Clobbered by COVID: A Closer Look at Workers and Families

• A new study finds that mothers suffered more negative mental effects than fathers during the pandemic.
• A second study finds that essential workers had better mental health outcomes in states with mask mandates and other supportive policies.
• Together, the studies highlight both the micro- and macro-level factors that correlated with mental health during the pandemic.

Introduction

The COVID-19 pandemic caused major worldwide disruptions that will take years to analyze and appreciate fully. Social scientists are now beginning to publish some of the earliest scholarly studies about the effects of COVID. In this post, we review 2 new articles:

• In Society and Mental Health, Sylvia Fuller, Manlin Cai, and Donna Lero at the University of British Columbia and University of Guelph studied parents’ mental health.
• Also in Society and Mental Health, Rachel Donnelly and Adam K. Schoenbachler at Vanderbilt University examined the relationship between essential workers’ mental health and state-level policies.

Read on to learn more about the effects of COVID, the two studies’ findings, and what we can do about the problems they raise.

Study #1: Parents’ Mid-Pandemic Mental Health

The onset of COVID-19 brought about significant stressors for parents, including job losses, the closure of schools and childcare centers, and reduced access to social support networks. Despite the introduction of vaccines and a reduction in health risks, the mental health impacts, especially gendered ones, persisted. Early research has indicated that mothers, in particular, continued to face psychological distress well into the pandemic. But several gaps remain in the research:

• Less attention has been given to the long-term effects and the nuanced differences between mothers and fathers.
• Furthermore, the pandemic’s impact was not uniform, with households facing high COVID-19 health risks experiencing unique challenges.
• These challenges included increased caregiving demands, heightened stress due to potential exposure, and the need for specialized work/care strategies, all of which could exacerbate mental health disparities, particularly when considering gender differences.

The authors define the work/care interface as the intersection of employment and caregiving responsibilities that parents navigate, particularly during the pandemic. This concept encompasses the challenges and stressors arising from trying to balance work demands with the increased needs for direct care, supervision, and emotional support of children. The work/care interface is affected by various pandemic-related factors, including school and childcare closures, the necessity of remote schooling, and changes in employment conditions.

Methods

Utilizing survey data from Canadian parents, the research investigates how changes at the work/care interface have influenced gender gaps in mental health. It pays special attention to within-gender differences, especially among parents with high-risk household members, offering insights into how the pandemic’s later stages have perpetuated or altered earlier observed trends in parental mental health.

Data Collection

• The study utilizes data from the Canadian portion of the international “familydemic” survey, conducted between August 20 and September 6, 2021.
• Participants included 4,683 parents, aged 20 to 55, with children aged 10 years or younger, living in the same household.
• The survey targeted a diverse group, ensuring representation across single parents, Indigenous communities, the LGBTQ+ population, and various racial minority groups, adhering to quotas based on provincial population sizes.

Sample Selection

• The analysis focused on 3,905 employed parents prior to the pandemic, excluding 397 self-employed individuals due to differing employment changes but including those who moved to self-employment during the pandemic.
• Further refinement led to excluding 278 non-partnered parents and 448 respondents with missing data, resulting in a final sample of 2,782 parents.

Variables

• Mental Health Measurement: Utilized a global self-assessment scale asking participants to rate their mental health before and during the pandemic, treating current mental health as a continuous dependent variable.
• Gender Identification: Included male and female respondents, with the survey accommodating a broad understanding of gender identity.
• High-Risk Household Identification: Asked whether any household members were at increased risk of severe COVID-19 outcomes, acknowledging the limitations of self-reported health status but leveraging Canada’s health system and vaccine rollout as indicators of heightened risk awareness.
• Care Demands and Employment Changes: Survey questions explored disruptions to childcare, changes in caregiving time, pandemic-related employment disruptions, and career prospects.
• Balancing Work and Care: Included concerns about managing childcare alongside work or school obligations, with responses treated on a linear scale.

The study controlled for pre-pandemic mental health, current employment status, disability, individual and family health risks, youngest child’s age, household income, and partner’s employment status to account for preexisting conditions and family dynamics affecting mental health.

Findings

Unsurprisingly, all parents reported lower mental health compared to pre-pandemic levels:

• Fathers in high-risk families reported declines (-16.5%) similar to those of other fathers (-16.4%), despite lower pre-pandemic mental health baselines.
• Mothers, however, experienced more significant declines in mental health than fathers.
• Mothers in high-risk families (-23.9%) reported larger and statistically significant declines compared to other mothers (-18.6%).

In other words, the pandemic intensified mental health disparities, especially between mothers in high-risk families and other groups, with these mothers bearing the heaviest mental health burden. Gender differences in mental health were more pronounced in high-risk families.

Delving deeper into why these mental health disparities manifested, the authors found that:

• Concerns about family functioning accounted for a substantial portion of the gender mental health gap, with mothers more exposed to this stressor.
• Mothers reported a greater share of pandemic childcare, contributing to the gender mental health gap.
• Employment disruptions did not independently predict mental health, but mothers expressed more concern over career prospects, affecting the gender gap.
• Contrary to initial hypotheses, care disruptions did not show a gender-differentiated impact on mental health.

Focusing specifically upon high-risk families, Fuller et al. find that mothers in these families were especially vulnerable:

• Mothers in high-risk families faced unique challenges, with care disruptions and the mental load of family functioning contributing significantly to their mental health decline.
• Employment factors, like furlough, had a markedly negative impact on mothers in high-risk families compared to others.
• Among fathers, high-risk family status minimally impacted mental health gaps. However, specific work/care stressors, like the decision to keep children home, showed differential impacts.

Study #2: Essential Workers’ Mid-Pandemic Mental Health

During the COVID-19 pandemic, “essential workers” — individuals whose in-person work is critical to societal functioning — faced unparalleled challenges and stressors. These roles spanned various sectors, including healthcare, food and beverage, manufacturing, and more, encompassing a significant portion of the workforce deemed crucial during the pandemic shutdowns.

• Research from the early months of the pandemic revealed that essential workers, particularly in healthcare and other critical sectors, reported worse mental health outcomes than their nonessential counterparts globally.
• The study authors note that workers from disadvantaged backgrounds may face additional stress on their mental health from financial strain and job precarity.

But the mental health impact on essential workers varied across the United States, raising questions as to why this was the case. Donnelly and Schoenbachler wonder whether state policies regarding safety measures and economic support may have played a role. Therefore, they investigate the potential protective effects of policies like mask mandates and paid sick leave on essential workers’ mental health. Their hypotheses are reprinted here:

• Hypothesis 1: Compared to nonessential workers, essential workers will have a higher risk of depression and anxiety during the second year of the COVID-19 pandemic (April–July 2021), especially essential workers with lower levels of educational attainment.
• Hypothesis 2: The association between essential work status and mental health will be moderated by state-level policies, especially for workers with lower levels of educational attainment.

Methods

This study utilizes data from the U.S. Census Bureau’s Household Pulse Survey (HPS), Phase 3.1, collected between April 14 and July 5, 2021, to investigate the mental health of essential workers:

• The HPS was chosen for its timeliness, large sample size, and inclusion of questions pertinent to essential work and mental health alongside the respondent state of residence.
• The final analytic sample comprised 178,469 adults aged 25 to 65 who were employed in the last seven days, excluding those with incomplete mental health data and residents of Washington D.C. due to its unique political context.
• By examining a nationally representative sample, the study offers insights into the mental health of essential workers in the second year of the pandemic, a period marked by the reopening of the economy and continued high COVID-19 case rates.

Measures:

The study combines the stress process model, which examines the sources and effects of stress on mental health, with a socioecological approach that considers the influence of state-level policies on individual well-being.

• Essential Worker Status: Identified based on respondents working outside the home in specified settings deemed essential during the pandemic, including healthcare, food and beverage stores, manufacturing, and other essential roles, contrasted against nonessential workers.
• Mental Health: Utilized the Generalized Anxiety Disorder scale (GAD-2) and the Patient Health Questionnaire (PHQ-2) to measure symptoms of anxiety and depression, respectively, creating binary measures for both conditions based on validated cut points.
• State-Level Policies: Examined the impact of mask mandates, COVID-19-specific paid leave expansions, and state minimum wage levels in 2021 on essential workers’ mental health.
• Covariates: Controlled for age, gender, race/ethnicity, educational attainment, and state-level COVID-19 mortality rates, along with the political context of each state in 2021.

The authors employed multilevel logistic regression models to account for individuals nested within states, testing for the effect of essential work on mental health outcomes and the moderating role of state-level policies. Models were sequentially developed to first assess the impact of essential worker status, and then explore interactions between essential work, educational attainment, and state policies.

Findings

Overall, approximately half of the analyzed sample were identified as working in essential jobs from April to July 2021, primarily in healthcare (12%) and other essential roles (32%).

• Elevated rates of depression (19%) and anxiety (24%) were observed among the workforce, a significant increase compared to pre-pandemic levels but a slight decrease from the early pandemic phase.
• Notably, food and beverage workers exhibited the highest rates of anxiety (32%) and depression (29%) among essential worker categories, suggesting a pronounced mental health impact within this subgroup.

Both hypotheses advanced by the authors were confirmed by the data:

• The authors correctly predicted that lower levels of educational attainment were associated with higher probabilities of anxiety and depression among essential workers, indicating an intersection of occupational and socioeconomic vulnerabilities.
• A substantial variability in mental health outcomes across states was noted, with food and beverage workers consistently showing higher rates of mental health issues.
• State policies, including mask mandates, expanded paid leave, and higher minimum wage, showed a mitigating effect on the adverse mental health outcomes for food and beverage workers.

These findings suggest that supportive state-level policies can play a crucial role in protecting the mental health of essential workers, particularly those in higher-risk settings.

Conclusions

Together, these two studies paint a grim picture of workers’ and families’ mental health in both the U.S. and Canada during 2021. However, they also suggest solutions:

• The authors of the first study highlight the importance of social support and equitable caregiving arrangements within households.
• For high-risk families, their study suggests ongoing challenges, emphasizing the need for targeted mental health supports and flexible work policies to address these disparities.
• The authors of the second study call for targeted interventions and policies to support the mental health of essential workers, with a particular focus on those in high-risk sectors and with lower educational backgrounds.

Both studies call for further research into the mental health effects of the pandemic as it continues to evolve.

What Can You Do?

The findings from these studies provide valuable insights into the mental health struggles faced by workers and families during the COVID-19 pandemic. Here are some actionable steps that readers can take to help alleviate these struggles:

1. Promote Work-Life Balance: Encourage flexible work arrangements, such as remote work or flexible hours, to help parents balance work and caregiving responsibilities.
2. Support Equitable Caregiving: Advocate for shared caregiving responsibilities within households to reduce the disproportionate burden on mothers.
3. Increase Access to Mental Health Resources: Support initiatives that provide accessible mental health services, including online counseling and support groups, especially for high-risk families.
4. Advocate for Supportive Workplace Policies: Lobby for policies that protect workers’ mental health, such as paid sick leave, mental health days, and job security for those needing time off for mental health reasons.
5. Promote Social Support Networks: Encourage the creation and maintenance of social support networks, both online and in-person, to provide emotional support and reduce feelings of isolation.
6. Educate on Mental Health Awareness: Raise awareness about the importance of mental health and the impact of the pandemic on mental well-being, encouraging individuals to seek help when needed.
7. Support Policies for Essential Workers: Advocate for state and federal policies that support the mental health of essential workers, such as mask mandates, hazard pay, and access to protective equipment.
8. Volunteer or Donate to Mental Health Organizations: Support organizations that provide mental health services and resources to those affected by the pandemic.
9. Encourage Healthy Coping Mechanisms: Promote activities that support mental well-being, such as exercise, mindfulness, and hobbies, and discourage unhealthy coping mechanisms like substance abuse.
10. Stay Informed and Advocate for Change: Stay informed about the ongoing impacts of the pandemic on mental health and advocate for policies and practices that address these challenges.

By taking these steps, readers can contribute to alleviating the mental health struggles faced by workers and families during the COVID-19 pandemic.

How has the pandemic affected your work-life balance, and what strategies have you found helpful in managing stress? Let us know in the comments!

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