Risk perception and coping mechanisms by gender identity and education level during the COVID-19 syndemic in Spain
Bennett, Matthew (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
López-Jiménez, Tomàs (Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i de Medicina Preventiva i Salut Pública)
Medina-Perucha, Laura (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
León-Gómez, Brenda Biaani (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Berenguera, Anna (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Jacques-Aviñó, Constanza (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)

Date:	2025
Abstract:	It is important to have a detailed understanding of the association between risk perception, coping mechanisms, and mental health outcomes during the COVID-19 syndemic across axes of inequity such as gender identity and education level. We conducted a cross-sectional study among 2,066 adults (≥ 18 years) living in Spain via an online survey from April 8 to May 28, 2021. Anxiety and depression were the main outcomes considered to assess mental health, measured with the Generalized Anxiety Disorder 7 item (GAD-7) and Patient Health Questionnaire 9 item (PHQ-9), respectively. We analyzed the distribution of anxiety and depression levels across risk perception and coping mechanism variables, stratifying by gender identity and education level. Anxiety and depression levels were associated with age in a gradient fashion, with the 18-30 age group reporting the highest anxiety levels in both women (aOR: 3. 11, 95% CI: 1. 57-6. 17) and men (aOR: 4. 92, 1. 90-12. 74). This gradient was maintained especially in individuals with university level studies. For women, higher anxiety levels were associated with perceived risk in meeting up with friends and family (aOR: 1. 73, 1. 12-2. 67) and being out in public (aOR 2. 98, 2. 15-4. 14), whereas men perceived more risk in occupying closed public spaces and using public transportation (e. g. , aOR: 2. 14, 95% CI: 1. 09-4. 22). Connecting with friends and family was the most effective coping mechanism. In general, women reported more effective coping mechanisms than men and findings were strongest in the population with university level studies. Likewise, men with university level studies reported more effective coping mechanisms than men without university level studies. Women and men with university level studies reported higher risk perception and more effective coping mechanisms during the COVID-19 syndemic than individuals without a university level education. These findings reveal possible strategies for primary care and public health agencies to follow to improve mental health outcomes along different axes of inequity, especially in the case of future syndemics and public health crises.
Grants:	Instituto de Salud Carlos III RD16/0007/0001
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Educational level ; Social class ; Health inequities ; Mental health
Published in:	BMC Psychology, Vol. 13 Num. 1 (June 2025) , ISSN 2050-7283

DOI: 10.1186/s40359-025-02611-5
PMID: 40462188

17 p, 905.3 KB

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