Mental Health Status by Race, Ethnicity and Socioeconomic Status among Young Adults in Texas during COVID-19

Priya B Thomas; Dale S Mantey; Stephanie L Clendennen; Melissa B Harrell

doi:10.1007/s40615-024-01923-3

Mental Health Status by Race, Ethnicity and Socioeconomic Status among Young Adults in Texas during COVID-19

J Racial Ethn Health Disparities. 2024 Feb 12. doi: 10.1007/s40615-024-01923-3. Online ahead of print.

Authors

Priya B Thomas¹, Dale S Mantey^{2

3

4}, Stephanie L Clendennen², Melissa B Harrell²

Affiliations

¹ Department of Epidemiology, UTHealth Houston School of Public Health, Austin, TX, USA. priya.thomas@uth.tmc.edu.
² Department of Epidemiology, UTHealth Houston School of Public Health, Austin, TX, USA.
³ Department of Health Promotion and Behavioral Science, UTHealth Houston School of Public Health, Austin, TX, USA.
⁴ Michael and Susan Dell Center for Healthy Living, Austin, TX, USA.

PMID: 38347309
DOI: 10.1007/s40615-024-01923-3

Abstract

Background: Differences in symptoms of depression and anxiety by race/ethnicity and socioeconomic status (SES) among a diverse cohort of young adults during the COVID-19 pandemic (Spring 2020-Fall 2021) have not been examined.

Method: We analyzed four waves of biannual, panel data from n = 2629 emerging adults (16-25 years old) from the Texas Adolescent Tobacco and Marketing Surveillance study (TATAMS). We conducted a series of mixed effects ordinal logistic regression models to compare the independent and joint effects of race/ethnicity and SES on symptoms of (a) depression and (b) anxiety, adjusting for sex, cohort, and time.

Results: Symptoms of depression (aOR range: 1.54 - 2.19; 95% CI: 1.02 - 3.08) and anxiety (aOR range: 1.64 - 2.19; 95% CI: 1.22 - 2.79) were elevated among low SES young adults, across all racial/ethnic groups. Across SES groups, symptoms of depression were lower among non-Hispanic Blacks compared to non-Hispanic Whites (aOR range: 0.33 - 0.41; 95% CI: 0.18 - 0.62) and Hispanics /Latinos (aOR range: 0.33 - 0.38; 95% CI: 0.20 - 0.57); similarly, symptoms of anxiety were lower among non-Hispanic Blacks compared to non-Hispanic Whites (aOR range: 0.44; 95% CI: 25 - 0.77) and Hispanics/Latinos (aOR range: 0.47 - 0.56; 95% CI: 0.29 - 0.83). No significant interaction (joint effect) was observed between SES and race/ethnicity during this period.

Conclusion: Low SES was persistently related to poor mental health. Lower odds of symptoms of anxiety and depression among non-Hispanic Black young adults may reflect the 'mental health paradox'. Overall, mental health policies should prioritize lower SES young adults regardless of race and ethnicity.

Keywords: Anxiety; COVID-19; Depression; Economic inequalities; Young adults.