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Health Disparities

Factors Associated With Symptoms of Depression and Anxiety Among Women Experiencing Homelessness and Unstable Housing During the COVID-19 Pandemic

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

1 Credit CME

JAMA Network Open

Published Online: July 14, 2021

Research Letter

Article Information and Disclosures

Elise D. Riley, PhD, MPH¹;

Samantha E. Dilworth, MS¹;

Derek D. Satre, PhD^2,3;

Michael J. Silverberg, PhD, MPH³;

Torsten B. Neilands, PhD¹;

Christina Mangurian, MD, MAS²;

Sheri D. Weiser, MD, MPH¹

Author Affiliations

¹Department of Medicine, University of California, San Francisco
²Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco
³Division of Research, Kaiser Permanente Northern California, Oakland

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The prevalence of depression among individuals in the US has increased 300% during the COVID-19 pandemic, with a greater burden of illness in individuals with lower incomes.¹ With the goal of informing adaptation of services for socioeconomically marginalized individuals, we surveyed mental health symptoms and social challenges experienced during the COVID-19 pandemic among women experiencing homelessness and unstable housing (HUH). Extrapolating from the available evidence,²^,3 there are approximately 440 000 women experiencing HUH in the US.

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Article Information

Accepted for Publication: May 5, 2021.

Published: July 14, 2021. doi:10.1001/jamanetworkopen.2021.17035

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 Riley ED et al. JAMA Network Open.

Corresponding Author: Elise D. Riley, PhD, MPH, Department of Medicine, University of California, San Francisco, 1001 Potrero Ave, Mailbox 0874, San Francisco, CA 94143-0874 (elise.riley@ucsf.edu).

Author Contributions: Dr Riley and Ms Dilworth had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Riley, Weiser.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Riley.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Dilworth, Neilands.

Obtained funding: Riley.

Administrative, technical, or material support: Riley, Dilworth, Satre.

Supervision: Riley, Mangurian.

Conflict of Interest Disclosures: Dr Silverberg reported receiving grants from Gilead Sciences, Inc outside the submitted work. Dr Neilands reported receiving grants from the National Institutes of Health (NIH) as coinvestigator outside the submitted work. Dr Mangurian reported receiving grants from the NIH, Genentech, Weston Havens, Doris Duke Charitable Foundation, and the California Health Care Foundation outside the submitted work. Dr Weiser reported receiving grants from the NIH, SF Hearts Foundation, Kaiser Community Benefits, and TDRP outside the submitted work. No other disclosures were reported.

Funding/Support: This research was supported by RGPO Emergency COVID-19 Research Seed Funding provided by the California HIV/AIDS Research Program of the University of California (grant R00RG3097 to Dr Riley) and the NIH (grants R01 DA037012, R01 DA049648, and K24 DA039780 to Dr Riley). Dr Satre was also supported by the Dolby Family Center for Mood Disorders at the University of California, San Francisco.

Role of the Funder/Sponsor: The funders 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.

Meeting Presentation: Portions of this article were presented at the 2021 International Women’s and Children’s Health and Gender (InWomen’s) Group Conference (breakout session 5); June 18, 2021; https://web.cvent.com/event/b4bae4b4-896d-4125-b512-bfbb0b8f37f0/websitePage:adc4407a-ff86-4457-a889-84f3d36ae609.

Additional Contributions: Carl Braun, BS, Aron O’Donnell, BS, and Lizet Campos, BS (all from University of California, San Francisco), assisted with data collection. Elizabeth Chur, BA (freelance editor), provided editing assistance. All acknowledged individuals received compensation for their contributions and agreed to be named here.

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 credit toward the CME [and Self-Assessment requirements] of the American Board of Surgery’s Continuous Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.