Association Between Structural Determinants of Health and Posttraumatic Stress Symptoms during the COVID-19 Pandemic

Abstract

Psychological problems, such as post-traumatic stress symptoms (PTSS), are among the most important complications associated with the COVID-19 pandemic in people. Studying the social determinants of health (SDH) and its impact on the populations during the crisis will help governments deal better with health emergencies so that every person can have an equal opportunity to stay healthy. To determine what factors affect PTSS, we conducted a study to investigate the association between structural determinants of health and PTSS during the COVID-19 pandemic. We conducted a cross-sectional study on 370 people referred to a selected laboratory between June and July 2020 in Karaj province, Iran. Post-traumatic stress disorder (PTSD) 8-item inventory was used to evaluate the PTSS and its subscales, including intrusion, avoidance, and hypervigilance in the participants. Overall, 51.2% of participants were male, and 17.3% were positive for the IgM or IgG COVID-19 test. The most common symptoms in these patients were weakness, myalgia, cough, anosmia, and fever. The prevalence of total PTSS, intrusion, avoidance, and hypervigilance symptoms were 7.1%, 25.7%, 41.6%, and 16.2%, respectively. In univariable regression analysis, female gender (p-value=0.01, 95%CI (2.25-0.31)), un-employment (p-value=0.011, 95%CI (0.37-2.81)), having symptoms of COVID-19 disease (p-value=0.000, 95%CI (.82-2.75)), underlying chronic disease, were directly associated with PTSS. Results showed that sex and occupation as structural determinants of health could affect PTSS in the COVID-19 pandemic. However, in the multivariable model, having symptoms of the COVID-19 disease and underlying disease affected PTSS.