Accumulation of economic hardship and health during the COVID-19 pandemic: Social causation or selection?

The relation between economic stressors and higher education students' mental health during the initial outbreak of the COVID-19 pandemic

AIMS

The COVID-19 pandemic has had a large impact on the financial situation of higher education students, disproportionately affecting students with a low socioeconomic status (SES). This raises the question of whether economic stressors related to COVID-19 have aggravated existing socioeconomic inequalities in mental health. This study examined the relationship between economic stressors and students' depressive symptoms, and the role of students' SES and countries' socioeconomic conditions.

METHODS

Data from the COVID-19 International Student Well-being Study was used for multilevel analyses, with depressive symptoms as dependent variable. Three indicators measured SES: educational level of the parents, ability to borrow money from their social network, and struggling with financial resources prior to COVID-19.

RESULTS

Students with a low SES had more depressive symptoms, and those not able to borrow money and with parents without higher education were more exposed to a deterioration in their financial situation. Both economic stressors (reduction in working hours and a deterioration of their financial situation) were positively related to depressive symptoms. In addition, the positive relationship between a decrease in working hours and depressive symptoms was stronger in countries with a higher unemployment rate.

CONCLUSIONS

We observed socioeconomic inequalities in students' mental health, which, in part, can be ascribed to a larger exposure to the economic stressors related to COVID-19 among students' with a low SES. The macroeconomic context also played a role, as the impact of a reduction in working hours on depressive symptoms was stronger in countries with poor economic conditions.

Young adults from disadvantaged groups experience more stress and deterioration in mental health associated with polycrisis

The recent polycrisis (COVID-19, Ukraine war, climate change, economic crisis) has been associated with mental health through cumulative stress, with young people being particularly vulnerable. We surveyed 403 college students from Poland to examine their psychological responses to the experienced crises. The results showed that polycrisis was associated with worse mental health of college students from disadvantaged groups (based on gender, sexual orientation, and financial situation) compared to other college students, in four areas: sense of proximity to the crises, stress caused by the crises, sense of responsibility for mitigating the crises, and experiencing everyday moral dilemmas regarding the crises. These young adults also suffered more in terms of negative affectivity, depressive symptoms, and subjective physical and mental health. Our findings suggest that when discussing public mental health perspectives, it is important to consider consequences of cumulative stress and its greater impact on young people from disadvantaged groups.

COVID-19 and health care-related financial toxicity in the United States: Evidence from the 2022 National Health Interview Survey

BACKGROUND

Despite the common perception of the socioeconomic burden of the COVID-19 pandemic, quantification of the relationship between COVID-19 and indicators of health care-related financial toxicity in the general population has been limited. This study aimed to provide estimates of these relationships in a nationally representative sample of the US adult population.

METHODS

Using the data on 27,480 adults from the 2022 National Health Interview Survey, we fitted multivariable logistic regression models to assess the differential risks of financial toxicity as manifested by the financial hardship in paying medical bills, delayed and forgone medical care, and medication nonadherence, by COVID-19 diagnosis, severity, and duration of symptoms.

RESULTS

We found that compared to individuals not having COVID-19, individuals with severe symptoms of COVID-19 were 1.86, 1.50, 1.76, and 1.77 times more likely to experience financial hardship, delay medical care, forgo medical care, and skip/delay/take less medication, respectively. Similarly, individuals with symptoms lasting for 3 or more months were 1.94, 1.65, 1.87, and 2.20 times more likely to experience these measures of financial toxicity, respectively.

CONCLUSIONS

The estimates of the relationship between COVID-19 and financial toxicity will facilitate effective communications for policy actions aimed at alleviating the burden of the COVID-19 pandemic.

Health-related exit from employment before and during the COVID-19 pandemic in Norway: Analysis of population-wide register data 2013-2021

People with health problems experience various labor market disadvantages, such as hiring discrimination and heightened risk of firing, but the impact of deteriorating economic conditions on health-related labor market mobility remains poorly understood. The strength of the downturn/crisis will most likely make a difference. During minor downturns, when few employees are made redundant, health-related exit may occur frequently since employers prefer to keep those with good health on the payroll. However, during major economic crises, when large-scale downsizing and firm closures abound, there will be less discretionary room for employers. Thus, some mechanisms that usually are damaging for people with health problems (e.g., seniority rules and negative connotations), can be neutralized, ultimately leading to smaller health differentials in labor market outcomes. The current study used population-wide administrative register data, covering the years 2013-2021, to examine health-related exit from employment (to unemployment/social assistance) before and during the COVID-19 pandemic in Norway. The pandemic spurred a major crisis on the Norwegian labor market and led to a record-high unemployment rate of 10.6 percent in March 2020. Restricting the analytical samples to labor market insiders, linear probability models showed that previous recipients of health-related benefits had a higher unemployment likelihood in the pre-crisis year 2019. The relative importance of poor health changed non-negligibly, however, during the COVID-19 pandemic. When identical statistical analyses were run on the crisis year 2020, health-related exit from employment was dampened. Yet, this labor market equalization was not followed by smaller health differentials in work income in 2021, mainly because people with good health retained or regained decent-paying jobs when the economic conditions improved again. In conclusion, major economic crises can lead to an equalization of labor market disadvantages for people with health problems, but health-related inequalities may reemerge when the economy recovers.

Social causation, social selection, and economic selection in the health outcomes of Chinese older adults and their gender disparities

Background

The economic selection hypothesis, which argues that the initial economic situation determines both subsequent health and economic conditions, has been drawn into the debate on causation-selection issues. This study aims to construct a path model with self-rated health and depression score of older adults as health outcomes to measure and compare the social causation forces of wealth accumulation, social selection forces of adulthood health, and economic selection forces of childhood economics, and to examine their gender disparities.

Methods

Data was obtained from a sample of 19613 older adults aged 45 years or above from the 2014 life history survey and the 2015 routine follow-up survey of the China Health and Retirement Longitudinal Study. Structural equation modeling analysis was conducted employing the full information maximum likelihood estimation method.

Results

The presence of social causation, social selection, and economic selection were all statistically supported. In self-rated health, social selection forces held the dominant position, while social causation forces were comparable to economic selection forces. In depression score, social selection still exhibited stronger forces than economic selection, but social causation had forces close to social selection and greater than economic selection. The forces of the three hypotheses in self-rated health did not significantly change with gender, but social causation exerted mightier forces than economic selection within the male group, unlike the female group. The forces of economic selection in depression score were greater in females than males and no significant differences were observed among the forces of the three hypotheses in the female group.

Conclusions

Social causation, social selection, and economic selection operate simultaneously on the self-rated health and depression score of older adults. However, the force magnitudes of the three hypotheses and/or their rankings differ by health outcomes and gender.

Do early life traumas moderate the impact of cumulative pandemic stress on anger?

Do early life traumas condition the psychological consequences of pandemic stressors? Using national data from the Crime, Health, and Politics Survey (May-June 2021), we examine whether early life traumas buffer or amplify the impact of cumulative pandemic stressors (CPS) on anger, an understudied measure of emotional distress. We examine two competing perspectives. The trauma amplification perspective posits that people who experience early life traumas are especially vulnerable to subsequent stressors, while the trauma resiliency perspective suggests the opposite, that people who experience traumas in early life are less vulnerable to subsequent stressors. The trauma resiliency perspective was partially supported by our analyses. Although early life traumas abated the impact of three or more pandemic stressors on anger, we failed to observe any attenuation at lower levels of pandemic stress exposure. We extend previous research by recasting the common stress proliferation model as a stress modification model and by focusing on feelings of anger. Findings are discussed in the context of social stress, mental health, and the COVID-19 pandemic.

The Early 2020 COVID-19 Outbreak in China and Subsequent Flourishing: Medium-Term Effects and Intervening Mechanisms

In early 2020, a COVID-19 outbreak occurred in Hubei Province of China. Exploiting the geographic concentration of China's COVID-19 cases in Hubei (the initial epicenter), we compare Hubei and non-Hubei residents to examine the medium-term effect of exposure to the COVID-19 outbreak on mental well-being. We examine flourishing-a comprehensive assessment of well-being that is not merely the absence of mental illness-and investigate a broad set of psychosocial and economic mediators that may link initial outbreak exposure to subsequent flourishing. We use ordinary least squares regression models to analyze national panel data collected in early 2020 and late 2021 (N = 3,169). Results show that flourishing scores remain lower for Hubei than non-Hubei residents almost two years following the early 2020 COVID-19 outbreak. Mediation analysis reveals that Hubei residents' lower incidences of job promotion and lower sense of control are the two most important mediators accounting for their lower flourishing relative to non-Hubei residents. Combined, this study provides the first evidence of the medium-term psychological vulnerability borne by individuals who lived in the initial epicenter of the COVID-19 pandemic. Findings on the intervening mechanisms shed light on the policy initiatives needed for post-pandemic mental well-being recovery in China and other countries.

Understanding trends in loneliness during the COVID-19 pandemic in The Netherlands: the moderating role of gender, age, and living arrangement

Objectives: Evidence suggests that the COVID-19 pandemic and the preventive lockdown measures increased loneliness levels. However, most studies are cross-sectional or rely on a pre-post (pandemic) design. This study relies on multiple observations to analyze the impact of the lockdown on loneliness levels in the Netherlands, and test whether it differed by gender, age, and living arrangement.Methods: Longitudinal data from the Covid-Questionnaire within the Lifelines Cohort Study from the northern Netherlands was used. Data was gathered between March 2020 and July 2021 with a total of 21 waves and 769,526 observations nested in 74,844 individuals. The outcome was a multi-dimensional Loneliness Index. The association between the lockdown period and loneliness levels was estimated using fixed-effects linear regression. Moderation effects were tested by means of two-way interactions.Results: Loneliness levels increased during stricter lockdown periods, and decreased when preventive measures were relaxed. Women and young adults experienced stronger fluctuations in their loneliness levels, whereas living arrangement did not play a notable moderating role.Conclusion: This study calls for special attention to be paid to the public issue of loneliness during periods of lockdown. Women and young adults appear as particularly vulnerable groups during the Covid-19 pandemic.

Examining standardized consumer-generated social determinants of health and resilience data supported by Omaha System terminology

Nursing terminologies like the Omaha System are foundational in realizing the vision of formal representation of social determinants of health (SDOH) data and whole-person health across biological, behavioral, social, and environmental domains. This study objective was to examine standardized consumer-generated SDOH data and resilience (strengths) using the MyStrengths+MyHealth (MSMH) app built using Omaha System. Overall, 19 SDOH concepts were analyzed including 19 Strengths, 175 Challenges, and 76 Needs with additional analysis around Income Challenges. Data from 919 participants presented an average of 11(SD = 6.1) Strengths, 21(SD = 15.8) Challenges, and 15(SD = 14.9) Needs. Participants with at least one Income Challenge (n = 573) had significantly (P < .001) less Strengths [9.4(6.4)], more Challenges [27.4(15.5)], and more Needs [15.1(14.9)] compared to without an Income Challenge (n = 337) Strengths [13.4(4.5)], Challenges [10.5(8.9)], and Needs [5.1(10.0)]. This standards-based approach to examining consumer-generated SDOH and resilience data presents a great opportunity in understanding 360-degree whole-person health as a step towards addressing health inequities.

Inflation hardship, gender, and mental health

Inflation hit a 40 year high in the United States in 2022, yet the impact of inflation related hardships on distress is poorly understood, particularly the impact on women, whose income is already more limited. Using data from the US Household Pulse Survey (September-November 2022), we test whether exposure to inflation hardships is associated with greater distress and whether this association is moderated by gender (n = 119,531). We draw on a list of eighteen inflation related hardships (e.g., purchasing less food, working additional jobs, delaying medical treatment) to construct an ordinal measure of exposure to inflation hardship ranging from "no inflation hardship" to "five or more inflation hardships." We observe that an increasing number of inflation hardships is associated with higher levels of distress. We find no evidence of gender differences in the magnitude of that association at lower levels of inflation hardship (four inflation hardships or less). However, our findings suggest that exposure to five or more inflation hardships is more strongly associated with distress among men compared to women. The current study provides new insights into the cumulative burden of inflation hardships on mental health and the role that gender plays in this association.

Anticipatory stress, state policy contexts, and mental health during the COVID-19 pandemic

Substantial economic disruptions during the COVID-19 pandemic upended daily life and contributed to a widespread symptom of psychological distress during this period. Disruptions also led to more concerns about future stressful events related to financial hardship, or economic-related anticipatory stress, with the potential to undermine mental health. Although prior research provides ample evidence that state policies can impact mental and physical health, it has not considered how state policy contexts reduce adverse psychological outcomes stemming from economic-related anticipatory stress. The present study uses national survey data from the Census Bureau's Household Pulse Survey (April 2020-October 2020) to examine the extent to which state policy contexts moderate the association between economic-related anticipatory stress and depression/anxiety. We find that states with stronger social safety nets weakened the impact of anticipatory stress on depression/anxiety. This finding held for different types of anticipated economic hardships (i.e., reduced income, difficulty paying rent, difficulty affording food), as well as for policies that existed prior to COVID-19 and policies enacted in response to COVID-19. Findings provide strong evidence that state policies may buffer against poor mental outcomes for people who even anticipate facing economic uncertainty during the COVID-19 pandemic. We provide insight into how state policy contexts can shape individual experiences in ways that impact the mental health outcomes of the United States population.

Cumulative Pandemic Stressors, Psychosocial Resources, and Psychological Distress: Toward a More Comprehensive Test of a Pandemic Stress Process

Although the mental health consequences of individual COVID-19 stressors (e.g., bereavement, job loss, or financial strain) have been well-documented, little is known about the cumulative toll of multiple pandemic stressors. Using national data from the Crime, Health, and Politics Survey (May–June 2021), we test whether the accumulation of pandemic stressors is associated with greater psychological distress. We also consider whether this association is moderated by psychosocial resources (i.e., mastery, self-esteem, and social support). Our findings suggest that individuals who report three or more pandemic stressors tend to exhibit greater psychological distress than those who report fewer pandemic stressors or no pandemic stressors. While mastery offsets the impact of pandemic stressors at higher levels of stress exposure (i.e., two or more COVID-19 stressors), social support and self-esteem played a stress-buffering role to a point, but became ineffective at the highest levels of pandemic stress. The current study provides new insights into the pandemic stress process by conceptualizing and operationalizing the cumulative impact of COVID-19 stressors. We also confirm the continued significance of traditional coping resources in the context of novel pandemic stressors.

The interrelations between psychological outcome trajectories and resource changes amid large-scale disasters: A growth mixture modeling analysis

Currently little is known about the interrelations between changes in psychiatric symptoms and changes in resources (personal, social, financial) amid large-scale disasters. This study investigated trajectories of psychiatric symptoms and their relationships with different patterns of changes in personal, social, and financial resources between 2020 and 2022 amid the COVID-19 pandemic. A population-representative sample (N = 1333) was recruited to complete self-report instruments at the pandemic's acute phase (February-July 2020, T1), and again at 1-year (March-August 2021, T2) and 1.5-year (September 2021-February 2022, T3) follow-ups. Respondents reported depressive and anxiety symptoms, self-efficacy, perceived social support, and financial capacity. Growth mixture modeling (GMM) identified four trajectories of depressive and anxiety symptoms: resilience (72.39-74.19%), recovery (8.40-11.93%), delayed distress (7.20-7.35%), and chronic distress (8.33-10.20%). Four patterns were demonstrated in resource changes: persistent high resources (40.89-47.64%), resource gain (12.08-15.60%), resource loss (6.30-10.43%), and persistent low resources (28.73-36.61%). Loss and gain in financial resources characterized chronic distress and resilience, respectively. Loss in personal resources characterized delayed distress, whereas loss or no gain in social resources was related to chronic/delayed distress. Respondents in resilience were also more likely to have persistent high resources while those with delayed/chronic distress were more likely to have persistent low resources. These results provide an initial evidence base for advancing current understanding on trajectories of resilience and psychopathology in the context of resource changes during and after large-scale disasters.

Adult life-course trajectories of psychological distress and economic outcomes in midlife during the COVID-19 pandemic: evidence from the 1958 and 1970 British birth cohorts

PURPOSE

Financial adversity in times of economic recession have been shown to have an unequal effect on individuals with prior mental health problems. This study investigated the relationship between mental health groupings across the adult life-course and change in financial situation and employment status during the COVID-19 pandemic, as well as the use of financial measures to mitigate the economic shock.

METHODS

Using two nationally representative British birth cohorts, the National Child Development Study (1958) n = 17,415 and 1970 British Cohort Study n = 17,198, we identified 5 different life-course trajectories of psychological distress from adolescence to midlife which were similar but not identical across the two cohorts. We explored their relation to changes in financial and employment circumstances at different stages during the pandemic from May 2020 to March 2021, applying multinomial logistic regression and controlling for numerous early life covariates, including family socio-economic status (SES). In addition, we ran modified Poisson models with robust standard errors to identify whether different mental health trajectories were supported by government and used other methods to mitigate their financial situation.

RESULTS

We found that the financial circumstances of pre-pandemic trajectories of psychological distress with differential onset, severity, and chronicity across the life-course were exacerbated by the COVID-19 economic shock. The 'stable-high' (persistent severe symptoms) and 'adult-onset' (symptoms developing in 30s, but later decreasing) groups were vulnerable to job loss. Compared to pre-pandemic trajectory groupings with no, minor, or psychological distress symptoms in early adulthood, the 'stable-high', 'midlife-onset' (symptoms developing in midlife), and 'adult-onset' trajectory groups were more likely to seek support from the UK governments economic response package. However, trajectories with pre-pandemic psychological distress were also at greater risk of reducing consumption, dis-saving, relying on increased financial help from family and friends, and also taking payment holidays (agreements with lenders to pause mortgage, credit card or loan payments for a set period) and borrowing.

CONCLUSION

This work highlights different trajectories of pre-pandemic psychological distress, compared to groups with no symptoms were more vulnerable to pandemic-related economic shock and job loss. By adopting unsustainable mitigating measures (borrowing and payment holidays) to support their financial circumstances during COVID-19, these mental health trajectories are at even more risk of lasting adverse impacts and future economic difficulties.

Changes in Religiosity and Reliance on God During the COVID-19 Pandemic: A Protective Role Under Conditions of Financial Strain?

BACKGROUND

The COVID-19 pandemic was one of the most devastating disasters of the twenty-first century and has exacted a steep health and economic toll. During times of suffering caused by the pandemic, religion/spirituality may prove to be a consistent and valuable coping resource.

PURPOSE

We situate changes in religious importance and reliance on God as key aspects of religious life that may be important coping mechanisms in response to pandemic-related financial hardship, addressing a gap in the literature on religious coping during the pandemic and considering self-reported changes in religiosity.

METHODS

We use data from a nationally representative sample of Americans that was collected in 2021 (N = 1704) and employ a series of OLS Regression Models.

RESULTS

Our results suggest that relying more heavily on God was associated with lower psychological distress, and a stronger reliance on God buffered the deleterious consequences of financial strain on psychological distress. No such patterns were documented for religious importance.

CONCLUSION AND IMPLICATIONS

We discuss our findings within the broader religion and health literature as to whether secondary control via a divine power reduces or enhances individual agency and discuss religion/spirituality may be a consistent and valuable coping resource through adversity and suffering. Though it may be challenging to maintain, or increase, religious/spiritual beliefs in the face of adversity, that there were observed benefits to well-being for doing so could serve as insightful guidance for both religious leaders and R/S individuals.

Mating in Captivity: The Influence of Social Location on Sexual Satisfaction through Phases of the COVID-19 Pandemic

The recent global pandemic provides a natural experiment "intervention" to examine how differing baseline social dynamics such as gender, education, and politics shaped diverging patterns of well-being during rapidly shifting societal conditions. Using married adults from a nationally representative panel study in the United States from August 2019 to August 2021, discontinuous growth curves reveal a large drop in average married sexual satisfaction in both quality and frequency directly following the pandemic onset. Moreover, sexual satisfaction remained largely suppressed for the subsequent 18 months, apart from a brief "optimism blip" in the fall of 2020. Race, age, income, employment, parenthood, education, and political affiliation all appear as meaningful predictors, but these differ across various phases of the pandemic and by gender. These results reveal evidence of lingering changes in subjective sexual well-being as well as patterns of catastrophe risk and resilience moderated by social location factors.

Flourishing despite Chronic Obstructive Pulmonary Disease (COPD): Findings from a Nationally Representative Survey of Canadians Aged 50 and Older

Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of mortality and is often associated with serious disability and depression. Little is known about the characteristics of those who are in complete mental health (CMH) despite having COPD. This study’s objectives are to: (1) estimate the prevalence and odds of absence of psychiatric disorders (APD) and CMH among older adults that reported having COPD, compared to their peers that did not; (2) identify factors associated with APD and with CMH. Bivariate and logistic regression analyses were conducted using the nationally representative Canadian Community Health Survey—Mental Health. The results indicate that there was a significantly (p < 0.001) lower prevalence of APD (86.7% vs. 95.0%) and CMH (66.7% vs. 77.0%) among older adults aged 50+ with COPD (n = 703) compared to those without COPD (n = 10,189). Half of the sample was female (50.5%) and the majority of whom were under age 70 (62.5%). Factors significantly (p < 0.05) associated with higher odds of APD and of CMH among older adults with COPD include being married, having a confidant, being physically active, and having no lifetime history of major depressive disorder or generalized anxiety disorder. For every additional adverse childhood experience, the odds of APD declined by 31%. The majority of those with COPD are mentally flourishing despite having this disabling and life-threatening disorder. These findings underline the importance of targeted interventions and outreach to those most vulnerable to poorer mental health outcomes including the socially isolated.

Socioeconomic stratification and trajectories of social trust during COVID-19

Extant theory suggests that crises such as the COVID-19 pandemic may change people's trust in others. A crisis-to-solidarity model suggests that people become more trusting, while a crisis-to-negative experience theory suggests that people lose trust, and a stability perspective predicts that social trust will largely remain unchanged. We argue that, when a crisis occurs, trust is likely to fall into distinct trajectories of change that will conform to these different perspectives, and placement into contrasting trajectories of change will be predicated on socioeconomic position. To test our argument, we use data from multiple waves of Canadian national surveys conducted from September 2019 to February 2021 and examine how two major forms of social trust-generalized trust and neighborhood trust-changed during the COVID-19 pandemic. A longitudinal latent class analysis (LLCA) shows increasing, decreasing, and stable trajectories of trust, which conform to each of the proposed patterns. We further show that individuals' baseline socioeconomic position is a strong indicator of the placement in these trajectories. Both forms of trust increased among individuals with higher socioeconomic positions while decreased among individuals with lower socioeconomic positions. This research contributes to the literature on the social context of trust by reconciling contrasting views of the consequences of crises for trust, and also in showing that the segmentation of changes in trust are proscribed by structures of social stratification.

Surviving in Crisis Mode: The Effect of Material Hardship and Social Support on Emotional Wellbeing Among People in Poverty During COVID-19

The COVID-19 pandemic triggered a sudden economic crisis that led to increases in hardship and poverty. Motivated by the concern that people living in long-term poverty have few reserves to draw upon in times of crisis and may experience severe consequences, this study focuses on the association between material hardship and emotional wellbeing among people in poverty. The data were collected in two waves of telephone surveys during the pandemic (n = 88). Participants for the study were recruited through social service departments in six cities in Northern Israel. The findings show that COVID-19 increased material hardship, and that material hardship has detrimental effects on the four measures of emotional wellbeing selected (stress, anxiety, depression, and physical symptoms). Informal social support has positive effects on emotional wellbeing but it does not counter the negative effects of material hardship. Policy implications are discussed.

Low assets predict persistent depression through living difficulties amid large-scale disasters: A cohort study

BACKGROUND

In face of large-scale disasters, persons with fewer assets are at greater risk of persistent poorer mental health than persons with more assets. Everyday daily routine disruptions and financial hardship could mediate this association.

METHODS

This prospective population-representative study in Hong Kong aimed to investigate the relation between assets during the acute phase of COVID-19 (February-August 2020, T1) and persistent probable depression from T1 to March-August 2021 (T2), as well as the mediating effects of daily routine disruptions and financial hardship on the assets-depression association.

RESULTS

Low assets at T1 prospectively related to persistent probable depression from T1 to T2. Primary routine disruptions (i.e., healthy eating and sleep) at T1 and financial hardship at T2 were found to fully mediate the association between T1 assets and persistent probable depression.

LIMITATIONS

Persistent probable depression reported on the PHQ-9 should be further verified with clinical diagnoses/interviews.

CONCLUSIONS

The COVID-19 pandemic was accompanied by a global economic downturn. Persons who have fewer assets could be at greater risk of depression during this period. Our findings suggest a need to provide behavioral and financial assistance to persons with fewer assets in the short run and a need to ensure that everyone has adequate assets to mitigate the mental health consequences of the COVID-19 pandemic in the long run.

Association between fear of COVID-19 and hoarding behavior during the outbreak of the COVID-19 pandemic: The mediating role of mental health status

Hoarding behavior can effectively improve people's ability to resist risks, so as to reduce the negative effects of risks. However, excessive hoarding behavior will seriously reduce people's quality of life. The COVID-19 pandemic can cause excessive hoarding in a large number of people in a short period of time, and also cause a series of economic problems such as social material shortage. It is unclear how hoarding levels are linked to fear and negative emotions caused by COVID-19 among people of different educational backgrounds and social status. The purpose of this study was to explore the relationship between fear of COVID-19 and hoarding behavior in different populations in school and social contexts, as well as the mediating role of negative emotions and the moderating role of subjective/objective social status and education level in this process. An online cross-sectional survey was conducted in various provinces in China in January 2022. Demographic information, the MacArthur Scale of Subjective Social Status, the Fear of COVID-19 scale, the Depression Anxiety Stress-21, and the Saving Inventory-Revised were used to evaluate the severity of individual hoarding symptoms, the frequency of hoarding, the degree of fear, and the negative emotions (depression, anxiety, stress) caused by COVID-19. Research data showed that fear of COVID-19 was significantly correlated with hoarding behavior (p &lt; 0.05). Fear of COVID-19 was significantly lower in the student sample than in the nonstudent sample (p &lt; 0.05). Negative emotions played a mediating role in the relationship between fear of COVID-19 and hoarding behavior (p &lt; 0.05). Educational and economic levels moderated this process, but social status did not. Compared with the student sample, educational background and income had less of a moderating effect on the depression, anxiety, and stress caused by fear of COVID-19 in the nonstudent sample. However, these factors had a more regulative effect on the clutter and excessive acquisition behavior caused by depression, anxiety, and stress, although not on difficulty discarding. These findings suggest that reduce negative emotions in the population, improve cognitive levels, and provide financial support from governments may be effective ways to reduce hoarding symptoms.

The Contributions of Social Stressors and Coping Resources to Psychological Distress Among Those Who Experienced Furlough or Job Loss Due to COVID-19

The COVID-19 pandemic precipitated a global economic recession resulting in widespread unemployment and worker furloughs. Using national survey data (n = 2,000), this study examines whether and how employment-based discrepancies in financial strains, anticipatory stressors, and personal coping resources contribute to elevated psychological distress among those who experienced involuntary job displacement due to COVID-19. Disaggregating displaced workers into those who were furloughed and those who lost their job due to the pandemic, I find that both groups report more depressive symptoms and anger than the stably employed and respondents whose unemployment is not COVID-related. Greater financial strains and smaller reserves of coping resources contribute in varying degrees to heightened levels of distress found among displaced workers, however, anticipatory stress about economic security is the predominant factor driving disparities in psychological distress. These findings, and the central role of anticipatory stressors in shaping employment-based differences in mental health during the pandemic, are discussed.

Enhancing empowerment in young adults during the COVID-19 era in Italy through the Photovoice technique

The spread of COVID-19 has led to increasingly stringent containment measures. After the first period of lockdown, there has been an easing of measures worldwide. However, this choice has helped bring about a second wave to be faced by many states. The present research was conducting during the period in which it was necessary for the population to find strategies for living with COVID-19. The proposed action research envisaged the use of Photovoice and, due to social distancing, was carried out online. A total of 250 young adults were involved with the aim of bringing out individual and community solutions for effective coexistence with COVID-19. The data, collected through a triangulation process, were analysed on the basis of grounded theory and the support of NVivo 12. The results highlight how online Photovoice is an effective tool for implementing individual and community empowerment and for identifying solutions to live with COVID-19.

At Which Area Level Does COVID-19 Infection Matter Most for an Individual’s Self-Rated Health? A Multilevel Fixed-Effects Model Analysis in Japan

Several studies have reported the adverse impacts of the COVID-19 pandemic on health outcomes. However, little is known about which area of COVID-19 infection matters most for an individual’s subjective health outcomes. We addressed this issue in the present study. We used the longitudinal data of 2260 individuals obtained from a two-wave internet-based nationwide survey conducted in Japan. We estimated the multilevel regression models, which controlled for fixed effects at the individual and prefecture levels, to explain an individual’s self-rated health (SRH) based on the reported number of new COVID-19 infection cases at different area levels: prefecture, group of neighboring prefectures, and regional bloc. We found that SRH was highly associated with the average and maximum number of new infection cases among neighboring prefectures or in the regional bloc, but not with those at the prefecture level, if used jointly as explanatory variables. The results suggest that inter-prefectural coordination is needed not only to contain COVID-19 but also to reduce its adverse impact on the subjective health outcomes of residents.

Self-rated health when population health is challenged by the COVID-19 pandemic; a longitudinal study

RATIONALE

The coronavirus disease 2019 (COVID-19) pandemic and consequent lockdown measures have had a large impact on people's lives. Recent evidence suggests that self-rated health (SRH) scores remained relatively stable or increased during the pandemic.

OBJECTIVE

For the current project, we examine potential changes in the variance decomposition of SRH before and during the COVID-19 pandemic in the Netherlands.

METHODS

We analyse data from the Netherlands Twin Register to examine pre-pandemic SRH scores (N = 16,127), pandemic SRH scores (N = 17,451), and SRH difference scores (N = 7464). Additionally, we perform bivariate genetic analyses to estimate genetic and environmental variance components in pre-pandemic and pandemic SRH, and estimate the genetic correlation to assess potential gene-environment interaction.

RESULTS

The majority of the sample (66.7%) reported the same SRH before and during the pandemic, while 10.8% reported a decrease, and 22.5% an increase. Individuals who reported good/excellent SRH before the pandemic were most likely to report unchanged SRH during the pandemic, and individuals with bad/mediocre/reasonable SRH more often reported increased SRH. The bivariate longitudinal genetic model reveals no significant change in variance decomposition of SRH from before to during the pandemic, with a heritability estimate of 45% (CI 36%-52%). We found that the genetic correlation could be constrained to 1, and a moderate unique environmental correlation (r_E = 0.49, CI = 0.37 to 0.60).

CONCLUSIONS

We theorize that the increases in SRH are explained by uninfected individuals evaluating their health more positively than under normal circumstances (partly through social comparison with infected individuals), rather than actual improvements. As the same genes are expressed under different environmental exposures, these results imply no evidence for gene-environment interaction. While different environmental factors might influence SRH at the two time-points, the influence of environmental factors does not become relatively more important during the pandemic.

The impact of the COVID lockdown on alcohol consumption in the Netherlands. The role of living arrangements and social isolation

BACKGROUND

The COVID-19 pandemic and the subsequent lockdown have a strong impact on health and health behaviours, such as alcohol consumption. Although there is some evidence of an overall decline in alcohol consumption during the lockdown, studies also show an increase in risky drinking patterns, e.g. solitary drinking, and differences between subgroups of individuals, e.g. depending on their living arrangement. Yet most studies rely on cross-sectional designs with retrospective questions, and small samples.

METHODS

A longitudinal study was conducted using 13 waves of the COVID-Questionnaire within the Lifelines cohort from the northern Netherlands (n = 63,194). The outcome was alcohol consumption (glasses per week) between April 2020 and July 2021. Linear fixed-effects models were fitted to analyse trends in alcohol consumption, and these were compared with pre-COVID drinking levels. Moreover, the role of living arrangement and feelings of social isolation as potential moderators was tested.

RESULTS

Alcohol consumption during the pandemic was lower than in previous years, and the seasonal pattern differed from the pre-COVID one, with levels being lower when lockdown measures were stricter. Moreover, the seasonal pattern differed by living arrangement: those living alone saw a relative increase in drinking throughout tight lockdown periods, whereas those living with children showed the strongest increase during the summer. Social isolation showed a weaker moderation effect.

CONCLUSIONS

Overall alcohol levels were down in the pandemic, and in particular during strict lockdowns. Those living on their own and those who felt more isolated reacted more strongly to the lockdown, the longer it lasted.

A protective rung on the ladder? How past and current social status shaped changes in health during COVID-19

An emerging body of work has started to document population health consequences of the social and economic transformations during the COVID-19 pandemic. We consider an individual’s relative social position in the stratification system—subjective social status (SSS)—and assess how past (childhood) and current SSS predict change in self-rated health during the pandemic. Using two waves of data from the Canadian Quality of Work and Economic Life Study, we follow respondents between the onset of lockdown measures in March and May of 2020 (N = 1886). Drawing from the life course perspective and stress process model, we find that lower current SSS predicts a greater likelihood of being in stable poor health and reporting declining health. Lower past SSS predicts a higher chance of being in stable poor health indirectly through current SSS. And lower cumulative SSS that sums both past and present SSS also predicts stable poor health, while perceived upward mobility over time is associated with stable good health. This robust relationship between SSS and health in such a short time period of two months at the start of the COVID-19 pandemic provides an important glimpse into the influence that SSS has on population health.

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Using two waves of data from the Canadian Quality of Work and Economic Life Study, we follow respondents between the onset of lockdown measures in March and May of 2020 (N = 1886). Drawing from the life course perspective and stress process model, we find that lower current SSS predicts a greater likelihood of being in stable poor health and reporting declining health.

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Lower past SSS predicts a higher chance of being in stable poor health indirectly through current SSS. And lower cumulative SSS that sums both past and present SSS also predicts stable poor health, while perceived upward mobility over time is associated with stable good health.

COVID-19 bereavement, depressive symptoms, and binge drinking

The COVID-19 pandemic has caused the death of over half a million Americans, leaving in its wake widespread grief and despair. Using national survey data (n ​= ​1998) and a treatment-weighting strategy, this study examines how COVID-19 bereavement associates with depressive symptoms and binge drinking. After adjustment for non-random exposure to COVID-19 bereavement, I find that respondents who have lost someone close to them to the virus report greater depressive symptomology and more frequent binge drinking. Among essential workers, the loss of a close tie to COVID-19 exacerbates these associations, with bereavement posing stronger effects for depressive symptoms and binge drinking for members of this group. The implications of these findings for the long-term mental health of the bereaved and those most vulnerable to the virus are discussed.

COVID-19, Economic Impact, Mental Health, and Coping Behaviors: A Conceptual Framework and Future Research Directions

The COVID-19 pandemic has caused serious economic and social consequences. Recent research shows that the pandemic has not only caused a physical health crisis but also caused many psychological and mental crises. Based on the contemporary cognitive-behavioral models, this article offers a conceptual analysis of how the pandemic affects individual mental health and coping behaviors from the perspective of individual economic status, individual context, and social context. The analysis shows that (1) the pandemic has led to increased economic uncertainty, increased unemployment and underemployment pressure, increased income uncertainty, and different degrees of employment pressure and economic difficulties; (2) these difficulties have stimulated different levels of mental health problems, ranging from perceived insecurity (environmental, food safety, etc.), worry, fear, to stress, anxiety, depression, etc., and the mental health deterioration varies across different groups, with the symptoms of psychological distress are more obvious among disadvantageous groups; and (3) mental health problems have caused behavior changes, and various stress behaviors such as protective behaviors and resistive behaviors. Future research directions are suggested.

Long-Term Impact of Economic Downturn and Loneliness on Psychological Distress: Triple Crises of COVID-19 Pandemic

Background: The COVID-19 crisis poses global mental health and global economy challenges. However, there is a lack of longitudinal research investigating whether financial instability and social disruption may increase the risk of developing mental health problems over time that may potentially outlast the pandemic. Methods: We conducted an online survey for members of the general population (n = 2703) in Germany during the twelve months spanning from April 2020 to March 2021. We investigated the development of COVID-19 related psychological distress, the number of unemployed people, federal government debt, income distribution, and loneliness over the time period. Results: Over a period of twelve months, 53.6% of respondents in Germany reported experiencing psychological distress, varying from mild levels, 34.2%, to severe levels, 19.4%, of distress. High federal government debt, high incident COVID-19 cases, low incomes, and the prevalence of loneliness were found to be associated with increased long-term mental health problems. Psychological distress scores were most strongly increased in female and young respondents as well as those who reported fewer years of education, low income, and higher loneliness. Conclusions: Our study highlights factors that have a long-term impact on mental health amid the COVID-19 pandemic. We suggest that specific mental-health services could be offered to support high-risk groups experiencing financial fragility and loneliness. For purposes of safeguarding their mental health there is a need to monitor and track such risk factors in real time.

Are Spaniards Happier When the Bars Are Open? Using Life Satisfaction to Evaluate COVID-19 Non-Pharmaceutical Interventions (NPIs)

The COVID-19 pandemic has challenged governments worldwide with the design of appropriate policies that maximize health outcomes while minimizing economic and mental health consequences. This paper explores sources of individuals' life satisfaction during the COVID-19 pandemic, paying special attention to the effects of non-pharmaceutical interventions (NPIs). We studied the specific case of Spanish regions and focused on bar and restaurant closures using data from a continuous voluntary web survey that we merged with information about region-specific policies that identified when and where bars and restaurants were closed. We estimated an endogenous binary-treatment-regression model and found that closing bars and restaurants had a significant negative impact on happiness. The results were statistically significant after controlling for the pandemic context, health, income, work, and other personal characteristics and circumstances. We interpreted the results in terms of the positive effect of socialization, individuals' feelings of freedom, and the comparative nature of life satisfaction.

Mental Health and the City in the Post-COVID-19 Era

The article describes the risks for the mental health and wellbeing of urban-dwellers in relation to changes in the spatial structure of a city that could be caused by the COVID-19 pandemic. A year of lockdown has changed the way of life in the city and negated its principal function as a place of various meetings and social interactions. The danger of long-term isolation and being cut-off from an urban lifestyle is not only a challenge facing individuals, but it also creates threats on various collective levels. Hindered interpersonal relations, stress, and the fear of another person lower the quality of life and may contribute to the development of mental diseases. Out of fear against coronavirus, part of the society has sought safety by moving out of the densely populated city centres. The dangerous results of these phenomena are shown by research based on the newest literature regarding the influence of COVID-19 and the lockdown on mental health, urban planning, and the long-term spatial effects of the pandemic such as the urban sprawl. The breakdown of the spatial structure, the loosening of the urban tissue, and urban sprawl are going to increase anthropopressure, inhibit access to mental health treatment, and will even further contribute to the isolation of part of the society. In addition, research has shown that urban structure loosening as a kind of distancing is not an effective method in the fight against the SARS-COV pandemic. Creating dense and effective cities through the appropriate management of development during and after the pandemic may be a key element that will facilitate the prevention of mental health deterioration and wellbeing. It is also the only possibility to achieve the selected Sustainable Development Goals, which as of today are under threat.

COVID-Related Concerns, the Need for Help, and Perceived Microaggression among Young Ultra-Orthodox Jewish Respondents in Israel

Minority groups are especially vulnerable to the negative psychological and economic consequences of the COVID-19 pandemic. This study focused on one prominent minority group in Israel: ultra-Orthodox Jews. It examined the rate of exposure to COVID-19, adherence to COVID-19 mitigation guidelines, difficulties with adherence to COVID-19 guidelines, COVID-related concerns, financial hardships, the need for help, and microaggression during the first wave of the pandemic (April–May 2020). It then examined multivariate prediction of COVID-related concerns, the need for help, and microaggression. The sample comprised 252 respondents, with 67% female and a mean age of 32.85 (SD = 10.63). Results showed that 78.8% of the participants knew at least one person who had tested positive for COVID-19, and 31.4% knew at least one person who had passed away from COVID-19. Only 59.7% of the participants reported high adherence to social distancing guidelines. Perceived microaggression was predicted by the difficulties with adherence to COVID-19 guidelines, the level of stress associated with exposure to the media, and financial hardships. The study’s implications point to the centrality of perceived microaggression and the necessity of adopting culturally sensitive approaches to engage minorities in public efforts to fight the spread of viruses.