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BACKGROUND: Based on CSS 2019 data, this article analyzes the impact of Basic Medical Insurance for Urban and Rural Residents (BMIUR) on perceived social equity of residents. METHOD: Using the CSS data of 2019, this article analyzes the influence of BMIUR on the perception of social equity of residents, on the basis of 2SLS model and mediating effect model. RESULTS: We find that BMIUR has a significantly positive impact on the perception of social equity. That is to say, BMIUR can improve residents' evaluation of social equity and further promote the level of social equity, which makes residents more happiness. The conclusion remains valid after using robustness test and propensity score matching to conduct counterfactual reasoning. The discussion of mechanism indicates that the influence of BMIUR is mediated by enhancing social capital, improving satisfaction of income distribution and reducing self-paid medical expenses. This study also finds that the influence of BMIUR is more obvious in the low-income, low-skilled and mid-west groups. CONCLUSION: The reform of the medical security system should be regarded as a foothold for improving people's well-being and promoting social equity; Expanding people's social capital through multiple channels and improving income distribution mechanisms; Strengthen vocational skills training, especially to provide more public services and social security for low-income groups, low-skilled groups, and groups in the western region of China, in order to improve the welfare and policy effectiveness of China's social security reform.
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BACKGROUND: In the United States (US), three types of vaccines are available to prevent invasive meningococcal disease (IMD), a severe and potentially fatal infection: quadrivalent conjugate vaccines against serogroups A, C, W, Y (MenACWY), and monovalent vaccines against serogroup B (MenB) as well as a newly licensed pentavalent vaccine (MenABCWY) protecting against serogroup A, B, C, W, and Y. The CDC's Advisory Committee on Immunization Practices (ACIP) routinely recommends MenACWY vaccine for all 11- to 12-year-olds with a booster dose at 16 years. MenB vaccination is recommended based on shared clinical decision-making (SCDM) for 16- to 23-year-olds. Recently, the pentavalent meningococcal vaccine (MenABCWY) was recommended by the ACIP. Meningococcal vaccine uptake is suboptimal across the country, particularly among individuals with lower socioeconomic status (SES), despite these recommendations. The objective of the spatial analyses was to assess the relationship between stocking of MenACWY and MenB vaccines, area-level SES, and state-level policies. METHODS: The number of MenACWY and MenB doses stocked by vaccinators was obtained from IQVIA and the CDC's Vaccine for Children (VFC) program and compiled into a county-level dataset from 2016 to 2019. SES, as measured using the CDC's Social Vulnerability Index (SVI), state-level school recommendations, and universal purchasing programs were among the main county-level covariates included to control for factors likely influencing stocking. Data were stratified by public and private market. Bayesian spatial regression models were developed to quantify the variations in rates of stocking and the relative rates of stocking of both vaccines. RESULTS: After accounting for county-level characteristics, lower SES counties tended to have fewer doses of MenB relative to MenACWY on both public and private markets. Lower SES counties tended to have more supply of public vs. private doses. Universal purchasing programs had a strong effect on the markets for both vaccines shifting nearly all doses to the public market. School vaccination strategy was key for improving stocking rates. CONCLUSIONS: Overall, the results show that MenACWY has greater stock relative to MenB across the US. This difference is exacerbated in vulnerable areas without school entry requirements for vaccination and results in inequity of vaccine availability. Beyond state-level policy and SES differences, SCDM recommendations may be a contributing factor, although this was not directly assessed by our model.
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Infecções Meningocócicas , Vacinas Meningocócicas , Humanos , Vacinas Meningocócicas/administração & dosagem , Estados Unidos , Infecções Meningocócicas/prevenção & controle , Criança , Adolescente , Disparidades em Assistência à Saúde/estatística & dados numéricos , Adulto Jovem , Acessibilidade aos Serviços de SaúdeRESUMO
This narrative review comprehensively examines the intricate relationship between period poverty and the Sustainable Development Goals (SDGs), positioning it as a critical public health challenge with far-reaching implications. Through an in-depth analysis of the multifaceted impact of period poverty on public health, including its effects on reproductive health, mental well-being, and economic participation, the paper underscores the urgent need to address this issue within the framework of the SDGs. An overview of existing literature on period poverty, its impact on health and well-being, and its relation to the SDGs was carried out. Different perspectives, interventions, and policy approaches to addressing period poverty were also explored. By illuminating the interplay between period poverty and various SDGs, particularly those related to gender equality, health, education, and economic empowerment, the study emphasizes the imperative of integrating menstrual health and hygiene into global development efforts. Advocating for targeted policies, funding, and advocacy, the manuscript calls for a holistic and inclusive approach to breaking the cycle of period poverty, ultimately contributing to advancing the SDGs and fostering a more equitable and healthier global society. Efforts to eradicate period poverty - providing affordable menstrual products, improving sanitation infrastructure, enhancing education, and implementing supportive policies - lead to significant progress in public health and gender equity. By prioritizing menstrual health management in public health policies, educational programs, and economic strategies, we can ensure that everyone who menstruates can do so with dignity and without limits on their potential.
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The future of plant-based diets is a complex public health issue inextricably linked to planetary health. Shifting the world's population to consume nutrient-rich, plant-based diets is among the most impactful strategies to transition to sustainable food systems to feed 10 billion people by 2050. This review summarizes how international expert bodies define sustainable diets and food systems and describes types of sustainable dietary patterns. It also explores how the type and proportion of plant- versus animal-source foods and alternative proteins relate to sustainable diets to reduce diet-related morbidity and mortality. Thereafter, we synthesize evidence for current challenges and actions needed to achieve plant-based sustainable dietary patterns using a conceptual framework with principles to promote human health, ecological health, social equity, and economic prosperity. We recommend strategies for governments, businesses, and civil society to encourage marketplace choices that lead to plant-rich sustainable diets within healthy, equitable, and resilient agroecological food systems.
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Dieta Baseada em Plantas , Abastecimento de Alimentos , Humanos , Dieta Saudável , Dieta Baseada em Plantas/estatística & dados numéricos , Abastecimento de Alimentos/estatística & dados numéricos , Desenvolvimento SustentávelRESUMO
This comprehensive review delves into the intricate journey of marijuana in India, tracing its historical and cultural significance from ancient times to the present day. Despite its deep-rooted presence in religious rituals, traditional medicine, and cultural festivities, marijuana faces stringent prohibition under the Narcotic Drugs and Psychotropic Substances Act 1985. This review critically examines the current legal framework, highlighting its societal impacts and limitations. Through an evidence-based analysis, it advocates for a reevaluation of marijuana laws to align with contemporary realities, promoting public health, social equity, and economic development. By envisioning a future of evidence-based regulation and innovation, India can unlock the full potential of marijuana as a "miracle crop" for the betterment of its people and society.
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Urban park green spaces (UPGS) are a crucial element of social public resources closely related to the health and well-being of urban residents, and issues of equity have always been a focal point of concern. This study takes the downtown area of Nanchang as an example and uses more accurate point of interest (POI) and area of interest (AOI) data as analysis sources. The improved Gaussian two-step floating catchment area (G2SFCA) and spatial autocorrelation models are then used to assess the spatial and social equity in the study area, and the results of the two assessments were coupled to determine the optimization objective using the community as the smallest unit. Finally, the assessment results are combined with the k-means algorithm and particle swarm algorithm (PSO) to propose practical optimization strategies with the objectives of minimum walking distance and maximum fairness. The results indicate (1) There are significant differences in UPGS accessibility among residents with different walking distances, with the more densely populated Old Town and Honggu Tan areas having lower average accessibility and being the main areas of hidden blindness, while the fringe areas in the northern and south-western parts of the city are the main areas of visible blindness. (2) Overall, the UPGS accessibility in Nanchang City exhibits a spatial pattern of decreasing from the east, south, and west to the center. Nanchang City is in transition towards improving spatial and social equity while achieving basic regional equity. (3) There is a spatial positive correlation between socioeconomic level and UPGS accessibility, reflecting certain social inequity. (4) Based on the above research results, the UPGS layout optimization scheme was proposed, 29 new UPGS locations and regions were identified, and the overall accessibility was improved by 2.76. The research methodology and framework can be used as a tool to identify the underserved areas of UPGS and optimize the spatial and social equity of UPGS, which is in line with the current trend of urban development in the world and provides a scientific basis for urban infrastructure planning and spatial resource allocation.
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Parques Recreativos , Classe Social , Humanos , Cidades , Análise Espacial , CegueiraRESUMO
Background: The rapid emergence of China's digital economy has sparked profound interest in the complex interplay between digitalization and the provision of public services. This study aims to delve deeper into how the development of the digital economy impacts the level of equalization in public service delivery and evaluates whether institutional factors can moderate this transformation. Against the backdrop of pursuing "common prosperity," this research provides valuable guidance for policymaking and strategic planning. It ensures that the ascent of the digital economy not only elevates the standards of public services but also fosters their equitable distribution, thereby advancing the cause of social equity. Methodology: The study utilized the System Generalized Method of Moments (GMM) model along with longitudinal trend data spanning from 2009 to 2018. This approach facilitated an in-depth analysis of the relationship between the digital economy and the level of equalization in public service delivery. The application of this model provided deeper insights into the impact of the digital economy on public service equalization and the identification of underlying mechanisms. Findings: This study reveals a complex paradox that the digital economy is exacerbating regional disparities in the provision of basic public services. Furthermore, the research underscores the pivotal role of institutional environments in mitigating the adverse effects of the digital economy on public service provision. By examining the interplay between digital economy growth and institutional frameworks, the study suggests that adaptable and robust institutions are essential for harnessing the digital economy's benefits while minimizing its potential drawbacks. Conclusion: In conclusion, the findings from this study offer substantial insights into the dual impact of the digital economy on public service provision, enriching the ongoing discourse on digital transformation and social equity. The research underscores the significance of strategic policy reforms and institutional adjustments to harness the transformative power of the digital economy, promoting equitable access to public services and advancing the goal of "common prosperity" in the digital age.
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The COVID-19 pandemic pushed millions of Americans into food insecurity. Food policy councils (FPCs) across the country played a vital role in organizing coordinated food responses across multiple sectors. We used a social network analysis (SNA) approach to investigate: (1) the network of partnering organizations and agencies within FPCs; (2) how the characteristics of FPCs' network partnerships (i.e., degree, coreness, and density) related to programmatic, policy, and advocacy actions in response to the pandemic; and (3) how FPCs' use of a racial or social equity framework shifted their network partnerships and responses. Local government agencies and food supply chain actors were core in FPCs' network partnerships, while public utilities, correctional facilities, social justice groups, and others were non-core partners. Network density was more likely to be associated with any action by FPCs, and it was especially pronounced for advocacy actions taken by FPCs; trends were similar among FPCs that reported using a racial or social equity framework. The findings begin to uncover core actors in FPCs' partnerships and opportunities to establish new partnerships, particularly with social justice groups. The results also suggest that network density (interconnectedness) may be more important than other network characteristics when responding to food-related needs.
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COVID-19 , Pandemias , Humanos , COVID-19/epidemiologia , Alimentos , Órgãos Governamentais , Política NutricionalRESUMO
While theoretical connections between social inequity and boredom have been established, empirical evidence is lacking. Inequity aversion is important in this relationship. If individuals believe that the amount of work invested in pursuing an outcome has been unfairly devalued in relation to the investment of others, they may feel that their investment is greater than the outcome's worth. This experimental study explores whether devaluation of one's investment in a task, in relation to another individual's investment required to obtain equal rewards, is experienced as boredom. Undergraduate and graduate students (N = 31) were randomly assigned to one of three conditions and performed a monotonous task in the presence of a confederate, for equal reward. Exposure time to the confederate varied. It was expected that participants who spent more time on the task than the confederate would report more boredom and a negatively distorted time experience. Significant between-group effects were found for Tedium (F(2, 28) = 3.55, p = .04) and Temporal Estimation (F(2, 28) = 5.37, p = .01). Participants who spent more time on the task felt more bored (Mdiff = -1.05, p = .05) and rated time as progressing slower (Mdiff = -1.26, p = .03). There were no significant differences between the other conditions. A parsimonious interpretation is that the perceived inequity in resource investment costs associated with different lengths of social exposure during the boredom-inducing task increased the salience of investment loss, which was experienced as boredom and resulted in a distorted time experience.
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INTRODUCTION AND OBJECTIVE: Patella dislocation represents 3.3% of all knee injuries often leading to persistent instability. Medial patello-femoral ligament(MPFL) reconstruction is the standard method of treatment in the patellar instability. Rehabilitation after MPFL-R is a long and demanding procedure. The hypothesis presented reflects the idea that despite relatively good access to hospital care and surgical options, the post-operative rehabilitation care system is still inferior in rural areas versus the one offered in major cities and towns. MATERIAL AND METHODS: Between January 2015 - January 2018, 47 patients met the study inclusion criteria, diagnosed and operated on due to patellar instability. 8 patients were lost for full follow-up. Finally, 39 patients were included, divided into two groups - group A (19 from cities), group B (20 from rural area). Prospective KOOS and Kujala scales assessments were conducted: preoperative, 6 and 12 months after surgery. Knee isokinetic muscle strength was measured at 3 stages; prior to surgery, 6 and 12 months after reconstruction. RESULTS: All patients showed significant improvement measured in the KOOS and Kujala scales after the procedure, compared to the pre-operational results. Despite equal clinical improvement, patients from Group A(city) achieved better functional outcomes as presented in the results of knee extensor functional tests using a Biodex dynamometer. CONCLUSIONS: Rehabilitation after MPFL reconstruction improves muscle strength and clinical outcome. Patients from rural areas had inferior functional results in comparison to the patients from major cities, even 12 months after surgical patella stabilization. Despite the development of roads and transport according to the EU cohesion policy, there are still differences in rehabilitation results between rural and city areas.
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Instabilidade Articular , Articulação Patelofemoral , Humanos , Patela/cirurgia , Articulação Patelofemoral/lesões , Articulação Patelofemoral/cirurgia , Instabilidade Articular/cirurgia , Estudos Prospectivos , População UrbanaRESUMO
School based health centers (SBHCs) have been providing preventive, acute and chronic care in schools across the United States (US) for the past 40 years. A discussion of that care is provided in a companion article to this one. Several major societal issues of the 2020s, affecting the care provided in SBHCs, have taken place over the past 4 years. These issues, which will be discussed in this article, include the following: 1. The COVID pandemic had a major impact on utilization and services required at SBHCs, both at the peak of the pandemic, when schools were closed and since the peak of the pandemic, when schools reopened. 2. The transformation of mental health services, due both to increasing mental health needs of youth, as well as progression to new therapeutic modalities, has required expansion of services provided at SBHCs. 3. New immigrant health care needs and services have required a response by SBHCs to the substantial increase of new immigrants, most of whom are impacted by significant trauma, entering public schools nationally. 4. Telehealth integration into SBHC medical and mental health services, and its expansion to incorporate new technologies, have provided avenues for increased provision of services by SBHCs.
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COVID-19 , Emigrantes e Imigrantes , Serviços de Saúde Mental , Serviços de Saúde Escolar , Telemedicina , Humanos , COVID-19/epidemiologia , Telemedicina/organização & administração , Serviços de Saúde Escolar/organização & administração , Adolescente , Estados Unidos , Serviços de Saúde Mental/organização & administração , Criança , SARS-CoV-2 , Serviços de Saúde Mental Escolar , Pandemias , Acessibilidade aos Serviços de Saúde/organização & administraçãoRESUMO
PROBLEM: Transport policies generally prioritize improving safety and accessibility levels, as they are regarded as the most important indicators of the quality of the transport system serving the public. However, inequalities associated with safety and accessibility issues are generally overlooked in these policies. Despite the importance and necessity of transport policies to address equity issues, there is still scarce knowledge on the interactions between equity, safety, and accessibility. This research aims to address this gap in the literature by creating a better understanding of the relationships between accessibility levels and traffic safety with a focus on social equity perspectives. METHOD: A crash risk evaluation method and a Gravity model are utilized to analyze cycling safety and accessibility to jobs by bicycle. Two linear regression models (LM) were conducted to investigate the statistical correlations between cycling crash risk and accessibility. Moreover, the Bivariate local Moran's I method was employed to assess the spatial inequalities of distribution of crash risk and job accessibility over different income-level populations. RESULTS: The analyses showed that low-income people are not only disadvantaged in terms of job accessibility by bicycle but are also exposed to higher cycling crash risks, compared to high-income groups. Furthermore, most disadvantaged zones that have the highest need for road safety and accessibility improvements are identified as areas where low-income populations are exposed to higher crash risk and/or have lower access to jobs by bicycle. SUMMARY: This study contributes to the transport literature by investigating the interactions between safety and accessibility and the impacts on transport equity. The findings of the statistical and spatial analysis are beneficial for the decision-makers, considering the probable mutual implications of land-use and transport developments and projects aiming to improve safety, accessibility, or both for different population groups.
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Acidentes de Trânsito , Políticas , Humanos , Acidentes de Trânsito/prevenção & controle , Segurança , Análise Espacial , Modelos LinearesRESUMO
BACKGROUND: Mental health is a vital part of an individual's overall health and well-being, and the relationship between society and individuals has always been a focus of academic and public attention. However, the effect of social equity perceptions on individual mental health remains unclear. METHODS: Data were collected from 8,922 survey respondents with an average age of 47.533 years from the China Labor-force Dynamics Survey 2016 and 2018. The Center for Epidemiological Studies Depression scale was used to assess mental health. A two-way fixed effects regression model was used to determine the association between social equity perception and individual mental health. RESULTS: Individuals with higher perceptions of social equity were more likely to report better mental health ([Formula: see text] = -0.944, p < 0.01). Happiness, life satisfaction, and social trust partially play mediating roles in the relationship between social equity perception and individual mental health, while education and age play moderating roles. CONCLUSION: Social equity perception is a vital factor that affects mental health. Public policies should focus on helping less educated and older people improve their social equity perception to improve their mental health.
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Equidade em Saúde , Saúde Mental , Percepção Social , Idoso , Humanos , Pessoa de Meia-Idade , China , Confiança , População do Leste Asiático/psicologiaRESUMO
Institutions of higher education are feeling increasing pressure from both students and the international climate community to offer more courses and joint degrees on the role of the built environment in advancing climate action, population health, and social equity. The built environment plays a leading role in this new, transdisciplinary approach. Thoughtfully designed buildings, neighborhoods, and communities can simultaneously lower per capita greenhouse gas emissions, reduce population exposure to dangerous climate-sensitive extreme weather events, reduce disparities in climate-related health outcomes, and advance social equity goals. This mixed-methods study explored the extent to which post-secondary courses and joint degree programs teach students the research methods and technical skills they will need to design and implement built environment interventions addressing the effects of climate change on population health and social equity. The study found that the number of universities offering courses addressing climate, health, and equity in the built environment grew from 2018 to 2022. The number of joint planning/public health degree programs rose from four in 2005 to 15 in 2022. No joint architecture/public health degree programs were identified. A detailed review of 99 course descriptions from three universities found that 17 courses (roughly 1/5 of the total) covered population health, built environment, and climate change; and, 2/3 of the set (n = 60) covered two out of the three topics. Schools of public health were more likely to offer courses covering all three topics, whereas schools of architecture were more likely to include the building scale in relevant courses. Exposure pathways and social equity/vulnerable populations were the most common methods included in relevant courses. Professors and administrators at institutions identified by the study as "transdisciplinary-ready" reported that accreditation requirements and university rules governing the allocation of student tuition had slowed efforts to offer cross-listed courses. However, faculty in these institutions regularly collaborate informally with their peers - both on transdisciplinary research and by offering guest lectures in each other's courses. The results of this study show that, while universities have made great strides over the past 18 years in beginning to support transdisciplinary research and pedagogy, institutional barriers and gaps in key content areas remain.
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Fortalecimento Institucional , Instituições Acadêmicas , Humanos , Universidades , Saúde Pública/educação , Ambiente ConstruídoRESUMO
Social equity provisions in cannabis legislation are premised on the hope that the profit generated around adult-use cannabis can be leveraged to ameliorate the damage done by racially biased enforcement of prohibition in black and brown communities. As such, they encapsulate an attempt to reconcile the history of racism in the enforcement of cannabis law through its new future as a profit generating commodity. These programs are gaining traction, but with minimal empirical examination. The development and implementation of these programs raises a number of questions in need of study that we outline in this paper. We argue that Creary's concept of bounded justice-which critiques the inherent limitations of social justice projects that ignore structural forms of social exclusion-can provide a framework for critical understanding of the limitations of such programs, ethnographically grounded empirical research, and a framework for evaluating the justice impacts of legislation. Specifically, we argue that in order to interrogate the possibilities for social justice projects around cannabis, we must address equity at a deeper level by working with communities to investigate hyper-localized and historical factors that have influenced systems and structures.
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Food hubs have emerged as innovative alternatives to the conventional United States food system. As aggregators of small local farms, food hubs hold the potential to transform food production, distribution, and consumption, while fostering environmental sustainability and social equity. However, assessing their contributions to environmental sustainability and social equity is challenging due to the diverse structures and practices of U.S. food hubs. This study presents the findings of a national survey of food hub managers conducted in 2022 to assess the sustainability objectives and practices of food hubs across the United States. Our survey questions were designed based on a comprehensive framework of social and environmental sustainability criteria. Our results reveal that food hubs make valuable contributions in supporting small producers and providing healthy local food options. However, there is room for improvement in their environmental sustainability practices, as they only meet 47% of the defined environmental sustainability goals. Addressing food insecurity is a high priority for food hubs, although not their top priority, and many offer fresh food access to low-income households. Food hubs also contribute to environmental sustainability by reducing food transportation, promoting healthy food production methods, and minimizing waste. While food hubs meet 67% of the defined social sustainability goals, there are opportunities for improvement in reaching important institutional stakeholders and enhancing consumer education on healthy nutrition and lifestyles. Expanding technical assistance for farmers is also critical. By addressing these opportunities for improvement, food hubs can drive progress towards a more resilient and equitable food system in the United States.
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The cannabis legalization movement in the United States has experienced unprecedented success in the past decade due to a wave of grassroots reforms in states across the country. The current legalization movement began in 2012, when Colorado and Washington became the first two states to legalize the use and sale of cannabis for adults aged ≥ 21 years. Since then, the use of cannabis has been legalized in 21 states, Guam, the Northern Mariana Islands, and Washington, DC. Many of these states have explicitly framed the law change as a rejection of the War on Drugs and its harms, felt disproportionately in Black and Brown communities. However, racial inequities in cannabis arrests have increased in states that have legalized cannabis for adult use. Moreover, states working to implement social equity and community reinvestment programs have made little progress toward their goals. This commentary describes how US drug policy, racist in intention, gave way to drug policy that perpetuates racism, even when its ostensible or stated goal is equity. As the United States prepares for national legalization of cannabis, it is critical that we break away from past legislation and mandate equity in cannabis policy. Developing meaningful mandates will require us to acknowledge our history of using drug policy for the racist goals of social control and extortion, study the experience of states that are trying to implement social equity programs, listen to Black leaders and other leaders of color who have developed guidance for equity-focused cannabis policy, and commit to a new paradigm. If we are willing to do these things, we may be able to legalize cannabis in an anti-racist way that will stop causing harm and enable us to effectively implement reparative practices.
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Cannabis , Adulto , Humanos , Estados Unidos , Legislação de Medicamentos , Política Pública , ComércioRESUMO
There is a void in the health promotion literature concerning the role of health insurance. This study offers a comparative analysis of employee health insurance in the United States and the Philippines. As the first study of its kind, it examines insurance as an instrument of health promotion policy for improving population health and reducing healthcare costs. The following questions guide this study: (i) How has insurance coverage of employee healthcare in these two countries evolved and changed over time, and why? (ii) What factors incentivize payers (employers and insurers) to incorporate health promotion into their health plans, even if health promotion does not fall within the traditional ambit of insurance? and (iii) How does health promotion through the insurance vehicle operate cost-efficiently and within the Global Health Promotion framework of the World Health Organization (WHO)? US and Philippine public-use datasets were gathered and disaggregated to address these questions. The Affordable Care Act (ACA) in the US and universal healthcare legislation leading to the Universal Healthcare Act (UHC) in the Philippines initiated major paradigmatic shifts in insurance coverage. Health literacy, behavioral change and social equity are objectives pursued in both countries by mandating and/or nudging payers to offer health screenings, wellness and fitness programs and primary preventive and diagnostic services. By providing a means to finance access to promotive health and encourage individual responsibility for risk prevention ('healthism'), insurance influences social attitudes about health. However, our findings indicate that outcomes and relative success vary depending on a country's insurance environment, its regulation and the economic, political and socio-cultural forces that affect or shape it (e.g. private markets vs. multi-payer system). Contextual realities also drive incentives and rewards to payers and users of promotive health benefits against the backdrop of financial risk or exposure.
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Patient Protection and Affordable Care Act , Local de Trabalho , Estados Unidos , Humanos , Filipinas , Exercício Físico , Promoção da SaúdeRESUMO
Background: Many people changed their travel behavior during the coronavirus pandemic with more telecommuting, fewer trip frequencies, and less use of transit and ride-hailing to avoid infection. The lack of outdoor activities may result in social isolation and then trigger anxiety or depressive symptoms. Research objective: This study examines the relationship between anxiety and depression, and correlates various sociodemographic, income, job status, health-related factors, and travel behavior changes in six large U.S. cities. Data: U.S. Census Household Pulse Survey Phases 3.0 and 3.1 are employed. Method: GAD-2 and PHQ-2 are used to screen the scores of anxiety and depression. The synthetic minority oversampling technique is applied to correct sample distribution. The multivariate mixed model is employed to examine relationships. Results: (1) Anxiety and depression are positively correlated, and the percentage of high anxiety is greater than the percentage of high depression. (2) The levels of anxiety and depression significantly vary across the six cities. (3) Women, young, singles, and white people have higher levels of anxiety and depression during the pandemic. (4) People who are willing to receive vaccination tend to have higher levels of anxiety and depression. (5) The prevalence of depressive disorders is significantly lower in the high-income group. (6) People who applied for unemployment insurance and experienced expense difficulties are more likely to suffer high levels of anxiety and depression. (7) Travel behavior changes, measured by increased telecommuting, reduced trip frequency, and reduced use of transit and ride-hailing, all suggest positive correlations with anxiety and depression. Conclusions: More assistance and attention should be given to women, singles, and low-income households to reduce the prevalence of mental stress in vulnerable groups. Telecommuting can be but need to work with other travel demand management strategies. Travel and outdoor activities should be promoted under the new normal.