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

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.