COVID-19 Stress and the Health of Black Americans in the Rural South
Abstract
The Impact of the COVID-19 Pandemic on Black Americans
Predicting Black Americans’ Mental and Physical Health During the COVID-19 Pandemic
The Current Study
Method
Participants
Measures
Exposure to COVID-19-related stressors
Health outcomes
Depressive symptoms
General health
Sleep problems
Perceived impact and stress due to COVID-19
Prepandemic stressors
Financial strain
Racial discrimination
Chronic stress
Prepandemic resources
Marital quality
General support from family and friends
Variable | Correlation | Women | Men | ||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | N | M | SD | N | M | SD | |
1. COVID-19-related stressors (W5.5) | — | .22** | .19* | .21* | −.30** | −.21* | .25** | −.18* | .32** | .24** | .30** | 191 | 6.81 | 3.12 | 138 | 6.29 | 3.19 |
2. Financial strain (W5) | .16* | — | .16 | .35** | −.19* | −.20* | −.02 | −.15 | .11 | .10 | .17* | 189 | 0.00 | 1.71 | 138 | −0.02 | 1.71 |
3. Racial discrimination (W5) | .24** | .21** | — | .23** | −.03 | −.03 | .08 | −.11 | .25** | .13 | .19* | 190 | 18.64 | 5.67 | 138 | 16.70 | 6.09 |
4. Chronic stress (W5) | .16* | .55** | .19** | — | −.25** | −.17* | .13 | −.14 | .24** | .09 | .13 | 190 | 6.32 | 4.19 | 138 | 5.32 | 4.61 |
5. Marital quality (W5) | −.29** | −.20* | −.20* | −.19* | — | .20* | −.05 | .03 | −.09 | −.20* | −.22* | 129 | 24.22 | 5.89 | 121 | 25.93 | 4.72 |
6. General support from family and friends (W5) | −.02 | −.26** | .01 | −.34** | .09 | — | −.21* | .18* | −.17 | −.05 | −.18* | 181 | 12.04 | 5.60 | 138 | 15.50 | 2.15 |
7. Depression (W5.5) | .40** | .15* | .14 | .22** | −.41** | −.01 | — | −.28** | .52** | .05 | .27** | 188 | 9.28 | 5.74 | 138 | 6.86 | 5.17 |
8. General health (W5.5) | −.20** | −.23** | −.08 | −.29** | .17 | .06 | −.26** | — | −.34** | −.03 | −.22* | 190 | 5.86 | 1.66 | 136 | 5.77 | 1.53 |
9. Sleep problems (W5.5) | .43** | .18* | .23** | .26** | −.28** | .03 | .60** | −.34** | — | .22* | .32** | 190 | 14.92 | 4.36 | 137 | 12.89 | 4.02 |
10. Overall daily impact from COVID-19 (W5.5) | .28** | .07 | .16* | .11 | −.19* | .02 | .31** | −.26** | .31** | — | .68** | 191 | 5.37 | 1.59 | 138 | 5.07 | 1.85 |
11. Overall stress due to COVID-19 (W5.5) | .21** | −.08 | .15* | .08 | −.18* | .08 | .36** | −.31** | .37** | .55** | — | 191 | 5.25 | 1.65 | 138 | 4.72 | 1.90 |
Analytic plan
Results
Research Question 1: changes in health after the onset of the COVID-19 pandemic
Outcomes | Women | Men | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
N | ΔM | SD | t | df | p | N | ΔM | SD | t | df | p | |
Wave 4 to Wave 5 | ||||||||||||
Depression | 188 | −0.75 | 4.87 | −2.10 | 187 | .04 | 133 | 0.35 | 4.28 | 0.93 | 132 | .35 |
Sleep problems | 188 | −0.09 | 5.13 | −0.24 | 187 | .81 | 133 | 0.41 | 3.61 | 1.30 | 132 | .19 |
Wave 5 to Wave 5.5 | ||||||||||||
Depression | 187 | 2.56 | 5.41 | 6.50 | 186 | .00 | 138 | 0.71 | 5.59 | 1.49 | 137 | .14 |
Sleep problems | 189 | 1.01 | 4.72 | 2.96 | 188 | .00 | 137 | −0.40 | 4.19 | −1.12 | 136 | .27 |
General health | 189 | −0.47 | 1.79 | −3.61 | 188 | .00 | 136 | −0.39 | 1.69 | −2.69 | 135 | .01 |
Wave 4 to Wave 5.5 | ||||||||||||
Depression | 186 | 1.78 | 5.85 | 4.16 | 185 | .00 | 133 | 0.99 | 5.42 | 2.11 | 132 | .04 |
Sleep problems | 188 | 0.95 | 4.86 | 2.68 | 187 | .01 | 132 | −0.03 | 4.27 | −0.08 | 131 | .94 |
Research Question 2: associations between exposure to COVID-related stressors and health
Research Question 3: prepandemic stressors, exposure to COVID-related stressors, and health
Bivariate associations
Indirect-effect models
Prepandemic stressor (W5) and health during the pandemic (W5.5) | N | Indirect effect through exposure to COVID-19-related stressors (a × b) | Direct effect (c′) | ||||
---|---|---|---|---|---|---|---|
Coefficient | Boot SE | 95% CI | Coefficient | SE | p | ||
Results for women | |||||||
Financial strain | |||||||
Depression | 186 | 0.20 | 0.10 | [0.020, 0.400] | 0.29 | 0.23 | .21 |
General health | 188 | −0.02 | 0.02 | [−0.062, 0.001] | −0.20 | 0.07 | .01 |
Sleep problems | 188 | 0.16 | 0.08 | [0.017, 0.338] | 0.30 | 0.17 | .08 |
Perceived daily impact of COVID-19 | 189 | 0.04 | 0.02 | [0.003, 0.090] | 0.02 | 0.07 | .74 |
Perceived stress due to COVID-19 | 189 | 0.04 | 0.02 | [0.003, 0.084] | −0.11 | 0.07 | .12 |
Racial discrimination | |||||||
Depression | 187 | 0.09 | 0.03 | [0.037, 0.162] | 0.05 | 0.07 | .52 |
General health | 189 | −0.01 | 0.01 | [−0.028, −0.002] | −0.01 | 0.02 | .68 |
Sleep problems | 189 | 0.07 | 0.03 | [0.029, 0.125] | 0.11 | 0.05 | .04 |
Perceived daily impact of COVID-19 | 190 | 0.01 | 0.01 | [0.002, 0.029] | 0.03 | 0.02 | .16 |
Perceived stress due to COVID-19 | 190 | 0.01 | 0.01 | [0.002, 0.030] | 0.03 | 0.02 | .16 |
Chronic stress | |||||||
Depression | 187 | 0.09 | 0.04 | [0.026, 0.171] | 0.21 | 0.09 | .03 |
General health | 189 | −0.01 | 0.01 | [−0.027, 0.001] | −0.11 | 0.03 | .00 |
Sleep problems | 189 | 0.08 | 0.03 | [0.020, 0.140] | 0.20 | 0.07 | .00 |
Perceived daily impact of COVID-19 | 190 | 0.02 | 0.01 | [0.002, 0.037] | 0.03 | 0.03 | .33 |
Perceived stress due to COVID-19 | 190 | 0.01 | 0.01 | [0.001, 0.030] | 0.02 | 0.03 | .53 |
Results for men | |||||||
Financial strain | |||||||
Depression | 138 | 0.18 | 0.10 | [0.026, 0.400] | −0.24 | 0.26 | .35 |
General health | 136 | −0.03 | 0.02 | [−0.080, −0.001] | −0.10 | 0.08 | .19 |
Sleep problems | 137 | 0.15 | 0.08 | [0.031, 0.332] | 0.12 | 0.20 | .56 |
Perceived daily impact of COVID-19 | 138 | 0.06 | 0.04 | [0.006, 0.140] | 0.06 | 0.09 | .55 |
Perceived stress due to COVID-19 | 138 | 0.07 | 0.04 | [0.014, 0.157] | 0.12 | 0.09 | .19 |
Racial discrimination | |||||||
Depression | 138 | 0.04 | 0.02 | [0.004, 0.096] | 0.03 | 0.07 | .65 |
General health | 136 | −0.01 | 0.01 | [−0.021, 0.000] | −0.02 | 0.02 | .36 |
Sleep problems | 137 | 0.03 | 0.02 | [0.005, 0.082] | 0.13 | 0.05 | .02 |
Perceived daily impact of COVID-19 | 138 | 0.01 | 0.01 | [0.001, 0.033] | 0.03 | 0.03 | .33 |
Perceived stress due to COVID-19 | 138 | 0.02 | 0.01 | [0.003, 0.036] | 0.04 | 0.03 | .11 |
Chronic stress | |||||||
Depression | 138 | 0.05 | 0.03 | [0.006, 0.134] | 0.09 | 0.10 | .34 |
General health | 136 | −0.01 | 0.01 | [−0.027, 0.000] | −0.04 | 0.03 | .22 |
Sleep problems | 137 | 0.05 | 0.03 | [0.006, 0.110] | 0.16 | 0.07 | .02 |
Perceived daily impact of COVID-19 | 138 | 0.02 | 0.01 | [0.002, 0.050] | 0.02 | 0.03 | .60 |
Perceived stress due to COVID-19 | 138 | 0.02 | 0.01 | [0.004, 0.054] | 0.03 | 0.03 | .37 |
Research Question 4: prepandemic resources, exposure to COVID-related stressors, and health
Bivariate associations
Indirect-effect models
Prepandemic resource (W5) and health during the pandemic (W5.5) | N | Indirect effect through exposure to COVID-19-related stressors (a × b) | Direct effect (c′) | ||||
---|---|---|---|---|---|---|---|
Coefficient | Boot SE | 95% CI | Coefficient | SE | p | ||
Results for women | |||||||
Marital quality | |||||||
Depression | 128 | −0.10 | 0.04 | [−0.179, −0.031] | −0.31 | 0.08 | .00 |
General health | 129 | 0.01 | 0.01 | [−0.003, 0.030] | 0.03 | 0.02 | .16 |
Sleep problems | 129 | −0.10 | 0.03 | [−0.167, −0.035] | −0.11 | 0.06 | .06 |
Perceived daily impact of COVID-19 | 129 | −0.01 | 0.01 | [−0.031, 0.008] | −0.04 | 0.02 | .09 |
Perceived stress due to COVID-19 | 129 | −0.01 | 0.01 | [−0.038, 0.001] | −0.03 | 0.02 | .16 |
General support from family and friends | |||||||
Depression | 178 | −0.01 | 0.03 | [−0.066, 0.062] | −0.01 | 0.07 | .91 |
General health | 180 | 0.00 | 0.01 | [−0.010, 0.012] | 0.02 | 0.02 | .41 |
Sleep problems | 180 | −0.01 | 0.03 | [−0.058, 0.047] | 0.03 | 0.05 | .60 |
Perceived daily impact of COVID-19 | 181 | 0.00 | 0.01 | [−0.017, 0.014] | 0.01 | 0.02 | .64 |
Perceived stress due to COVID-19 | 181 | 0.00 | 0.01 | [−0.013, 0.011] | 0.03 | 0.02 | .22 |
Results for men | |||||||
Marital quality | |||||||
Depression | 121 | −0.09 | 0.05 | [−0.198, −0.018] | 0.04 | 0.10 | .72 |
General health | 119 | 0.02 | 0.01 | [0.002, −0.044] | −0.01 | 0.03 | .76 |
Sleep problems | 120 | −0.08 | 0.03 | [−0.154, −0.023] | 0.00 | 0.08 | .98 |
Perceived daily impact of COVID-19 | 121 | −0.02 | 0.02 | [−0.057, 0.002] | −0.05 | 0.04 | .14 |
Perceived stress due to COVID-19 | 121 | −0.03 | 0.02 | [−0.070, −0.008] | −0.06 | 0.04 | .13 |
General support from family and friends | |||||||
Depression | 138 | −0.11 | 0.07 | [−0.267, −0.008] | −0.40 | 0.20 | .05 |
General health | 136 | 0.02 | 0.02 | [0.000, 0.062] | 0.11 | 0.06 | .09 |
Sleep problems | 137 | −0.11 | 0.06 | [−0.247, −0.016] | −0.20 | 0.16 | .21 |
Perceived daily impact of COVID-19 | 138 | −0.04 | 0.03 | [−0.105, −0.004] | 0.00 | 0.07 | .97 |
Perceived stress due to COVID-19 | 138 | −0.05 | 0.03 | [−0.114, −0.009] | −0.11 | 0.07 | .15 |
Discussion
Summary of findings
Strengths and limitations
Future directions and implications
Conclusion
Acknowledgments
ORCID iD
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This article was published in Clinical Psychological Science.
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