Healthline Mental Health Index: Week of April 26 — U.S. Population

We see mixed results this week. On the positive side, the percentage of Americans who report being fearful of contracting the new coronavirus shows a decline vs. the previous 2 weeks. The percentage who exhibit anxiety and depression, as measured by the PHQ-4 scale*, decreased as well. However, the percentage who show signs of moderate to severe depression remains unchanged. In addition, anxiety and depression are increasing among some subgroups of the population, particularly among African Americans.

Key Findings

  • Fear of contracting the virus: 56% of U.S. adults are now scared about contracting the new coronavirus, down from 60% the week of April 12. 

  • Mental health: Anxiety and depression levels overall are improving, with 45% of the U.S. population falling out of the normal range on the PHQ-4 scale*, down from 49% 2 weeks prior. However, 21% do remain in the moderate to severe range. We also see differences by generation:

    • Young adults are more affected by depression and anxiety. In the most recent week, 33% of people ages 18-34 report signs of moderate to severe depression vs. 25% of people ages 35-54 and 11% of those 55 years old or older. 

    • Depression and anxiety increased slightly among ages 18-34 in the most recent week compared with 2 weeks prior (+3%), while these conditions remained stable and decreased slightly among ages 35-54 and those 55 years old or older. 

  • Health questions: The percentage of Americans with health questions and concerns declined across all topics except for “grief and trauma counseling,” which, although lower overall, remains stable at 8%.

Supporting Graphs

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Increased Anxiety Levels Among Black Americans

Data collected by YouGov and Healthline in the week of April 26 shows that anxiety and depression increased among black people compared to the previous 2 weeks as measured by the PHQ4 scale*. More specifically, we see an 8% increase in the percentage of black people who showed signs of moderate to severe depression during that time period. In comparison, this number declined by 5% among Hispanic people and remained virtually flat among white people. Overall, Hispanic people remain most affected with 26% showing moderate to severe depression compared with 22% of black people and 20% of white people in the week of April 26.

*For reference, the four-item Patient Health Questionnaire-4 (PHQ-4) is a brief and validated questionnaire that consists of a two-item depression scale and a two-item anxiety scale. People are asked to indicate how often in the last 2 weeks they have been bothered by “feeling nervous, anxious, or on edge”; “not being able to stop or control worrying”; “little interest or pleasure in doing things”; and “feeling down, depressed, or hopeless.” The first two items provide a measure of anxiety, and the last two a measure of depression. Responses are scored from 0 to 3 with responses “not at all” scored as 0, “several days” as 1, “more than half the days” as 2, and “nearly every day” as 3. Scores equal or greater than 3 across the first two questions suggest anxiety. Scores equal or greater than 3 across the last two questions suggest depression. Total scores on the PHQ-4 scale are determined by adding together the scores of each of the four items and are rated as normal (0-2), mild (3-5), moderate (6-8), and severe (9-12).

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