State containment measures, living arrangements, and mental health of U.S. older adults during the COVID-19 pandemic

Abstract

Objectives

Early in the coronavirus pandemic, U.S. states implemented several different types of containment measures to slow the disease’s spread. Early evidence indicates containment measures were associated with changes in individuals’ mental health. This study explores the associations between U.S. state containment measures and older adults’ mental health and importantly, whether the associations vary by living arrangement and gender.

Methods

The study analyzed national sample of adults aged 50 or older from 12 waves (April-July 2020) of the U.S. Household Pulse Survey (N = 394,934). State fixed-effects models linked four state containment measures (stay-at-home order, restaurant closure, bar closure, and movie theater closure) to levels of depression and anxiety across different types of living arrangements, net of controls. Men and women were analyzed separately.

Results

Stay-at-home order and restaurant and bar closure, but not movie theater closure, were associated with higher levels of depression and anxiety in older adults. Living arrangements moderated the associations for women but not men. For women, compared to living alone, living with a spouse or intergenerational family was associated with higher levels of anxiety and depression during stay-at-home order and restaurant closure.

Conclusion

The associations between containment measures and mental health vary by type of living arrangement and were gendered, likely because household situations create different demands and supports that men and woman experience differently. Although containment measures are necessary to protect public health, paying attention to these underlying dynamics can inform policymakers’ efforts to implement policies that balance harms and benefits for older adults.

Keywords:

• Business closure
• gender differences
• psychological well-being
• stay-at-home order
• U.S. state policy

Disclosure statement

No potential conflict of interest was reported by the author.

Funding

This research was supported by the Ministry of Science and Technology, Taiwan under Grant No. MOST 110-2410-H-004 140-MY2.

Data availability statement

The data that support the findings of this study are openly available from U.S. Census Bureau at https://www.census.gov/programs-surveys/household-pulse-survey.html.