Social support as the protector of mental health during the COVID-19 pandemic: Population-based longitudinal evidence across pre- and post-vaccine phases.

This longitudinal study examined how perceived social and emotional support was associated with symptoms of depression and anxiety during the COVID-19 pandemic in a sample of a general adult population of Wisconsin, before and after the availability of vaccines. Using a statewide population-based longitudinal household cohort data from two critical pandemic phases (January-March 2021 and June-August 2021), a series of regression analyses were performed to explicitly test associations across distinct phases of the pandemic, using generalized estimating equations (GEE), adjusting for age, gender, race and ethnicity, education, and income. Before vaccines were available, participants with inadequate social support significantly had a higher prevalence of symptoms of depression (PR = 2.10; 95% CI = 1.85, 2.38; p<0.001) and anxiety (PR = 1.64; 95% CI = 1.48, 1.83; p < 0.001), compared to those with adequate social support. Although the overall prevalence of depressive and anxiety symptoms decreased over time, the association between social support and mental health was stronger after the vaccines were widely distributed. Longitudinal findings of this study emphasize the critical role social and emotional support plays as a social determinant of common psychiatric symptoms. It highlights that the role of social and emotional support on mental health is not static but rather, it varies over time, in response to changing conditions in the society that are closely tied to public health policies. This study offers implications for population-level preparedness in future public-health emergencies. Future research on both perceived and received social support with longer longitudinal assessments is warranted.