Investigating the Mental Health Burden of the COVID-19 Pandemic in Two Populations from Different Socioeconomic Levels in São Paulo, Brazil: A Qualitative Analysis

Background: Brazil ranks among the top 10 countries regarding coronavirus disease (COVID-19) infections and deaths, and São Paulo is recognized as a super-spreader city with 85% of transmissions nationwide. The burden of the pandemic in Brazil had a strong territorial influence and was higher in the most vulnerable populations. This study investigated the impact of the pandemic on the mental health of two populations from regions with different socioeconomic levels in São Paulo, Brazil. Methods: A qualitative social-empirical approach was adopted through two focus groups: Group SP1 (upper-middle socioeconomic status) and Group SP2 (low socioeconomic status). The material was analyzed using a thematic analysis. Results: The COVID-19 pandemic profoundly affected the mental health of all participants. Both groups reported heightened levels of fear, anger, anxiety, and stress. However, notable differences were observed. While reports from Group SP1 often linked these emotions to feelings of isolation, loneliness, relationship difficulties, and challenges with work or education, reports from Group SP2 primarily cited concerns about restrictive measures, including their effects on employment, working conditions, and income. On the other hand, it also presented an opportunity for individuals in group SP1 to report improvements in their well-being. Conclusion: Territorial and socioeconomic factors significantly shaped the COVID-19 pandemic’s impact on the mental well-being of São Paulo residents. We encourage community-level investigations to inform local policies that address specific unmet needs within the community.