Unequal Effects of the Lockdown on Mental Health in Shanghai: The Moderating and Mediating Role of Neighborhood Environment and Online Social Connections.

The COVID-19 pandemic profoundly impacted population mental health worldwide. Few studies examined how the neighborhood environment and online social connections might influence the social gradient in mental health during the pandemic lockdown. We aim to examine the moderating and mediating role of neighborhood environment and online social connections in the association between socioeconomic status (SES) and mental health outcomes. We conducted a cross-sectional online survey of 3763 Shanghai residents during the COVID-19 lockdown between April 29 and June 1, 2022. Employing OLS linear regression analyses, our findings reveal that SES was negatively associated with depressive symptoms (B = 0.173, p < 0.001) and anxiety (B = 0.147, p < 0.001). The findings supported our hypotheses that this disparity in mental health was partially mediated by neighborhood social capital, community management, and the extent of online social connections measured by the frequency of social connection through the social media WeChat (all p < 0.05). Additionally, neighborhood social capital, community management, and online social connections also mitigated SES-driven mental health inequalities (all p < 0.05). The study underscores the significance of the neighborhood environment and online social interactions in amplifying SES-related mental health effects, offering valuable insights for urban planning and health equity strategies.