BACKGROUND: Housing insecurity is an important social determinant of health that has been linked to poor mental health. The beginning of the COVID-19 pandemic marked a time of major upheaval and has been linked to worsening experiences with anxiety and depression. It is not well understood how pre-pandemic housing insecurity may be associated with trajectories of anxiety and depression in the early months of the COVID-19 pandemic.
METHODS: Using data from the NIH All of Us Research Program, we estimated the correlation between pre-pandemic housing insecurity and repeated measures of anxiety and depression symptoms between May and July 2020. We combined data from baseline surveys and the COVID-19 Participant Experience Survey (COPE) and used generalized linear models with a logit link to estimate results.
RESULTS: Our sample included 37,535 participants. Those who reported housing insecurity prior to the start of the pandemic were significantly more likely to report moderate-to-severe symptoms of anxiety (AOR 1.630, p < .001) and depression (AOR 1.877, p < .001) across all months. Trajectories of anxiety and depression symptoms did not differ between May and July 2020 for those who reported housing insecurity versus those who did not.
CONCLUSIONS: This study examined how experiences and trajectories of anxiety and depression symptoms differed by housing insecurity status among a novel large national sample. Experiencing housing insecurity prior to the start of the COVID-19 pandemic was associated with a greater likelihood of moderate-to-severe anxiety and depression from May to July 2020, and this difference was consistent over time.
Associations between pre-pandemic housing insecurity and reports of anxiety and depression in the early months of the COVID-19 pandemic: An analysis of the All of Us Research Program cohort
BMC Public Health, 25 (1), 3266. doi: 10.1186/s12889-025-24535-w. PMCID: PMC12487285.