Social vulnerability, COVID-19 impact, and decision making among adults in a low-resource community.
Julia W Felton, Jill A Rabinowitz, Justin C Strickland, Brion S Maher, Monicia Summers, Kent Key, Jennifer E Johnson, Richard Yi
Author Information
Julia W Felton: Center for Health Policy & Health Services Research, Henry Ford Health, One Ford Place, Detroit, MI 48202, USA. Electronic address: jfelton4@hfhs.org.
Jill A Rabinowitz: Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, 624N. Broadway, Baltimore, MD 21205, USA.
Justin C Strickland: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Dr, Baltimore, MD 21037, USA.
Brion S Maher: Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, 624N. Broadway, Baltimore, MD 21205, USA.
Monicia Summers: Division of Public Health, Michigan State University, 200 East 1st St., Flint, MI 48502, USA.
Kent Key: Division of Public Health, Michigan State University, 200 East 1st St., Flint, MI 48502, USA.
Jennifer E Johnson: Division of Public Health, Michigan State University, 200 East 1st St., Flint, MI 48502, USA.
Richard Yi: Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, 1000 Sunnyside Ave., Lawrence, KS 66045, USA.
Socially vulnerable individuals, including those with greater exposure to adversity and social instability, are at greater risk for a variety of negative outcomes following exposure to public health crises. One hypothesized mechanism linking social vulnerability to poor health outcomes is delay discounting, the behavioral tendency to select smaller immediately available rewards relative to larger delayed rewards. However, little research has examined the impact of real-world disease outbreaks, such as the COVID-19 pandemic, on the relation between social vulnerability and delay discounting. This study examined whether the severity of COVID-19 impact moderated the association between social vulnerability and delay discounting in a diverse sample of 72 human adults (M = 42.4; 69% Black; 87% female) drawn from two low-resource urban areas. Contrary to hypotheses, results indicated that exposure to more severe COVID-19 impacts did not affect decision making among individuals with higher levels of social vulnerability. Conversely, findings suggest that individuals with lower levels of social vulnerability who reported more significant impacts of COVID-19 evidenced a greater tendency to select larger, delayed rewards relative to individuals with greater social vulnerability. Findings suggest the recent pandemic may influence the relation between social vulnerability and behavioral processes underlying health decision-making.
