(see Poster Gallery) Increased Mental Health Problems after the Lifting of COVID-19 Lockdown Among Low-Income Workers in the United States

Background and Purpose: The economic and social impacts of the COVID-19 pandemic will linger for years, with significantly impacts on the health of the workforce. Evidence to date suggests that the pandemic has different effects on workers’ mental health, depending on whether they are classified as “essential” workers (e.g., first responders, health care workers, transportation workers) due to the exemption of ‘stay-at-home’ implementation as well as the degree of risk exposure. Ample evidence has outlined the immediate and delayed adverse effects of both the pandemic and the lockdown on individuals’ mental health. However, little research has explored the delayed impact on low-income workers’ mental health after lifting the lockdown. This study hypothesizes that the relative return to normal life may have relieved the psychological distress for the low-income workers, and will explore how the lifting of the lockdown has impacted their mental health, with special attention to essential workers.

Methods: Data came from the Household Pulse Survey, administered by the U.S. Census Bureau, which has collected information on how the pandemic impacted households. Using the five phases of the data, collected every quarter staring in April 2020, the study sample was restricted to non-elderly low-income adults who were employed when they responded to the survey (N=97,892). This study examined their changes in four measures of mental health statuses (frequencies of feeling anxious, worried, having little interest, and feeling depressed) before the intervention (before the lifting) and after the intervention (after the lifting), using an Interrupted Times Serious regression (ITSR) analysis with a focus on essential workers.

Results: The results from the ITSR analysis showed a high probability of mental health problems after lifting the first COVID-19 lockdown, which was significantly associated with high levels of feeling depressed, anxious, and worried. There was no difference of feeling little interest across before and after the lifting. Essential workers were at a greater risk for mental health problems, than those in nonessential work. Additionally, essential workers in low occupational class (e.g., unskilled manual jobs) were at a greater risk of experiencing mental health problems than individuals in higher occupational class.

Conclusions and Implications: Our analysis result showed that the mental health continued to deteriorate for low-income workers, which contradicted the findings of other studies that showed general improvements of mental health associated with lifting the lockdown. Economic recessions place a disproportionate burden on low-income essential workers, with significant impacts on mental health. During the pandemic, essential workers were at increased risk of mental health conditions such as anxiety and depression, compared with those in nonessential work. This suggests the need to recognize the challenge this vital workforce face in pandemics and have an important public health and policy implication to protect this population.