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

COVID-19大流行及其引发的缓解政策可能对全球经济产生了深远的影响。 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。减轻 随着COVID-19的蔓延，美国一些州颁布了诸如居家令和企业关闭等政策。到 为了减轻不利的经济和健康影响，一些州颁布了暂停驱逐等政策， 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的死亡率 通过社会孤立、工作与家庭冲突、人际关系紧张、经济福利、就业中断， 和更多.该提案的总体目标是严格评估州一级的COVID-19 缓解政策影响了心理健康以及药物过量和自杀造成的相关死亡率 工作年龄和老年人。该项目意义重大，将产生持续影响，因为它：1） 确定了国家的缓解政策如何影响心理健康和死亡率在短期和长期- 2）利用成年人关于COVID-19和缓解政策如何影响他们生活的自我报告， 心理健康与药物过量和自杀死亡率的县级行政数据，以及3） 以经验为基础，制定有意义的国家减缓政策综合措施，以评估其对 心理健康和死亡率。该项目的创新之处在于：1）使用并扩展了新的调查数据 从工作年龄的成年人那里了解大流行及其缓解政策如何影响他们的生活，2）最近使用- 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)重点关注政策对心理健康和相关死亡原因的影响，特别是药物， 吸毒过量和自杀，短期和长期的。该项目将通过三个方面实现其目标。 具体目标。目标1确定了美国各州的COVID-19政策如何与成人心理相关 健康它使用了一项新的全国性调查，调查对象是18-64岁的美国成年人（全国幸福感调查）， 二月/三月2021由PI Monnat.利用其关于COVID-19如何影响人们生活的自我报告数据，我们将 评估：a）各州的COVID-19政策如何预测个人在大约一年后的心理健康状况 新冠肺炎始于美国，B）经济、社会和卫生保健条件如何有助于解释这种关联; 以及c）这些关联如何随年龄、性别、种族/民族和教育而变化。目标2确定了美国各州如何 COVID-19政策影响了县级的致命药物过量和自杀率。使用死亡率数据， 国家生命统计系统，我们将评估：a）各州COVID-19的即时和滞后影响 关于县级18岁及以上成年人致命药物过量和自杀率的政策，B）经济性如何， 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 与联盟密切合作，收集四个新的核武器年度浪潮，以确定长期 国家COVID-19政策和个人适应对成年人心理健康的影响。

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.