Financial hardship and social assistance as determinants of mental health and food and housing insecurity during the COVID-19 pandemic in the United States.
Financial hardship and social assistance as determinants of mental health and food and housing insecurity during the COVID-19 pandemic in the United States.
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DOI：
10.1016/j.ssmph.2021.100862
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发表时间：
2021-12
期刊：
影响因子：
--
通讯作者：
Kim D
中科院分区：
文献类型：
--
作者：
Kim D
尽管通过《美国联邦关怀法案》（U.S. federal CARES Act）提供的社会援助在2019冠状病毒病大流行期间提供了扩大的失业保险福利，直到2020年夏天，但尚不清楚在随后的几个月里，社会援助是否足以满足日常支出需求，并遏制经济困难带来的不利健康后遗症。本研究利用多变量泊松对数二项回归和2020年9月至12月期间91222名美国工作年龄成年人和28842名成年租房者的重复横断面家庭脉搏调查数据，在考虑到接受社会援助后，探讨了经济困难与心理健康结果以及食物和住房不安全之间的关系。2020年9月至12月，经济困难逐步加剧，非西班牙裔黑人、西班牙裔美国人和低收入家庭受到的影响尤为严重。经历相当大的经济困难（与没有困难相比）预示着焦虑和抑郁症状的风险增加近3倍（例如，调整患病率比，抑郁的PR = 2.75, 95% CI = 2.54-2.98, P < 0.001），食物不足的风险增加23倍（PR = 22.71, 95% CI = 15.62-33.01, P < 0.001），可能被驱逐的风险增加27倍（PR = 27.20, 95% CI = 10.63-69.59, P < 0.001）。在所有结果中，这些关系在每一个连续较高的经济困难水平上都更强（线性趋势的所有P值<0.001），并且超过了社会援助的收益。即使将社会援助收入考虑在内，经历经济困难的工作年龄成年人出现焦虑和抑郁症状、食物不足以及预期的住房驱逐的风险也明显更大。这些调查结果表明，迫切需要直接和持续的现金救济，远远超过目前的社会援助水平，以减轻这一流行病对数百万美国人，包括弱势少数群体和低收入人口的福祉的不利影响。
While social assistance through the U.S. federal CARES Act provided expanded unemployment insurance benefits during the COVID-19 pandemic until the summer of 2020, it is unclear whether social assistance was sufficient in subsequent months to meet everyday spending needs and to curb the adverse health-related sequelae of financial hardship. Using multivariable Poisson log-binomial regression and repeated cross-sectional Household Pulse Survey data between September and December 2020 on 91,222 working-aged U.S. adults and 28,842 adult housing renters, this study explored the associations of financial hardship with mental health outcomes and food and housing insecurity after accounting for receipt of social assistance. Financial hardship rose progressively from September to December 2020, and disproportionately affected Black non-Hispanic and Hispanic Americans and lower-income households. Experiencing considerable financial hardship (vs no hardship) predicted nearly 3-fold higher risks of anxiety and depressive symptoms (e.g., adjusted prevalence ratio, PR of depression = 2.75, 95% CI = 2.54–2.98, P < .001), a 23-fold higher risk of food insufficiency (PR = 22.71, 95% CI = 15.62–33.01, P < .001), and a 27-fold higher risk of a likely eviction (PR = 27.20, 95% CI = 10.63–69.59, P < .001). Across outcomes, these relationships were stronger at each successively higher level of financial hardship (all P values for linear trend <0.001), and more than offset benefits from social assistance. Even after accounting for social assistance receipt, working-aged adults experiencing financial hardship had markedly greater risks of anxiety and depressive symptoms, food insufficiency, and an anticipated housing eviction. These findings point to the urgent need for direct and sustained cash relief well in excess of current levels of social assistance to mitigate the pandemic's adverse impacts on the well-being of millions of Americans, including vulnerable minority and low-income populations.
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影响因子：
39
作者：
Berkowitz SA;Basu S
通讯作者：
Basu S
影响因子：
12.7
作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
Platt, Stephen
DOI：
10.1073/pnas.2009609117
发表时间：
2020-11-03
影响因子：
11.1
作者：
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通讯作者：
Velthorst, Eva
影响因子：
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作者：
Assari, Shervin
通讯作者：
Assari, Shervin