Growing Job-Related Income Losses, Increasing Social Inequalities, and Physical and Mental Health Impact During the COVID-19 Pandemic, United States, April – December 2020

Abstract

Background: The COVID-19 pandemic has led to substantial socioeconomic disruptions and increases in mental health problems in the United States (US) and globally. Whether social inequalities in job losses and resultant physical and mental health problems have worsened over the course of the pandemic are not well studied. Using temporal, nationally representative data, this study examines racial/ethnic and socioeconomic inequalities in jobrelated income losses and their associated health impact among US adults aged 18-64 years during the pandemic. Methods: Using April, August, and December 2020 rounds of the US Census Bureau’s Household Pulse Survey (N = 56,788 for April; 83,244 for August; and 52,150 for December), social determinants of jobrelated income losses and associated impacts on self-assessed fair/poor health and depression were analyzed by multivariate logistic regression. Results: In December, more than 108 million or 55.5% of US adults reported that they or someone in their household experienced a loss of employment income since March 13, 2020. An additional 68 million or 34.6% of adults reported expecting this economic hardship in the next four weeks due to the pandemic. Blacks/African Americans, Hispanics, other/multiple-race groups, low-income, and low-education adults, and renters were significantly more likely to experience job-related income losses. Controlling for covariates, those reporting job-related income losses had 51% higher odds of experiencing fair/poor health and 106% higher odds of experiencing serious depression than those with no income losses in December 2020. The prevalence of fair/poor health varied from 11.6% for Asians with no job/income losses to 28.8% for Hispanics and 32.3% for Blacks with job/income losses. The prevalence of serious depression varied from 6.5% for Asians with no income losses to 21.6% for Non-Hispanic Whites and 21.8% for Blacks with job/income losses. Conclusion and Implications for Translation: Job-related income losses and prevalence of poor health, and serious depression increased markedly during the pandemic. More than half of all ethnic-minority and socially disadvantaged adults reported job-related income losses due to the coronavirus pandemic, with 20- 45% of them experiencing poor health or serious depression.