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Unemployment Insurance, Health-Related Social Needs, Health Care Access, and Mental Health During the COVID-19 Pandemic

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

More than 30 million jobs have been lost during the coronavirus disease 2019 (COVID-19) pandemic.1 Unemployment insurance (UI) was temporarily expanded by the Coronavirus Aid, Relief, and Economic Security (CARES) Act,2 but further reform is under debate. Key CARES Act provisions were adding $600 weekly federal payments to state payments (Federal Pandemic Unemployment Compensation), longer benefit duration (Pandemic Emergency Unemployment Compensation), and broadened eligibility for minimum-wage, self-employed, contract, and gig workers (Pandemic Unemployment Assistance).2

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Article Information

Accepted for Publication: October 10, 2020.

Published Online: November 30, 2020. doi:10.1001/jamainternmed.2020.7048

Corresponding Author: Seth A. Berkowitz, MD, MPH, Division of General Medicine and Clinical Epidemiology, Department of Medicine, University of North Carolina at Chapel Hill, 5034 Old Clinic Bldg, CB 7110, Chapel Hill, NC 27599 (seth_berkowitz@med.unc.edu).

Author Contributions: Dr Berkowitz had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: All authors.

Acquisition, analysis, or interpretation of data: Berkowitz.

Drafting of the manuscript: Berkowitz.

Critical revision of the manuscript for important intellectual content: Basu.

Statistical analysis: Berkowitz.

Supervision: Basu.

Conflict of Interest Disclosures: Dr Berkowitz reported receiving grants from the National Institute of Diabetes and Digestive and Kidney Diseases during the conduct of the study and personal fees from Aspen Institute outside the submitted work. Dr Basu reported receiving grants from the National Institutes of Health and Centers for Disease Control and Prevention and personal fees from PLOS Medicine, the New England Journal of Medicine, Collective Health, and HealthRight 360 outside the submitted work.

Funding/Support: Funding for Dr Berkowitz’s role in the study was provided by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health (award No. K23DK109200).

Role of the Funder/Sponsor: The National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Disclaimer: The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Additional Information: The data are publicly available. Analysis code for replication is provided via the weblink in the main text.

References
1.
US Department of Labor. Unemployment insurance weekly claims. Accessed August 4, 2020. https://www.dol.gov/ui/data.pdf
2.
Coronavirus Aid, Relief, and Economic Security (CARES) Act, S 3548, 116th Cong (2019-2020). Accessed August 4, 2020. https://www.congress.gov/bill/116th-congress/senate-bill/3548/text?q=product+actualizaci%C3%B3n
3.
Renahy  E , Mitchell  C , Molnar  A ,  et al.  Connections between unemployment insurance, poverty and health: a systematic review.   Eur J Public Health. 2018;28(2):269-275. doi:10.1093/eurpub/ckx235PubMedGoogle ScholarCrossref
4.
Alaimo  K , Briefel  RR , Frongillo  EA  Jr , Olson  CM .  Food insufficiency exists in the United States: results from the third National Health and Nutrition Examination Survey (NHANES III).   Am J Public Health. 1998;88(3):419-426. doi:10.2105/AJPH.88.3.419PubMedGoogle ScholarCrossref
5.
Kroenke  K , Spitzer  RL , Williams  JBW .  The Patient Health Questionnaire-2: validity of a two-item depression screener.   Med Care. 2003;41(11):1284-1292. doi:10.1097/01.MLR.0000093487.78664.3CPubMedGoogle ScholarCrossref
6.
Kroenke  K , Spitzer  RL , Williams  JBW , Monahan  PO , Löwe  B .  Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection.   Ann Intern Med. 2007;146(5):317-325. doi:10.7326/0003-4819-146-5-200703060-00004PubMedGoogle ScholarCrossref
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