Community Mobility and Depressive Symptoms during the COVID-19 Pandemic in the United States

Roy H. Perlis*, Kristin Lunz Trujillo, Alauna Safarpour, Alexi Quintana, Matthew D. Simonson, Jasper Perlis, Mauricio Santillana, Katherine Ognyanova, Matthew A. Baum, James N. Druckman, David Lazer

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Importance: Marked elevation in levels of depressive symptoms compared with historical norms have been described during the COVID-19 pandemic, and understanding the extent to which these are associated with diminished in-person social interaction could inform public health planning for future pandemics or other disasters. Objective: To describe the association between living in a US county with diminished mobility during the COVID-19 pandemic and self-reported depressive symptoms, while accounting for potential local and state-level confounding factors. Design, Setting, and Participants: This survey study used 18 waves of a nonprobability internet survey conducted in the United States between May 2020 and April 2022. Participants included respondents who were 18 years and older and lived in 1 of the 50 US states or Washington DC. Main Outcome and Measure: Depressive symptoms measured by the Patient Health Questionnaire-9 (PHQ-9); county-level community mobility estimates from mobile apps; COVID-19 policies at the US state level from the Oxford stringency index. Results: The 192271 survey respondents had a mean (SD) of age 43.1 (16.5) years, and 768 (0.4%) were American Indian or Alaska Native individuals, 11448 (6.0%) were Asian individuals, 20277 (10.5%) were Black individuals, 15036 (7.8%) were Hispanic individuals, 1975 (1.0%) were Pacific Islander individuals, 138702 (72.1%) were White individuals, and 4065 (2.1%) were individuals of another race. Additionally, 126381 respondents (65.7%) identified as female and 65890 (34.3%) as male. Mean (SD) depression severity by PHQ-9 was 7.2 (6.8). In a mixed-effects linear regression model, the mean county-level proportion of individuals not leaving home was associated with a greater level of depression symptoms (β, 2.58; 95% CI, 1.57-3.58) after adjustment for individual sociodemographic features. Results were similar after the inclusion in regression models of local COVID-19 activity, weather, and county-level economic features, and persisted after widespread availability of COVID-19 vaccination. They were attenuated by the inclusion of state-level pandemic restrictions. Two restrictions, mandatory mask-wearing in public (β, 0.23; 95% CI, 0.15-0.30) and policies cancelling public events (β, 0.37; 95% CI, 0.22-0.51), demonstrated modest independent associations with depressive symptom severity. Conclusions and Relevance: In this study, depressive symptoms were greater in locales and times with diminished community mobility. Strategies to understand the potential public health consequences of pandemic responses are needed..

Original languageEnglish (US)
Pages (from-to)E2334945
JournalJAMA network open
Issue number9
StatePublished - Sep 27 2023

ASJC Scopus subject areas

  • General Medicine


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