyze the patterns of FI and to assess the Supplemental Nutrition Assistance Program (SNAP), FAPs for children, and community FAPs. Approximately 18.6% of participants faced FI, 41% of whom experienced FI for the first time. SNAP significantly lowered the odds of being food insufficient by 24.5% among households who were already food insufficient before the pandemic and by 11.9% for households with children. FAPs for children slightly reduced FI among households with children, but those who participated in these programs still had higher prevalence of food insufficiency than those who did not. Community FAPs were not effective. The findings suggest increasing the benefit level of SNAP for households with lowest income, strengthening their partnership with community FAPs, and distributing more emergent assistance to the most vulnerable households.