Understanding the community and social determinants in mental health inequity: the impact of mass social distancing during the COVID-19 pandemic

Abstract

ABSTRACT This study investigates the relations of individual capacity and community attributes with adults’ (age 18+) psychological impacts (i.e. anxiety, depression, and comorbidity of the two) from social restriction directives during the COVID-19 pandemic. Controlling for community-level environmental factors and individual-level characteristics, multilevel logistic regressions were carried out with nationally representative and COVID-19-specialized data from the Household Pulse Survey (N = 1,205,194) conducted by the U.S. Census Bureau between 23 April 2020 and 7 June 2021. Regression estimates show that the lack of community capacities (e.g. poverty and transit use) during the pandemic and individuals’ economic vulnerabilities (e.g. loss of income and housing instability) exacerbate mental illnesses as social distancing measures are prolonged. Particularly, a more stringent stay-at-home order was found to be related to a marginal increase in the risk of anxiety (OR = 1.014, CI = 1.000–1.029), depression (OR = 1.016, CI = 1.003–1.030), and their comorbidity (OR = 1.018, CI = 1.003–1.034). These findings suggest that the psychological impact of social distancing order can be determined by combining the effects of both individual and community capacities.