Diminished mental well-being in the COVID-19 pandemic: The role of infection risk, social disconnection, and income loss at the individual and neighborhood levels

• Self-reported decline in mental well-being during the pandemic was associated with less social connection. • Residents in neighborhoods with a faster return to physical mobility experienced less decline in mental well-being. • Decline in mental well-being was not independently related to income decline. • Decline in mental well-being was not related to neighborhood-level risk of COVID-19 infection. • Persons of color reported less decline in mental well-being. • Women, younger, and more educated persons reported greater decline in mental well-being. • More online activity was associated with more decline in mental well-being, unless the online activity was with friends and family or for religious services. • Findings are consistent with Durkheimian theory rather than fundamental cause theory. The decline in mental well-being in the early months of the COVID-19 pandemic occurred in the context of risk of infection, diminished social connection, and fear of income loss. However, these interrelated challenges varied in different ways with individual and neighborhood characteristics. This study poses contrasting hypotheses about the potential consequences of these challenges for mental health, drawing on fundamental cause theory and Durkheimian theory, and tests these hypotheses with individual-level data from a survey of Boston residents in the first months of the pandemic and neighborhood-level data from the census and other sources. Faster rates of post-lockdown increase in neighborhood level mobility, not lower infection rates, were associated with less self-reported decline in mental well-being. Persons of color, who reported greater economic impact than White residents, still reported less decline in mental well-being. Women, younger and more educated persons, and those who felt lonelier reported more adverse impact on mental well-being. More online activity was associated with decreased mental well-being, except when online engagement was with friends and family or was part of a religious community. These findings deepen understanding of the Black-White mental health paradox, highlight the importance of patterns of social connection in explaining the pandemic’s psychological effects as predicted by Durkheimian theory, and should inform planning to lessen these effects in future pandemics.