Disruptions to the social determinants of health and mental health indicators during the pandemic in eight countries

Bibliographic Data

ID21257629
AuthorsSalma M Abdalla (0000-0001-5474-4521, Boston University, corresponding author), Samuel B Rosenberg (0000-0003-0537-9729, Boston University), Gregory H Cohen (0009-0001-2272-913X, Boston University), Catherine K Ettman (0000-0002-4827-5383, Johns Hopkins University), Laura Magaña (0000-0002-6767-4339, Association of Schools and Programs of Public Health), Elaine O Nsoesie (0000-0001-9170-8714, Boston University), Lora Sabin (0000-0002-2782-542X, Boston University), Lora L Sabin, Sandro Galea (0000-0002-7534-0945, Boston University)
Year2023
Volume4
Pages100249
Publication date2023-12-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueSSM - Mental Health (JOURNAL)
Journal identifiersISSN: 2666-5603 • E-ISSN: 2666-5603
PublisherElsevier BV (PUBLISHER)
DOI10.1016/j.ssmmh.2023.100249
OpenAlexW4385154954
LanguageEN
Citations received2
References cited35

The social determinants of health (SDoH) shape both the risk of mental disorders and access to treatment. There is ample evidence detailing the decline in mental health during the Covid-19 pandemic. However, there is a gap in our understanding of the association between disruptions to SDoH and adverse psychological indicators in different contexts. Data were collected through a multi-country, random, anonymous, opt-in, cross-sectional online survey in eight geographically diverse countries—Brazil, China, Germany, Egypt, India, Indonesia, Nigeria, and the United States. We documented the relationship between experiencing self/family job loss, financial problems, and food/supplies shortages and adverse mental health indicators—depression symptoms and probable posttraumatic stress disorder (PTSD). Almost one-third of respondents who experienced at least one disruption had depression symptoms (32.3%, 95% CI: 30.3%–34.4%). This was consistent across countries, except Indonesia. Reporting at least one Covid-19 related SDoH disruption had 1.26 (95% CI: 1.14-1.39) times the risk of depression symptoms compared to respondents reporting no Covid-19 related SDoH disruptions. Across countries, experiencing at least one Covid-19 related SDoH disruption had significantly increased risk of depression symptoms, except for China, Egypt, and Indonesia. The prevalence of probable PTSD among respondents who reported at least one SDoH disruption was 8.4% (95% CI: 7.3%–9.5%). The prevalence was comparably elevated within countries, except for China. Reporting at least one SDoH disruption was associated with greater odds of probable PTSD in the overall adjusted model (OR=2.87, 95% CI: 2.31-3.59) and in the models for countries except for China and Indonesia. Disruptions to SDoH due to the pandemic were associated with an elevated burden of symptoms of depression and probable PTSD across geographically diverse countries, with a few exceptions particularly in China. This highlights the need to account for the broader consequences of mitigation policies that potentially have an impact on the health of populations

China · Cross-sectional study · Environmental health · Geography · Logistic regression · Mental health · Odds · Odds ratio · Pandemic · Psychiatry · Public health · Social determinants of health · Sociology · COVID-19 and Mental Health · Demography · Employment and Welfare Studies · Health disparities and outcomes · Medicine · Psychology