Low assets predict persistent depression through living difficulties amid large-scale disasters: A cohort study

Area of Science:

• Mental Health Research
• Sociology
• Public Health

Background:

• Large-scale disasters disproportionately affect individuals with fewer assets, leading to poorer mental health outcomes.
• Financial hardship and disruptions to daily life are potential mediators in the association between assets and mental health.
• The COVID-19 pandemic, coupled with economic downturns, exacerbates mental health risks for vulnerable populations.

Purpose of the Study:

• To examine the prospective relationship between asset levels during the COVID-19 pandemic's acute phase and persistent probable depression.
• To investigate the mediating roles of daily routine disruptions and financial hardship in the assets-depression association.
• To provide insights into mental health support strategies during public health crises.

Main Methods:

• A prospective, population-representative study was conducted in Hong Kong.
• Data were collected during the acute phase of COVID-19 (February-August 2020, T1) and followed up (March-August 2021, T2).
• The study assessed assets, probable depression (using PHQ-9), daily routine disruptions, and financial hardship.

Main Results:

• Lower asset levels at T1 were prospectively associated with persistent probable depression from T1 to T2.
• Primary disruptions in daily routines (e.g., healthy eating, sleep) at T1 fully mediated the relationship.
• Financial hardship at T2 also fully mediated the association between initial assets and persistent depression.

Conclusions:

• The findings underscore the vulnerability of individuals with fewer assets to depression during crises like the COVID-19 pandemic.
• Behavioral and financial assistance is crucial for those with fewer assets in the short term.
• Long-term strategies should focus on ensuring adequate assets for all to mitigate mental health consequences of future crises.