How Right Now: The Role of Social Determinants of Health As They Relate to Emotional Well-Being Amidst the COVID-19 Pandemic

Authors

  • Amelia Burke-Garcia, PhD, MA
  • Ashani Johnson-Turbes, PhD
  • Elizabeth W. Mitchell, PhD, MA
  • Jorge M. Vallery Verlenden, PhD
  • Richard Puddy, PhD, MPH
  • Melissa C. Mercado, PhD, MSc, MA
  • Pierce Nelson
  • Craig Thomas, PhD
  • Cynthia Crick
  • Rebecca Leeb, PhD
  • Lucy Rabinowitz
  • Lily McCutchan
  • Kanru Xia, PhD
  • Laura Wagstaff
  • Miao Feng, PhD
  • Larisa Caicedo
  • Emily Tolbert

DOI:

https://doi.org/10.5055/jem.0573

Keywords:

social determinants of health, vital conditions for health, mental health, emotional well-being, coping, resilience, COVID-19, pandemic, disproportionately affected populations

Abstract

Pandemics are stressful times, full of uncertainty and fear. During the COVID-19 pandemic, many Americans have experienced feelings of stress, grief, and loss. How Right Now (HRN)–and its Spanish-language counterpart, Qué Hacer Ahora (QHA)–is an evidence-based, culturally-relevant communication campaign designed to promote and strengthen the emotional well-being and resiliency of populations adversely affected by the COVID-19 pandemic and beyond. Developed by the Centers for Disease Control and Prevention (CDC) with support from the CDC Foundation, the campaign aims to help all Americans but has a specific focus on some of the disproportionately affected groups, including adults over 65 and their caregivers, individuals with pre-existing physical and mental health conditions, people experiencing violence, and those experiencing economic distress. Based on rapid, but robust, formative research, HRN offers audience-centric messages representing the real, everyday experiences and emotions that these audiences are having and addresses them in actionable ways. These include messages that address the social and structural barriers that disproportionately-affected groups have been facing long before the pandemic—and which are felt more acutely now. This paper provides an overview of the rapid, mixed-method, culturally-responsive formative research process undertaken to inform the development of HRN. Specifically, it describes how HRN’s disproportionately-affected audiences describe and discuss their emotional well-being during COVID-19 through the lens of Social Determinants of Health (SDOH). We introduce a secondary theory, Vital Conditions for Health and Well-Being (VCHW), which conceptualizes holistic well-being and the conditions that give rise to it and identifies levers for community change and improvement. Data collection methods included an environmental scan (n ≥ 700 publications); social listening (n ≥ 1 million social media posts); partner needs-assessment calls (n = 16); partner-convened listening sessions with community members (n = 29), online focus groups (n = 10), and a national probability survey (n = 731), all in English and Spanish. Findings suggest that HRN’s priority audiences’ emotional well-being and SDOH are interconnected. Disruptions in SDOH due to the COVID-19 pandemic can lead to emotional well-being challenges, eg, anxiety, for HRN’s priority audiences. While some disruptions may lead some people to adapt, connect with others, and be more resilient, there is a disparate impact of emotional well-being amid COVID-19 for those already experiencing disparities linked to SDOH. Understanding the perspectives and experiences of disproportionately affected populations through the lens of SDOH is vital to identifying the kinds of supports and services–like How Right Now/Qué Hacer Ahora–required for these populations.

Author Biographies

Amelia Burke-Garcia, PhD, MA

Program Area Director, Public Health Department, NORC @ the University of Chicago, Bethesda, Maryland

Ashani Johnson-Turbes, PhD

McDonald's Corporation, Chicago, Illinois

Elizabeth W. Mitchell, PhD, MA

Centers for Disease Control and Prevention, Atlanta, Georgia

Jorge M. Vallery Verlenden, PhD

Centers for Disease Control and Prevention, Atlanta, Georgia

Richard Puddy, PhD, MPH

Centers for Disease Control and Prevention, Atlanta, Georgia

Melissa C. Mercado, PhD, MSc, MA

Centers for Disease Control and Prevention, Atlanta, Georgia

Pierce Nelson

CDC Foundation, Atlanta, Georgia

Craig Thomas, PhD

Centers for Disease Control and Prevention, Atlanta, Georgia

Cynthia Crick

Centers for Disease Control and Prevention, Atlanta, Georgia

Rebecca Leeb, PhD

Centers for Disease Control and Prevention, Atlanta, Georgia

Lucy Rabinowitz

NORC @ the University of Chicago, Bethesda, Maryland

Lily McCutchan

NORC @ the University of Chicago, Bethesda, Maryland

Kanru Xia, PhD

NORC @ the University of Chicago, Bethesda, Maryland

Laura Wagstaff

NORC @ the University of Chicago, Bethesda, Maryland

Miao Feng, PhD

NORC @ the University of Chicago, Bethesda, Maryland

Larisa Caicedo

TMNCorp, Rockville, Maryland

Emily Tolbert

Maryland Department of Health, Baltimore, Maryland

References

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Published

07/01/2021

How to Cite

Burke-Garcia, PhD, MA, A., A. Johnson-Turbes, PhD, E. W. Mitchell, PhD, MA, J. M. Vallery Verlenden, PhD, R. Puddy, PhD, MPH, M. C. Mercado, PhD, MSc, MA, P. Nelson, C. Thomas, PhD, C. Crick, R. Leeb, PhD, L. Rabinowitz, L. McCutchan, K. Xia, PhD, L. Wagstaff, M. Feng, PhD, L. Caicedo, and E. Tolbert. “How Right Now: The Role of Social Determinants of Health As They Relate to Emotional Well-Being Amidst the COVID-19 Pandemic”. Journal of Emergency Management, vol. 19, no. 9, July 2021, pp. 17-62, doi:10.5055/jem.0573.