Emotional responses to COVID-19 stressors increase avoidance of health information and access to care

The COVID-19 pandemic, like other crises, has had direct and indirect impacts on people’s lives, many of which have been negative. However, there is little evidence about how COVID-19 affects decision-making. Emotional responses to COVID-19- related stressors, such as local cases and income loss, provide a pathway for these stressors to affect decision-making. In this study, we examine linkages between exposure to COVID-19-related stressors—focusing on temporally specific local case counts and loss of income due to the pandemic—and behaviors for important health decisions with both individual (accessing health care) and societal (accessing information about antimicrobial resistance (AMR)) relevance. In the analysis of two health behaviors that use data from 1) a custom AMR survey and 2) the U.S. Census’s Household Pulse Survey, which asked about accessing healthcare, we find that exposure to COVID-19 stressors significantly increases feelings of hopelessness. Higher levels of hopelessness are associated with an increased probability of avoiding health information about AMR and foregoing or delaying needed medical care. Mediation analysis confirms that hopelessness is an important pathway through which COVID-19-related stressors affect avoidance behaviors. Our results suggest that large- scale crises may diminish action on other important personal and societal health issues facing humanity through emotion-mediated changes in decision-making.