Disruptions to the social determinants of health and mental health indicators during the pandemic in eight countries

被引:1
作者
Abdalla, Salma M. [1 ]
Rosenberg, Samuel B. [1 ]
Cohen, Gregory H. [1 ]
Ettman, Catherine K. [2 ]
Magana, Laura [3 ]
Nsoesie, Elaine O. [4 ]
Sabin, Lora L. [4 ]
Galea, Sandro [1 ]
机构
[1] Boston Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA 02215 USA
[2] Johns Hopkins Bloomberg Sch Publ Hlth, Baltimore, MD USA
[3] Assoc Sch & Programs Publ Hlth, Washington, DC USA
[4] Boston Univ, Sch Publ Hlth, Dept Global Hlth, Boston, MA USA
来源
SSM-MENTAL HEALTH | 2023年 / 4卷
关键词
Social determinants of health; SDoH; Mental health; Depression; PTSD; post-traumatic stress disorder; Covid-19; POSTTRAUMATIC-STRESS-DISORDER; FOOD INSECURITY; ANXIETY; VERSION; WOMEN;
D O I
10.1016/j.ssmmh.2023.100249
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Introduction: The social determinants of health (SDoH) shape both the risk of mental disorders and access to treatment. There is ample evidence detailing the decline in mental health during the Covid-19 pandemic. However, there is a gap in our understanding of the association between disruptions to SDoH and adverse psychological indicators in different contexts.Methods: Data were collected through a multi-country, random, anonymous, opt-in, cross-sectional online survey in eight geographically diverse countries-Brazil, China, Germany, Egypt, India, Indonesia, Nigeria, and the United States. We documented the relationship between experiencing self/family job loss, financial problems, and food/supplies shortages and adverse mental health indicators-depression symptoms and probable post traumatic stress disorder (PTSD).Results: Almost one-third of respondents who experienced at least one disruption had depression symptoms (32.3%, 95% CI: 30.3%-34.4%). This was consistent across countries, except Indonesia. Reporting at least one Covid-19 related SDoH disruption had 1.26 (95% CI: 1.14-1.39) times the risk of depression symptoms compared to respondents reporting no Covid-19 related SDoH disruptions. Across countries, experiencing at least one Covid-19 related SDoH disruption had significantly increased risk of depression symptoms, except for China, Egypt, and Indonesia. The prevalence of probable PTSD among respondents who reported at least one SDoH disruption was 8.4% (95% CI: 7.3%-9.5%). The prevalence was comparably elevated within countries, except for China. Reporting at least one SDoH disruption was associated with greater odds of probable PTSD in the overall adjusted model (OR=2.87, 95% CI: 2.31-3.59) and in the models for countries except for China and Indonesia. Conclusion: Disruptions to SDoH due to the pandemic were associated with an elevated burden of symptoms of depression and probable PTSD across geographically diverse countries, with a few exceptions particularly in China. This highlights the need to account for the broader consequences of mitigation policies that potentially have an impact on the health of populations.
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