Minorities bore disproportionate mental health impact of pandemic

Racial and ethnic minorities bore a disproportionate mental health burden during the COVID-19 pandemic, according to a new study published this week in the open-access journal PLOS ONE by Andrew Chan of Harvard Medical School, Tim Spector of King's College London, and colleagues.

Previous research has established that minorities have borne a disproportionate COVID-19 burden, including higher rates of infection, severe disease, hospitalization and death, when compared to non-Hispanic whites. Moreover, a three-fold increase in the incidence of depression symptoms has been reported in the wake of the pandemic. However, the effects of COVID-19 on the mental health of minorities were unclear.

In the new study, the researchers used data on 691,473 people in the U.S. and U.K. who responded to the smartphone-based COVID Symptom Study between January 23, 2021 and June 9, 2021. Participants were recruited through social media, reported baseline information and then logged daily information on symptoms and COVID-19 testing results using the Zoe app. Questions were included from the PHQ-4 (Panvalidated 4-item Patient Health Questionnaire for Depression and Anxiety), PHQ-9 and the GAD-7 (7-item General Anxiety Disorder) screening tools.

The study found that, after controlling for personal factors including prior mental health diagnoses and changes in leisure time activities, Black participants in the U.S. were 1.16 times more likely to screen positive for depression than White participants (95% CI 1.02-1.31). Compared to White participants, Hispanic participants in the U.S. were 1.23 times more likely to screen positive for depression (95% CI 1.11-1.36) and 1.23 times more likely to show signs of anxiety (95% CI 1.12-1.34). Similar results were seen for Black and Asian participants in the U.K. as well as within other subgroups of participants including Black healthcare workers, who had higher odds of depression and anxiety than White healthcare workers.

The authors conclude that minority communities in both the U.S. and U.K. have been disproportionately impacts by the mental health burden of COVID-19 and stand to suffer well beyond any presumed conclusion of the pandemic.

The authors add: "The early phase of COVID-19 pandemic was incredibly disruptive to everyday life. We found that racial and ethnic minorities in the U.S. and U.K. were more likely to screen positive for depression and anxiety. This suggests a disproportionate impact and mental health burden on persons of color, which need to be considered as we reshape health care systems to prioritize the long-term consequences of this disease."