Location matters: Regional variation in association of community burden of COVID-19 with caregiver and youth worry

Our study characterized associations between three indicators of COVID-19's community-level impact in 20 geographically diverse metropolitan regions and how worried youth and their caregivers in the Adolescent Brain Cognitive Development℠ Study have been about COVID-19. County-level COVID-19 case/death rates and monthly unemployment rates were geocoded to participants' addresses. Caregivers' (vs. youths') COVID-19-related worry was more strongly associated with COVID-19's community impact, independent of sociodemographics and pre-pandemic anxiety levels, with these associations varying by location. Public-health agencies and healthcare providers should avoid adopting uniform "one-size-fits-all" approaches to addressing COVID-19-related emotional distress and must consider specific communities' needs, challenges, and strengths.