Inequalities in Mental Health During the COVID-19 Pandemic: The Interplay of Individual Pandemic Stressors and State Sociopolitical Contexts

COVID-19 大流行期间心理健康的不平等：个人大流行压力源与国家社会政治背景的相互作用

• 批准号: 10354674
• 负责人: Rachel Donnelly
• 金额: $ 8.85万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-12-20 至 2023-10-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10354674
• 关键词: Address; Adult; American; Anxiety; COVID-19 pandemic; Censuses; Complex; Data; Data Set; Distress; E-learning; Employment; Ethnic Origin; Exposure to; Family; Feeling suicidal; Future; Gender; Goals; Health; Heterogeneity; Household; Income; Individual; Inequality; Insurance Benefits; Intervention; Knowledge; Life; Link; Mediating; Medicaid eligibility; Mental Depression; Mental Health; Minority Women; Outcome; Pattern; Personal Satisfaction; Physiologic pulse; Play; Policies; Population; Premature Mortality; Process; Race; Reaction; Research; Resources; Role; Scientific Advances and Accomplishments; Shapes; Social Identification; Social Policies; Socioeconomic Status; Stress; Surveys; Suspensions; Testing; Thinking; Time; United States; Vulnerable Populations; Walkers; Woman; Work; experience; geographic disparity; health disparity; health economics; health inequalities; improved; innovation; insight; low socioeconomic status; mortality; mortality risk; novel; pandemic disease; pandemic stress; people of color; physical conditioning; population health; psychological distress; racial and ethnic; response; socioeconomics; stressor; unemployment insurance

Project Summary/Abstract The COVID-19 pandemic is a historic crisis that is likely to exacerbate stress and undermine mental health in the United States. Indeed, rates of depression, anxiety, and suicide ideation are shockingly high during the pandemic and the adverse mental health experiences during the pandemic disproportionately burden less educated adults, racial/ethnic minorities, and women. However, the micro- and macro-level factors contributing to mental health disparities during the pandemic are complex and not fully understood. Unequal exposure to pandemic-related stressors (i.e., stress due to work, family, financial circumstances) are likely to result in significant disparities in mental health. Yet, these processes unfold within macro-level state sociopolitical contexts that may influence experiences of pandemic stress and exacerbate or ameliorate disparities in mental health. Thus, the overarching goal of the proposed project is to consider the extent to which individual pandemic stressors and state sociopolitical contexts jointly shape disparities in depression and anxiety. Specifically, this project aims to: 1) determine whether specific pandemic stressors explain disparities in mental health by race/ethnicity, educational attainment, and gender and 2) identify state-level policies and contexts that impact individual-level stress processes and create population disparities in mental health. To do so, the project will rely on a novel, large national dataset (Household Pulse Survey) and state- specific data on existing social policies and policies enacted in response to the pandemic. The proposed project will provide a new way of thinking about mental health disparities during the pandemic by shifting the focus from purely individual-level explanations to a broader framework that considers the interplay of individual-level stressors and state-level policies. By focusing on states as structural drivers of mental health, we will improve understanding of how state policies protect or harm Americans and their mental health during times of crisis, with far-reaching implications beyond the current pandemic. The proposed project has implications for long-term patterns of health and mortality. Because psychological distress can erode physical health and increase mortality risk over time, mental health disparities during the pandemic may exacerbate existing disparities in health and mortality for years to come. Moreover, geographic inequalities in mental health across states may fuel growing geographic inequalities in health and mortality after the pandemic.

项目概要/摘要 COVID-19 大流行是一场历史性危机，可能会加剧压力并损害精神 在美国的健康状况。事实上，抑郁、焦虑和自杀意念的发生率高得惊人 大流行期间以及大流行期间不良的心理健康经历不成比例 给受教育程度较低的成年人、少数种族/族裔和妇女带来负担。但微观和宏观层面的因素 大流行期间造成心理健康差异的因素很复杂，而且尚未得到充分了解。不等 暴露于与流行病相关的压力源（即工作、家庭、经济状况造成的压力）可能会 造成心理健康方面的显着差异。然而，这些过程是在宏观国家层面展开的 可能影响流行病压力经历并加剧或改善的社会政治背景 心理健康方面的差异。因此，拟议项目的总体目标是考虑程度 哪些流行病压力因素和国家社会政治背景共同塑造了抑郁症的差异 和焦虑。具体来说，该项目旨在：1）确定特定的流行病压力源是否可以解释 按种族/民族、教育程度和性别划分的心理健康差异；2) 确定州一级 影响个人压力过程并造成心理差异的政策和环境 健康。为此，该项目将依赖于一个新颖的大型国家数据集（家庭脉搏调查）和国家 - 有关现有社会政策和为应对这一流行病而制定的政策的具体数据。 拟议的项目将为思考这一时期的心理健康差异提供一种新的方式。 通过将重点从纯粹的个人层面的解释转移到更广泛的框架来应对大流行病 个人层面的压力源和国家层面的政策之间的相互作用。通过关注国家作为结构性驱动因素 心理健康，我们将提高对国家政策如何保护或伤害美国人及其人民的理解 危机时期的心理健康，其深远影响超出了当前的大流行。这 拟议项目对健康和死亡率的长期模式具有影响。因为心理上 随着时间的推移，痛苦会损害身体健康并增加死亡风险，期间心理健康差异 大流行可能会在未来几年加剧现有的健康和死亡率差异。此外，地理 各州心理健康方面的不平等可能会加剧健康和死亡率方面的地域不平等 疫情过后。