Race-Ethnicity and Depressive Symptoms Among U.S. Older Adults in the COVID-19 Pandemic: Uncovering the Counterbalancing Mechanisms.

Abstract

Drawing on the counterbalancing framework, this study examined the counteracting roles of coronavirus disease (COVID)-related stressors (i.e., infection threat, family activity disruption, economic impact) and psychological resilience in explaining racial-ethnic disparities in depressive symptoms during the COVID-19 pandemic. A competitive mediation model was fitted using nationally representative data from the Health and Retirement Study COVID-19 Project, which were collected in June 2020 (N = 1,717). A competitive mediation model was specified within which the associations between race-ethnicity categories and depressive symptoms were mediated by infection threat, family activity disruption, economic impact, and psychological resilience. A list of pre-COVID covariates and pre-COVID depressive symptoms were adjusted for in this model. Infection threat, family activity disruption, economic impact, and psychological resilience were all higher among non-Hispanic Blacks and Hispanics than among non-Hispanic Whites. Economic impact had a positive whereas psychological resilience had a negative direct effect on depressive symptoms net of pre-COVID covariates and pre-COVID depressive symptoms. Mediation analyses revealed that, compared to non-Hispanic Whites, non-Hispanic Blacks and Hispanics had higher depressive symptoms due to their higher family activity disruption and higher economic impact, but their higher levels of psychological resilience also reduced depressive symptoms. The counteracting indirect effects offset each other, resulting in a null total effect of race-ethnicity on depressive symptoms. These findings suggest that interventions addressing the mental health impact of COVID should consider race/ethnicity-specific vulnerabilities and resilience. Future studies need to consider the complex and potentially counterbalancing mechanisms linking race-ethnicity and mental health.