Pandemic will likely cause long-term health problems, impact vulnerable populations

The novel coronavirus (COVID-19) pandemic's life-altering effects are likely to result in lasting physical and mental health consequences for many people, particularly those from vulnerable populations, according to a new study led by the Yale School of Public Health and published in the journal Proceedings of the National Academy of Sciences.

The researchers studied low-income women from New Orleans who were surveyed the year prior to, and at intervals after, Hurricane Katrina struck in 2005. The women reported a range of traumatic experiences during Katrina, many of which are like those now occurring during the pandemic, including bereavement, lack of access to medical care, and scarcity of medications.

The research showed that at one, four and 12 years after the hurricane, the exposures most strongly associated with posttraumatic stress, psychological distress, general health, and physical health symptoms were those most common to the current pandemic. The pandemic continues to cause widespread death and sickness, as well as job loss and severe economic hardship for many, the researchers said.

The study results suggest that, in addition to promoting actions to reduce COVID-19 transmission and addressing longstanding health disparities contributing to COVID-19 morbidity and mortality, public health measures should also prevent and mitigate exposures that will have indirect effects on mental and physical health. This includes preventing lapses in medical care and medication access.

Additionally, another key exposure in the study was fear for one's own safety and the safety of others. As such, public health messaging should provide tips for managing anxiety and fear, in addition to promoting efforts to increase safety from COVID-19 transmission. Supplemental health services should be provided to those who are bereaved or are experiencing clinically significant fear and anxiety related the pandemic, said Sarah Lowe, lead author of the study.

The study did not include other exposures that are taking place during the pandemic, such as financial losses and unemployment, which are also likely to have additional and significant impacts on public health.

The results suggest that, in addition to promoting actions to reduce COVID-19 transmission and addressing longstanding health disparities contributing to COVID-19 morbidity and mortality, public health measures should also prevent and mitigate exposures that will have indirect effects on mental and physical health. This includes preventing lapses in medical care and medication access.

Additionally, another key exposure in the study was fear for one's own safety and the safety of others. As such, public health messaging should provide tips for managing anxiety and fear, in addition to promoting efforts to increase safety from COVID-19 transmission. Supplemental health services should be provided to those who are bereaved or are experiencing clinically significant fear and anxiety related the pandemic, Lowe said.

Although a large body of previous research has shown that greater exposure during a disaster is associated with adverse mental and physical health outcomes, most studies have relied on counts of different disaster-related exposures rather than separately examining specific trauma and stressors upon which policymakers and practitioners can intervene, Lowe said. Moreover, few studies have adjusted for preexisting health conditions or socioeconomic vulnerabilities.

"This study represents a step toward disentangling the health consequences of disasters,” said Lowe in a statement, “while also recognizing more longstanding factors that contribute to health disparities.”