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Mental Health Consequences of COVID-19: The Role of the Social Determinants of Health

There have been many concerns about COVID-19’s intersection with mental health since the start of the pandemic, especially among individuals with pre-existing mental health conditions as these individuals might also have more chronic medical conditions that increase their risk for contracting severe COVID-19 compared with individuals without any mental health condition. Although researchers have predicted adverse mental health outcomes following a COVID-19 diagnosis, few studies quantify the mental health consequences of COVID-19.  The pandemic has also raised concerns that social inequalities in health could unevenly impact COVID-19 related mortality and morbidity, with individuals and families living in poverty and disadvantaged conditions being disproportionately impacted. During the COVID-19 pandemic, many low-wage workers have been deemed as essential including agricultural workers, home care workers, grocery store workers, and restaurant workers. In addition, evidence suggests that social determinants of health (SDOH) indicators such as low income, social exclusion, unemployment, adverse childhood experiences, and food and housing insecurity can lead to poor mental health outcomes. There is limited information linking how the SDOH indicators correlate with onset of new mental health conditions among individuals who contracted COVID-19. Understanding the relationship is important as policy responses to the mental health impact of the pandemic could be more effectively formulated if the underlying factors that contribute to adverse mental health outcomes are better understood. A Research Brief April 9, 2021 prepared by Dr Mir for the Office of the Assistant Secretary for Planning and Evaluation outlines that patients with a COVID-19 diagnosis experienced a new onset of mental health condition following their COVID-19 diagnosis compared to patients who tested negative for COVID-19 or had a COVID-19 symptom. Among patients who experienced a new onset of mental health condition, the most common types were anxiety (70-75%) and major depression (31-33%). The data quantifies the contribution of SDOH indicators to the development of the mental health condition. The odds of developing a mental health condition after COVID-19 diagnosis were significantly higher among individuals with health-related social needs associated with childhood upbringing,  education, employment, and/or housing.

Mir M. Ali, Ph.D., Health Economist. Mental Health Consequences of COVID-19: The Role of Social Determinants of Health (Issue Brief). Washington, DC: Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services. April 9, 2021.

Link to the full reporthttps://aspe.hhs.gov/mh-consequences-covid