The COVID-19 Pandemic and Its Effects on Mental Health-A before, during, and after Comparison Using the U.S. Census Bureau's Household Pulse Survey.

BACKGROUND

Although significantly increased mental health concerns were noted globally during the first year of the COVID-19 pandemic, much less is known about the mental health trends during the COVID-19 recovery period. We aimed to compare current anxiety or depression rates to those before and during the first year of the pandemic and to evaluate demographic differences.

METHODS

We analyzed Household Pulse Survey data prospectively collected from a representative U.S. population sample. We compared the anxiety or depression rates from the first pandemic year (04/2020-05/2021) and recovery period (06/2023-03/2024) from the national cohort and demographic subgroups using two-sided paired -tests and regression analyses and compared these to pre-pandemic (01/2019-12/2019) rates using one-sided -tests.

RESULTS

The national estimates for anxiety or depression improved during the recent COVID-19 recovery period as compared to the first year (29.5 ± 5.5 vs. 37.6 ± 3.1; < 0.0001) but did not return to the pre-pandemic benchmark (29.5% vs. 10.8%; < 0.001). Higher rates were noted in younger individuals aged 18-29 years ( < 0.0001), in individuals with less than a high school diploma ( < 0.0001), or with disabilities ( < 0.0001). Non-Hispanic Asians reported the lowest rates ( < 0.0001), and no significant gender differences were noted.

CONCLUSION

The U.S. population's mental health concerns have improved since the first year of the pandemic but remain above pre-pandemic benchmarks. Certain demographic subgroups are at higher risk, indicating the need for targeted health care and economic policy interventions to address these disparities.