Anxiety and Depression Symptoms Among Young U.S. Essential Workers During the COVID-19 Pandemic.

Objective: Emerging cross-sectional data indicate that essential workers in the COVID-19 era face increased mental health risks. This study longitudinally examined clinical symptoms of generalized anxiety disorder, depression, and posttraumatic stress disorder (PTSD) among U.S. essential workers, including health care workers and workers in indispensable occupations such as manufacturing, food industry, construction, transportation, hospitality, and emergency services, during the COVID-19 pandemic. The authors anticipated high symptom levels and greater symptom severity among women versus men and among younger adults compared with older adults. Analyses also explored the association between COVID-19 vaccination status and clinical symptoms.
Methods: This four-wave online survey study assessed clinical symptoms in a convenience sample of 4,136 essential workers at baseline and 14, 30, and 90 days between August and December 2021. Symptoms of anxiety, depression, and PTSD were measured with the Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, and Primary Care PTSD Screen instruments, respectively.
Results: At every time point, 74%-78% of respondents reported symptoms of anxiety and depression, which were highest among younger adults (ages 18-22 years), females, and transgender respondents. Vaccinated participants had slightly higher symptom levels than unvaccinated respondents. Rates of clinical symptoms did not change significantly over time.
Conclusions: Essential workers consistently reported symptoms of generalized anxiety, depression, or PTSD, especially younger adult, female, and transgender participants. The overwhelming and unprecedented nature of the COVID-19 pandemic underscores the need to offer mental health care to essential workers, especially those in these subgroups. Employers and administrators should support and proactively encourage employees to access care when needed.
Competing Interests: Dr. Fisher has received funding support from the NVLD Project and from TeleSage, Inc., has received donor support for the Man O’ War Project for equine-assisted psychotherapy projects (including the Earl I. Mack Foundation, the David and Julia Koch Foundation, the Jockey Club, the Mary and Daniel Loughran Foundation, the Gulfstream Park Racing Association, Meta Aerospace Capital, Ltd., and Tactical Air Support), and has received royalties from the Research Foundation for Mental Hygiene. Dr. Lewis-Fernández had common stock ownership in Vistagen Therapeutics, sold November 2021, and received an honorarium for a training presentation from AbbVie. The other authors report no financial relationships with commercial interests.