School of Nursing, University of California, Los Angeles, California, USA.
School of Nursing, Purdue University, West Lafayette, Indiana, USA.
J Adv Nurs. 2024 Feb;80(2):683-691. doi: 10.1111/jan.15803. Epub 2023 Aug 7.
To explore the impact of structural and intermediary social determinants of health (SDoH) on Californian adults' mental health during the early phase of the COVID-19 pandemic.
This cross-sectional study used data from the 2020 cycle of the California Health Interview Survey, the largest US state-level population health survey.
Descriptive statistics and logistic regression were used to analyse the data. Using a general social determinant of health framework, we operationalized different survey questions to measure structural and intermediary determinants of mental health.
Mental health during the early phase of COVID-19 among adults in California was associated with age, gender, health conditions, delayed care, employment status (loss of job or reduced income) and discrimination. People in higher social strata were more likely to have better mental health for many of these factors.
This study supports the assertion that material circumstances (such as employment status) and discrimination are associated with experiencing mental health issues among adults in California during COVID-19. Racism is a public health issue, and as nurses, addressing racism is critical. In addition, much work is needed to address SDoH to improve health outcomes, especially among marginalized populations.
This study addressed the knowledge gap concerning the social determinants of mental health among Californian adults during the early phase of the COVID-19 pandemic. Those who had reduced income and those who lost their jobs during the COVID-19 pandemic were 46% and 56%, respectively, more likely to report mental health problems. Those who experienced discrimination in healthcare were 304% more likely to report mental health issues. This research will increase the understanding of the social determinants of health, particularly for those with chronic illnesses and mental health issues during the COVID-19 pandemic.
No patient or public contribution, as we used an existing US state dataset. However, California Health Interview Survey is the largest state health survey in the United States and interviews more than 20,000 households each year representing the health care needs of Californians.
探讨结构性和中介性健康社会决定因素（SDoH）对 COVID-19 大流行早期加利福尼亚州成年人心理健康的影响。
本横断面研究使用了 2020 年加利福尼亚健康访谈调查的循环数据，这是美国最大的州级人群健康调查。
使用描述性统计和逻辑回归分析数据。我们使用一般健康社会决定因素框架，将不同的调查问题操作化为衡量心理健康的结构性和中介性决定因素。
COVID-19 大流行早期，加利福尼亚州成年人的心理健康与年龄、性别、健康状况、延迟护理、就业状况（失业或收入减少）和歧视有关。对于许多这些因素，社会地位较高的人更有可能拥有更好的心理健康。
这项研究支持这样一种说法，即物质环境（如就业状况）和歧视与 COVID-19 期间加利福尼亚州成年人经历心理健康问题有关。种族主义是一个公共卫生问题，作为护士，解决种族主义问题至关重要。此外，还需要做大量工作来解决 SDoH 问题，以改善健康结果，特别是在边缘化人群中。
本研究解决了 COVID-19 大流行早期加利福尼亚州成年人心理健康的社会决定因素方面的知识差距。在 COVID-19 大流行期间，收入减少和失业的人分别有 46%和 56%更有可能报告心理健康问题。在医疗保健中经历歧视的人报告心理健康问题的可能性高 304%。这项研究将增加对健康社会决定因素的理解，特别是对那些在 COVID-19 大流行期间患有慢性疾病和心理健康问题的人。
由于我们使用了现有的美国州数据集，因此没有患者或公众的贡献。然而，加利福尼亚健康访谈调查是美国最大的州健康调查，每年采访超过 20000 户家庭，代表加利福尼亚人的医疗保健需求。
