Stress and Distress during the COVID-19 Pandemic: The Role of Neighborhood Context.

Michelle C Kondo,Lisa Richardson,Christopher N Morrison,Charles C Branas,Kimberly Wu,Katherine P Theall,Jeanette Gustat,Erica Felker-Kantor

doi:10.3390/ijerph19052779

Abstract

Neighborhoods play a central role in health and mental health, particularly during disasters and crises such as the COVID-19 pandemic. We examined changes in psychological distress following the pandemic, and the potential role of neighborhood conditions among 244 residents of New Orleans, Louisiana. Using modified linear regression models, we assessed associations between neighborhood characteristics and change in psychological distress from before to during the pandemic, testing effect modification by sex and social support. While higher density of offsite alcohol outlets (β = 0.89; 95% CI: 0.52, 1.23), assault rate (β = 0.14; 95% CI: 0.03, 0.24), and walkable streets (β = 0.05; 95% CI: 0.02, 0.07) in neighborhoods were associated with an increase in distress, access to neighborhood parks (β = −0.03; 95% CI: −0.05, −0.01), collective efficacy (β = −0.23; 95% CI: −0.35, −0.09), and homicide rate (β = −1.2; 95% CI: −1.8, −0.6) were associated with reduced distress related to the pandemic. These relationships were modified by sex and social support. Findings revealed the important but complicated relationship between psychological distress and neighborhood characteristics. While a deeper understanding of the neighborhoods’ role in distress is needed, interventions that target neighborhood environments to ameliorate or prevent the residents’ distress may be important not only during crisis situations.

Highlights

Introduction published maps and institutional affilThe Coronavirus disease 2019 (COVID-19) pandemic has had considerable negative effects attributable to direct traumatic experiences associated with illness from the disease as well as indirect consequences of quarantine measures, employment loss, and education restriction
We examined the impact of several neighborhood conditions as potential buffers or exacerbators of psychological distress during the pandemic
After adjusting for potential confounders, we found that higher perceived collective efficacy, homicide rate, and park score were associated with a decrease in distress

Summary

Introduction

The Coronavirus disease 2019 (COVID-19) pandemic has had considerable negative effects attributable to direct traumatic experiences associated with illness from the disease as well as indirect consequences of quarantine measures, employment loss, and education restriction. Research documents decreased psychological well-being and increased anxiety and depression compared to pre-pandemic prevalence [1]. A comparison of findings from the National Health Interview Survey pre-COVID-19 and responses during the pandemic found that U.S adults were eight times more likely to suffer symptoms of serious psychological distress (an emotional state that can look like anxiety or depression [2]), and three times more likely to suffer moderate psychological distress [3]. Stress is the body’s physiologic response to real or perceived external threats, which can be an important protective mechanism (McEwen, 1998). Stress experienced chronically and coping mechanisms (McEwen and Gianaros, 2010) can lead to significant health harms.

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