Research, Analytics, and Development Core, Baylor Scott & White Research Institute, Dallas, Texas, USA.
University of Texas at Arlington, School of Social Work, Arlington, Texas, USA.
Popul Health Manag. 2022 Jun;25(3):384-391. doi: 10.1089/pop.2021.0214. Epub 2021 Oct 14.
The COVID-19 pandemic has caused disproportionate suffering among vulnerable and socioeconomically disadvantaged portions of the population. Low-income and minority populations are likely to experience disparate disease and mental health burdens. Currently, there is little evidence regarding how the experience of the early months of the US COVID-19 outbreak differed by income level, and how that related to mental health symptoms. The present study used data from a national sample of US adults (n = 5023) who completed measures related to the COVID experience, the COVID-19 Fear Scale, the Generalized Anxiety Disorder-7 (GAD-7), and the Patient Health Questionnaire-8 (PHQ-8). Multivariable regression was performed to determine whether income level (low: <$45,000 vs high: ≥$75,000) was significantly associated with COVID experience measures, PHQ-8, GAD-7, and COVID fear scores. Among the low-income group, COVID-19 had a significantly greater negative impact on: family income/employment, access to food, access to mental health treatment, and stress and discord in the family. Participants in the low-income group also had greater odds of a PHQ-8 score ≥10 (odds ratio [OR] = 1.38, 95% confidence interval [CI] 1.08, 1.77) and a GAD-7 score ≥10 (OR = 1.65, 95% CI 1.27, 2.14) compared to those in the high-income group. Study findings suggest substantial differences in how COVID-19 impacted daily life and mental health between adults living in low-income households compared to high-earning households during the early months of the pandemic.
新冠疫情对弱势群体和社会经济弱势群体造成了不成比例的痛苦。低收入和少数族裔人群可能会面临不同的疾病和心理健康负担。目前,几乎没有证据表明美国新冠疫情早期的经历在收入水平上有何不同,以及这种差异与心理健康症状有何关系。本研究使用了来自美国成年人(n=5023)的全国性样本数据,他们完成了与新冠体验相关的测量、新冠恐惧量表、广泛性焦虑障碍 7 项量表(GAD-7)和患者健康问卷 8 项量表(PHQ-8)。采用多变量回归分析来确定收入水平(低:<$45000 与高:≥$75000)是否与新冠体验指标、PHQ-8、GAD-7 和新冠恐惧评分显著相关。在低收入组中,新冠疫情对家庭收入/就业、获得食物、获得心理健康治疗以及家庭压力和不和谐产生了更大的负面影响。低收入组的参与者也更有可能出现 PHQ-8 评分≥10(优势比 [OR] = 1.38,95%置信区间 [CI] 1.08,1.77)和 GAD-7 评分≥10(OR = 1.65,95% CI 1.27,2.14),而高收入组的参与者则没有。研究结果表明,在疫情早期,与高收入家庭相比,生活在低收入家庭中的成年人在新冠疫情对日常生活和心理健康的影响方面存在显著差异。