Financial Hardship and Social Assistance as Determinants of Mental Health and Food and Housing Insecurity During the COVID-19 Pandemic

Kim, D.

Background: While social assistance through the federal Coronavirus Aid, Relief, and Economic Security (CARES) Act provided expanded UI benefits during the coronavirus disease 2019 (COVID-19) pandemic until July 2020, it is unclear whether social assistance was in subsequent months sufficient to meet everyday spending needs and to curb adverse sequelae of financial hardship. Among working-aged Americans with job-related income loss during the pandemic, this study explored the associations of financial hardship with mental health outcomes and food and housing insecurity after accounting for receipt of social assistance. Methods: Using multivariable logistic regression and pooled repeated cross-sectional individual-level data on working-aged adults from nationally-representative surveys administered from September to November 2020, this study investigated the relationships between financial hardship and depressive and anxiety symptoms, food insufficiency, and, among housing renters, the likelihood of being evicted, controlling for the receipt of social assistance and other demographic and socioeconomic factors. Results: Experiencing somewhat of a financial hardship (vs no hardship) was linked to approximately 3-4 times higher odds of depressive or anxiety symptoms and a likely eviction, and a 15 times higher odds of food insufficiency. Experiencing considerable financial hardship (vs no hardship) predicted a 6-fold higher odds of depressive or anxiety symptoms, a 24-fold higher odds of a likely eviction, and a more than 50-fold higher odds of food insufficiency (all P values <.001). Conclusions: Even after accounting for receipt of social assistance, working-aged adults experiencing financial hardship had markedly greater odds of anxiety or depressive symptoms, food insufficiency, and an anticipated housing eviction. Across outcomes, these relationships were stronger at each successively higher level of financial hardship, and more than offset any corresponding benefits from social assistance. Overall, the findings from the present study point to the urgent need for direct and sustained cash relief well in excess of current levels of social assistance, as well as the imperative of extending housing renter eviction protections among Americans.