Susceptibility of Racial/Ethnic Minorities to Major Depressive Disorders during Disasters: The Role Played By Job Losses during the COVID-19 Pandemic

Background: In the United States, racial/ethnic minorities are disproportionately affected by mental health conditions, especially during natural disasters (Ma et al., 2020). In addition, while job losses have been universal in the US since the outbreak of the COVID-19 Pandemic, Hispanics and Black non-Hispanics have been particularly hard hit. According to the Conservation of Resources theory (Hobfall, 2011), resource losses during natural disasters lead to poor mental health conditions. However, the specific role played by job losses on increased levels of Major Depressive Disorders (MDD) among racial/ethnic minorities in the US has not been investigated. We address the following two questions:

1. Were racial/ethnic minorities more susceptible to MDD a year after the outbreak of COVID-19 Pandemic?
2. If so, then to what extent have job losses during the Pandemic accounted for this increased susceptibility?

Methods: To answer these questions, we analyzed the Household Pulse Survey data collected by the US Census (N = 77,104) representing the national adult population (18 years and older) in March, 2021. Using the PHQ-2 scale (Kroenke et al., 2003) to measure levels of MDD, we employed population-weighted two-way cross tabulations with Pearson X² to examine the relative prevalence of MDD among racial/ethnic groups contingent upon a series of demographic variables, including a dichotomous variable to indicate whether or not a respondent lost a job because of the Pandemic. Finally, we constructed two population-weighted logistic regression models to estimate the probability of MDD for individuals by adding these variables sequentially. STATA 15 MP was employed for all statistical analyses.

Results: Our tabulation results show that MDD is disproportionately and significantly (p <0.01) higher among the subpopulations of Hispanics (28%) and Black non-Hispanics (27%) than among White non-Hispanics (22%). The prevalence of job loss is also disproportionately higher among Hispanics (58%) and Black non-Hispanics (50%) than among White non-Hispanics (39%).

Our first regression shows that after controlling for all demographic variables, the odds of having MDD for Hispanics is significantly higher than for White non-Hispanics [Odds ratio (OR) =1.21; 95% Confidence Interval (CI):1.06, 1.39], and similarly that the odds of MDD for Black non-Hispanics is also significantly higher than for White non-Hispanics (OR = 1.18; 95% CI: 1.02, 1.36). However, our second regression shows that race/ethnic identity is no longer a significant risk factor when we further control for Pandemic-related job losses. Instead, job loss is a major risk factor for MDD (OR = 2.10; 95% CI: 1.93, 2.29). This suggests that job losses may largely account for the significant relationship between race/ethnicity and MDD prevalence.

Conclusions and Implications: Our results show that (1) Hispanics and Black non-Hispanics continue to be the groups most vulnerable to MDD more than a year after the Pandemic began, and that (2) the extremely high unemployment rates among these racial/ethnic minorities have contributed this vulnerability. To mitigate the risks of suffering from MDD among these particularly vulnerable groups, social work practice for disaster resilience should focus on providing them with additional skills needed to increase their employment opportunities.