Long-term mental health impacts of COVID-19 uneven in Los Angeles County

New evidence has emerged about the long-term effects of the COVID-19 pandemic on Los Angeles County, according to a recent study in the journal PLOS ONE. Scientists at USC and the Los Angeles County Department of Public Health (DPH) found that existing disparities in mental health between white and non-white residents worsened.

The study used two surveys conducted in 2018 and spring 2021 to measure the risk of major depression among adults, alongside data on death rates. The researchers looked at monthly averages between March 2020 (when the first stay-in-place orders were issued) and mid-April 2021 (after the peak of the pandemic). The prefecture was divided into three zones based on this data:

• an area of ​​high mortality from COVID-19 that spans metropolitan LA, South LA County, and East LA County.
• an area of ​​low mortality from COVID-19 that includes West LA County and the South Bay.
• and a medium COVID-19 mortality region that includes the San Gabriel, San Fernando, and Antelope Valleys.

Perhaps unsurprisingly, residents in areas with high mortality from COVID-19 were more likely to be at risk for depression compared to those in areas with moderate and low mortality from COVID-19. But when researchers grouped respondents by race, they found a stark divide. They observed an overall trend toward increased risk of depression in the most affected areas among nonwhite residents of Los Angeles County, including those from Asian, Black, Hispanic, and Native American racial and ethnic groups, but not for white residents.

In 2021, non-white respondents in the area most affected by deaths from COVID-19 were more likely to be at risk of depression than their peers in the area with low mortality from COVID-19.

Even in 2018, the risk of depression was more prevalent among non-white residents of metro LA, South LA, and East LA than among non-white residents of West LA and the South Bay. By 2021, that gap had grown. The results documented by the researchers remained even after adjusting for other factors.

The pandemic hit nonwhites much harder than whites, and we hypothesized that the impact on mental health is linked to living conditions. You may see people in multigenerational households, which means that when COVID-19 hits, they won’t have enough room to quarantine family members. The type of jobs they worked might be in industries that offer little protection and little time off to even try. This could completely increase their stress and eat away at their ability to deal with the pandemic.

Jonathan Lam, PhD, MPH, Corresponding Author and Assistant Professor, Research Emergency Medicine, Keck School of Medicine, University of Southern California

Charting Inequalities in Pandemic Threats to Life and Well-Being

The study paints a contrasting picture of the impact of COVID-19 on communities in Los Angeles County. In each of the three zones, the death rate from the coronavirus was more than twice as high among non-white residents as among white residents.

Other numbers highlighted a remarkable reversal. In 2018, white residents of Los Angeles County in each of the three zones actually had a higher death rate compared to non-white residents. With most nonwhite residents of Los Angeles County being Hispanic, the root of this disparity may come from a phenomenon known as the Latino paradox. In trends documented as far back as the 1980s, Latinos have enjoyed higher life expectancies and lower mortality rates than whites, even though, on average, they face socioeconomic factors and health risks that negate this advantage.

The study adds to growing evidence that the coronavirus had, at least temporarily, erased the Latino paradox.

“Post-coronavirus, non-whites have higher mortality,” said senior author Neeraj Sood, PhD, a professor at the USC Price School of Public Policy and director of the COVID Initiative at the USC Schaeffer Center for Health Policy and Economics. “There is a stark divide in the impact of COVID. Depending on who you are and where you live, your experience during the pandemic could be much worse.”

The 2021 survey was part of the Los Angeles Pandemic Surveillance Cohort Initiative, a collaboration that unites the USC Schaeffer Center, the Keck School of Medicine Department of Population and Public Health Sciences, and the Los Angeles County Department of Public Health. Researchers asked 1,222 participants from across the county about how often they had experienced depressed mood and lack of pleasure from daily activities in the previous two weeks. The existing 2018 survey took the same measures.

The researchers’ findings increased understanding of the little-studied topic of the long-term impact of the pandemic on mental health in Los Angeles County. What they learned can help efforts to alleviate these difficulties through programs such as Los Angeles County Wellness Centers and Community Public Health Teams initiatives.

“These results raise awareness of the significant impact of living and working conditions on emotional well-being, particularly in low-income, Black, and Latino communities,” said co-author William Nicholas, PhD, MPH, director of the Center for Health Impact . Assessment at Los Angeles County DPH. “It is critical for us to recognize that improving mental health requires investment in efforts that address the social and economic conditions that affect all health outcomes.”

The study could also help target aid in future virus outbreaks.

Lam said: “A similar pandemic could happen in the future. Our research provides an interesting test case for how we adapt. When we plan how we allocate our mental health resources, we should put more in the communities with the greatest need. “