Coronavirus disease 2019 (COVID-19) introduced stressors to mental health, including loneliness stemming from social isolation, fear of contracting the disease, economic strain, and uncertainty about the future. We fielded a national survey measuring symptoms of psychological distress and loneliness among US adults in April 2020 and compared results with national data from 2018.

Serious psychological distress was reported by 13.6% of US adults in April 2020 vs 3.9% in 2018. 1 How psychological distress has changed over the course of the coronavirus disease 2019 (COVID-19) pandemic is unknown.

IMPORTANCEThe coronavirus disease 2019 (COVID-19) pandemic has caused major disruptions in the US health care system. OBJECTIVE To estimate frequency of and reasons for reported forgone medical care from March to mid-July 2020 and examine characteristics of US adults who reported forgoing care.

Background: Persons with serious mental illness (SMI) die 10–20 years earlier than the general population; cancer is the second leading cause of death. Differences in cancer screening between SMI and the general population are not well understood. Objectives: To describe receipt of cancer screening among individuals with versus without SMI and to explore clinicians’ perceptions around cancer screening for people with SMI. Methods: Mixed-methods study using 2010–2017 MarketScan commercial insurance administrative claims data and semi-structured clinician interviews. In the quantitative analyses, we used multivariate logistic regression analyses to calculate the likelihood of receiving cervical, breast, colorectal, or prostate cancer screening among people with versus without SMI, defined as schizophrenia or bipolar disorder. We conducted semi-structured interviews with 17 primary care physicians and 15 psychiatrists. Interview transcripts were coded using a hybrid deductive/inductive approach. Results: Relative to those without SMI, individuals with SMI were less likely to receive screening for cervical cancer [adjusted odds ratio (aOR): 0.80; 95% confidence interval (CI): 0.80–0.81], breast cancer (aOR: 0.79; 95% CI: 0.78–0.80), colorectal cancer (aOR: 0.90; 95% CI: 0.89–0.91), and prostate cancer (aOR: 0.85; 95% CI: 0.84–0.87). Clinicians identified 5 themes that may help explain the lower rates of cancer screening in persons with SMI: access to care, available support, prioritization of other issues, communication, and patient concerns. Conclusions: People with SMI were less likely to receive 4 common types of cancer screening. Improving cancer screening rates in the SMI population will likely require a multidisciplinary approach to overcome barriers to screening.

Objectives. To examine how sociodemographic, political, religious, and civic characteristics; trust in science; and fixed versus fluid worldview were associated with evolving public support for social distancing, indoor mask wearing, and contact tracing to control the COVID-19 pandemic. Methods. Surveys were conducted with a nationally representative cohort of US adults in April, July, and November 2020. Results. Support for social distancing among US adults dropped from 89% in April to 79% in July, but then remained stable in November 2020 at 78%. In July and November, more than three quarters of respondents supported mask wearing and nearly as many supported contact tracing. In regression-adjusted models, support differences for social distancing, mask wearing, and contact tracing were most pronounced by age, partisanship, and trust in science. Having a more fluid worldview independently predicted higher support for contact tracing. Conclusions. Ongoing resistance to nonpharmaceutical public health responses among key subgroups challenge transmission control. Public Health Implications. Developing persuasive communication efforts targeting young adults, political conservatives, and those distrusting science should be a critical priority. (Am J Public Health. Published online ahead of print March 18, 2021: e1–e12. https://doi.org/10.2105/AJPH.2020.306148 )