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Introduction: This study explores the association between self-perceived personal and community changes due to COVID-19 and health among vulnerable primary care patients experiencing multiple chronic conditions. Methods: Between September 2017 and February 2021, we obtained data from 2,426 primary care patients managing multiple chronic conditions from across the United States. We assessed the relationship between self-perceived personal and community changes due to COVID-19 and change in health measured by the PROMIS-29 mental and physical health summary scores, GAD-7 (anxiety), andPHQ-9 (depression), and DASI (functional capacity) adjusting for relevant demographic, neighborhood characteristics, and county covariates. Results: After adjustment, self-perceived personal and community changes due to COVID-19 were associated with significantly worse mental health summary scores (ß = -0.55; 95% Confidence Interval (CI) = -0.72, -0.37), anxiety (ß = 0.28; 95% CI = 0.16, 0.39), depression (ß = 0.35; 95% CI = 0.22, 0.47), and physical health summary scores (ß = -0.44; 95% CI = 0.88, 0.00). There was no association with functional capacity (ß = - 0.05; 95% CI = -0.16, 0.05). Discussion: Among adults managing multiple chronic conditions, self-perceived personal and community changes due to COVID-19 were associated with health. This vulnerable population may be particularly susceptible to the negative effects of COVID-19. As we do not know the long-term health effects of COVID, this paper establishes a baseline of epidemiological data on COVID-19 burden and health among primary care patients with multiple chronic conditions. [ABSTRACT FROM AUTHOR]

Objectives: Financial hardships, job losses, and social isolation during the COVID-19 pandemic have increased food insecurity. We examined associations between food insecurity–related interventions and mental health among US adults aged ≥18 years from April 2020 through August 2021. Methods: We pooled data from the Household Pulse Survey from April 2020 through August 2021 (N = 2 253 567 adults). To estimate associations between mental health and food insecurity, we examined the following interventions: the Supplemental Nutrition Assistance Program (SNAP), Economic Impact Payments (stimulus funds), unemployment insurance, and free meals. We calculated psychological distress index (PDI) scores (Cronbach α = 0.91) through principal components analysis using 4 mental health variables: depression, anxiety, worry, and lack of interest (with a standardized mean score [SD] = 100 [20]). We conducted multivariable linear regression to estimate the interactive effects of the intervention and food insecurity on psychological distress, controlling for sociodemographic characteristics. Results: During the study period, adults with food insecurity had higher mean PDI scores than adults without food insecurity. Food insecurity was associated with increased PDI scores after controlling for sociodemographic characteristics. In stratified models, negative associations between food insecurity and mental health (as shown by reductions in PDI scores) were mitigated by SNAP (−4.5), stimulus fund (−4.1), unemployment insurance (−4.4), and free meal (−4.4) interventions. The mitigation effects of interventions on PDI were greater for non-Hispanic White adults than for non-Hispanic Black or Asian adults. Conclusions: Future research on food insecurity and mental health should include investigations on programs and policies that could be of most benefit to racial and ethnic minority groups. [ABSTRACT FROM AUTHOR]

Despite the proliferation of studies documenting the relationship between physical limitation and depressive symptoms in the United States, we currently do not know (1) whether physical impairment is associated with other dimensions of emotional well-being and (2) if these associations differ for men and women as well as married and nonmarried adults. We use panel data from two national samples to examine gender and marital status variations in the impact of physical limitation on four indicators of mental health. We find that physical limitation is associated with increases in depressive symptoms and negative feelings as well as decreases in positive emotions. Although the patterns are complex, we also find gender and marital status differences in these associations. Our results provide additional support for Aneshensel’s (1992; Aneshensel, Rutter, and Lachenbruch 1991) argument about the highly contingent nature of stress reactivity and contribute to theory about both gender and marital status differences in the impact of stress on mental health. [ABSTRACT FROM PUBLISHER]

We consider the association between racial discrimination and depression in a relatively comprehensive assessment of general social stress. Data for this investigation come from a sample of Miami-Dade County young adults; the present analyses are limited to African American and white non-Hispanic respondents. Findings indicate that perceptions of discrimination are strongly related to psychological distress. Surprisingly, however, these perceptions contribute almost nothing to an understanding of the origins of racial differences in depression. It appears that differences in lifetime adversity and in exposure to recent and chronic stressors capture those variations in personal history and circumstance which are linked to and arise from social disadvantage and which are relevant to mental health. Variations in these more general forms of social stress account for observed racial differences in depressive symptomatology. [ABSTRACT FROM AUTHOR]

The present study reports comparative male-female vulnerability to several stressed life circumstances that have been implicated in the development of depression. My analysis, which draws on data from a 1978 survey of 1,026 adults in central Wisconsin who were administered the Psychiatric Evaluation Research Instrument (PERI) Depression Scale, is based on a structural modeling approach that controls for the confounding of dysphoric mood and other forms of distress with a depressive syndrome. Findings show that women are more likely than men to suffer hardships associated with the absence of a spouse, social isolation, financial difficulties, and chronic health problems. However, none of these hardships has a significantly greater impact on depressive syndrome levels for women than for men. [ABSTRACT FROM AUTHOR]