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Younger adults hit hardest by pandemic-related anxiety and depression

In a recent study published within the journal JAMA Network Open, researchers investigate age-related disparities in anxiety and depression in the course of the coronavirus disease 2019 (COVID-19) pandemic.

Study: Age Disparities in Prevalence of Anxiety and Depression Amongst U.S. Adults In the course of the COVID-19 Pandemic. Image Credit: maxbelchenko /


Within the ten years before the COVID-19 pandemic, adolescents and young adults in america were related to higher levels of mental health issues than older adults. Yet, studies haven’t investigated whether mental health worsened in the course of the COVID-19 pandemic amongst younger adults or all adult age groups.

Research studies focused on the primary few months after the onset of the COVID-19 pandemic identified as much as a sixfold increase in the degrees of tension and depression in the course of the COVID-19 pandemic amongst U.S. young adults. Nevertheless, there stays an absence of studies examining their persistence throughout the pandemic.

Age disparity likely widened or narrowed in the course of the COVID-19 pandemic; nevertheless, its prevalence would have been higher for younger adults than their older counterparts on the pandemic’s starting and later fell for all age groups as vaccines became available.

In regards to the study

The researchers investigated three million responses to the Household Pulse Survey (HPS) accomplished between April 2020 and August 2022. Moreover, state-level week-on-week data on COVID-19 cases and deaths, including all pandemic- and non-pandemic-related stressors measured within the HPS, were also analyzed.

These data included younger adults’ economic state and their responses to COVID-19 case counts and vaccine availability. Each U.S. Census Bureau-sponsored HPS survey covered about 63,000 respondents, with a response rate of 6.4%.

A decomposition evaluation was performed to measure the age disparity statistically elucidated by differences in stress exposure across age groups versus differences of their susceptibility to those stressors. Two-item screeners were used to measure respondents’ anxiety and depression levels, with scores of three or higher indicating clinical significance.

This evaluation adjusted for demographic aspects, including gender, age, race/ethnicity, educational status, and income, and likewise considered the impact of historical and ongoing inequalities.

Several variables were used to measure economic precarity based on home ownership, employment status, and experiencing income loss in the course of the COVID-19 pandemic.

Within the statistical evaluation, the Blinder-Oaxaca decomposition method was used to investigate differences in anxiety and depression between adults aged 18-39 and 40-59 years. Demographic differences within the prevalence of tension and depression, in addition to the association between stressors and mental health outcomes for young adults versus middle-aged adults, were also analyzed.

Study findings

Young adults aged 18 to 39 years had the best prevalence of clinically relevant anxiety and depression symptoms, with their prevalence decreasing with age. The authors noted differences based on age, education level, and household income.

Anxiety and depression levels were higher amongst females than males. Interestingly, over 50% of individuals with high anxiety scores had higher depression scores, whereas over 80% with high depression scores had higher anxiety scores.

Younger adults also had lower household incomes, lower rates of living alone, and better scores on the economic risk composite in comparison with middle-aged adults. Nevertheless, each groups were related to comparable income and employment loss rates as a consequence of the COVID-19 pandemic. 

Importantly, young adults were probably the most exposed to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and fewer prone to report getting vaccinated.

While COVID-19 case numbers were more robustly related to anxiety and depression in younger adults than older adults, the situation was strikingly opposing concerning improvements in mental well-being after COVID-19 vaccination. Thus, COVID-19 vaccination improved the mental well-being of adults aged 40 years or older to a greater extent as in comparison with those aged 18 to 39 years. The evaluation also confirmed that mental health didn’t worsen amongst respondents who lived alone or with their children.

No matter age, all individuals with high scores on the economic risk scale showed high levels of tension and depression. Decomposition evaluation results revealed that about 20% of the age-related disparity in anxiety and depression trusted various demographic characteristics, including income, which might have translated to an estimated 1.8 million fewer U.S. young adults showing clinically relevant anxiety or depression symptoms. 


The present study offers precious insights into various aspects related to anxiety and depression symptoms, including stress exposures related to the COVID-19 pandemic and economic precarity, a non-pandemic-related stressor. Moreover, aspects related to the pandemic and economic stress likely influenced one another.

Various events and social stressors, corresponding to mass shootings and geopolitical events, also influenced persistently elevated anxiety and depression observed amongst young adults, thus highlighting the necessity for targeted mental health care and economic policies.

Nearly one-third of age-related disparities between young adults and middle-aged adults within the U.S. were attributable to differences of their demographic and economic conditions. Although some older adults also experienced anxiety and depression, the presence of those symptoms reduced with the provision of COVID-19 vaccines, unlike in younger adults.

Journal reference:

  • Collier, V. S., Chen, S., & Adam, E. K. (2023). Age Disparities in Prevalence of Anxiety and Depression Amongst US Adults In the course of the COVID-19 Pandemic. JAMA Network Open 6(11). doi:10.1001/jamanetworkopen.2023.45073
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