States' COVID-19 Mitigation Policies and Psychological Health, Drug Overdose, and Suicide among U.S. Adults

新冠肺炎大流行及其引发的缓解政策可能对 美国成年人的心理健康，包括他们死于药物过量和自杀的风险。为了缓解 随着新冠肺炎的传播，美国一些州制定了在家工作命令和关闭企业等政策。至 减轻不利的经济和健康影响，一些州颁布了驱逐、暂停和延长等政策 失业救济金。这些政策可能影响了成年人的心理健康和相关死亡率 通过社会孤立、工作家庭冲突、人际关系紧张、经济福祉、就业中断、 还有更多。这项提案的首要目标是严格评估国家级新冠肺炎 缓解政策影响了心理健康和因吸毒过量和自杀而导致的相关死亡率 在工作年龄和老年人中。该项目意义重大，并将产生持续影响，因为它：1) 确定各州的缓解政策在短期和长期内如何影响心理健康和死亡率- 条款，2)利用成年人关于新冠肺炎和缓解政策如何影响他们的生活和 心理健康和县级行政部门关于吸毒过量和自杀死亡的数据，以及3) 经验性地制定有意义的国家缓解政策的综合衡量标准，以评估其影响 心理健康和死亡率。该项目的创新之处在于：1)使用和扩展了新颖的调查数据 从工作年龄的成年人关于大流行及其缓解政策如何影响他们的生活，2)使用最近- 开发了用于分析包含高维和相关数据的大型上下文数据集的方法 3)侧重于政策对心理健康和相关死因的影响，特别是药物-- 从短期和长期来看，吸毒过量和自杀。该项目将通过三个阶段完成其目标 明确的目标。目标1确定了美国各州的新冠肺炎政策与成人心理之间的关系 健康。它使用了一项针对18岁美国成年人的新的全国性调查-(全国幸福调查)，该调查是在 2021年2月/3月，作者：Pi Monnat。使用其关于新冠肺炎如何影响人们生活的自我报告数据，我们将 评估：a)各州的新冠肺炎政策如何预测大约一年后个人的心理健康 新冠肺炎起源于美国，b)经济、社会和医疗条件如何帮助解释这种关联； 以及c)不同年龄、性别、种族/民族和教育程度的关联有何不同。目标2确定了美国各州的 新冠肺炎政策影响了县级的致命性药物过量和自杀率。使用来自中国的死亡率数据 国家生命统计系统，我们将评估：a)各州新冠肺炎的直接和滞后影响 关于县级吸毒过量和18岁及以上成年人自杀率的政策，b)如何经济， 社会和卫生保健条件解释了这些影响，以及c)年龄、性别和种族/民族的差异。目标3 与该联盟密切合作，收集四个新的NWS年度浪潮，以确定较长期的 国家新冠肺炎政策和个人适应对成人心理健康的影响。

The COVID-19 pandemic and the mitigation policies it prompted may have had profound consequences for the psychological health of U.S. adults, including their risk of dying from drug overdose and suicide. To mitigate the spread of COVID-19, some U.S. states enacted policies like stay-at-home orders and business closures. To mitigate adverse economic and health effects, some states enacted policies like eviction moratoria and extended unemployment benefits. These policies may have affected adults’ psychological health and related mortality through social isolation, work-family conflict, interpersonal strain, economic wellbeing, employment disruptions, and more. The overarching objective of this proposal is to rigorously assess how state-level COVID-19 mitigation policies have affected psychological health and related mortality from drug overdose and suicide among working age and older adults. The project is significant and will have a sustained impact because it: 1) identifies how states’ mitigation policies affect psychological health and mortality in both the short and longer- terms, 2) leverages adults’ self-reports of how COVID-19 and mitigation policies affected their lives and psychological health with county-level administrative data on drug overdose and suicide mortality, and 3) empirically develops meaningful composite measures of state mitigation policies to assess their impact on psychological health and mortality. The project is innovative in that it: 1) uses and extends novel survey data from working-age adults on how the pandemic and its mitigation policies affected their lives, 2) uses recently- developed methods for analyzing large contextual datasets containing high-dimensional and correlated data and 3) focuses on the impacts of policies on psychological health and related causes of death, specifically drug- overdoses and suicides, in the short and longer terms. The project will accomplish its objective through three Specific Aims. Aim 1 identifies how U.S. states’ COVID-19 policies are associated with adult psychological health. It uses a new, national survey of U.S. adults aged 18-64 (National Wellbeing Survey) conducted in Feb/Mar 2021 by PI Monnat. Using its self-reported data on how COVID-19 has affected people’s lives, we will assess: a) how states’ COVID-19 policies predict individuals’ psychological health approximately one year after COVID-19 began in the U.S., b) how economic, social, and health care conditions help explain the associations; and c) how the associations vary by age, sex, race/ethnicity, and education. Aim 2 identifies how U.S. states’ COVID-19 policies affected fatal drug overdose and suicide rates at the county level. Using mortality data from the National Vital Statistics System, we will assess: a) the immediate and lagged effects of states’ COVID-19 policies on county-level fatal drug overdose and suicide rates among adults aged 18 and older, b) how economic, social, and health care conditions explain these effects, and c) variation by age, sex, and race/ethnicity. Aim 3 collects four new annual waves of the NWS, in close collaboration with the Consortium, to identify longer-term consequences of states’ COVID-19 policies and individuals’ adaptations on adult psychological health.