The numerous negative health impacts of COVID-19, which include expected changes to psychiatric illness and physical activity (PA), are disproportionately distributed in the United States. Mental illnesses and physical inactivity are prevalent among U.S. college students. This study examined whether there was a change in minutes of PA and depression scores after a stay-at-home order and examined predictors of these changes. An online survey was sent to all undergraduate and graduate students attending a large, diverse university via an electronic newsletter. The survey requested information about demographic and academic data, cardiorespiratory fitness, and depression symptoms. Paired t-tests and logistic regression were employed. Our sample (n = 194) was predominantly female (73%), young (mean age of 25), not a sexual minority (82%), and had a mean 3.4 GPA. Students reported worse depression scores (p < 0.01) and fewer minutes of PA (p = 0.01) after the stay-at-home order. There was a small but significant (p = 0.04) correlation between changes in total minutes of PA and depression scores. Senior (p = 0.05) and Hispanic (p = 0.03) students were less likely to report worsening depression scores than freshmen and white students, respectively. Asian students were significantly more likely than white students to report decreased PA. This study suggests that COVID-19 and its consequences may be contributing to reduced PA and greater depression symptoms in college students and that sub-groups have been affected differently. Targeted interventions to promote PA and support mental health may bolster the ability for resilience of college students.

Background: Chronic school absenteeism is prevalent among high school students in the United States. Its impacts on academic success and health are cause for concern. One specific area of concern is its relationship to youth substance use; chronic absenteeism is associated with using alcohol, marijuana, tobacco, and other drugs. Despite important findings, absent from the literature is a recent and systematic synthesis of related research. Objective: We aimed to examine the literature to provide a better understanding of the relationship between chronic school absenteeism and the use of alcohol, tobacco, marijuana and other drugs among U.S. high school students. Methods: We conducted an integrative review of existing peer-reviewed literature using key terms in five databases from the education and health sectors. We included English-language, quantitative and qualitative studies published between 1992 and October 2017 and focused on U.S. students in grades 9 through 12 and between ages 13 and 21. We extracted data and study quality measures for included studies. Results: After screening 3,130 articles using titles and abstracts and reviewing 99 full-text articles, 37 met inclusion criteria. Most were cross-sectional, used local-level data, widely varied in sampling, were of limited generalizability, and simultaneously considered school absenteeism and the use of multiple substances. Due to methodological issues, the relationship between chronic absenteeism and substance use is difficult to fully understand. Conclusions: We confirm the connection between school absenteeism and substance use among U.S. youth, highlight a limited understanding of how and why this relationship manifests, and call for absenteeism research that uses longitudinal methods, national data, and clearly articulated methodologies and self-appraised limitations.

Community mitigation strategies could help reduce COVID-19 incidence, but there are few studies that explore associations nationally and by urbanicity. In a national county-level analysis, we examined the probability of being identified as a county with rapidly increasing COVID-19 incidence (rapid riser identification) during the summer of 2020 by implementation of mitigation policies prior to the summer, overall and by urbanicity. We analyzed county-level data on rapid riser identification during June 1–September 30, 2020 and statewide closures and statewide mask mandates starting March 19 (obtained from state government websites). Poisson regression models with robust standard error estimation were used to examine differences in the probability of rapid riser identification by implementation of mitigation policies (P-value< .05); associations were adjusted for county population size. Counties in states that closed for 0–59 days were more likely to become a rapid riser county than those that closed for >59 days, particularly in nonmetropolitan areas. The probability of becoming a rapid riser county was 43% lower among counties that had statewide mask mandates at reopening (adjusted prevalence ratio = 0.57; 95% confidence intervals = 0.51–0.63); when stratified by urbanicity, associations were more pronounced in nonmetropolitan areas. These results underscore the potential value of community mitigation strategies in limiting the COVID-19 spread, especially in nonmetropolitan areas.

Background: Structural stigma in the form of discriminatory laws and policies impacts the mental health of sexual and gender minorities, especially with regard to suicidality. However, this relationship could be moderated by resilience. The past two years has brought anti-SGM legislation, particularly transgender sports bans, at the state level in the United States into focus. This study aims to understand if the relationship between familiarity with transgender sports bans (proposed or enacted) and suicidality was moderated by individual or community resilience. Methods: This was a cross-sectional study of survey data collected from a national sample of 1033 SGM adults in the United States between 28 January and 7 February 2022. Univariate and multivariate moderation analyses were used. Results: In the univariate analyses and the final model, community resilience moderated the relationship between structural stigma and suicidality (p = 0.0002); however, individual resilience did not (p = 0.0664). Conclusion: Interventions to bolster community resilience may attenuate the negative mental health impacts of structural stigma and are warranted, along with concerted efforts to minimize structural stigma in the form of discriminatory laws and policies targeting people who are SGM.

Background: Discriminatory laws and policies are a form of structural stigma that is associated with increased suicidality among sexual and gender minority (SGM) people. Unfortunately, in the United States, there has been an increase in state-level discriminatory laws and policies targeting SGM people in 2021 and 2022, particularly, transgender sports bans. The purpose of this study was to (1) determine if familiarity with transgender sports bans was associated with suicidality among SGM adults; and (2) determine if interpersonal stigma and/or individual stigma mediated this association. Methods: This was a cross-sectional study of data collected from a national sample of 1033 SGM adults in the United States between 28 January and 7 February 2022. Univariate and serial mediator models were used in this analysis. Results: The increased suicidality was associated with familiarity with state-level transgender sports bans among SGM adults (p-value = 0.0150). Even after interpersonal and individual stigma mediated this relationship, the association between suicidality and familiarity with state-level transgender sports bans remained (p-value = 0.0106). Conclusion: State-level transgender sports bans appear to exacerbate existing disparities in mental health, especially for individuals who are familiar with the bans. They directly discriminate against people who are transgender and indirectly stigmatize the broader SGM community.