Saaka Sulemana Ansumah, Antabe Roger, Luginaah Isaac
Department of Geography and Environment, Faculty of Social Science, University of Western Ontario, London, Ontario, Canada.
Department of Health and Society, University of Toronto Scarborough, Toronto, Ontario, Canada.
PLOS Glob Public Health. 2025 Jun 4;5(6):e0004728. doi: 10.1371/journal.pgph.0004728. eCollection 2025.
Mental health (MH) remains a major public health concern in Canada and has been exacerbated by the unprecedented challenges of the COVID-19 pandemic and the associated restrictions on physical movement. While considerable work has been done on the impact of COVID-19 on the physical and MH of the general population, relatively less work has focused on the MH of persons with disabilities (PWDs). Although the COVID-19 containment measures including lockdowns, social distancing, quarantine, and closure of nonessential services were intended to reduce the direct risks of COVID-19, the socioeconomic consequences of those restrictions and the uncertainties surrounding the virus, inadvertently had adverse impact on the MH and well-being of Canadian residents, particularly, among already marginalized groups such as PWDs. Moreover, PWDs were identified as disproportionately vulnerable to the psychological impacts of the pandemic containment measures which compromised their overall Positive Mental Health (PMH): a state of well-being where individuals can realize their full potential, manage life's stresses, work productively, and contribute to society. This study addresses the research gap by examining the effect of the pandemic on the MH of PWDs in Canada using a cross-sectional analysis of the 2021 Canadian Housing Survey (N = 15,626), a subset of people who reported disabilities. Logistic regression models were employed for this cross-sectional analysis. The results show that females (OR = 0.789; P < 0.001), those who experienced COVID-19 economic hardship (OR = 0.703; P < 0.001), and dwelling dissatisfaction (OR = 0.585; P < 0.001), significantly reported about 0.79, 0.70, and 0.59 times lower odds of positive Mental Health (PMH), respectively. On the other hand, those who had post-secondary educational attainment (OR = 1.210; P < 0.001), strong sense of community belonging (OR = 2.056; P < 0.001), and civic engagement with their communities (OR = 1.204; P < 0.001), were significantly associated with 1.21, 2.06, and 1.20 times higher odds of PMH, respectively. Additionally, immigration status, household type, the province of residence, and neighborhood-specific challenges such as race-based harassments, and drug use/dealings emerged as significant predictors of PMH. The findings underscore the positive impacts of empowering elements such as strong community ties on the MH of PWDs during public health crisis. Also, the findings prompt the pressing need for identifying and addressing the unique challenges of PWDs in Canada, particularly, the less educated and socioeconomically disadvantaged, as part of effort to foster PMH in the country. Overall, these findings suggest the need to prioritize and strengthen disability-inclusive MH programs for future public health crises.
心理健康(MH)仍是加拿大主要的公共卫生问题,并且因新冠疫情带来的前所未有的挑战以及相关的人员流动限制而加剧。虽然在新冠疫情对普通人群的身体和心理健康影响方面已经开展了大量工作,但相对较少的工作聚焦于残疾人(PWDs)的心理健康。尽管包括封锁、社交距离、隔离以及关闭非必要服务在内的新冠疫情防控措施旨在降低感染新冠病毒的直接风险,但这些限制措施的社会经济后果以及围绕病毒的不确定性,无意间对加拿大居民的心理健康和福祉产生了不利影响,尤其是在残疾人等已经处于边缘地位的群体中。此外,残疾人被认定为在疫情防控措施的心理影响方面格外脆弱,这些措施损害了他们的总体积极心理健康(PMH):即个体能够充分发挥自身潜力、应对生活压力、高效工作并为社会做出贡献的一种幸福状态。本研究通过对2021年加拿大住房调查(N = 15,626)中报告有残疾的人群子集进行横断面分析,来探讨疫情对加拿大残疾人心理健康的影响,从而填补这一研究空白。本横断面分析采用了逻辑回归模型。结果显示,女性(比值比[OR] = 0.789;P < 0.001)、经历过新冠疫情经济困难的人(OR = 0.703;P < 0.001)以及对居住环境不满意的人(OR = 0.585;P < 0.001),其积极心理健康(PMH)的几率分别显著降低约0.79倍、0.70倍和0.59倍。另一方面,拥有大专及以上学历的人(OR = 1.210;P < 0.001)、强烈的社区归属感(OR = 2.056;P < 0.001)以及与社区的公民参与度(OR = 1.204;P < 0.001),分别与PMH几率显著高出1.21倍、2.06倍和1.20倍显著相关。此外,移民身份、家庭类型、居住省份以及特定社区的挑战,如基于种族的骚扰和吸毒/毒品交易,也成为PMH的重要预测因素。研究结果强调了在公共卫生危机期间,诸如紧密社区联系等赋能因素对残疾人心理健康的积极影响。同时,研究结果也凸显了迫切需要识别并应对加拿大残疾人所面临的独特挑战,尤其是受教育程度较低和社会经济地位不利的群体,以此作为在该国促进积极心理健康的努力的一部分。总体而言,这些研究结果表明,在未来公共卫生危机中,需要优先考虑并加强包含残疾人的心理健康项目。