Anxiety, Depression Persist for Some Despite Waning Pandemic
Adults who are young, have household incomes below $75,000, or have some college but no degree are still experiencing elevated anxiety and depression
By Anthony P. Carnevale, Heidi Booth, and Emma Wenzinger
The COVID-19 pandemic took a toll on Americans’ mental health. Illness and death, risk of contracting COVID-19, isolation, financial difficulties, and uncertainty all contributed to increased stress and anxiety. About 4 in 10 Americans reported symptoms consistent with generalized anxiety disorder or major depressive disorder during the pandemic, up significantly from 1 in 10 adults reporting such symptoms in 2019. Adults with less education, young people, women, and lower-income adults were more likely to report symptoms of poor mental health in the first months of the pandemic.
As the pandemic began to wane and the federal government enacted another major economic stimulus, American adults reported better mental health. After peaking in January, the number of new daily COVID-19 cases in the United States declined rapidly as distribution of the vaccine ramped up. The percentage of the US population that had received at least one dose of a COVID-19 vaccine rose from almost 8 at the beginning of February to nearly 30 by the end of March. Also in March, the CDC issued guidance that loosened restrictions for vaccinated people at some indoor gatherings, and the White House announced that the vaccines would be available to all American adults by May 1.
As the public health situation turned the corner, the unemployment rate continued to hover above 6 percent. A second major stimulus, the American Rescue Plan, was signed into law on March 11. In addition to funding for unemployment insurance, housing assistance, schools, and vaccine distribution, the stimulus included $1,400 checks that were distributed as early as March 12 to single adults with incomes below $75,000 and adults with higher incomes who are married or heads of household.
Data from the Household Pulse Survey, a biweekly data collection by the US Census Bureau, show a decline in self-reported symptoms of anxiety and depression typically associated with generalized anxiety disorder and major depressive disorder, respectively, from February to March 2021.¹ However, in some cases, those with the highest rates of anxiety or depression over the past year showed the slowest improvement.
Adults in lower-income households generally reported higher rates of anxiety and depression than those in higher-income households, consistent with pre-pandemic trends. Mental health among adults in households with incomes below $75,000 showed little improvement from February to March. Among adults with household incomes below $75,000, there was a 2 percentage point decline in both the share who reported anxiety and the share who reported depression (Figure 1). Adults with household incomes above $75,000 saw greater improvement in their mental health symptoms, with a 4 percentage point decrease in anxiety and a 3 percentage point decrease in depression.
Figure 1. Adults with household incomes below $75,000 reported smaller decreases in rates of anxiety and depression than those with higher household incomes from February to March.
Source: Georgetown University Center on Education and the Workforce analysis of data from the US Census Bureau, Household Pulse Survey, February 3–15, February 17–March 1, March 3–15, and March 17–29, 2021.
Note: The numbers in Figure 1 may differ slightly from the numbers discussed above due to rounding. Rates of anxiety among adults with household incomes above $75,000 fell from 27.4 percent in February to 23.7 percent in March.
Young, But Not Carefree
Even before the pandemic, young adults were more likely to report poor mental health. Differences by age were especially pronounced in the past year: for some periods, more than half of young adults (age 18 through 29) reported experiencing symptoms of anxiety or depression, according to the CDC. The percentage of adults who reported experiencing these symptoms declined with age.
Young people faced many challenges during the pandemic, including higher rates of unemployment amid a sudden recession. Many wound up altering their education plans; more than 75 percent of households with at least one member planning to take postsecondary classes in fall 2020 reported some sort of a change in their education plans. At the same time, however, young adults may have been more willing to disclose mental health symptoms.
Among adults with household incomes below $75,000, respondents from all age groups in March reported better mental health than respondents had in February. Adults ages 18 through 29 and 60 and above reported the greatest improvement in their symptoms of anxiety (Figure 2). Reports of anxiety symptoms by young adults decreased from 50 percent to 46 percent. Adults over the age of 60 likewise reported feeling anxious less often, with a decrease from 28 percent to 25 percent. Reports of anxiety symptoms among adults ages 30 through 59 hardly changed.
Figure 2. Among adults with household incomes below $75,000, the youngest and oldest age groups reported the greatest reduction in their symptoms of anxiety from February to March.
Source: Georgetown University Center on Education and the Workforce analysis of data from the US Census Bureau, Household Pulse Survey, February 3–15, February 17–March 1, March 3–15, and March 17–29, 2021.
More Education, Better Mental Health?
In general, adults with less education had higher rates of depression and anxiety throughout the pandemic. A CDC analysis of adults across income levels shows that those with less than a high school diploma typically reported the highest rates of anxiety and depression, followed by those with some college education but no degree. For associate’s, bachelor’s, and graduate degree holders, relatively good mental health may be related to higher earnings and more economic stability.
More education does not always correspond with better mental health, however. Among adults with household incomes below $75,000, adults with some college education but no degree consistently reported the highest rates of anxiety: 44 percent in February and 40 percent in March (Figure 3). Some people with some college but no degree may be carrying the student loan debt burden that comes from attending college, but not receiving a credential that could boost earnings to help pay off that debt, which may be associated with poor mental health outcomes.² However, these adults also showed the greatest improvement in their mental health from February to March.
Adults with a high school diploma reported the second largest improvement, with a change from 36 percent reporting anxiety in February to 33 percent in March.
Figure 3. Among adults with household incomes below $75,000, those with some college but no degree reported the highest rates of anxiety and the most improvement from February to March.
Source: Georgetown University Center on Education and the Workforce analysis of data from the US Census Bureau, Household Pulse Survey, February 3–15, February 17–March 1, March 3–15, and March 17–29, 2021.
A CDC analysis signals continued progress in adults’ mental health symptoms as the pandemic has subsided this spring. Rates of anxiety and depression varied somewhat among racial and ethnic groups, but most groups showed some improvement in their mental health from February to March. Young adults and those with some college education but no degree reported some of the highest rates of anxiety but also showed significant improvement in their symptoms.
Despite the sharp decline in COVID-19 cases and steady economic recovery, however, other groups’ mental health has shown less improvement. Adults with household incomes below $75,000, who reported high rates of anxiety and depression during the pandemic, saw slower improvement in their symptoms than adults from higher-income households.
As normal life returns in the United States, one persistent challenge will be reducing now-widespread symptoms of mental health disorders. Many of those who are continuing to experience anxiety and depression may need treatment and financial support even when concerns about COVID-19 and the economy abate.
¹ In drawing our conclusions, we defined “symptoms of anxiety” and “symptoms of depression” according to a standard scoring system used by the CDC for the Household Pulse Survey. Using that system, we assigned a numerical value to the answers for both the anxiety and depression questions in which not at all = 0, several days = 1, more than half the days = 2, and nearly every day = 3. We added the two responses to create separate depression and anxiety scales. A sum of three or more on the PHQ-2 has been shown to be associated with diagnoses of major depressive disorder, and a sum of three or more on the GAD-2 has been shown to be associated with diagnoses of generalized anxiety disorder. In our analyses pertaining to anxiety, we included only those responses that answered both questions relating to anxiety. In our analyses pertaining to depression, we included only those responses that answered both questions relating to depression. We based our calculations on the percentage of adults who reported symptoms of anxiety or depression that have been shown to be associated with diagnoses of generalized anxiety disorder or major depressive disorder.
² Students who start but do not complete a credential have more difficulty paying off their student loans than students who earned a credential, according to Third Way. Adults with some college education but no degree often have high debt-to-income ratios, which a 2019 Student Loan Planner survey found is related to poor mental health.
Dr. Anthony Carnevale is director and research professor, Heidi Booth is a research analyst, and Emma Wenzinger is a strategic communications specialist at the Georgetown University Center on Education and the Workforce. CEW is an independent, nonprofit research and policy institute affiliated with the Georgetown McCourt School of Public Policy. CEW studies the links among education, career qualifications, and workforce demands.
Thanks to Ban Cheah for data analysis, Gayle Cinquegrani for editorial feedback, Artem Gulish for quantitative feedback, Johnna Guillerman for graphic design, and Frank Zhang for figure design.
