It has been more than four years since the World Health Organization declared the COVID-19 outbreak a global pandemic. With massive disruptions in virtually every aspect of society, the epidemic challenged all of us, impacting our psychological well-being as well as our physical health.

The National Institutes of Health (NIH) played a crucial role in the pandemic response through programs like the Researching COVID to Enhance Recovery (RECOVER) initiative, the Rapid Acceleration of Diagnostics (RADx®) initiative, and the Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV) public-private partnership.

To address the potential social, behavioral, and economic (SBE) impacts of the epidemic, the Office of Behavioral and Social Sciences Research (OBSSR) moved quickly. NIH initiatives highlighting behavioral and social sciences research (BSSR) included the NIH Community Engagement Alliance (CEAL) against COVID-19 disparities; an OBSSR-led administrative supplement on the impact of COVID-19 among women, children, and people with disabilities; and the Social, Behavioral, and Economic Impacts of COVID-19 in Vulnerable and Health Disparity Population Initiative (SBE COVID-19 Initiative), which OBSSR was proud to lead.

The SBE COVID-19 Initiative was a core part of NIH’s COVID-19 response, promoting research to improve predictions about various mitigation efforts, assess the health impacts of significant socioeconomic events, and evaluate digital and community-based interventions.

This SBE COVID-19 Initiative led to:

• 24 funded supplements focused on digital and community health
• A commentary in the journal Translational Behavioral Medicine on NIH’s social and behavioral research in response to the COVID-19 pandemic
• 28 funded supplements for data science longitudinal studies
• Timely research on the economic health impacts of COVID-19 through funding to the National Bureau of Economic Research
• Research on county-level disparities in COVID-19 morbidity and mortality through a contract with the Institute for Health Metrics and Evaluation

The Initiative also helped develop a community of investigators who produced valuable research findings, including—

• Not All Homes Are Safe: Family Violence Following the Onset of the COVID-19 Pandemic (February 2022)
• Risk for Depression Tripled During the COVID-19 Pandemic in Emerging Adults Followed for the Last 8 Years (April 2023)
• Inequitable Access to General and Behavioral Healthcare in the U.S. During the COVID-19 Pandemic: A Role for Telehealth? (April 2023)
• Blurred Border or Safe Harbor? Emotional Well-Being Among Sexual and Gender Minority Adults Working From Home During COVID-19 (April 2023)
• COVID-19 Stress and Child Behavior: Examining Discrimination and Social Support in Racially Diverse ECHO Cohorts (August 2023)

A key product of the SBE COVID-19 Initiative is the SBE COVID Consortium, a hub for communication and collaboration among NIH-funded projects housed at the University of Michigan. The consortium focuses on disparities and vulnerable populations. It includes 15 research sites studying various aspects of SBE impacts of COVID, such as chronic disease care, school resources, parenting stress, drug use, maternal health, and mitigation policies.

The Consortium consists of two parts:

1. Individual population research projects supported by participating NIH institutes, centers, and offices
2. A Coordinating Center that develops research, dissemination, and data-sharing activities and serves as a catalyst for engagement across consortium projects and the broader research community

The Coordinating Center activities have produced a growing body of resources to inform policy. In the first three years, the Center—

• Created a COVID Measure Archive to promote consistency and comparability across studies
• Developed Common Data Elements for COVID mitigation policies to standardize data collection and ensure comparable results across studies
• Awarded pilot grants to foster innovative measurement of SBE indicators related to the COVID-19 pandemic
• Disseminated research through such activities as publication spotlights of funded research and webinars sharing findings and resources

In May 2024, the Coordinating Center held its annual meeting, which included presentations from grantees on their latest research results and findings. A key takeaway from nearly all the presentations was the significant disparities in how the COVID-19 pandemic affected people and groups. For example—

• Elbel and colleagues found that in New York City public schools, early vaccine eligibility and COVID vaccine uptake increased math and English language arts scores and decreased potential sick days, outpatient visits, and COVID infections. These effects were most pronounced when the community infection rate was high.
• Hung, Li, and colleagues examined trends in prenatal care access during the pandemic in states with differing telehealth policies. They found that in a state that loosened its telehealth policies (allowing for more prenatal telehealth visits), prenatal care remained at a stable, adequate level, whereas in a state that did not loosen telehealth policies, adequate prenatal care dropped substantially.

Resources such as the SBE COVID Consortium offer insights into the impacts of the COVID-19 pandemic that provide valuable information for future biological threats. We have gathered valuable lessons on best practices for mitigation, the impact of these efforts, and effective communication of vaccination and health information. Practices for developing measures and data resources are in place for easy adaptation to future needs. Most critically, we have modelled the importance of adopting a comprehensive approach that incorporates from the outset insights from the behavioral and social sciences.