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ABSTRACT Hispanic/Latino populations experienced disproportionate exposure to depression risk factors during the COVID-19 pandemic. While aggregated data confirm the risks of depressive

symptoms among Hispanic/Latino individuals, little research uses disaggregated data to investigate these risks based on ethnic subgroups. Using the “Understanding the Impact of the Novel

Coronavirus (COVID-19) and Social Distancing on Physical and Psychosocial (Mental) Health and Chronic Diseases” survey, which was distributed nationally between May 13, 2021, and January 9,

2022 (N = 5413), we estimated the prevalence of depressive symptoms among Hispanic/Latino ethnic subgroups during the pandemic. We performed descriptive analysis on a 116-item survey, which

collected disaggregated data from Hispanic/Latino individuals aged ≥ 18 years (n = 1181). About one-third of the participants reported depressive symptoms (31.3%), with those who

self-identified as other Hispanic/Latino/Spanish origin (40.2%) reporting the highest depressive symptom prevalence. Among participants who reported depression treatment before the pandemic,

the highest reports of treatment were among Puerto Rican (81.8%) participants. More than one-third of participants receiving prior depression treatment (38.7%) reported treatment

interference by the pandemic, mostly among Central American individuals (50.0%). This study highlights the need for integrating more disaggregated data into public health approaches which

seek to target population subgroups and reduce racial/ethnic mental health disparities. SIMILAR CONTENT BEING VIEWED BY OTHERS ACCELERATED GLOBAL BURDEN OF DEPRESSIVE DISORDERS DURING THE

COVID-19 PANDEMIC FROM 2019 TO 2021 Article Open access 19 March 2025 INFLUENCE OF THE COVID-19 PANDEMIC ON THE PREVALENCE OF DEPRESSION IN U.S. ADULTS: EVIDENCE FROM NHANES Article Open

access 24 January 2025 IMPACT OF THE COVID-19 PANDEMIC ON YOUNG PEOPLE WITH AND WITHOUT PRE-EXISTING MENTAL HEALTH PROBLEMS Article Open access 14 April 2023 INTRODUCTION The COVID-19

pandemic has increased (and continues to increase) stress in many populations, affecting their mental health. Evidence suggests that pandemics increase the risk of developing mental

disorders and poor mental well-being1. The percentage of United States (US) adults with symptoms of anxiety or depressive disorder increased from 36.4% to 41.5% between August 2020 and

February 20212. In particular, compared to pre-pandemic, the prevalence of depressive symptoms and major depressive disorder has risen since the COVID-19 pandemic began3,4,5. Depression is

one of the most common mental health disorders6. It is characterized by persistently low or depressed mood, decreased interest in pleasurable activities, feelings of guilt or worthlessness,

poor concentration, sleep disturbances, or thoughts of suicide7. Therefore, the rise in depression during the COVID-19 pandemic is a major concern that needs to be further evaluated by

identifying the population subgroups most likely to be affected in a similar situation. The prevalence of depressive symptoms in the US was more than threefold higher during the COVID-19

pandemic compared to before the pandemic4. Moreover, research shows that communities of color have been disproportionately impacted by the COVID-19 pandemic8,9,10. The National Institute of

Mental Health has reported that major life changes, trauma, and stress are significant risk factors for depression11. Given the overall increased rates of depression and its risk factors

since the advent of COVID-19, it is crucial to examine and understand unique experiences among ethnic minority communities, including Hispanic/Latino populations, where risk factors may be

more prevalent and their implications more severe. During the COVID-19 pandemic, Hispanic/Latino populations experienced disproportionate exposure to stressors and COVID-19 risk factors12.

These factors include being essential workers, residing in dense neighborhoods and larger households, and facing difficulties in maintaining optimal social distancing, which increase the

risk of psychological distress and depression13,14,15. The effects of the COVID-19 pandemic have exacerbated several determinants of mental health3, including discrimination, socioeconomic

status (SES), familial relationships, poor housing quality and housing instability, employment, and job insecurity16,17,18. Nearly eight million (18.4%) Hispanic/Latino adults reported

having a mental illness during the early stages of the pandemic in 202019. Moreover, it has been observed that Hispanic/Latino individuals are experiencing greater COVID-19-related stress

when compared to non-Hispanic/Latino White persons9,20. While studies during the pandemic have shown a clear risk of depressive symptoms among Hispanic/Latino individuals, few have examined

this from a Hispanic/Latino ethnic subgroup perspective, which could more clearly identify group differences21,22,23. This current descriptive analysis addresses this research gap by

estimating the prevalence of depressive symptoms among US Hispanic/Latino ethnic subgroups during the COVID-19 pandemic using a nationally distributed survey. Current studies exploring

Hispanic/Latino populations are limited, and become more so by subgroup range and availability24. As such, our aim for this descriptive study, which is exploratory in nature, is to aid in

hypothesis generation. Also, by disaggregating population data, this study provides a more comprehensive understanding of Hispanic/Latino population health and enables the design of more

tailored and specific interventions/recommendations. METHODS The “Understanding the Impact of the Novel Coronavirus (COVID-19) and Social Distancing on Physical and Psychosocial (Mental)

Health and Chronic Diseases” survey was distributed nationally between May 13, 2021, and January 9, 2022, and was cross-sectional in design. Qualtrics LLC was contracted to facilitate

recruitment and distribution of the web-based survey, distributing 10,000 surveys to US-born (i.e., Hispanic/Latino, White, Black, Asian, American Indian/Alaskan Native, Native

Hawaiian/Pacific Islander) and foreign-born (i.e., African, Middle Eastern, Hispanic/Latino, Asian) individuals. Oversampling was applied for low-income and rural adults. The research

support firm, Information Management Services, Inc., cleaned and managed the deidentified survey data. Further information regarding the survey design and implementation has been reported

elsewhere25. The 116-item survey collected data from multiple domains, including but not limited to the impacts of the COVID-19 pandemic, mental health, acculturation, demographic, and

socioeconomic factors. Of the 5938 surveys returned, 5413 (91.16%) were deemed complete and usable for analysis after expert review and fraud detection (Qualtrics and Information Management

Services, Inc.). The Hispanic/Latino subsample of 1181 participants was used for this descriptive study. Descriptives were tabulated from the total Hispanic/Latino survey subsample, and then

by Hispanic/Latino subgroups (i.e., Mexican/Mexican American, Puerto Rican, Cuban/Cuban American, Dominican, Central American, South American, other Hispanic/Latino/Spanish origin group).

Chi-squared tests with _p_-values were used to determine statistically significant differences in the prevalence of depressive symptoms by sociodemographic characteristics (Table 1). Mental

health questions included self-reported general mental health, effects of COVID-19 pandemic on depression treatment (based on self-reported responses of whether there was treatment prior to

and during the pandemic), and Patient Health Questionaire-2 (PHQ-2). PHQ-2 was categorized as either no depressive symptoms or depressive symptoms based on scores of 0 to 2 or 3 to 6,

respectively, for the following two items: whether over the last 2 weeks they experienced (1) “Little interest or pleasure in doing things”; and (2) Feeling down, depressed, or hopeless”.

The following responses were scored accordingly: (1) “not at all” for a score of 0; (2) “several days” for a score of 1; (3) “more than half the days” for a score of 2; and (4) “nearly every

day” for a score of 3. Demographic information included age, gender, and marital status. Socioeconomic status information included educational attainment and employment status.

Acculturation questions included linguistic acculturation based on English speaking proficiency (i.e., none or poor; fairly well; well; very well) and length of stay in the US since first

arrived. COVID-19 vaccination status was also asked. The overall research protocol of the study was reviewed by the National Institutes of Health (NIH) Institutional Review Board (IRB) for

exempt review and was approved on December 23, 2020 (IRB#000308). The NIH—Intramural Research Program IRB—Human Research Protections Program—Office of Human Subjects Research Protections

determined that our protocol did not involve human subjects and was excluded from IRB review. Informed consent was obtained from all subjects who participated in the survey. RESULTS As shown

in Table 1, the Hispanic/Latino sample was primarily Mexican/Mexican American (45.1%), followed by Puerto Rican (16.0%), South American (12.1%), other Hispanic/Latino/Spanish origin (8.9%),

Cuban/Cuban American (7.0%), Dominican (5.7%), and Central American (5.2%) participants. The majority of the participants were women (61.6%), aged 18–35 (49.6%), married (39.6%), had some

college, vocational or technical education (30.9%), were unemployed or nontraditional workers (42.0%), and had a household income of less than $25,000 (24.8%). Most of the sample reported

being in the US for 10 years or more (76.5%) and speak English well/very well (86.9%). When asked about COVID-19 vaccination status, the majority reported being vaccinated (67.1%). Overall,

most of the participants (74.0%) reported good and very good/excellent general mental health (33.4 and 40.6%, respectively). South American (50.4%), Central American (49.2%), and Cuban/Cuban

American (48.8%) participants reported the highest proportions of very good/excellent mental health, followed by other Hispanic/Latino/Spanish origin (40.4%), Mexican/Mexican American

(37.8%), Puerto Rican (37.4%), and Dominican (32.8%) participants. About 7% of the total participants reported poor general mental health, and Mexican/Mexican Americans had the highest

prevalence (8.3%) within individual subgroups. This was followed by Puerto Rican (7.5%), other Hispanic/Latino/Spanish origin (6.7%), South American (5.0%), Central American (4.9%),

Dominican (4.5%), and Cuban/Cuban American (2.4%) participants. More than 31% of the total sample reported depressive symptoms. The subgroup other Hispanic/Latino/Spanish origin had the

highest percentage of depressive symptoms (40.2%) followed by Puerto Rican (34.6%), Mexican/Mexican American (31.6%), Dominican (29.2%), Cuban/Cuban American (28.9%), Central American

(27.9%), and South American (23.1%) participants. Within the total sample, 35.2% reported no depression treatment before the COVID-19 pandemic. The highest reports of no depression treatment

before the pandemic were among Dominican participants (66.7%). This was followed by South American (55.6%), other Hispanic/Latino/Spanish origin (52.9%), Central American (50%), Cuban/Cuban

American (35.7%), Mexican/Mexican American (32.6%), and Puerto Rican (18.2%) participants. In contrast, the highest reports of depression treatment before the COVID-19 pandemic were among

Puerto Rican participants (81.8%), followed by Mexican/Mexican American (67.4%), Cuban/Cuban American (64.3%), Central American (50.0%), other Hispanic/Latino/Spanish origin (47.1%), South

American (44.4%), and Dominican (33.3%) participants. Further, 38.7% of participants reported that COVID-19 interfered with their depression treatment. Central American participants reported

the highest interference (50%), followed by other Hispanic/Latino/Spanish origin (47.1%), Puerto Rican (40.9%), Mexican/Mexican American (40.2%), Dominican (33.3%), Cuban/Cuban American

(28.6%), and South American (22.2%) participants. The majority of participants reported living in the US (acculturation) for 10 years or more (76.5%). Acculturation of 10 years or more was

most prevalent among Mexican/Mexican American (85.5%) and Puerto Rican participants (79.8%). This was followed by Cuban/Cuban American (78.3%), Central American (68.9%), Dominican (65.2%),

other Hispanic/Latino/Spanish origin (63.5%), and South American participants (55.9%). DISCUSSION The COVID-19 pandemic has exacerbated mental health disorder symptoms in the US population,

especially in Hispanic/Latino individuals. However, there is limited information on mental health disorder symptoms among Hispanic/Latino ethnic subgroups to identify and delineate group

differences to enhance tailoring public health messages and interventions. We disaggregated data to conduct descriptive analyses and estimate the prevalence of depressive symptoms among

Hispanic/Latino ethnic subgroups during the COVID-19 pandemic using a sample surveyed from across the US. We found that about one-third of the participants reported experiencing depressive

symptoms. However, only 6.8% of total participants reported poor mental health. This may be indicative of stigma, prejudice, discrimination, mental health perspectives and implicit biases

against individuals who struggle with mental health26. Past research has found that while Hispanic/Latino individuals are at high risk of depression, unmet mental health needs are often

predicated on stigma, which impacts how individuals view themselves and others26,27,28. Therefore, while a tendency towards social desirability bias may have influenced how participants

reported general mental health status, responses to PHQ-2 revealed that there may be a discrepancy in individual perceptions of mental health vs. individual experiences of depressive

symptoms. This has important implications for overall population health when considering the comorbidities of depression, such as diabetes, cancer, and heart disease, which are among the

leading causes of death among the Hispanic/Latino population11,29. Additionally, within the US population, Hispanic/Latino prevalences of distress, anxiety, and depression were among the

highest of any racial/ethnic minority group during the COVID-19 pandemic12,30,31. Subsequently, there is a need for more research using disaggregated data to unravel between- and

within-population subgroup mental health disparities. By specifically exploring how the Hispanic/Latino (sub)population may be disparately exposed to and impacted by depression risk factors,

effective steps can be taken to mitigate such risk factors and more equitably serve the respective subgroups. Among all individual ethnic subgroups, other Hispanic/Latino/Spanish origin and

Puerto Rican participants reported the highest prevalence of depressive symptoms. These findings are consistent with other studies which have found Puerto Ricans to have a higher prevalence

of psychological distress and depression when compared with other Hispanic/Latino ethnic subgroups32,33. This finding highlights the need to create interventions that target increased

depressive symptoms within specific Hispanic/Latino subgroups, as some subgroups might be at higher risks for psychological distress and depression with the advent of large-scale societal

disruptions/stressors such as the pandemic. Furthermore, the prevalence of depressive symptoms among participants of other Hispanic/Latino/Spanish origin, who may have identified as natives

of various countries and/or territories, underscores the importance of data disaggregation and oversampling when exploring health disparities among minority populations. Future studies

should take these considerations into account to create a more holistic understanding of the unique experiences of different Hispanic/Latino ethnic subgroups, and how their needs can be most

effectively met. The highest reports of poor general mental health were observed among Mexican/Mexican American and Puerto Rican participants. Though very limited literature has compared

mental health between Hispanic/Latino subgroups, our finding regarding Mexican/Mexican Americans contrasts with literature that found them to have lower odds of psychiatric disorders than

other Latino subgroups34. On the other hand, South American and Cuban/Cuban Americans had the highest reports of good and very good/excellent general mental health. These results may be

associated with socioeconomic status and related outcomes. The 2020 US Census found that Cubans lived in households with median net worths almost double those of Mexican/Mexican Americans

and Puerto Ricans35. More research should analyze relationships between socioeconomic statuses and related indicators (i.e., educational attainment, employment status, etc.), as well as

their impacts on mental health risk exposure and resource access across Hispanic/Latino subpopulations. More than 1 in 3 Hispanic/Latino individuals who were receiving depression treatment

before the pandemic reported treatment interference due to COVID-19. While Central American individuals reported the highest rates of depression treatment interference, this subpopulation

was followed closely by Puerto Rican and Mexican/Mexican American individuals. These mental health disparities, compounded by the fact that Puerto Rican and Mexican/Mexican American persons

reported the highest rates of depression treatment pre-pandemic36,37,38 as well as the highest rates of poor general mental health, are troubling. The treatment interference among

Hispanic/Latino persons is concerning because mental health treatment has not decreased in the general US population. One study found that between 2015 and 2019, there were widespread

increases in depression across the US, though commensurate increases in treatment were not observed39. However, after the onset of the pandemic in 2021, the Centers for Disease Control and

Prevention (CDC) reported that the percentage of US adults receiving mental health treatment increased from 19.2 to 21.6%40. This implies that the observed increase in treatment occurred

despite COVID-19-related interferences experienced by Hispanic/Latino individuals, highlighting the extent of disparities in mental health and access to treatment. Thus, while treatment for

depressive symptoms may serve as an indicator of healthcare access, it may be a less accurate indicator of mental health burden. For instance, while Cuban participants reported the lowest

rate of poor mental health, they had the third highest prevalence for depression treatment before COVID-19. Conversely, although Dominican participants reported the fourth highest rate of

depressive symptoms during the pandemic, they had the lowest prevalence of depression treatment before COVID-19. These findings emphasize an increased need not only to allocate mental health

resources for the Hispanic/Latino population overall but also to enhance access and outreach efforts targeting more vulnerable subpopulations. The aforementioned findings related to Puerto

Rican and Mexican/Mexican American mental health and treatment utilization (and interference) dovetail with findings related to acculturation. For all the Hispanic/Latino ethnic subgroups in

our study, most participants reported living in the US for more than 10 years. The Mexican/Mexican American and Puerto Rican subgroups had the highest proportions of participants who lived

in the US for more than 10 years. Reports of poor general mental health despite high levels of acculturation align with past research findings indicating that as length of stay in the US

increases, immigrant health decreases41,42,43. Furthermore, while length of stay may increase assimilation and access to resources such as mental health treatment44, past research has found

that underutilization is still common within immigrant communities. Immigrants often face barriers such as stigma, and low linguistic proficiency, and rely more on religious and social

supports instead of more formal mental health treatments38,45,46,47. Previous research has also found that mental health treatment access is limited by higher rates of poverty and lower

rates of insurance among Hispanic/Latino populations compared to non-Hispanic White individuals48. These disparities may have been exacerbated during the pandemic. Therefore, in examining

potential associations between years lived in the US and prevalence of depressive symptoms among Hispanic/Latino ethnic subgroups, future research should consider cultural differences and

stigma that may impact mental health treatment utilization, despite increased assimilation and access to resources over time. Accounting for such considerations in future longitudinal

studies could provide additional insights into depression treatment utilization among Hispanic/Latino subgroups and support the development of more tailored mental health interventions.

Additionally, past research has found that interventions based on Western concepts of mental health conditions can lead to poorer engagement and outcomes among ethnic minorities49,50,51.

Nonetheless, culturally tailored, adaptable mental health interventions are associated with greater symptom improvements among ethnic minority groups49,50,51. In the case of Hispanic/Latino

populations, such adaptations have taken the form of language-matching and training therapists in values such as _respeto_ (obedience to authority) and _familismo_ (the concept that both

nuclear and extended family are central to and more important than the individual)50. While such adaptations have been observed to improve outcomes, further developments in research and

public health interventions should evolve to ensure that the nuanced cultural backgrounds of various ethnic subgroups can be understood and catered to in the pursuit of mental health across

populations ranging from Hispanic/Latino to Asian, African, and beyond52,53. There are some limitations to our study. Though our study is exploratory in nature and provides disaggregated

data on Hispanic/Latino groups to aid in hypothesis-generation, the majority of the participants were Mexican/Mexican American individuals (45.1%). Thus, the results of this study are not

representative or generalizable across all Hispanic/Latino subgroups in the US. Secondly, the ethnic subgroups of South American and Central American participants represent multiple

countries which are not disaggregated within our results, and other ethnic subgroups had very limited survey participants. This highlights a need for oversampling of underrepresented

Hispanic/Latino ethnic subgroups. Finally, the survey was only administered online and in English, potentially hindering participation based on English literacy and access to technology.

CONCLUSION Overall, this study, which relied on disaggregated data, revealed a higher prevalence of depressive symptoms among Hispanic/Latino ethnic subgroups during the COVID-19 pandemic

than might have been deduced from aggregated datasets. Whereas mental health treatment received by US adults increased in general over the course of the pandemic, this study presents

evidence that such treatment was largely interfered with among the Hispanic/Latino population and within more vulnerable ethnic subgroups (e.g., reporting higher prevalence of depressive

symptoms and/or poor general mental health). Considering the study’s findings, further research is warranted to better understand the mental health experiences of respective ethnic subgroups

within the Hispanic/Latino community. This consideration can support more effective examination and execution of culturally protective strategies, health communication, and interventions.

It will be crucial to support not only the general population but also the Hispanic/Latino ethnic subgroups with the resources to mitigate mental health disorder risks and factors that may

lead to depression and its comorbidities. The results of our study can be used to encourage further research on disaggregated Hispanic/Latino ethnic subgroups and increase oversampling of

underrepresented populations in addressing mental health disparities in population subgroups. DATA AVAILABILITY The data are available by making a request through Dr. FW per the new Data

Management and Sharing Agreement plan. ABBREVIATIONS * DF: Degrees of freedom * IRB: Institutional Review Board * NIH: National Institutes of Health * PHQ-2: Patient Health Questionaire-2 *

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https://doi.org/10.1146/annurev-clinpsy-032813-153729 (2014). Article  Google Scholar  Download references ACKNOWLEDGEMENTS ME, JC, DA, KV, FAMI, and FW efforts are supported by the Division

of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health. Opinions and comments expressed in this article belong to the authors

and do not necessarily reflect those of the U.S. Government, Department of Health and Human Services, National Institutes of Health, and National Institute on Minority Health and Health

Disparities. FUNDING This work is supported by the Division of Intramural Research, National Institute on Minority Health and Health Disparities (ZIA MD000015). Opinions and comments

expressed in this article belong to the authors and do not necessarily reflect those of the U.S. Government, Department of Health and Human Services, National Institutes of Health, and

National Institute on Minority Health and Health Disparities. AUTHOR INFORMATION Author notes * These authors contributed equally: Maryam Elhabashy, Jolyna Chiangong, Kevin Villalobos,

Francisco A. Montiel Ishino and David Adzrago. AUTHORS AND AFFILIATIONS * Division of Intramural Research, National Institute on Minority Health and Health Disparities, 11545 Rockville Pike,

Bethesda, MD, USA Maryam Elhabashy, Jolyna Chiangong, Kevin Villalobos, David Adzrago & Faustine Williams * Division of Intramural Research, National Institute of Environmental Health

Sciences, National Institutes of Health, Durham, NC, USA Francisco A. Montiel Ishino Authors * Maryam Elhabashy View author publications You can also search for this author inPubMed Google

Scholar * Jolyna Chiangong View author publications You can also search for this author inPubMed Google Scholar * Kevin Villalobos View author publications You can also search for this

author inPubMed Google Scholar * Francisco A. Montiel Ishino View author publications You can also search for this author inPubMed Google Scholar * David Adzrago View author publications You

can also search for this author inPubMed Google Scholar * Faustine Williams View author publications You can also search for this author inPubMed Google Scholar CONTRIBUTIONS M.E.:

Writing—Original Draft Preparation, Writing—Review and Editing. J.C.: Original Draft Preparation, Writing—Review and Editing. K.V.: Conceptualization and Design, Methodology, Formal

Analysis, Visualization, Writing—Original Draft Preparation, Writing—Review and Editing. F.M.I.: Conceptualization and Design, Methodology, Formal Analysis, Visualization, Writing—Original

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ARTICLE Elhabashy, M., Chiangong, J., Villalobos, K. _et al._ Prevalence of depressive symptoms among Hispanic/Latino ethnic subgroups during the COVID-19 pandemic. _Sci Rep_ 14, 6727

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