Self-Reported Anxiety in Spain: A Gendered Approach One Year After the Start of COVID-19 Pandemic

The COVID-19 pandemic has an impact on mental health. However, there is little evidence on how different axes of social inequity influence mental health from a gender perspective and over time. Our aim is to analyze anxiety according to gender identity and other axes of social inequities (migration status, sexual orientation, age, and employment conditions) one year after the start of the COVID-19 pandemic in Spain. We conducted a cross-sectional study among adults living in Spain with an online survey from April 8 to May 28, 2021. The main variable was anxiety measured by Generalized Anxiety Disorder Scale (GAD-7). Sex-stratified multivariate logistic regression models were constructed to assess the association between axes of inequities and anxiety. Our findings (N = 2,053) suggest that women have greater anxiety risk than men (35.2 vs. 28.2%, respectively). We observe in both genders that there is a clear age gradient, with anxiety decreasing as age increases; and that there is an association between worsening employment status and anxiety risk, although there is a difference between women by education level. Additionally, not having Spanish nationality is also associated with greater anxiety risk in women. In men, identifying as non-heterosexual is associated with a higher risk of anxiety. The axes of inequities have different effects according to gender identity. These differences in anxiety risk by population subgroup must be taken into account in order to sensibly and equitably treat the surge in mental health disorders brought on by the COVID-19 pandemic.

Automated summary

The COVID-19 pandemic has had a negative impact on mental health, but there is limited evidence on how different axes of social inequity, particularly from a gender perspective, influence mental health over time. This study aims to analyze the anxiety levels of individuals based on their gender identity and other social inequities one year after the start of the COVID-19 pandemic in Spain. The findings suggest that women have a higher risk of anxiety compared to men, and this risk is influenced by factors such as age, employment conditions, educational level, and nationality. In men, non-heterosexual identity is associated with a higher risk of anxiety. The study highlights the importance of considering the impact of social inequities on mental health in order to provide appropriate and equitable treatment for the increasing mental health disorders caused by the COVID-19 pandemic.