Primary Submission Category: Mental health/function
Stressors, assets, and symptoms of anxiety in the U.S. population during the COVID-19 pandemic: a nationally representative, longitudinal study from 2020 through 2022
Authors: Catherine Ettman Salma Abdalla Ruochen Wang Sam Rosen Sandro Galea
Presenting Author: Catherine Ettman*
Mental health is sensitive to economic and social contexts; in particular, experiencing largescale disruption and individual stressors may be associated with poor mental health. We aimed to estimate changes in and risk factors for population anxiety in U.S. adults over the COVID-19 pandemic. Using a nationally representative, longitudinal panel sample of U.S. adults in Spring 2020, 2021, and 2022, we estimated the prevalence of probable anxiety using the Generalized Anxiety Disorder (GAD-7) score ≥10. We used generalized estimating equations (GEE) to estimate the association of risk factors with anxiety over time, clustering at the individual level to account for repeated measures. The national prevalence of probable anxiety decreased from 24.4% in 2020 to 21.3% in 2022 (p=0.0486). Each additional stressor was associated with 14% increased odds of anxiety for adults across the COVID-19 pandemic. Factors associated with increased odds of anxiety were: younger age (OR 2.55 [95% CI 1.67,3.89] for ages 18-39 relative to ≥60 years), lower income (OR 2.06 [95% CI 1.17,3.63 for ≤$19,000 relative to ≥$75,000), and having COVID (OR 1.54 [95%CI 1.12,2.14]) were associated with greater odds of anxiety over time. The stressors most strongly associated with anxiety in 2022 were: job loss, difficulties paying rent, general financial difficulties, feeling alone, having family or relationship problems, being evicted, losing health insurance, and divorce or separation. Efforts to address stressors may help mitigate the effects of COVID-19 on anxiety in U.S. adults.