Today, our team published findings from the first longitudinal study on depression conducted on a representative sample of U.S. adults followed from Spring 2020 to 2021. We followed the same group of adults over 1 year to see how depression changed. Unlike every other traumatic event in recent history, we found that depression stayed high during the COVID-19 pandemic, and may have increased slightly between March-April 2020 and March-April 2021. Our team conducted one of the first studies to show that depression increased threefold from before COVID-19 to the start of it. We now see that depression went from 8.5% before COVID-19 to 27.8% in Spring 2020 up to 32.8% in Spring 2021. Today‚Äôs study shows that depression is not relenting. 

Why?

Mental health is particularly responsive to our socioeconomic context. While socioeconomic status is known to change physical indicators over time, small changes in socioeconomic status can present themselves in mental health indicators much sooner. We found that people who experienced stressors, such as challenges with child care, difficulties paying rent, and losing a job were the ones who were more likely to report depression during COVID-19. In previous studies, we found that the persons who were reporting stressors like job loss were the very ones who had fewer assets going into the pandemic, and therefore had less buffering to protect themselves from the disruption caused by the pandemic. 


Unlike other traumatic events, COVID-19 has been ongoing. As we lift COVID-19 precautions, we still see the economic consequences of the pandemic, with empty storefronts, half-filled public transport, and quiet city centers. As part of the world moves on with remote work options, the other part remains left behind, with stressors mounting and assets stagnating or declining. As the effects of the pandemic linger, they disproportionately affect people who had low assets going into this pandemic, leading to additional stressors and poor mental health. 

What can help? In the short-term, it will be necessary to ensure that those who need mental health care can get it, whether through telemedicine or through in-person counseling. Funding mental health care will be critical, to link patients to providers and ensure that all people can access resources needed (not only those with means to do so). In the medium and long-term, we need to address the fundamental socioeconomic roots of poor mental health, and, in particular, the inequalities that generate a disproportionate burden of poor health for certain groups. When lack of money, housing, employment, child care, and other key assets means poor mental health, creating positive psychological outcomes means broadening access to these resources. Policies like the child tax credit and infrastructure bills can create the contexts in which people with low income and high income can thrive. Easing the burden of poor mental health will require us to re-build a society where all can access the resources they need to be healthy, both mentally and physically. 

Author(s)

  • Catherine Ettman is Chief of Staff in the Office of the Dean at Boston University School of Public Health and a PhD candidate in Health Services Research at Brown University School of Public Health. Catherine studied public policy at Princeton University and has previously worked in campaign politics in Washington, D.C., and Texas. She is the co-editor of Urban Health (Oxford University Press, 2019). Her work explores the social and economic factors that shape population mental health.