Abstract
OBJECTIVE: To examine the relationship between the COVID-19 pandemic and the preexisting gender mental health gap in symptoms as well as service utilization. STUDY SETTING AND DESIGN: Using repeated cross-sectional data, the study compares the gender mental health gap between American female and male college students before and after the start of the COVID-19 pandemic. Adjustments are made for preexisting trends. The study constructs an overall index of poor mental health, based on self-reported symptoms and service utilization related to anxiety, depression, and eating disorders. The gender mental health gap is also broken into the gender symptoms gap and the gender service utilization gap; each is analyzed separately by race, ethnicity, and sexuality. DATA SOURCES AND ANALYTIC SAMPLE: The study draws on secondary data from the National College Health Assessment Surveys from fall 2015 to fall 2022 and focuses on young American college students, ages 18-25 years old. PRINCIPAL FINDINGS: The gender mental health gap, measured using the overall index of poor mental health, increased by 15.6% [95% CI: 5.67-25.6]. The gender symptom gap in eating disorders increased by 38.8% [95% CI: 24.4-53.1] and is consistently observed across race, ethnicity, and sexuality, except among non-Hispanic Asian students. Minimal to no long-term significant differences are observed for the gender symptom gap in anxiety and depression. The gender service utilization gap, on the other hand, increased for all illnesses, with slight increases for anxiety and depression. CONCLUSIONS: The COVID-19 pandemic was accompanied by an exacerbation of the already existing rise in eating disorders among female college students. In symptoms of anxiety and depression, the gap between women and men stayed constant during the pandemic. Action is required to understand and address the factors that led to a rise in the symptoms of eating disorders among women.