A new study led by researchers at the Yale School of Public Health suggests that there were more COVID-19 infections in counties that reported high numbers of poor mental health days among residents.The findings add important evidence to justify recent calls for mental health interventions to not only quell the spread of COVID-19, but also improve health outcomes across communities. The study was published in the American Journal of Preventive Medicine.Yale scientists have already found that the COVID -19 crisis has taken a significant toll on the wellbeing of Americans. In fact, according to a recent YSPH study, New York residents reported misusing alcohol at staggering rates in the early months of the pandemic. But relatively few researchers have grappled with the opposite relationship – that is, the potential connection between poor mental health and COVID-19 infections. Even fewer have evaluated this relationship at a state-wide level.That’s where this study comes in, said YSPH Assistant Professor Yusuf Ransome, Dr.PH., who led the research.“We wanted to look at things differently, address the lack of studies with an ecological-level focus and produce evidence to strengthen calls for interventions,” he said.We wanted to look at things differently, address the lack of studies with an ecological-level focus and produce evidence to strengthen calls for interventions.Yusuf RansomeWith survey data from the Behavioral Risk Factor Surveillance System to gauge the extent that adults experienced poor mental health in 2019, the researchers performed statistical analyses and then compared the results with COVID-19 infections from 2020. After controlling for regional variations and socioeconomic vulnerabilities, the researchers even pinpointed the states in which the association was highest: Arizona, Montana and Nevada.These states were surprising, Ransome said. The South was hit particularly hard by the pandemic in 2020, and mental wellbeing has been a public health concern for decades, yet, the association there was not as strong as in the West.Still, the researchers were not able to use the data to say that poor mental health led to COVID-19 infections. But they said that the findings fit what they already knew: Immune systems that are already compromised by the stress of the pandemic and social inequities may also be vulnerable to infection.“We call for policies that strengthen surveillance systems to better capture a range of mental health outcomes in the population, address social inequalities that give rise to poor mental health, and funding to create, sustain, and equitably distribute mental health resources, including wellness care centers across U.S. communities,” Ransome said.