Kemp Christopher G, Mensa-Kwao Augustina, Concepcion Tessa, Hughsam Matt, Queen Emily, Sinha Moitreyee, Collins Pamela Y
Johns Hopkins University, Department of International Health, Baltimore, MD, USA.
University of Washington, Department of Global Health, Seattle, WA, USA.
SSM Ment Health. 2023 Dec;3:100214. doi: 10.1016/j.ssmmh.2023.100214. Epub 2023 Apr 23.
People in the United States have faced numerous large and intersecting threats to their mental health since the onset of the coronavirus disease pandemic. This study aimed to understand the unique relationships between these co-occurring threats - including the police killings of unarmed Black people and the fight for racial justice - and how they affect mental health symptoms among various demographic groups.
Data on population mental health, state-level COVID-19 incidence rates, cases of police-involved killings, and occurrences of racial justice protests were analyzed. The primary outcome was depression or anxiety symptoms. Regression models were used to estimate prospective associations between individual-, household-, and state-level exposures to hypothesized mental health threats and subsequent depression or anxiety symptoms.
Data from 2,085,041 individual participants were included. Most were women (51.2%), and most were white, non-Hispanic (61.2%), with almost half (47.7%) reporting some loss of household income since March 13, 2020. Neither the killing of unarmed Black people by police, nor the above-average occurrence of Black Lives Matter (BLM) protests, were observed to be associated with anxiety or depressive symptoms in the overall population, though the BLM protests were associated with reduced depressive and anxiety symptoms among younger participants. State-level COVID-19 incidence risk was more strongly associated with depressive and anxiety symptoms among women, Black people, older people, and higher income people, compared to men, white people, younger people, and lower income people.
Our findings are relevant for anticipating and addressing the mental health consequences of social injustice and protest movements in the context of COVID-19 pandemic, as well as future pandemics. Promoting population mental health requires addressing underlying social and structural inequities and prioritizing the pursuit of social justice and health equity as a primary mental health intervention.
自冠状病毒病大流行开始以来，美国民众面临着众多对其心理健康构成重大且相互交织的威胁。本研究旨在了解这些同时出现的威胁之间的独特关系——包括警察对 unarmed Black people 的杀戮以及为种族正义而进行的斗争——以及它们如何影响不同人口群体的心理健康症状。
分析了关于人口心理健康、州级 COVID - 19 发病率、警察参与杀人案件以及种族正义抗议事件的数据。主要结果是抑郁或焦虑症状。回归模型用于估计个人、家庭和州层面暴露于假设的心理健康威胁与随后的抑郁或焦虑症状之间的前瞻性关联。
纳入了来自 2,085,041 名个体参与者的数据。大多数是女性（51.2%），大多数是白人、非西班牙裔（61.2%），几乎一半（47.7%）的人报告自 2020 年 3 月 13 日以来家庭收入有所损失。虽然“黑人的命也是命”（BLM）抗议活动与年轻参与者中抑郁和焦虑症状的减轻有关，但总体人群中，警察对 unarmed Black people 的杀戮以及高于平均水平的 BLM 抗议活动均未被观察到与焦虑或抑郁症状相关。与男性、白人、年轻人和低收入人群相比，州级 COVID - 19 发病风险与女性、黑人、老年人和高收入人群中的抑郁和焦虑症状关联更强。
我们的研究结果对于预测和应对 COVID - 19 大流行以及未来大流行背景下社会不公和抗议运动对心理健康的影响具有重要意义。促进人口心理健康需要解决潜在的社会和结构不平等问题，并将追求社会正义和健康公平作为主要的心理健康干预措施予以优先考虑。
