Pandemic stress effects are hitting some harder than others


We are coming up on a year since the pandemic hit and began changing our lives in dramatic ways.  Using data collected by federal agencies, we wanted to know who’s mental health is struggling most during these extraordinary times.


When the pandemic first hit, the National Center for Health Statistics (NCHS) partnered with the Census Bureau on an experimental data system called the Household Pulse Survey. This 20-minute online survey was designed to complement the ability of the federal statistical system to rapidly respond and provide relevant information about the impact of the coronavirus pandemic in the U.S.


They began collecting survey data on April 23 and have shared the results of these surveys through December 7.  We took a look at the data to create a snapshot view of which groups in the United States are struggling the most and may need the most mental health attention.


National Results


Starting with the big picture, at the beginning of the pandemic 35.9% of those surveyed said they experienced symptoms of anxiety and depression within the last seven days.  By December 7, that number rose by 5.5% to 41.4%.


Symptoms by Age Group


While every age group except the oldest reported increasing symptoms of anxiety and depression, it is clear from this survey that the youngest age groups are struggling more with these symptoms.  People in this age group may be more likely to suffer economically as businesses close and unemployment rises.  They are also more likely to be caring for school-aged children and may be suffering increase levels of anxiety and depression related to school shutdowns.


Age Group April 23 Dec 7 % Change
18-29 years 46.8% 56.5% +9.7%
30-39 years 39.6% 47.6% +8%
40-49 years 38.9% 45.3% +6.4%
50-59 years 35.8% 40.0% +4.2%
60-69 years 28.9% 32.3% +3.4%
70-79 years 21.5% 26.4% +4.9%
80 years + 21.1% 19.4% -1.7%




Symptoms by Gender


School shutdowns have proven to negatively impact women over men since the pandemic began.  In April, already 40.7% of the women surveyed reported symptoms of anxiety and depression.  By December that number had increased 5% to 45.7%.


Men on the other hand also experienced increased symptoms.  At the beginning, 31% of the men surveyed admitted to experiencing symptoms of anxiety and depression.   By December 36.8% of men reported experiencing these symptoms, which is a 5.8% increase.




Symptoms by Race/Hispanic Ethnicity


While African American and Asian respondents indicated increased levels of anxiety and depression at the end of the year, they reported less of an increase than Caucasian, multi-racial and Hispanic/Latino repsondents.


Race/Hispanic Ethnicity April 23 Dec 7 % Change
Hispanic/Latino 42.7% 48.0% +5.3%
Non-Hispanic Asian, single race 31.9% 35.0% +3.1%
Non-Hispanic black, single race 38.9% 42.5% +3.6%
Non-Hispanic white, single race 33.6% 39.6% +6%
Non-Hispanic, other races & multi-racial 43.9% 49.8% +5.9%




Symptoms by Education Level


One of the biggest increases in levels of anxiety and depression occurred in people with less than a high school diploma.  This may be because they were most likely to become unemployed during shutdowns and also because they may have fewer coping skills and less ability to understand what has become a complex and confusing news cycle.


Level of Education April 23 Dec 7 % Change
Less than a high school diploma 45.5% 53.0% +7.5%
High school diploma or GED 36.7% 42.3% +5.6%
Some college/Associate’s degree 38.5% 45.0% +6.5%
Bachelor’s degree or higher 30.7% 35.0% +4.3%




State-by-State Results


Probably the most stunning of the survey’s results is the difference in reported symptoms between states.  We looked at the Top 10 states and compared them to the bottom 10 states.  A very large difference emerged.


Looking at how citizens of individual states are faring during the pandemic revealed that symptoms of anxiety and depression vary greatly by geography.  We think it will be interesting to further study this dynamic to discern what factors influenced these differences in experience.  Regardless, the data also suggests areas where there is a significantly increased need for mental health services in the coming months to years.


Top 10 States


State April 23 Dec 7 % Change
New York 41.4% 39.6% -2.5%
Massachusetts 40.6% 39.4% -1.2%
South Caroline 33.3% 33.6% +0.3%
Michigan 39.4% 40.1% +0.7%
Connecticut 40.2% 41.6% +1.4%
Florida 36.8% 39.4% +2.6%
Maine 34.3% 36.9% +2.6%
New Jersey 37.6% 40.8% +3.2%
Arizona 36.4% 39.8% +3.4%
Georgia 36.2% 39.9% +3.7%




Bottom 10 States


State April 23 Dec 7 % Change
Wyoming 31.0% 44.8% +13.8%
Nevada 34.8% 47.2% +12.4%
Mississippi 34.5% 46.8% +12.3%
Montana 27.3% 39.4% +12.1%
New Mexico 34.6% 46.1% +11.5%
Alaska 31.5% 42.6% +11.1%
Nebraska 28.6% 39.6% +11.0%
Oregon 36.8% 47.6% +10.8%
West Virginia 34.3% 44.2% +9.9%
Oklahoma 34.1% 43.9% +9.8%





It may not be possible to understand everything we need to understand about the pandemic by looking only at levels of anxiety and depression; however, we believe that by understanding who is most likely to be suffering increased stresses and where those people live that we can better understand how mental health practitioners and facilities can best prepare for 2021 to deliver these much-needed services.


Here at Substance Solutions, we are constantly looking at insurance reimbursement numbers, mental health statistics and asking mental health facilities what they need most to maximize their billing efficiency.