In the context of the COVID-19 pandemic, both economic and racial/ethnic disparities were dramatically on display, with life and death consequences. COVID-19 served as a deadly wake-up call regarding the need to better understand how existing social, economic, and health disparities were compounded in their consequences on disadvantaged communities in the wake of disaster, in this case, a deadly pandemic. To develop improved preparations for responding to future epidemics, it was especially important to understand how COVID-19 affected substance use (SU) and mental health (MH) across different racial/ethnic communities.

Therefore, the Stress and COVID-19 (S&C) Study was designed to address such questions by expanding an ongoing study, which immediately entered the field and recruited a random selection of participants from four ongoing, longitudinal epidemiologic studies examining the impact of different types of trauma and stress in the York City metropolitan area, the epicenter of COVID-19. Taken together, these studies encompassed a broad range of SES and racial/ethnic diversity (49% minority; 51% white), with the participants thoroughly characterized in multiple waves of data during key stressors, traumas, as well as thorough diagnostic assessments of SU and MH.

The first wave of the proposed S&C Study, which was initiated in mid-March 2020 to capture early indicators, interviewed, via telephone, a random selection (n=1,000) of participants drawn from four ongoing studies (N=6,178), including the Parent Grant study focused on a (98%) minority population, and assessed the multifaceted impacts that COVID was having, especially on SU and MH behaviors, with a sample of N=800.

This project supported the follow-up phase of work, which consisted of two additional waves of data collection, at six and nine months after the conclusion of the first wave (months 1-3), and the analysis of all waves of data. This allowed for a longitudinal trajectory analysis of the COVID-19 impact on SU and MH outcomes. Importantly, this S&C Study design also allowed for the utilization of 2-4 waves of detailed pre-COVID-19 data on each subject, including SU and MH behaviors and diagnoses, and a wide range of important risk factors for post-COVID outcomes.