Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States.
Biostatistics and Data Science Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, United States.
Front Public Health. 2024 Aug 8;12:1404897. doi: 10.3389/fpubh.2024.1404897. eCollection 2024.
The COVID-19 pandemic has had a wide-ranging impact on mental health. Diverse populations experienced the pandemic differently, highlighting pre-existing inequalities and creating new challenges in recovery. Understanding the effects across diverse populations and identifying protective factors is crucial for guiding future pandemic preparedness. The objectives of this study were to (1) describe the specific COVID-19-related impacts associated with general well-being, (2) identify protective factors associated with better mental health outcomes, and (3) assess racial disparities in pandemic impact and protective factors.
A cross-sectional survey of Louisiana residents was conducted in summer 2020, yielding a sample of 986 Black and White adults. The exposure was overall pandemic impact, measured using the Epidemic-Pandemic Impacts Inventory, and the outcome was general well-being (GWB), measured with the General Well-Being Schedule. Potential protective factors included social support, resilience, and social cohesion. Linear regression models were constructed to examine the association between pandemic impact and GWB, with each protective factor added as an effect modifier. These relationships were further assessed for differences by race.
Pandemic stressors can be grouped into social, health, work, finance, and family-related impacts. Black persons displayed higher levels of pandemic impact as well as lower levels of social support, resilience, and social cohesion ( < 0.0001), highlighting existing racial disparities, though Black respondents and White respondents exhibited no differences in general-well being. Social support, resilience, and social cohesion were identified as protective factors for both groups ( < 0.0001, respectively), but these protective effects deteriorated as pandemic impacts increased. The addition of a pandemic impact by race interaction term was also significant in each model ( = 0.0020, < 0.0001, and = 0.0095, respectively) and showed that the protective effects of social support and resilience deteriorated more rapidly for Black persons than White persons, while the protective effects of social cohesion deteriorated more rapidly for White persons than Black persons.
This study emphasizes the importance of psychosocial resources in buffering the mental health impact of pandemics. It also suggests greater vulnerability for marginalized communities lacking access to crucial support systems. Findings underscore the need for targeted interventions that bolster access to social support, promote resilience, and strengthen social cohesion, particularly within minority groups. Additionally, policymakers should consider proactive measures to assist in recovery and mitigate the disproportionate impact of future crises on vulnerable populations.
COVID-19 大流行对心理健康产生了广泛影响。不同人群对大流行的体验不同，突出了先前存在的不平等现象，并在恢复过程中带来了新的挑战。了解不同人群的影响并确定保护因素对于指导未来的大流行准备工作至关重要。本研究的目的是：（1）描述与总体幸福感相关的特定 COVID-19 相关影响，（2）确定与更好的心理健康结果相关的保护因素，（3）评估大流行影响和保护因素方面的种族差异。
2020 年夏季对路易斯安那州居民进行了横断面调查，得出了 986 名黑人和白人成年人的样本。暴露因素是总体大流行影响，使用大流行影响清单进行测量，结果是总体幸福感（GWB），使用一般幸福感量表进行测量。潜在的保护因素包括社会支持、适应力和社会凝聚力。构建线性回归模型来研究大流行影响与 GWB 之间的关系，每个保护因素均作为效应修饰剂添加。进一步评估了种族差异对这些关系的影响。
大流行压力源可分为社会、健康、工作、财务和家庭相关影响。黑人表现出更高水平的大流行影响以及更低水平的社会支持、适应力和社会凝聚力（<0.0001），突出了现有的种族差异，尽管黑人受访者和白人受访者在一般幸福感方面没有差异。社会支持、适应力和社会凝聚力被确定为两个群体的保护因素（<0.0001，分别），但随着大流行影响的增加，这些保护作用会恶化。在每个模型中添加大流行影响与种族的交互项也具有统计学意义（=0.0020、<0.0001 和=0.0095，分别），表明社会支持和适应力的保护作用对黑人的恶化速度快于白人，而社会凝聚力的保护作用对白人的恶化速度快于黑人。
本研究强调了心理社会资源在缓冲大流行对心理健康影响方面的重要性。它还表明，缺乏获得关键支持系统的机会的边缘化社区更加脆弱。研究结果强调了需要有针对性的干预措施，增强社会支持、促进适应力和加强社会凝聚力，特别是在少数民族群体中。此外，政策制定者应考虑采取积极措施，帮助弱势群体从危机中恢复，并减轻未来危机对弱势人群的不成比例影响。
