Anxiety and Depression Among Different Races with Chronic Conditions in the US Prior to and During COVID-19

Abstract

Research Question: Did different racial/ethnic groups with chronic conditions in the United States experience anxiety and depression differently during the COVID-19 pandemic, compared to pre-COVID?

Background and Significance: There is no doubt that COVID affected many peoples¿ lives drastically. There is plenty of research that illustrates how COVID affected people¿s anxiety and depression levels. However, research is lacking when it comes to those who suffer from chronic diseases. People who suffer from chronic diseases not only might have been at higher risk for adverse COVID outcomes but were also those who may have lost access to certain medical care. This study will evaluate how anxiety and depression levels changed in those patients with chronic diseases pre-COVID compared to post COVID. It will also evaluate how COVID affected anxiety and depression levels in those with chronic diseases compared to people who have no chronic diseases.

Materials and Methods: We conducted an analysis of the Health Information National Trend Surveys 5 (HINTS 5) Cycle 4 data. The survey administration time was categorized into pre-COVID-19 (before March 11, 2020, weighted N = 77,501,549) and during COVID-19 (on and after March 11, 2020, weighted N = 37,222,019) periods. Anxiety and depression were assessed using the Patient Health Questionnaire (PHQ), and a comparison was made between the two periods. To assess the association of the COVID-19 pandemic with anxiety/depression, separate multivariable logistic regression analyses were conducted. These analyses were adjusted for variables such as age, sex, insurance, income, and education.

Results: During the COVID-19 period, a higher percentage of non-Hispanic whites (NHW) with chronic conditions reported experiencing anxiety (24.3% vs. 11.5%, p = 0.0021) and depression (20.7% vs. 9.3%, p = 0.0034) compared to the pre-COVID-19 period. After adjusting for relevant factors, the adjusted odds ratio (AOR) for anxiety and depression among NHWs with chronic conditions during the COVID-19 pandemic was 2.02 (95% confidence interval: 1.10¿3.73, p = 0.025) and 2.33 (95% confidence interval: 1.17¿4.65, p = 0.018), respectively, when compared to NHWs surveyed before the onset of the COVID-19 pandemic.

Conclusion: The prevalence of anxiety and depression increased among non-Hispanic white (NHW) adults with chronic conditions during the COVID-19 pandemic, but there was no similar association observed among people of color.