Mental Health Status by Race, Ethnicity and Socioeconomic Status among Young Adults in Texas during COVID-19

Background Differences in symptoms of depression and anxiety by race/ethnicity and socioeconomic status (SES) among a diverse cohort of young adults during the COVID-19 pandemic (Spring 2020-Fall 2021) have not been examined. Method We analyzed four waves of biannual, panel data from n = 2629 emerging adults (16–25 years old) from the Texas Adolescent Tobacco and Marketing Surveillance study (TATAMS). We conducted a series of mixed effects ordinal logistic regression models to compare the independent and joint effects of race/ethnicity and SES on symptoms of (a) depression and (b) anxiety, adjusting for sex, cohort, and time. Results Symptoms of depression (aOR range: 1.54 – 2.19; 95% CI: 1.02 – 3.08) and anxiety (aOR range: 1.64 – 2.19; 95% CI: 1.22 – 2.79) were elevated among low SES young adults, across all racial/ethnic groups. Across SES groups, symptoms of depression were lower among non-Hispanic Blacks compared to non-Hispanic Whites (aOR range: 0.33 – 0.41; 95% CI: 0.18 – 0.62) and Hispanics /Latinos (aOR range: 0.33 – 0.38; 95% CI: 0.20 – 0.57); similarly, symptoms of anxiety were lower among non-Hispanic Blacks compared to non-Hispanic Whites (aOR range: 0.44; 95% CI: 25 – 0.77) and Hispanics/Latinos (aOR range: 0.47 – 0.56; 95% CI: 0.29 – 0.83). No significant interaction (joint effect) was observed between SES and race/ethnicity during this period. Conclusion Low SES was persistently related to poor mental health. Lower odds of symptoms of anxiety and depression among non-Hispanic Black young adults may reflect the ‘mental health paradox’. Overall, mental health policies should prioritize lower SES young adults regardless of race and ethnicity.