Disparate Disruptions: Intersectional COVID-19 Employment Effects by Age, Gender, Education, and Race/Ethnicity

Beyond the pandemic: the relationship between macroeconomic conditions and healthcare worker shortages in the United States

BACKGROUND

While the COVID-19 pandemic undoubtedly catalyzed healthcare workforce challenges, alone it does not explain ongoing workforce shortages. This study examines how broader economic trends and industry competition may influence worker movement in and out of healthcare. This analysis aims to (1) examine healthcare worker leaver rates over time, (2) quantify the strength of the relationship between national unemployment and healthcare worker leaver rates, and (3) describe variation in this relationship by worker characteristics.

METHODS

This observational, repeated cross-sectional study used nationally representative data from the 2003-2022 Annual Social and Economic Supplement of the Current Population Survey. Respondents are adult US civilian individuals employed in the healthcare industry. For each year, we defined healthcare leavers as individuals in healthcare-specific occupations who reported exiting the healthcare industry between the prior and current year, including workers who (1) changed industry, termed "industry leavers", (2) left the labor market, or (3) became unemployed. We compared healthcare leaver rates among healthcare workers to unemployment rates for all US workers with particular focus on industry leavers. Leaver rates were analyzed by worker sociodemographic and occupational characteristics.

RESULTS

Healthcare industry leaver rates had a moderate negative correlation with the US unemployment rate (r=-0.58, p = 0.007) and unemployment rates in several competing industries of professional services (r=-0.61, p = 0.005) and retail (r=-0.58, p = 0.008), but weaker insignificant negative correlations with hospitality (r=-0.29, p = 0.215) and educational services unemployment (r=-0.21, p = 0.375). Weak to moderate negative correlations were noted between the US unemployment rate and industry leaver rates of workers in high (r=-0.32, p = 0.169) and medium (r=-0.52, p = 0.020) education groups, while industry leaver rates in low education groups had a stronger negative correlation with the unemployment rate (r=-0.60, p = 0.005).

CONCLUSIONS

The easing of pandemic-era stresses on healthcare has not resolved healthcare workforce shortages. The findings of this study on historical employment trends suggest that when overall unemployment remains low, healthcare employers may struggle to recruit and retain workers due to competition from other sectors. Findings suggest that healthcare employers should take a long-range, cyclical view of worker shortages by tailoring their workforce strategies to current economic conditions while planning for the next cycle.

Risk of Job Loss During the COVID-19 Pandemic Predicts Anxiety in Women

Background and Objective: During the COVID-19 pandemic, women faced unique employment-related stressors, including higher exposure to unstable working conditions, increased workload changes due to motherhood, and greater risk of infection in certain jobs. This study explores how these factors influence women's anxiety and subjective well-being, aiming to identify vulnerable groups. Materials and Methods: 230 employed Slovene women, aged from 19 to 64 years (M = 32.60, SD = 10.41), participated in an online survey containing a State-Trait Anxiety Inventory (STAI-6), WHO-5 Well-being Index, and a set of questions regarding their occupation and demographic profile. Hierarchical linear regressions and chi-squared tests were performed. Results: The risk of job or income loss significantly predicted an increase in anxiety levels. However, despite fear of infection, none of the work-related variables predicted a significant decrease in subjective well-being. Women reporting risk of job or income loss are predominantly those with lower education and income, working students, self-employed, or working in the private sector. Conclusions: Employment insecurity is an important contributor to anxiety in women. The findings highlight the need to ensure job security, particularly for women working in precariat working conditions, as their work and economic stability prove to be vulnerable to external economic disturbances.

Racial and Ethnic Disparities in the Effects of COVID-19 on Employment Disruption and Financial Precarity

Previous research shows that minoritized (i.e. Black and Hispanic) older workers are more likely to work in jobs subject to employment disruptions and negative economic outcomes, including job and wage loss. Of the studies that have examined the pandemic-related employment and financial outcomes of minoritized older workers, few studies have accounted for the role that pre-COVID-19 financial precarity (i.e. ongoing financial strain) might play in post-COVID-19 financial precarity. Using data from the Health and Retirement Study, we evaluate the racial/ethnic differences in post-COVID-19 employment disruption and financial precarities among workers 51 years and older (N = 708 to 2,812 respondents depending on the outcome measure). Ordinary Least Squares regression and moderation analyses show that older Black and Hispanic workers were more likely to experience post-COVID-19 employment disruption and associated financial precarities (e.g. missed rent/mortgage payment). Furthermore, the consequences of preexisting financial precarity differed by race/ethnicity. Non-Hispanic white older workers without pre-COVID-19 financial precarity were uniquely protected from post-COVID-19 financial precarity, whereas Black and Hispanic older workers were more likely to experience post-COVID-19 financial precarity even in the absence of pre-COVID-19 precarity. Findings suggest that multi-level policies and interventions need to address structural inequity contributing to minoritized older workers' financial vulnerability during crises.

Assessing Unmet Social and Medical Needs among Latinx in Arizona throughout the COVID-19 Pandemic: Time-Varying Patterns by Social Determinants of Health

The pandemic exacerbated unmet social and medical needs, disproportionately impacting Latinx communities. This article examines how unmet needs varied from February 2021 to April 2023 among 428 Latinx individuals. Multiple-to-multiple path analysis models of cross-sectional surveys showed significant increases in unmet social (β = 0.17, p = .001) and medical (β = 0.12, p = .001) needs over time, with variations by age, language, and health insurance. Initially, older adults reported more unmet medical needs, but later, younger adults reported higher needs (β=-0.16, p = .001). Among Spanish speakers, both social (β = 0.24, p = .001) and medical (β = 0.20, p = .003) needs increased significantly. Uninsured individuals had significant increases in unmet social (β = 0.20, p = .001) and medical (β = 0.16, p = .013) needs, while those with public insurance experienced decreased social needs (β=-0.12, p = .017) compared to privately insured. These findings highlight growing disparities within the Latinx community, underscoring the need to prioritize vulnerable populations in public health responses and monitor program impacts for equitable access to essential services.

The faces of Long-COVID: interplay of symptom burden with socioeconomic, behavioral and healthcare factors

AIMS

The long-term effects of COVID-19 (Long COVID) include 19 symptoms ranging from mild to debilitating. We examined multidimensional correlates of Long COVID symptom burden.

METHODS

This study focused on participants who reported having had COVID in Spring 2023 (n = 656; 85% female, mean age = 55, 59% college). Participants were categorized into symptom-burden groups using Latent Profile Analysis of 19 Long-COVID symptoms. Measures included demographics; quality of life and well-being (QOL); and COVID-specific stressors. Bivariate and multivariate associations of symptom burden were examined.

RESULTS

A three-profile solution reflected low, medium, and high symptom burden, aligning with diagnosis confirmation and treatment by a healthcare provider. Higher symptom burden was associated with reporting more comorbidities; being unmarried, difficulty paying bills, being disabled from work, not having a college degree, younger age, higher body mass index, having had COVID multiple times, worse reported QOL, greater reported financial hardship and worry; maladaptive coping, and worse healthcare disruption, health/healthcare stress, racial-inequity stress, family-relationship problems, and social support. Multivariate modeling revealed that financial hardship, worry, risk-taking, comorbidities, health/healthcare stress, and younger age were risk factors for higher symptom burden, whereas social support and reducing substance use were protective factors.

CONCLUSIONS

Long-COVID symptom burden is associated with substantial, modifiable social and behavioral factors. Most notably, financial hardship was associated with more than three times the risk of high versus low Long-COVID symptom burden. These findings suggest the need for multi-pronged support in the absence of a cure, such as symptom palliation, telehealth, social services, and psychosocial support.

Review of the impacts of COVID-19 pandemic on the employment of college graduates in China and countermeasures to it

The employment of college graduates has always been the focus issue of the whole society. Affected by the COVID-19, college graduates are facing a severe employment situation. In the present study, we explore the impacts of the COVID-19 on the employment of college graduates. We explore the employment promotion measures introduced by Chinese government and colleges and universities through a quick review and illustrate the difficulties that college graduates face. Furthermore, the present study explores the impacts of the COVID-19 on five aspects of the employment of college graduates: recruitment demand reduce, employment competition rise, employment channels change, psychological anxiety increase and employment structural contradiction intensify. In addition, we conclude that the employment promotion measures introduced by Chinese government and colleges and universities in respond to the impacts of the COVID-19 on the employment of college graduates have significantly promoted the employment of college graduates to a large extent and we provide implications based on the application of the study. The findings of the present study are of great significance for all countries worldwide to better cope with various similar emergency events, to alleviate employment pressure and to promote better and fuller employment of college graduates.

Excess non-COVID-19-related mortality among inflammatory bowel disease decedents during the COVID-19 pandemic

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic disrupted healthcare in the United States.

AIM

To investigate COVID-19-related and non-COVID-19-related death and characteristics associated with excess death among inflammatory bowel disease (IBD) decedents.

METHODS

We performed a register-based study using data from the National Vital Statistics System, which reports death data from over 99% of the United States population, from January 1, 2006 through December 31, 2021. IBD-related deaths among adults 25 years and older were stratified by age, sex, race/ethnicity, place of death, and primary cause of death. Predicted and actual age-standardized mortality rates (ASMRs) per 100000 persons were compared.

RESULTS

49782 IBD-related deaths occurred during the study period. Non-COVID-19-related deaths increased by 13.14% in 2020 and 18.12% in 2021 [2020 ASMR: 1.55 actual vs 1.37 predicted, 95% confidence interval (CI): 1.26-1.49; 2021 ASMR: 1.63 actual vs 1.38 predicted, 95%CI: 1.26-1.49]. In 2020, non-COVID-19-related mortality increased by 17.65% in ulcerative colitis (UC) patients between the ages of 25 and 65 and 36.36% in non-Hispanic black (NHB) Crohn's disease (CD) patients. During the pandemic, deaths at home or on arrival and at medical facilities as well as deaths due to neoplasms also increased.

CONCLUSION

IBD patients suffered excess non-COVID-19-related death during the pandemic. Excess death was associated with younger age among UC patients, and with NHB race among CD patients. Increased death at home or on arrival and due to neoplasms suggests that delayed presentation and difficulty accessing healthcare may have led to increased IBD mortality.

"It made me feel like a shit parent": an intersectional analysis of pandemic mothering

The COVID-19 pandemic brought to the fore the everyday and exceptional challenges for mothers. Rarely, however, did research or social commentary acknowledge the multiplicities of motherhood during this prolonged period of risk, disruption, and uncertainty. This paper draws upon interviews with 24 mothers living in Aotearoa New Zealand during the pandemic, including women who were pregnant and gave birth during lockdowns, teenage mothers, single and low-income mothers, and working mothers. The sample was intentionally diverse, including Māori, Pacific, Asian and migrant mothers. Engaging an intersectional lens on motherhood and women's health, this paper builds upon and extends feminist research on mothers' experiences during the pandemic, highlighting the many different challenges facing mothers of diverse social, cultural, and economic positionalities and during various stages of motherhood. Across the sample, we reveal the significant emotional toll on mothers, particularly with the absence of critical social, medical and health support systems during lockdown periods and sustained social restrictions. Many of the women described how the pandemic affected their feelings about motherhood, prompting new reflections on their relationships with the home, family, work, and broader society. Despite some similarities, the pandemic experiences of Māori, Pacific, migrant and single mothers were further intensified by various forms of isolation, judgement, and discrimination. In this way, the pandemic shed light on the gendering of everyday maternal life, but also the need for more intersectional culturally and gender-responsive policies that acknowledge the multi-layered complexities of mothers' lives.

COVID-19's Unequal Toll: Differences in Health-Related Quality of Life by Gendered and Racialized Groups

We examine whether the COVID-19 pandemic was associated with changes to daily activity limitations due to poor physical or mental health and whether those changes were different within and between gendered and racialized groups. We analyze 497,302 observations across the 2019 and 2020 waves of the Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System survey. Among White men and women, the COVID-19 pandemic was associated with fewer days of health-related activity limitations and decreased frequent activity limitation (≥14 days in the past month) compared to the prepandemic period. By contrast, Latina and Black women experienced increased days of activity limitation and greater likelihood of frequent activity limitation, and these changes were significantly different than for White women. These findings are robust to the inclusion of structural inequality measures and demonstrate how systemic racism and sexism likely exacerbate a myriad of pandemic-related health problems.

A contemporary review of employee retirement

As societies in many developed countries grapple with the rapid aging trend of the population, the research field of retirement has gained increasing attention. Considering the extensive scope of psychological research on retirement, in this article we focus on providing a review of recent advancements, especially those that have not been covered in existing reviews. We structure our review around four primary empirical themes in alignment with the temporal process model of retirement: retirement planning, retirement decision-making, bridge employment, as well as retirement transition and adjustment. We conclude this review with a discussion on potential future research directions.

Dual pandemics? Assessing associations between area racism, COVID-19 case rates, and mental health among U.S. adults

Mental health worsened during the COVID-19 pandemic, especially among racially minoritized adults. Population-level racial attitudes, or area racism, may be associated with mental health, particularly during this historical moment, but this possibility has not been tested in prior research. In the present study, we use nationally representative data from the Household Pulse Survey (April-October 2020) to document associations between area racism and depression/anxiety in the United States among non-Hispanic Black, non-Hispanic Asian, Hispanic, non-Hispanic White, and other racial/ethnic minority adults. We further consider the national COVID-19 case rate to examine an additional macro-level stressor. Findings indicate that area racism was positively associated with depression and/or anxiety for Black, Hispanic, White, and other racial/ethnic minority adults. Moreover, COVID-19 cases posed an additional, independent mental health threat for most groups. This study points to area racism as a macro-level stressor and an antecedent of mental health for racially diverse groups of Americans.

COVID-19-Induced Inequalities and Mental Health: Testing the Moderating Roles of Self-rated Health and Race/Ethnicity

This study examines the relationship among COVID-19-induced social, economic, and educational inequalities on mental health (i.e., anxiety and depression). This study also examines if levels of self-rated health (SRH) moderate the relationship (i.e., COVID-induced inequalities [CII] and mental health), as well as examines the racial/ethnic group differences among 567 young adults in the mid-Atlantic region. Using a moderation model, results indicate that CII were significantly related to depression (b = .221, t(554) = 4.59, p = .000) and anxiety (b = .140, t(555) = 3.23, p = .001). SRH and race/ethnicity also moderated both relationships. At above-average SRH (i.e., moderator), higher CII were also significantly related to lower anxiety (Asian young adults only) and lower depression (Asian and White young adults only). Overall, SRH and race/ethnicity are important factors in the mental health impact of COVID-19 on young adults.

Nowhere to go? A study of marginalization, social connection, and mental health outcomes among young adults experiencing the COVID-19 pandemic

Background

The COVID-19 pandemic onset necessitated large-scale closures of third places, potentially exacerbating social barriers experienced by young adults in the United States. To better understand the role of urban form in facilitating socialization, we examine the effects of pandemic-based third place closures on mental health outcomes as mediated by changes in social connection. Because identifying as a racial, gender, or sexual minority can compound baseline disadvantages rooted in systemic inequities, we investigate outcome differences for non-white, woman/nonbinary, and LGBTQ+ young adults to disentangle identity-based nuances of the pandemic experience.

Methods

In February 2021, we administered a web-based survey with retrospective name and place generators to 313 18-to-34-year-olds in California, Illinois, and Texas. A structural equation model is estimated showing the direct and indirect effects of physical and virtual mobility constraints on mental health.

Results

Both the closure of third places and dissatisfaction with alternative social spaces are associated with the deterioration of social connections and mental health. The strongest direct predictor of mental health decline is dissatisfaction with virtual socialization (more significant for women and nonbinary respondents). Surprisingly, two distinct categories of third places (i.e., 'civic' and 'commercial') reveal different relationships with social connections and mental health outcomes. Asian, other non-white, and non-heterosexual young adults experienced greater 'civic' visit reduction, while those with intersecting identities of low income and woman/nonbinary or Black experienced greater 'commercial' visit reduction.

Conclusions

Physical and virtual mobility reductions contributed to the inequitable mental health outcomes experienced by young adults during the pandemic. This highlights the potential for a careful redesign of physical and virtual social spaces to support feelings of belonging/safety and spontaneous 'weak tie' interactions, encourages further investigation of social infrastructure's role in facilitating the maintenance of social connections and mental health, and reveals the value of examining differences in mobility-related experiences across social identities.

Ongoing Remote Work, Returning to Working at Work, or in between during COVID-19: What Promotes Subjective Well-Being?

The COVID-19 pandemic precipitated a massive turn to remote work, followed by subsequent shifts for many into hybrid or fully returning to the office. To understand the patterned dynamics of subjective well-being associated with shifting places of work, we conducted a nationally representative panel survey (October 2020 and April 2021) of U.S. employees who worked remotely at some point since the pandemic (N = 1,817). Cluster analysis identified four patterned constellations of well-being based on burnout, work-life conflict, and job and life satisfaction. A total return to office is generally more stressful, leading to significantly lower probabilities of being in the optimal low stress/high satisfaction constellation by Wave 2, especially for men and women without care obligations. Remote and hybrid arrangements have salutary effects; moving to hybrid is especially positive for minority men and less educated men, although it disadvantages White women's well-being.

Exposure to infection when accessing groceries reveals racial and socioeconomic inequities in navigating the pandemic

Disasters often create inequitable consequences along racial and socioeconomic lines, but a pandemic is distinctive in that communities must navigate the ongoing hazards of infection exposure. We examine this for accessing essential needs, specifically groceries. We propose three strategies for mitigating risk when accessing groceries: visit grocery stores less often; prioritize generalist grocery stores; seek out stores whose clientele have lower infection rates. The study uses a unique combination of data to examine racial and socioeconomic inequities in the ability to employ these strategies in the census block groups of greater Boston, MA in April 2020, including cellphone-generated GPS records to observe store visits, a resident survey, localized infection rates, and demographic and infrastructural characteristics. We also present an original quantification of the amount of infection risk exposure when visiting grocery stores using visits, volume of visitors at each store, and infection rates of those visitors' communities. Each of the three strategies for mitigating exposure were employed in Boston, though differentially by community. Communities with more Black and Latinx residents and lower income made relatively more grocery store visits. This was best explained by differential use of grocery delivery services. Exposure and exposure per visit were higher in communities with more Black and Latinx residents and higher infection rates even when accounting for strategies that diminish exposure. The findings highlight two forms of inequities: using wealth to transfer risk to others through grocery deliveries; and behavioral segregation by race that makes it difficult for marginalized communities to avoid hazards.

Employment Disruption and Wellbeing Among Young Adults: A Cross-National Study of Perceived Impact of the COVID-19 Lockdown

Young adulthood (18-30 years old) is a crucial period due to its developmental tasks such as career establishment and financial independence. However, young adults' relative lack of resources makes them vulnerable to employment disruptions (job loss and income loss), which may have both immediate and long-term effects on their financial wellbeing and mental health. The economic impact of COVID-19 restrictions resulted in an increase in unemployment and a decrease in income worldwide, especially for young adults. This study examined to what extent and how job loss and income loss due to the pandemic influenced young adults' perception of their present financial wellbeing, future financial wellbeing, and psychological wellbeing by using cross-sectional survey data collected from six countries (China, Italy, Lithuania, Portugal, Slovenia, and the United States). Results showed that the impact of income loss and job loss on all three types of wellbeing were mediated by young adults' negative perception of the COVID-19 lockdown restriction (i.e., perceived as a misfortune). Cross-country differences existed in the key variables. The association between employment disruptions, young adults' perception of the COVID-19 lockdown restriction, and wellbeing were equivalent across countries except China. Implications for policy and practice are discussed.

Precarious Employment and Well-Being: Insights from the COVID-19 Pandemic

While precarious employment is not a new concept, it has been brought to the center of scholarly and public discourse worldwide by the unprecedented COVID-19 pandemic. This essay delineates how precarious employment shapes well-being and situates that relationship in the context of the COVID-19 pandemic. The essay also provides an overview of how the nine articles boldly investigate how these two layers of global risk-precarious employment and the pandemic-interact to shape individuals' well-being. In addition to advancing theoretical and empirical knowledge by analyzing timely data from diverse sources and populations, these articles call for more efforts on worker protection reforms and government financial support.

Occupational social class differences in the impact of COVID-19 related employment disruptions on retirement planning amongst older workers in England

Purpose

This paper aims to examine the impact of COVID-19 related employment disruption on individuals’ retirement planning and whether these experiences differ by occupational social class.

Design/methodology/approach

To explore these issues, this study linked data from those who were employed in wave 9 of the English Longitudinal Study of Ageing (ELSA) main study with wave 1 of the ELSA COVID-19 study (N = 1,797). Multinominal regression analyses were conducted to explore whether the interaction between employment disruption and occupational social class was associated with planning to retire earlier or later than previously planned.

Findings

The results show that stopping work because of COVID-19 is associated with planning to retire earlier. However, there were no statistically significant interactions between occupational social class and employment disruptions on whether respondents planned to retire earlier or later.

Originality/value

This paper’s original contribution is in showing that the pandemic has had an impact on retirement decisions. Given the known negative effects of both involuntary early labour market exit, the findings suggest that the COVID-19 related employment disruptions are likely to exacerbate social inequalities in health, well-being in later life and, consequently, can help anticipate where there will be need for additional support in later life.

Unequal effects of the COVID-19 epidemic on employment: Differences by immigrant status and race/ethnicity

The COVID-19 epidemic resulted in a dramatic contraction in employment in the U.S., but the effects of this contraction have been unevenly distributed. We examine differences in employment among foreign- and native-born workers by race/ethnicity during the course of the epidemic. We test individual fixed-effects models based on data from the monthly CPS panel from January 2020 to December 2021 adjusting for seasonality. Immigrant men and women experienced greater declines in employment than non-immigrants of the same race/ethnicity when both compared to native-born Whites, but their disadvantage were limited to the initial months of the epidemic. Ethnoracial and immigrant status disparities were substantially reduced by the fall of 2020, except for Hispanic immigrant men and women, who still experienced substantial employment gaps with their native-born White counterparts. Differences in family characteristics account for Hispanic immigrant women's lower employment rates during the epidemic but do not appear to account for differences between Black and Asian women and native-born Whites. Observed disparities in employment by race/ethnicity and immigrant status cannot be fully explained by differences in education, the concentration of minority and immigrant workers in industries and occupations that suffered steeper employment declines, or regional differences in the intensity of the epidemic.

Psychological distress across intersections of race/ethnicity, gender, and marital status during the COVID-19 pandemic

OBJECTIVES

Analyze how psychological distress in the U.S. population during the COVID-19 pandemic differed across race/ethnicity, gender, and marital status.

DESIGN

Cross-sectional data collected March 19-24, 2020, as a part of the American Trends Panel (ATP) were used for this study (N=9,976). Weighted descriptive statistics were estimated. Next, generalized linear models were used to assess differences in psychological distress by race/ethnicity, gender, and marital status. Multivariate Ordinary Least Squares (OLS) regression analyses were estimated to assess patterns of psychological distress across race/ethnicity-gender net of COVID-19 pandemic variables and control variables. Lastly, OLS regression models were used to assess psychological distress by marital status. Wald tests were completed to compare distress across race/ethnicity-gender.

RESULTS

Adjusting for COVID-19 stressors and control variables, White women frequently reported higher distress compared to the other groups. Hispanic men reported lower distress symptoms than White men and Hispanic women. The cohabiting and married had lower distress symptoms compared to the never married. In the analyses by marital status, race/ethnicity-gender differences were present among the never married, married, and marital disruption groups such that White women reported higher distress than other groups. Black married women reported greater distress symptoms compared to married White and Hispanic men.

CONCLUSIONS

The findings of this study show that White women were especially vulnerable to psychological distress at the beginning of the COVID-19 pandemic. Further, despite marriage being a health-promoting status, it is only among the married that Black women reported greater distress than other groups. Married Black women and White women generally need psychological health resources as they are perhaps overtaxed in meeting the demands of family, such as teaching school-age children in the home or caring for elders during the pandemic.

Race-related differences in the economic, healthcare-access, and psychological impact of COVID-19: personal resources associated with resilience

Background

The impact of the coronavirus disease 2019 (COVID) is worse among those with fewer financial resources, in jobs not amenable to remote work, and in denser living conditions. People of color are more likely to be among these vulnerable groups. Although race itself is a social construction and not based on underlying genetic/biological differences, this study investigated race/ethnicity differences in the negative repercussions of COVID and in the benefits of psychological and social resources.

Methods

This cross-sectional, web-based study (n = 4817) was administered to a heterogeneous United States sample in Spring/Summer 2020. Information was gathered on the following COVID-specific variables: Infection Status, Coping with Lockdown, Social Support, Post-traumatic Growth, Interpersonal Conflict, Worry about Self, Financial Impact on Family, Lack of Money, Inadequate Access to Healthcare, and Housing Instability. Resilience was operationalized as the ability to maintain a sense of wellness in the face of the pandemic, using the DeltaQuest Wellness measure. Multivariate linear regression (adjusting for demographics) and propensity-matched cohort analysis (matched on demographics) evaluated the impact of COVID-specific variables on Wellness in separate models for Whites and Non-Whites.

Findings

Both sets of models retained the same COVID-specific variables and explained about half of the variance in wellness. Coping with Lockdown, Social Support, and Post-traumatic Growth were associated with higher levels of Wellness in both Whites and Non-Whites, while Interpersonal Conflict and Worry about Self were associated with lower levels of Wellness. While these associations are similar, Non-Whites reported worse levels of some positive resources (e.g., social support) and more challenging levels of negative stressors (e.g., interpersonal, worry, financial). Non-Whites also reported much higher levels of post-traumatic growth.

Conclusion

COVID was a source of worry and even conflict, but also unlocked people’s resources in use of health-enhancing behavioral strategies, social support, and renewed gratitude for sources of personal meaning and value. The similar relationships between Whites and Non-Whites on wellness and COVID-specific stressors across racial groups underscore that race is a social construction, not a biological fact. Focusing on a renewed appreciation for sources of personal meaning, and particularly faith, seemed to buffer much of the COVID-related stress for Non-Whites.

Supplementary Information

The online version contains supplementary material available at 10.1186/s41687-022-00514-2.

The Inequitable Burden of the COVID-19 Pandemic Among Marginalized Older Workers in the United States: An Intersectional Approach

OBJECTIVES

The COVID-19 pandemic has profoundly affected the lives of people globally, widening long-standing inequities. We examined the COVID-19 pandemic's impact on employment conditions by race/ethnicity, gender, and educational attainment and the association between such conditions and well-being in older adults in the United States.

METHODS

Using data from the Health and Retirement Study respondents interviewed between May 2020 and May 2021 when they were ≥55 years of age, we examined intersectional patterns in COVID-19-related changes in employment conditions among 4,107 participants working for pay at the start of the pandemic. We also examined the compounding nature of changes in employment conditions and their association with financial hardship, food insecurity, and poor self-rated health.

RESULTS

Relative to non-Hispanic White men with greater than high school education (>HS), Black and Latinx men and women were more likely to experience job loss irrespective of education; among those who did not experience job loss, men with ≤HS reporting Black, Latinx, or "other" race were >90% less likely to transition to remote work. Participants who experienced job loss with decreased income or continued in-person employment with decreased income/shift changes had greater prevalence of financial hardship, food insecurity, and poor/fair self-rated health than others.

DISCUSSION

The impact of COVID-19 on employment conditions is inequitably patterned and is associated with financial hardship, food insecurity, and adverse health in older adults. Policies to improve employment quality and expand social insurance programs among this group are needed to reduce growing inequities in well-being later in life.

The impact of the COVID-19 pandemic on pain and psychological functioning in young adults with chronic pain

ABSTRACT

Data are equivocal on the consequences of COVID-19 pandemic on pain and well-being for individuals with chronic pain. Furthermore, little is known regarding its impact on the health of young adults with chronic pain. We conducted a longitudinal study to compare pain, psychological functioning, and substance use before and during the pandemic of 196 young adults with chronic pain. Participants aged 18 to 24 years (M = 21.1 years; 79.6% females) reported on pain, anxiety, depression, and substance use before (October 2018-August 2019) and during the pandemic (October 2020-November 2020), in addition to the assessment of COVID-19 exposure and its impact. Before the pandemic, young adults experienced mild-to-moderate pain intensity (M = 3.75, SD = 2.33) and pain interference (M = 3.44, SD = 2.69). Findings were that pain intensity, pain interference, and depression symptoms remained stable during the pandemic. In contrast, anxiety symptoms increased significantly (M = 8.21, SD = 5.84 vs M = 8.89, SD = 5.95, P = 0.04). Tobacco, alcohol, and cannabis use were unchanged. Mixed linear models revealed that COVID-19 exposure and impact were not associated with changes in pain intensity or interference, with female sex associated with increased pain intensity (β = 0.86, P = 0.02) and pain interference (β = 0.87, P = 0.02). Our findings indicated relative stability of pain symptoms experienced by young adults with chronic pain. However, the increases in anxiety highlight the need to facilitate treatment access for mental health services to mitigate downstream impact.

Impact of the COVID-19 epidemic anxiety on college students' employment confidence and employment situation perception in China

The psychological problems and employment problems of college students have always been the focus of attention of all sectors of society. The COVID-19 epidemic has a great impact on the mental health and employment of Chinese college students. Under this background, this study discusses how epidemic anxiety affects the employment confidence and perception of employment situation of Chinese college students. Through the online questionnaire survey of 1,132 college students nationwide, and the ordinal logistic regression analysis of the survey data using Stata 16.0 software, the results show that: (1) Epidemic anxiety negatively affects Chinese college students' employment confidence and employment situation perception, and has a significant impact on employment confidence. The three control variables of employment guidance, older age and higher education have a significant positive impact on college students' employment confidence and employment situation perception. College students in the eastern region have stronger employment confidence and more optimistic employment situation perception. But the expected monthly salary is negatively correlated with employment confidence. (2) Male college students and Science and Engineering students' epidemic anxiety have a stronger negative impact on employment confidence and employment situation perception. (3) Employment guidance has a moderating effect on the relationship between epidemic anxiety, employment confidence and employment situation perception. Employment guidance can enhance college students' employment confidence and reduce their sense of employment crisis by alleviating epidemic anxiety. Combined with the research conclusions, it is proposed that the state and schools should pay attention to the psychological counseling of college students, strengthen the employment guidance of colleges and universities, vigorously support the development of small, medium-sized and micro enterprises, and improve the employment and entrepreneurship service system of college students, so as to promote the employment of college students.

Opioid Use Disorder and COVID-19: Treatment and Recovery Factors among Vulnerable Populations at the Intersection of Two U.S. Epidemics

Social inequities made some sociodemographic groups - including those of older age, minoritized race/ethnicity, and low socioeconomic status - disproportionately vulnerable to morbidity and mortality associated with the opioid epidemic and COVID-19 pandemic. Given shared vulnerability to these public health crises, it is critical to understand how COVID-19 impacts substance use disorder (SUD) treatment and recovery among people with these characteristics. The current study examined COVID-19's perceived impact on treatment factors and psychosocial outcomes by sociodemographic vulnerability. Patients receiving SUD treatment with a history of opioid misuse were recruited. Participants completed self-report questionnaires regarding the impact of COVID-19 on treatment indicators and mood and substance use symptoms. Most participants reported that COVID-19 decreased their treatment access and quality. There were no sociodemographic differences in treatment factors. Those with high sociodemographic vulnerability reported greater pandemic-related increases in depression and demonstrated greater mood symptoms. Post-hoc analyses demonstrated that unmet basic needs were significantly associated with lower treatment access and quality, greater mood symptoms, and higher substance use. Findings suggest pandemic-related stressors and barriers affected those across the sociodemographic spectrum. Treatment systems must address socioeconomic barriers to care exacerbated by the pandemic and bolster integrated treatment options for opioid use and mood disorders.

COVID-19 and Gender Gaps in Employment, Wages, and Work Hours: Lower Inequalities and Higher Motherhood Penalty

This paper investigates the dynamics and drivers of gender gaps in employment rates, wages, and work hours during the COVID-19 pandemic, relying on Estonian Labor Force Survey data for 2009-2020. We document that the pandemic has, if anything, reduced gender inequality in all three domains. The evolution of inequalities revealed cyclical pattern mirroring infection rate, with upswings largely driven by parenthood and gender segregation into industries. The results suggest that labor market penalties for women with young children and women employed in affected sectors may last longer than the pandemic, threatening to widen gender inequality in a long run.

Supplementary Information

The online version contains supplementary material available at 10.1057/s41294-022-00198-z.

Gender and Racial Discrimination in Hiring Before and During the COVID-19 Pandemic: Evidence from a Field Experiment of Accountants, 2018-2020

In this article, we ask whether macro-level changes during the first year of the COVID-19 pandemic relate to changes in the levels of discrimination against women and Black job-seekers at the point of hire. We develop three main hypotheses: that discrimination against women and Black job-seekers increases due to a reduction in labor demand; that discrimination against women decreases due to the reduced supply of women employees and applicants; and that discrimination against Black job-seekers decreases due to increased attention toward racial inequities associated with the Black Lives Matter protests during the summer of 2020. We test these hypotheses using a correspondence audit study collected over two periods, before and during the early COVID-19 pandemic, for one professional occupation: accountants. We find that White women experience a positive change in callbacks during the pandemic, being preferred over White men, and this change is concentrated in geographic areas that experienced relatively larger decreases in women's labor supply. Black women experience discrimination pre-pandemic but receive similar callbacks to White men during the pandemic. In contrast to both White and Black women, discrimination against Black men is persistent before and during the pandemic. Our findings are consistent with the prediction of gender-specific changes in labor supply being associated with gender-specific changes in hiring discrimination during the COVID-19 pandemic. More broadly, our study shows how hiring decision-making is related to macro-level labor market processes.

The Effect of the COVID-19 Pandemic on the Labor Markets of the Visegrad Countries

The COVID-19 pandemic caused a sudden and deep recession contributing, among other things, to a sharp rise in unemployment. The article addresses changes in the labor markets of the Visegrad countries (Czechia, Hungary, Poland, and Slovakia), covering the period 2018–2021. It attempts to answer the questions: how deep a slump was caused by the pandemic in these markets, how flexible forms of employment responded to it, and whether there were discriminatory phenomena (decline in employment and increase in unemployment in the most vulnerable groups in the labor market). The analysis was based on quarterly data published by Eurostat on the size and structure of the employed and unemployed population. The results of the compilations indicate a relatively small deepening of imbalances in the labor markets of the analyzed countries, a differentiated reaction of flexible forms of employment (depending on the form of employment), which was in line with expectations (they were used as a business cycle buffer). In most of the V4 countries, women were relatively less likely to lose their jobs than men during the pandemic. In a few cases, a relatively stronger decline in employment (increase in unemployment) affected young people, people aged 55–64, and people with the lowest education.

Parents' employment, income, and finances before and during the COVID-19 pandemic

The COVID-19 pandemic brought grave financial concerns for families in the United States as they attempted to navigate the multifaceted impacts of the pandemic. The present descriptive study examined Florida families' employment characteristics, credit card debt, savings characteristics, use of savings based on employment and income variables, and patterns of use of the first 2020 economic impact payment during the early stages of the COVID-19 pandemic. Responses to an online questionnaire were collected from 526 Florida residents, age 18 or older, who were parents of minor children during the time the study was conducted. Findings are indicative of varying financial impacts on families based on gender, marital status, income level, and employment status related to COVID-19. Implications are presented for employers, educators, researchers, policymakers, and families.

Quality of Life and Job Loss during the COVID-19 Pandemic: Mediation by Hopelessness and Moderation by Trait Emotional Intelligence

This study contributes to the knowledge on the effects of the COVID-19 pandemic by examining a moderated mediation model in which the impact of job loss over quality of life (QoL) is mediated by hopelessness and moderated by trait emotional intelligence (trait EI). Data were collected from a large nationally representative Italian sample of adult workers (N = 1610), who completed a series of anonymous online questionnaires. Total, direct and indirect effects were estimated through bootstrapped mediated moderation analyses providing 95% bias corrected bootstrap confidence intervals. After controlling for the effects of gender and age range, job loss was found to be negatively associated with QoL, and hopelessness partially mediated such relationship. These relationships were in turn moderated by trait EI. Our study suggests that trait EI levels act as protective factor for a good QoL, mitigating the impact of both job loss and hopelessness over QoL levels during the COVID-19 pandemic. Identifying psychological protective and/or risk factors for a better QoL is crucial for the development of interventions aimed at reducing the emotional impact of the pandemic and of its negative real-life consequences.

The impact of COVID-19 on migrant women in son Gotleu (Palma) and the development of outreach tools to improve health and social care

Aims

The objectives of this research protocol are as follows: to examine the influence of the COVID‐19 pandemic on health and social care for migrant women in the Son Gotleu district of Palma de Mallorca, Spain, and to develop outreach tools to target this specific group.

Design

This is a qualitative study that uses content analysis to obtain in‐depth knowledge of personal experience (manifest content) and contextual experience (latent content) in a specific social setting.

Methods

The study population are migrant women living in Son Gotleu district, who are segmented by their age and experience of COVID‐19, defined as positive or negative according to whether or not they have been infected with the disease.

Results

The shortcomings and needs relating to communication and health care that affect this group's current and future quality of life will be identified.

Conclusion

The study of migrant women offers a gateway allowing vulnerability in health care to be detected. An awareness of their needs will allow prototype tools to be developed to facilitate communication and care for general and acute health needs between the scientific community and the vulnerable population.

Resilience during Crisis and the Role of Age: Involuntary Telework during the COVID-19 Pandemic

We investigated the relationship between age, resilience, job demands and resources, and self-regulation in 1715 university employees during the COVID-19 pandemic (February 2021) by means of an online survey with closed and open questions. Correlation, regression, and qualitative analyses showed that older employees reported higher resilience than younger employees. This finding was robust after controlling for background factors (i.e., gender, expat status, job type, living alone). Age and resilience were directly related to higher job resources (i.e., job security and equipment), work-life balance, and seeing positives, whereas the relationship to demands was ambiguous. Age was unrelated to workload, negatively related to childcare, and positively to eldercare. Resilience was negatively related to workload but unrelated to childcare or eldercare demands. When all variables were combined to jointly predict resilience, age, job resources, and self-regulation resources predicted resilience, whereas demands (i.e., workload, childcare, and eldercare demands) did not. Our findings suggest that age-related advantages in well-being have persisted during the COVID-19 pandemic. Older workers were more likely to reframe the crisis and see it as an opportunity for personal growth. They possess and utilize resources in unique and beneficial ways, which could also benefit younger workers.

A shift in women's health? Older workers' self-reported health and employment settings during the COVID-19 pandemic

BACKGROUND

The first wave of COVID-19 has had a massive impact on work arrangements settings in many European countries with potential effects on health that are likely to vary across gender.

METHODS

Focusing on the workforce aged 50 and over in 27 European countries using data from SHARE wave 8 (N = 11,221), the study applies a generalized logit mixed-effects model to assess the relationship between negative and positive change in self-reported health since the start of the pandemic and change in employment settings using an interaction effect between gender and employment arrangements to distinguish their specific association by gender after controlling for socio-economic covariates and multicollinearity.

RESULTS

Female respondents have higher probabilities to declare a positive health when working fully or partially from home or when temporarily and permanently unemployed. However, introducing the main effect of gender exacerbates discrepancies and such benefits fade away. Differences across countries do not significantly change the estimates.

CONCLUSION

The benefits of work arrangements to improve women's health during the first wave of COVID-19 have not compensated the negative effect of gender discrepancies exacerbated by the pandemic to the extent that employment arrangements have no role, or just a negative impact, in modulating them.

Who is the "She" in the Pandemic "She-Cession"? Variation in COVID-19 Labor Market Outcomes by Gender and Family Status

The sharp decline in employment after the COVID-19 lockdown was not uniformly felt across demographic groups. Utilizing the 2017 to 2020 monthly Current Population Survey and using a difference-in-difference design, we investigate the varying impacts of COVID-19 on at-work status among the prime-working-age population, accounting for typical seasonal fluctuations in employment. The target population is grouped by gender, marital status, parenthood, and level of education. Our results uncover complex variations by gender, marital status, and children's age. Contrary to popular belief, married women without school-aged children did not experience a relative decline in employment compared to married fathers. A majority of disadvantages in employment that married women experienced are accounted for by controlling for typical seasonal fluctuations. The women whose employment was most distinctively adversely affected by COVID-19 during 2020 were less-educated never-married childless women and never-married mothers. Less-educated men who were not currently married also experienced a disadvantage in employment relative to equally educated married fathers. These findings imply that, during the pandemic recession, marriage offered a form of within-family insurance that we call the "added caregiver effect." The further implications of these findings are discussed.

Change in Depression and Its Determinants during the COVID-19 Pandemic: A Longitudinal Examination among Racially/Ethnically Diverse US Adults

This study examined longitudinal data to identify changes in the occurrence of depressive symptoms, and to explore if such changes were associated with socio-demographic, movement behaviors, and health variables during the COVID-19 pandemic, among a diverse sample of central Texas residents. Participants who completed two online surveys in 2020 (in June and November) from an on-going longitudinal study were included. Depressive symptoms were measured by Patient Health Questionnaire-2. Change in depressive symptoms' occurrence status between the two time points was categorized into (1) stable/improved, and (2) consistent depressive symptoms/declined. Sociodemographic factors, movement behaviors and health data were self-reported. Statistical analyses utilized descriptive statistics and logistical regression. Among a total of 290 individuals (84.1% female; 71.0% racial/ethnic minorities), 13.5% were categorized as consistent depressive symptoms/declined. Multivariable logistic regression indicated that racial/ethnic minorities, older age, and increased physical activity were associated with a lower likelihood, while greater sedentary time was associated with higher likelihood of consistent depressive symptoms/declined status. Between 3 months and 8 months into the pandemic, various socio-demographic and behavioral variables were associated with changes in depressive symptoms' occurrence status. Future research should explore the longer-term impacts of COVID-19 on depression among a diverse population and identify risk factors for depression.

The Age of Satisficing? Juggling Work, Education, and Competing Priorities during the COVID-19 Pandemic

The coronavirus disease 2019 pandemic continues to shape individuals' decisions about employment and postsecondary education. The authors leverage data from a longitudinal qualitative study of educational trajectories to examine how individuals responded to the shifting landscape of work and education. In the final wave of interviews with 56 individuals who started their postsecondary education at a community college 6 years ago, the authors found that most respondents described engaging in satisficing behaviors, making trade-offs to maintain their prepandemic trajectories where possible. More than a quarter of individuals, primarily those with access to fewer resources, described trajectories fraught with insecurity; they struggled to juggle competing obligations, especially in the face of an unpredictable labor market. A small portion of participants described making optimizing decisions, which were sometimes risky, to prioritize their aspirations. These descriptive patterns may partially explain mechanisms shaping recent shifts in employment and postsecondary education, including lower labor-market engagement and declines in college enrollment.

Beyond Hours Worked and Dollars Earned: Multidimensional EQ, Retirement Trajectories and Health in Later Life

The working lives of Americans have become less stable over the past several decades and older adults may be particularly vulnerable to these changes in employment quality (EQ). We aimed to develop a multidimensional indicator of EQ among older adults and identify EQ and retirement trajectories in the United States. Using longitudinal data on employment stability, material rewards, workers' rights, working-time arrangements, unionization, and interpersonal power relations from the Health and Retirement Study (HRS), we used principal component analysis to construct an EQ score. Then, we used sequence analysis to identify late-career EQ trajectories (age 50-70 years; N = 11,958 respondents), overall and by sociodemographics (race, gender, educational attainment, marital status). We subsequently examined the sociodemographic, employment, and health profiles of these trajectories. We identified 10 EQ trajectories; the most prevalent trajectories were Minimally Attached and Wealthy (13.9%) and Good EQ to Well-off Retirement (13.7%), however, 42% of respondents were classified into suboptimal trajectories. Those in suboptimal trajectories were disproportionately women, people of color, and less-educated. Individuals in the Poor EQ to Delayed and Poor Retirement and Unattached and Poor clusters self-reported the greatest prevalence of poor health and depression, while individuals in the Wealthy Business Owners and Great EQ to Well-off Retirement clusters self-reported the lowest prevalence of poor health and depression at baseline. Trajectories were substantially constrained for women of color. Although our study demonstrates EQ is inequitably distributed in later life, labor organizing and policy change may afford opportunities to improve EQ and retirement among marginalized populations.

Negative Employment Changes During the COVID-19 Pandemic and Psychological Distress: Evidence From a Nationally Representative Survey in the U.S

OBJECTIVE

We examined associations of negative employment changes during the COVID-19 pandemic with mental health in a national sample of U.S. workers, and whether the associations differed by race.

METHODS

Data were from the Health, Ethnicity, and Pandemic Study, a cross-sectional survey. The effects of negative employment changes on psychological distress in 1510 workers were examined via linear regression, and stratified analyses were conducted across racial subgroups.

RESULTS

After adjustment for covariates, compared to workers with no change in employment, those who experienced permanent job loss had the highest psychological distress (β and 95% CI = 3.27 [1.89, 4.65]). Permanent job loss had the greatest effect on psychological distress in Blacks and Asians.

CONCLUSION

Negative employment changes related to the pandemic may have deleterious impacts on workers' mental health, with disproportionate effects on racial minorities.

Who Is Watching the Children? A Quantitative Analysis of Strategies for Reconciling Work and Parenting during Lockdown in Northern Italy

(1) Background: In their efforts to contain the spread of COVID-19, most countries closed schools and kindergartens. To date, little is known about the strategies of working families reconciling work and parenting during repeated lockdown situations. (2) Methods: We performed a quantitative survey of working parents in Italy during a week of 'hard lockdown' in February/March 2021. (3) Results: 3725 voluntary adult participants from different households responded. Though officially not allowed, 53.4% of all participants sought help from people outside the nuclear family to bridge the situation, mostly the grandparents (79%; n = 1855). Overall, parental coping strategies included alternating working-childcare-turns with their partner (35%, n = 1316), working early in the morning or during nighttime (23%; n = 850), or leaving the children unattended (25%, n = 929). (4) Conclusions: The closure of schools/kindergartens forcefully shifts the responsibility for childcare onto the nuclear family, where new strategies arose, including health-damaging models of alternating work-childcare-shifts, 'illegal' involvement of third parties from outside the nuclear family, as well as neglect of age-related childcare. Our findings underline that working families need additional support strategies during repeated closure of childcare institutions to be able to reduce contact and minimize secondary damage.

Community vulnerability and mobility: What matters most in spatio-temporal modeling of the COVID-19 pandemic?

Community vulnerability is widely viewed as an important aspect to consider when modeling disease. Although COVID-19 does disproportionately impact vulnerable populations, human behavior as measured by community mobility is equally influential in understanding disease spread. In this research, we seek to understand which of four composite measures perform best in explaining disease spread and mortality, and we explore the extent to which mobility account for variance in the outcomes of interest. We compare two community mobility measures, three composite measures of community vulnerability, and one composite measure that combines vulnerability and human behavior to assess their relative feasibility in modeling the US COVID-19 pandemic. Extensions – via temporally dependent fixed effect coefficients – of the commonly used Bayesian spatio-temporal Poisson disease mapping models are implemented and compared in terms of goodness of fit as well as estimate precision and viability. A comparison of goodness of fit measures nearly unanimously suggests the human behavior-based models are superior. The duration at residence mobility measure indicates two unique and seemingly inverse relationships between mobility and the COVID-19 pandemic: the findings indicate decreased COVID-19 presence with decreased mobility early in the pandemic and increased COVID-19 presence with decreased mobility later in the pandemic. The early indication is likely influenced by a large presence of state-issued stay at home orders and self-quarantine, while the later indication likely emerges as a consequence of holiday gatherings in a country under limited restrictions. This study implements innovative statistical methods and furnishes results that challenge the generally accepted notion that vulnerability and deprivation are key to understanding disparities in health outcomes. We show that human behavior is equally, if not more important to understanding disease spread. We encourage researchers to build upon the work we start here and continue to explore how other behaviors influence the spread of COVID-19.

Trajectories of COVID-19 vaccine intentions among U.S. adults: The role of race and ethnicity

Research examining whether intentions to get a COVID-19 vaccine change over time is scarce. Moreover, the deep and pervasive history of medical racism in the U.S. has created a context in which some racial and ethnic groups exhibit greater levels of COVID-19 vaccine hesitancy; yet few researchers have attempted to determine whether these patterns persist with time. The purpose of this study was twofold: (a.) assess the role of time in COVID-19 vaccine intentions from April 2020 to January 2021, and (b.) examine whether race and ethnicity shape COVID-19 vaccine intention trajectories. Data were drawn from 9 waves of the Understanding America Study (n = 5023), a national probability panel study of U.S. adults. Multilevel logistic regression models were used to assess overall COVID-19 vaccine intention trajectories and trajectories by race and ethnicity. Results demonstrate intentions to get a COVID-19 vaccine significantly decreased from April 2020 to November 2020, but by January 2021, intentions to get a COVID-19 vaccine slightly increased. Findings also show trajectories significantly differed by racial and ethnic background. Asian/Pacific Islanders had the highest probability of likely getting a COVID-19 vaccine at baseline, followed by Whites and Latina/os. Black Americans exhibited the lowest probability of likely getting vaccinated, and, in most cases, the gap between Black Americans and other racial groups grew over time. Key findings from this study demonstrate that, among U.S. adults, time and race and ethnicity play significant roles in COVID-19 vaccine intentions. Understanding the role of time and race and racism in shaping COVID-19 vaccine intention trajectories can help government agencies and public health experts tasked with administrating vaccines better understand disparities in vaccine uptake.

Effects of the Great Recession on Educational Disparities in Cardiometabolic Health

BACKGROUND

Macroeconomic crises can exaggerate existing educational disparities in health. Few studies, however, have examined whether macroeconomic crises get under the skin to affect educational disparities in health-related biological processes.

PURPOSE

This study aimed to examine the effect of the economic recession of 2008 (i.e., Great Recession) on educational disparities in cardiometabolic risk and self-reported psychological distress.

METHODS

Data were drawn from two subsamples of the Midlife in the United States (MIDUS) study: the second wave of the MIDUS sample (pre-recession cohort, N = 985) and the refresher sample (post-recession cohort, N = 863). Educational attainment was categorized into high school education or less, some college, and bachelor's degree or higher. Outcomes included metabolic syndrome, C-reactive protein, and interleukin-6, as well as self-reported perceived stress, depressive symptoms, and financial distress.

RESULTS

Results showed that having a bachelor's degree or higher (compared to having a high school education or less) was more strongly associated with decreased metabolic syndrome symptoms in the post-recession cohort than the pre-recession cohort, above and beyond demographic, health, and behavioral covariates. These findings did not extend to systemic inflammation or psychological distress.

CONCLUSIONS

Our findings suggest that chronic macroeconomic stressors may widen the educational gap in physical health, particularly cardiometabolic health, by modifying biological and anthropometric risk factors implicated in metabolic syndrome.

The COVID-19 Family Stressor Scale: Validation and Measurement Invariance in Female and Male Caregivers

The COVID-19 pandemic has raised significant concerns regarding the effect of social disruptions on parental mental health, family well-being, and children's adjustment. Due to the pace of the pandemic, measures of pandemic-related disruption have not been subject to rigorous empirical validation. To address this gap, a multi-national sample (United Kingdom, 76%; United States, 19%; Canada, 4%, and Australia, 1%) of 372 female caregivers and 158 male caregivers of 5-18-year-old children was recruited online. Participants completed a survey including a 25-item scale indexing disruption in finances, basic needs, personal and family welfare, career/education, household responsibilities, and family relationships related to the pandemic. An exploratory factor analysis yielded an optimal three-factor solution: factors included Income Stress (five items related to income, debt, and job loss; loadings ranged from 0.57 to 0.91), Family Stress (seven items related to family altercations and child management; loadings from 0.57 to 0.87), and Chaos Stress (four items related to access to supplies, crowded shopping areas, news coverage; loadings from 0.53 to 0.70). Multiple-group confirmatory factor analysis demonstrated measurement invariance of each factor across female and male caregivers, indicating that factor structure, loadings, and thresholds were equivalent across groups. Composites reflective of each factor were computed, and Mann-Whitney U tests indicated that female caregivers consistently scored higher than male caregivers on COVID-19 stressors related to income, family, and chaos. Finally, concurrent validity was demonstrated by significant bivariate correlations between each scale and caregiver, family, and child outcomes, respectively. This demonstrates the validity of the COVID-19 Family Stressor Scale for use with female and male caregivers in family-based research. The current sample was predominantly White-European, married/common-law, and had at least some post-secondary education. Additional sampling and validation efforts are required across diverse ethnic/racial and socioeconomic groups.

Rapid Review on COVID-19, Work-Related Aspects, and Age Differences

The COVID-19 pandemic significantly impacted the labor market and multiple aspects of work and workers' life. The present rapid review analyzes this impact considering the effects that COVID-19 pandemic had on employment and work-related aspects across different age groups. A comprehensive literature search was performed on scientific contributions published between 2019 and March 2021, resulting in 36 papers pertinent to the scope of this review. Findings were grouped according to different topics, all linked to age: occupational risk, implications on the labor market (i.e., job loss and reemployment, job insecurity, turnover intentions and retirement, and healthcare workers' return-to-work phase), remote work, and key individual and organizational resources and strategies. Overall, the review revealed variability across age groups in the impact this pandemic had on employment and several work-related aspects (i.e., occupational risk, remote work). Findings supported an age-differential effect of normative history-graded events such as the current pandemic, highlighting different responses and consequences depending on workers' age.

Impact of the COVID-19 Pandemic on Older Adults: Rapid Review

BACKGROUND

The COVID-19 pandemic has drastically changed the lives of countless members of the general population. Older adults are known to experience loneliness, age discrimination, and excessive worry. It is therefore reasonable to anticipate that they would experience greater negative outcomes related to the COVID-19 pandemic given their increased isolation and risk for complications than younger adults.

OBJECTIVE

This study aims to synthesize the existing research on the impact of the COVID-19 pandemic, and associated isolation and protective measures, on older adults. The secondary objective is to investigate the impact of the COVID-19 pandemic, and associated isolation and protective measures, on older adults with Alzheimer disease and related dementias.

METHODS

A rapid review of the published literature was conducted on October 6, 2020, through a search of 6 online databases to synthesize results from published original studies regarding the impact of the COVID-19 pandemic on older adults. The Human Development Model conceptual framework-Disability Creation Process was used to describe and understand interactions between personal factors, environmental factors, and life habits. Methods and results are reported following the Preferred Reporting Items for Systematic Reviews and Meta-analyses Statement.

RESULTS

A total of 135 records were included from the initial search strategy of 13,452 individual studies. Of these, 113 (83.7%) studies were determined to be of level 4 according to the levels of evidence classification by the Centre for Evidence-Based Medicine. The presence of psychological symptoms, exacerbation of ageism, and physical deterioration of aged populations were reported in the included studies. Decreased social life and fewer in-person social interactions reported during the COVID-19 pandemic were occasionally associated with reduced quality of life and increased depression. Difficulties accessing services, sleep disturbances, and a reduction of physical activity were also noted.

CONCLUSIONS

Our results highlight the need for adequate isolation and protective measures. Older adults represent a heterogeneous group, which could explain the contradictory results found in the literature. Individual, organizational, and institutional strategies should be established to ensure that older adults are able to maintain social contacts, preserve family ties, and maintain the ability to give or receive help during the current pandemic. Future studies should focus on specific consequences and needs of more at-risk older adults to ensure their inclusion, both in public health recommendations and considerations made by policy makers.

Suffering and Salutogenesis: A Conceptual Analysis of Lessons for Psychiatry From Existential Positive Psychology (PP2.0) in the Setting of the COVID-19 Pandemic

The COVID-19 pandemic has had a widespread effect on the thoughts, emotions and behavior of millions of people all around the world. In this context, a large body of scientific literature examining the mental health impact of this global crisis has emerged. The majority of these studies have framed this impact in terms of pre-defined categories derived from psychiatric nosology, such as anxiety disorders, depression or post-traumatic stress disorder. These constructs often fail to capture the complexity of the actual experiences of the individuals being studied; more specifically, they describe these experiences exclusively in terms of disease, while neglecting their potentially adaptive or “salutogenic” aspects. Similarly, discussion of psychological assistance for these individuals has largely been confined to a reiteration of “evidence-based” psychological or pharmacological techniques which can be delivered using remote access technology. In the context of the COVID-19 pandemic, these approaches are likely to be of mixed efficacy. Conversely, “negative emotions” or distressing psychological experiences may actually be functional in the setting of a disaster or crisis, serving to minimize harm, maximize social coherence and compliance, and facilitate adherence to safety measures. The limitations of the “conventional” approach are, to a certain degree, inherent to the prevailing medical model of mental health. Beyond these considerations lies the concept of “salutogenesis,” a term which refers to the innate capacity of individuals to create and maintain health and well-being in the face of adversity. Using principles derived from the second wave of positive psychology (PP2.0), particularly its emphasis on the totality of human experience and the possibility of deriving meaning and character growth from suffering, this paper conceptually analyses the relevant aspects of salutogenesis and PP2.0, and proposes an alternate approach for addressing mental health concerns during the COVID-19 pandemic. Such an approach, while acknowledging the utility of the conventional medical-psychotherapeutic model in specific cases, reduces the risk of medicalizing human experience, and provides individuals and communities with opportunities for growth and adaptation. The benefits of this proposal could potentially extend far beyond the current crisis, offering an opportunity for the field of psychiatry and mental health research to move away from a purely “disease-centered” model.

A Survey to Evaluate the Association of COVID-19 Restrictions on Perceived Mood and Coping in Australian Community Level Athletes

Highlights: No differences in coping or well-being in Australian community athletes based on the level of support received during COVID-19 restrictions.Community level athletes had better coping when a training program was provided.No difference between individual or team community athletes for well-being or coping scores. Australian community level athletes faced unprecedented changes to their training and competition options as the global COVID-19 pandemic took a stronghold. This disruption was predicted to have a negative impact on emotional well-being as communities braced through periods of social isolation and physical distancing requirements. This study provides an Australian perspective on the emotional well-being of community level athletes and the extent to which they coped during the COVID-19 pandemic. Emotional well-being and coping were measured using the Brief Emotional Experience Scale and the 28-item Brief Cope Scale. Both instruments were administered along with other questions pertaining to participant demographics and training status via an online survey between April and June 2020. The survey was disseminated to community athletes through word-of-mouth and social media platforms. No significant differences in emotional well-being were observed between athlete groups as a result of COVID-19 and its associated restrictions. Coping scores also appeared to be preserved in Australian community athletes, which contrasts the impact expected as a result of the COVID-19 pandemic. While tentative, the observed preservation in coping may have buffered potential declines in emotional well-being, which has been documented in professional and semi-professional athletes and the general population. These unexpected findings and tentative suppositions warrant further investigation and highlight the importance of conducting a country- or region-specific approach to examining the impact of COVID-19 on community athletes, as responses to COVID-19 are undoubtedly not consistent throughout the world.

COVID-19 and the decline in Asian American employment

The unemployment rate has sharply increased as a result of the lockdown associated with the spread of COVID-19. The negative effect of the lockdown is more conspicuous among the less-educated workers than the highly-educated workers. Because Asian Americans are more likely to have a bachelor or higher degree than any other racial group, they are expected to be relatively immune to the drop in employment unless the detrimental impact of the lockdown is severer for Asian Americans. Exploiting the panel aspect of the Current Population Survey - Merged Outgoing Rotation Group, we examine the changes in At-work status before and after the lockdown and between the lockdown and months of the reopening. The empirical results uncover that Asian Americans are more negatively affected by the lockdown than any other racial group, net of education, immigration status, and other covariates. Surprisingly, the negative impact of the lockdown is entirely concentrated on less-educated Asian Americans. Regardless of gender, less-educated Asian Americans are substantially more likely to lose employment than equally educated Whites and are not more likely to regain employment during the reopening months. Other less-educated racial minorities do not experience more reduction in At-work status than Whites, net of covariates. Highly-educated Asian Americans' employment is equally affected by the lockdown with equally educated Whites.