Pandemic stresses tied to more anxiety, depression in Black US adults
The stresses of the COVID-19 pandemic have been particularly detrimental for the mental health of Black adults, finds a new US study in the Journal of Gerontology.
Georgia Institute of Technology and North Carolina State University (NCSU) researchers analyzed the daily symptom diaries of 526 US adults aged 21 to 79 years (54% White, 46% Black) kept for 21 days during October and November 2020. In a total of 3,605 diary entries, participants responded to questions about their anxiety and depression symptoms, stresses experienced in the prior 24 hours, and expected stresses in the next 24 hours.
Among White participants, older people reacted more to COVID-19–related stresses than their younger counterparts, but those stresses were consistently more detrimental for Black participants' anxiety levels, regardless of age.
Age was less negatively tied to depressive symptoms for Black than for White participants. Higher levels of stress were also more strongly linked to more depressive symptoms among Black rather than White participants.
Imminent expected stresses were associated with a jump in anxiety symptoms, particularly among older White adults. Black adults aged 21 to 30, however, had more anxiety and depressive symptoms than older White adults facing comparable stresses.
The study authors noted that systemic inequities—especially limited access to healthcare and a tendency to work in occupations with no work-from-home option—have put racial minorities at higher risk for COVID-19 infection and death.
"Although White older adults experienced an increase in daily anxiety when forecasting COVID-19 stress, the co-occurring pandemic of systemic racism may be more powerful than age-related vulnerabilities for Black adults," the researchers wrote.
In an NCSU news release, senior author Shevaun Neupert, PhD, said the findings suggest the need for culturally competent interventions that address the needs of both Black and White adults.
"Much of the existing literature on how older adults cope with stress has focused largely on older white adults," she said. "More research needs to be done to understand and address stress management processes and mental health in Black adults in general, and in older Black adults in particular."
Dec 5 J Gerontol study
Dec 6 NCSU news release
Study reveals pandemic-related delays in cancer-related diagnoses
The COVID-19 pandemic has likely caused delays in new cancer diagnoses, which in combination with disrupted cancer treatment could lead to poor patient outcomes, according to a national study of more than 9 million Veterans Affairs (VA) Healthcare System patients published yesterday in Cancer.
Led by University of Maryland at Baltimore researchers, the study measured decreases in patient visits related to prostate, lung, bladder, and colorectal cancers, related diagnostic procedures, and new cancer diagnoses before and after the emergence of COVID-19. The median age of patients having diagnostic or screening procedures for the four cancers was 67 years, 92% were men, 22% were Black, and 6.1% were Latino.
Relative to yearly averages in 2018 and 2019, colonoscopies fell by 45%, and prostate biopsies, chest computed tomography (CT) scans, and cystoscopies (bladder and urethra tests) dropped 29%, 10%, and 21%, respectively, in 2020.
New cancer diagnoses fell 13% to 23%, and cancer-related patient visits dropped in April and May 2020 compared with the same period in 2018 and 2019. Prostate cancer visits fell from an average of 63,496 in April 2018 and 2019 to 46,938 in April 2020, a 26% decrease.
Also, in April 2020, visits related to cancers of the lung, bladder, and colorectum declined by 10%, 27%, and 19% from baseline, respectively. Prostate biopsies, chest CT scans, cystoscopies, colonoscopies, and fecal occult blood tests (FOBTs, for detecting colorectal cancer) dropped by 80%, 64%, 74%, 93%, and 54%, respectively, from the same month in 2018 and 2019.
While cancer-related visits rebounded in summer, procedure volumes remained low throughout 2020. This decline resulted in an estimated deficit for 2020 of 133,231 colonoscopies (down 45%), 7,838 prostate biopsies (–29%), 62,793 chest CT scans (–12%), 20,680 cystoscopies (–21%), and 49,334 FOBTs (–13%). Screening chest CT scans showed no deficit for 2020.
The researchers created a chart for determining the time and resources needed to work through the pandemic-related procedure backlog.
"We hope that our work will help physicians, hospitals, and health care organizations anticipate the extent to which they have fallen behind in their efforts to diagnose new cancers," senior author Brajesh Lal, MD, of the Maryland VA and University of Maryland, said in a Wiley news release.
Dec 6 Cancer study
Dec 6 Wiley news release