Department of Epidemiology, New York University School of Global Public Health, NY, New York, USA.
Department of Public Health Policy and Management, New York University School of Global Public Health, NY, New York, USA.
Prev Med. 2022 Nov;164:107239. doi: 10.1016/j.ypmed.2022.107239. Epub 2022 Sep 1.
Although prior research has assessed public mental health in the U.S. throughout the COVID-19 pandemic, it is unclear how area-level unemployment impacted psychological well-being; moreover, studies that examine potential effect heterogeneity of the impact of area-level unemployment on well-being by employment status are lacking. To address these shortcomings, this study utilized data from Gallup's repeated cross-sectional, nationally representative COVID-19 web survey collected between April 2020 and July 2021 (n = 132,971). Survey modified Poisson regression models were estimated to determine the association between current unemployment rate in respondents' state of residence and experience of each of the following negative emotions during a lot of the prior day: sadness, worry, stress, anger, loneliness, depression, and anxiety. These models were stratified by employment status and sequentially adjusted for individual-level covariates, state fixed effects, and current state-level COVID-19 mortality. State-level unemployment was most strongly associated with sadness, followed by worry, anger, loneliness, stress, and anxiety; no associations were observed for depression. For sadness, worry, and stress, associations were strongest among full-time employed and retired individuals, and weakest among unemployed respondents and homemakers. Moreover, there was some evidence that state-level unemployment was negatively associated with the experience of anger in the early stages of the pandemic, and positively in its later stages. In sum, these findings suggest that Americans' emotional experience during the COVID-19 pandemic was considerably impacted by the state of the economy, highlighting the need for risk-buffering social policies.
尽管先前的研究已经评估了美国在整个 COVID-19 大流行期间的公众心理健康状况,但尚不清楚地区失业率如何影响心理健康;此外,缺乏研究检验地区失业率对就业状况不同人群的潜在影响的异质性。为了解决这些不足,本研究利用了盖洛普(Gallup)在 2020 年 4 月至 2021 年 7 月期间进行的重复横断面、全国代表性 COVID-19 网络调查的数据(n=132971)。采用调查修正泊松回归模型来确定受访者居住州的当前失业率与前一天经历的以下每种负面情绪之间的关联:悲伤、担忧、压力、愤怒、孤独、抑郁和焦虑。这些模型按就业状况分层,并按个体水平协变量、州固定效应和当前州级 COVID-19 死亡率进行顺序调整。州级失业率与悲伤的关联最强,其次是担忧、愤怒、孤独、压力和焦虑;与抑郁无关。对于悲伤、担忧和压力,全职就业和退休人员的关联最强,失业者和家庭主妇的关联最弱。此外,有证据表明,在大流行的早期阶段,州级失业率与愤怒体验呈负相关,而在后期阶段则呈正相关。总之,这些发现表明,美国人在 COVID-19 大流行期间的情绪体验受到经济状况的极大影响,这凸显了需要风险缓冲的社会政策。