Tracking the Role of Income Inequality on the Widening of Health Inequities During the COVID-19 Pandemic Among Adolescents Participating in the COMPASS Cohort Study

Before the COVID-19 pandemic, adolescents living in areas with high income inequality, or areas with large gaps between rich and poor, were more likely to have higher depressive and anxiety symptoms, more likely to use marijuana and e-cigarettes, and binge drink, in comparison to those living in areas with low income inequality. During the COVID-19 pandemic, the adverse association between social inequities and health outcomes may have worsened. The pandemic and public health measures disproportionately impacted people across socioeconomic status, racial/ethnic, immigrant, and gender groups. In this proposed investigation, we will study the association between income inequality and adolescent health outcomes, such as depression and anxiety, and substance use, such as cannabis use, cigarette smoking, and alcohol use throughout the pandemic. We hypothesize that health disparities observed before the pandemic will widen from 2019-2022. We will also test whether associations differ across socio-demographic groups. Finally, we will study potential mechanisms involved in which income inequality leads to health outcomes among adolescents.