Intersections of Health, Economic, and Social Concerns During the COVID-19 Pandemic in the United States

Abstract. A rise in mental health concerns in the United States during the COVID-19 pandemic has been observed. Examining patterns in how people experienced health, economic, and social concerns in the context of the pandemic and documenting relationships between these groups with mental health outcomes will fill a gap in the literature. Describing these associations is also in line with the United Nations (UN) Sustainable Developmental Goals of promoting health and reducing inequalities. In the current study, we conducted a latent class analysis with items assessing health, economic, and social concerns in a sample of 1,394 people. Associations between groups with depressive and anxiety symptoms were also examined. A six-class model showed good fit, and groups were named: high overall concern (32.98%), health concerns without health care (14.78%), health and economic concerns (17.46%), economic concerns (4.57%), health concerns with health care (19.77%), and low overall concern (10.43%). Group membership was associated with mental health, with four groups reporting anxiety symptoms above a clinical cutoff. The intersection of concerns observed in these groups may serve as a barrier to mental health treatment during or following the pandemic. Consistent with the UN Sustainable Developmental Goals, ensuring equitable access to mental health care in the United States following the pandemic must include addressing the unique intersections of social determinants of health that people face.