Methods: The sample for this study consisted of n=14,812 older adult respondents to the 2020 Household Pulse Survey (HPS), a weekly cross-sectional survey conducted by the US Census Bureau. The primary goal of the HPS is to produce data on the social and economic impacts of the coronavirus in America. A cumulative risk index (CRI) was created to assess the presence and quantity of risk factors across four major domains directly affected by conditions of the COVID-19 pandemic, including: food sufficiency, housing sufficiency, employment/income sufficiency, and healthcare access. Hierarchical linear regression models were then created to determine the effect gender, race, and cumulative pandemic-induced risk have on older adult feelings of anxiety, worry, anhedonia, and depression, along with any interaction effects between gender and race.
Results: Around 54% of the older adult sample (65 years of age and over) identified as female, with only around 13% belonging to a racial or ethnic group other than non-Hispanic white. The most common risk factor experienced was food insecurity (29.6%), followed by health care access (27.1%), employment/income insecurity (26.2%), and housing insecurity (10.1%). Regression models were then created for each of the four psychosocial factors, with each model including race, gender, and the cumulative risk index score. The cumulative risk index was a significant predictor for increased feelings of anxiety (β= 0.32, SE=0.01, CI= 0.30 – 0.33, p < 0.01), worry (β= 0.31, SE=0.01, CI= 0.30 – 0.32, p < 0.01), anhedonia (β= 0.30, SE=0.01, CI= 0.28 – 0.31, p < 0.01), and depression (β= 0.28, SE=0.01, CI= 0.27 – 0.29, p < 0.01). Additionally, significant interaction effects were observed between gender and race for anhedonia (β= -0.13, CI= -0.22 – -0.05, p < 0.01) and anxiety (β= -0.12, CI= -0.22 – -0.01, p < 0.01).
Conclusions and Implications: Findings from this study demonstrate that as exposure to adverse events increases, so too does the likelihood of experiencing mental health symptoms of anxiety, depression, anhedonia, and worry. The ramifications of the COVID-19 pandemic on the mental health of older adults in racial/ethnic minorities is significant and will likely be long-lasting. Greater study of the continuously evolving factors that impinge dissimilarly and disproportionately on the outcomes of distinct demographic groups is necessary in order to develop and provide effective resources to those most severely impacted