Stress and Distress during the COVID-19 Pandemic: The Role of Neighborhood Context.

Neighborhoods play a central role in health and mental health, particularly during disasters and crises such as the COVID-19 pandemic. We examined changes in psychological distress following the pandemic, and the potential role of neighborhood conditions among 244 residents of New Orleans, Louisiana. Using modified linear regression models, we assessed associations between neighborhood characteristics and change in psychological distress from before to during the pandemic, testing effect modification by sex and social support. While higher density of offsite alcohol outlets (β = 0.89; 95% CI: 0.52, 1.23), assault rate (β = 0.14; 95% CI: 0.03, 0.24), and walkable streets (β = 0.05; 95% CI: 0.02, 0.07) in neighborhoods were associated with an increase in distress, access to neighborhood parks (β = -0.03; 95% CI: -0.05, -0.01), collective efficacy (β = -0.23; 95% CI: -0.35, -0.09), and homicide rate (β = -1.2; 95% CI: -1.8, -0.6) were associated with reduced distress related to the pandemic. These relationships were modified by sex and social support. Findings revealed the important but complicated relationship between psychological distress and neighborhood characteristics. While a deeper understanding of the neighborhoods' role in distress is needed, interventions that target neighborhood environments to ameliorate or prevent the residents' distress may be important not only during crisis situations.