COVID-19 Concerns and Depression Among Older Adults: Does Race/Ethnic Status Moderate the Association?

Abstract

Background and Objectives: This study examined the association between COVID-19 concerns and depression among adults in later life. We also examined whether race/ethnic status moderated this relationship. Research Design and Methods: This study used data from the 2020 Health and Retirement Study. Using the 8-item CES-D scale, we defined probable depression as having three or more depressive symptoms. COVID-19 concerns included items such as concerns about respondents’ own health, the health of family members, respondents’ ability to get help from others, and concerns about the future. The associations between COVID-19 concerns and older adults’ depression were estimated with logistic regression models. Results: Compared to respondents with lower scores on the COVID-19 concern measures, those with higher scores were more likely to be depressed. The moderation model showed the relationship between concerns about what will happen in the future and depression was not as strong among non-Hispanic Black older adults compared to non-Hispanic White older adults. Concerns about own health, family members’ health, the older adult’s financial situation, and the ability to get help did not show moderation effects. Discussion and Implications: The results suggested that healthcare providers should focus on older persons to reduce disparities in the risk of depression during public health emergencies.

Keywords

emotional well-being worry anxiety mental health natural disasters

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References

Agrawal

Dróżdż

Makuch

Pietraszek

Sobieszczańska

Mazur

(2021). The assessment of fear of COVID-19 among the elderly population: A cross-sectional study. Journal of Clinical Medicine, 10(23), 5537. https://doi.org/10.3390/jcm10235537

Assari

Burgard

Zivin

(2015). Long-term reciprocal associations between depressive symptoms and number of chronic medical conditions: Longitudinal support for black–white health paradox. Journal of Racial and Ethnic Health Disparities, 2(4), 589–597. https://doi.org/10.1007/s40615-015-0116-9

Ayalon

Gum

A. M.

(2011). The relationships between major lifetime discrimination, everyday discrimination, and mental health in three racial and ethnic groups of older adults. Aging & Mental Health, 15(5), 587–594. https://doi.org/10.1080/13607863.2010.543664

Barnes

D. M.

Bates

L. M.

(2017). Do racial patterns in psychological distress shed light on the black–white depression paradox? A systematic review. Social Psychiatry and Psychiatric Epidemiology, 52(8), 913–928. https://doi.org/10.1007/s00127-017-1394-9

Brown

T. H.

Hargrove

T. W.

(2017). Psychosocial mechanisms underlying older black men’s health. The Journals of Gerontology: Series B, 73(2), 188–197. https://doi.org/10.1093/geronb/gbx091

Brown

T. H.

Richardson

L. J.

Hargrove

T. W.

Thomas

C. S.

(2016). Using multiple-hierarchy stratification and life course approaches to understand health inequalities: The intersecting consequences of race, gender, SES, and age. Journal of Health and Social Behavior, 57(2), 200–222. https://doi.org/10.1177/0022146516645165

Bui

C. N.

Peng

Mutchler

J. E.

Burr

J. A.

(2021). Race and ethnic group disparities in emotional distress among older adults during the COVID-19 pandemic. The Gerontologist, 61(2), 262–272. https://doi.org/10.1093/geront/gnaa217

Callaghan

Moghtaderi

Lueck

J. A.

Hotez

P. J.

Strych

Dor

Franklin Fowler

Motta

(2020). Correlates and disparities of COVID-19 vaccine hesitancy. SSRN Electronic Journal. https://doi.org/10.2139/ssrn.3667971

CDC . (2023, February 10). People with certain medical conditions. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html

10.

Dannefer

(2003). Cumulative advantage/disadvantage and the life course: Cross-fertilizing age and social science theory. The Journals of Gerontology: Series B, , 58(6), S327–S337. https://doi.org/10.1093/geronb/58.6.s327

11.

Fernández

R. S.

Crivelli

Guimet

N. M.

Allegri

R. F.

Pedreira

M. E.

(2020). Psychological distress associated with COVID-19 quarantine: Latent profile analysis, outcome prediction and mediation analysis. Journal of Affective Disorders, 277, 75–84. https://doi.org/10.1016/j.jad.2020.07.133

12.

Galehdar

Kamran

Toulabi

Heydari

(2020). Exploring nurses’ experiences of psychological distress during care of patients with COVID-19: A qualitative study. BMC Psychiatry, 20(1), 489. https://doi.org/10.1186/s12888-020-02898-1

13.

Gallagher

Wetherell

M. A.

(2020). Risk of depression in family caregivers: Unintended consequence of COVID-19. BJPsych Open, 6(6), Article e119. https://doi.org/10.1192/bjo.2020.99

14.

Yap

C. W.

Ong

Heng

B. H.

(2017). Social isolation, loneliness and their relationships with depressive symptoms: A population-based study. PLoS One, 12(8), Article e0182145. https://doi.org/10.1371/journal.pone.0182145

15.

Gee

G. C.

Ford

C. L.

(2011). Structural racism and health inequities: Old issues, new directions. Du Bois Review, 8(1), 115–132. https://doi.org/10.1017/S1742058X11000130

16.

Hobfoll

S. E.

Lilly

R. S.

(1993). Resource conservation as a strategy for community psychology. Journal of Community Psychology, 21(2), 128–148. https://doi.org/10.1002/1520-6629(199304)21:2<128::AID-JCOP2290210206>3.0.CO;2-5

17.

Hobfoll

S. E.

Shirom

Golembiewski

(2000). Conservation of resources theory. In Handbook of organizational behavior (pp. 57–80). Marcel Dekker.

18.

Jackson

J. S.

Knight

K. M.

Rafferty

J. A.

(2010). Race and unhealthy behaviors: Chronic stress, the HPA axis, and physical and mental health disparities over the life course. American Journal of Public Health (1971), 100(5), 933–939. https://doi.org/10.2105/AJPH.2008.143446

19.

Karakus

M. C.

Patton

L. C.

(2011). Depression and the onset of chronic illness in older adults: A 12-year prospective study. The Journal of Behavioral Health Services & Research, 38(3), 373–382. https://doi.org/10.1007/s11414-011-9234-2

20.

Keyes

C. L. M.

(2009). The black-white paradox in health: Flourishing in the face of social inequality and discrimination. Journal of Personality, 77(6), 1677–1706. https://doi.org/10.1111/j.1467-6494.2009.00597.x

21.

Khubchandani

Sharma

Price

J. H.

Wiblishauser

M. J.

Sharma

Webb

F. J.

(2021). COVID-19 vaccination hesitancy in the United States: A rapid national assessment. Journal of Community Health, 46(2), 270–277. https://doi.org/10.1007/s10900-020-00958-x

22.

Lincoln

K. D.

Taylor

R. J.

Bullard

K. M.

Chatters

L. M.

Woodward

A. T.

Himle

J. A.

Jackson

J. S.

(2010). Emotional support, negative interaction and DSM IV lifetime disorders among older African Americans: Findings from the National Survey of American Life (NSAL). International Journal of Geriatric Psychiatry, 25(6), 612–621. https://doi.org/10.1002/gps.2383

23.

Marchiondo

L. A.

Gonzales

Williams

L. J.

(2017). Trajectories of perceived workplace age discrimination and long-term associations with mental, self-rated, and occupational health. The Journals of Gerontology: Series B, 74(4), 655–663. https://doi.org/10.1093/geronb/gbx095

24.

McKnight-Eily

L. R.

Okoro

C. A.

Strine

T. W.

Verlenden

Hollis

N. D.

Njai

Mitchell

E. W.

Board

Puddy

Thomas

(2021). Racial and ethnic disparities in the prevalence of stress and worry, mental health conditions, and increased substance use among adults during the COVID-19 Pandemic — United States, April and May 2020. Morbidity and Mortality Weekly Report, 70(5), 162–166. https://doi.org/10.15585/mmwr.mm7005a3

25.

Mueller

A. L.

McNamara

M. S.

Sinclair

D. A.

(2020). Why does COVID-19 disproportionately affect older people? Aging, 12(10), 9959–9981. https://doi.org/10.18632/aging.103344

26.

Özdin

Bayrak Özdin

Ş.

(2020). Levels and predictors of anxiety, depression and health anxiety during COVID-19 pandemic in Turkish society: The importance of gender. International Journal of Social Psychiatry, 66(5), 504–511. https://doi.org/10.1177/0020764020927051

27.

Peleg

Nudelman

(2021). Associations between self-rated health and depressive symptoms among older adults: Does age matter? Social Science & Medicine ( 1982 ), 280, 114024–114024. https://doi.org/10.1016/j.socscimed.2021.114024

28.

Phelan

J. C.

Link

B. G.

(2015). Is racism a fundamental cause of inequalities in health? Annual Review of Sociology, 41(1), 311–330. https://doi.org/10.1146/annurev-soc-073014-112305

29.

Phelan

J. C.

Link

B. G.

Tehranifar

(2010). Social conditions as fundamental causes of health inequalities: Theory, evidence, and policy implications. Journal of Health and Social Behavior, 51(Suppl), S28–S40. https://doi.org/10.1177/0022146510383498

30.

Smedley

B. D.

Stith

A. Y.

Nelson

A. R.

(2003). Unequal treatment: Confronting racial and ethnic disparities in health care. National Academies Press (US).

31.

Steffens

D. C.

Fisher

G. G.

Langa

K. M.

Potter

G. G.

Plassman

B. L.

(2009). Prevalence of depression among older Americans: The aging, demographics and memory study. International Psychogeriatrics, 21(5), 879–888. https://doi.org/10.1017/s1041610209990044

32.

Steffick

D. E.

(2000). Documentation of affective functioning measures in the health and retirement study. University of Michigan, Survey Research Center, Institute for Social Research.

33.

Taylor

H. O.

Nguyen

A. W.

(2020). Depressive symptoms and loneliness among Black and White older adults: The moderating effects of race. Innovation in Aging, 4(5), igaa048. https://doi.org/10.1093/geroni/igaa048

34.

The White House . (2024). Fact sheet: Biden-Harris administration lowers mental health care costs by improving access to mental health and substance use care | the white House. The White House. https://www.whitehouse.gov/briefing-room/statements-releases/2024/09/09/fact-sheet-biden-harris-administration-lowers-mental-health-care-costs-by-improving-access-to-mental-health-and-substance-use-care/

35.

Wang

Verdery

A. M.

Margolis

Smith-Greenaway

(2022). Bereavement from COVID-19, gender, and reports of depression among older adults in Europe. The Journals of Gerontology: Series B, 77(7), e142–e149. https://doi.org/10.1093/geronb/gbab132

36.

Williams

D. R.

Cooper

L. A.

(2020). COVID-19 and health equity—a new kind of “herd immunity”. JAMA, 323(24), 2478–2480. https://doi.org/10.1001/jama.2020.8051

37.

Williams

D. R.

Lawrence

J. A.

Davis

B. A.

(2019). Racism and health: Evidence and needed research. Annual Review of Public Health, 40(1), 105–125. https://doi.org/10.1146/annurev-publhealth-040218-043750

38.

Yıldırım

Geçer

Akgül

Ö.

(2021). The impacts of vulnerability, perceived risk, and fear on preventive behaviours against COVID-19. Psychology, Health & Medicine, 26(1), 35–43. https://doi.org/10.1080/13548506.2020.1776891

39.

Zhang

(2011). Gender and marital status differences in depressive symptoms among elderly adults: The roles of family support and friend support. Aging & Mental Health, 15(7), 844–854. https://doi.org/10.1080/13607863.2011.569481

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