Primary Submission Category: Socioeconomic status
Savings, income, and depression across the pandemic: the experience of Four Americas from 2020 – 2022
Authors: Catherine Ettman Gregory Cohen Salma Abdalla Brian Castrucci Rachel Bork
Presenting Author: Catherine Ettman*
The prevalence of depression in U.S. adults during the COVID-19 pandemic has been high overall and particularly high among persons with fewer assets. Building on previous work on assets and mental health, we document the burden of depression in groups based on income and savings during the first two years of the COVID-19 pandemic. Using a nationally representative, longitudinal panel study of U.S. adults (N=1183) collected in April-May 2020 (T1), April-May 2021 (T2), and April-May 2022 (T3), we estimated the adjusted odds of reporting Clinically Relevant Depression (CRD)—defined as a score of ≥10 on the Patient Health Questionnaire-9 (PHQ-9)–at any time during the COVID-19 pandemic using generalized estimating equations (GEE) . The prevalence of CRD was consistently high in Spring 2020, Spring 2021, and Spring 2022 with 26.8% of U.S. adults reporting CRD in Spring 2022. We found that there were four distinct “Americas” that experienced different CRD trajectories over the COVID-19 pandemic, grouped by income (≥ $65,000) and savings (≥ $20,000) categories. Low income-low savings (low-low) America had the highest level of CRD across time, reporting 4.9 times the odds (95% CI 3.32, 7.21) of CRD at any time relative to high income-high savings (high-high) America. The prevalence of CRD across T1, T2, and T3 was 41% for low-low America, 24% for high-low America, 19% for low-high America, and 12% for high-high America. Four Americas defined by income and savings groupings experienced different depression trajectories over the course of the COVID-19 pandemic. Persons with low income and low savings reported 4.9 times the odds of clinically relevant depression as persons with high income and high savings over the course of the pandemic. While discussions on equity often focus on income, incorporating savings may provide insights into population experiences and mental health.