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

项目总结/摘要 COVID-19大流行是一场历史性危机，可能会加剧压力并破坏心理健康。 美国的健康。事实上，抑郁、焦虑和自杀意念的发生率高得惊人 大流行期间的不良心理健康经历 教育程度较低的成年人、少数民族和妇女的负担。然而，微观和宏观层面的因素 造成大流行病期间心理健康差异的原因是复杂的，尚未得到充分理解。不平等 暴露于与流行病相关的压力源（即，由于工作、家庭、财务状况等原因而产生的压力）可能会 导致心理健康方面的巨大差异。然而，这些过程是在宏观层面上展开的。 可能影响流行病压力体验并加剧或缓解 心理健康方面的差距。因此，拟议项目的总体目标是考虑 哪些个人流行压力源和国家社会政治背景共同塑造了抑郁症的差异 和焦虑具体而言，该项目旨在：1）确定特定的大流行压力因素是否解释了 按种族/民族、教育程度和性别分列的心理健康差异; 2）确定州一级的 政策和环境影响个人层面的压力过程，并在心理上造成人口差异， 健康为此，该项目将依赖于一个新的、大型的全国数据集（家庭脉搏调查）和国家- 关于现行社会政策和为应对这一流行病而颁布的政策的具体数据。 拟议的项目将提供一种新的方式来思考心理健康的差距， 通过将重点从纯粹的个人层面的解释转移到一个更广泛的框架， 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，我们将提高国家政策如何保护或伤害美国人及其 危机时期的心理健康，其深远影响超出了目前的流行病。的 拟议项目对健康和死亡率的长期模式有影响。因为心理 随着时间的推移，痛苦会侵蚀身体健康，增加死亡风险， 大流行可能会在未来几年加剧健康和死亡率方面的现有差距。此外，地理 各州精神健康的不平等可能会加剧健康和死亡率的地理不平等 疫情之后。

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.