All ETDs from UAB

Advisory Committee Chair

Allyson Hall

Advisory Committee Members

Kristine R Hearld

Soumya Niranjian

Jessica H Williams

Document Type


Date of Award


Degree Name by School

Executive Doctor of Science (DSc) School of Health Professions


The COVID-19 pandemic has inflicted profound challenges upon California, exacerbating disparities in care, access, and health outcomes within vulnerable and deprived communities. Especially, this crisis has led to a surge in mental health issues, with anxiety and depression emerging as predominant psychopathologies, and the rates of anxiety and depression are alarmingly high in disadvantaged communities. In California, the strikingly high prevalence of these symptoms at 31.7%, compared to the national average of 32.3%, sounds a critical alarm. Despite empirical investigations into anxiety and depression rates across a range of demographic groups worldwide—such as survivors, healthcare professionals, children, adolescents, and adults—the nuanced relationship between COVID-19 related psychopathologies and Social Determinants of Health (SDoH) at the community level has received limited attention. In addition, recent research underscores that among these factors, it is the dire lack of social connections and heightened sensitivity to distance barriers that stand out as the most pressing concerns. This study bridges this gap by examining the relationship between anxiety, depression, and individual and community-level SDoH indicators, including sensitivity to distance barriers, area deprivation, and social capital. Focusing on COVID-19 vaccine seekers, the research offers vital insights to tailor interventions and policies urgently needed to address the mental health challenges within California’s pandemic context. Multilevel mixed effect logistic regression models revealed that area deprivation did not exhibit a significant association with anxiety and depression psychopathologies. Conversely, a noteworthy finding emerged, indicating that individuals with strong bonding social connections displayed a decreased likelihood of experiencing severe symptoms of anxiety. Additionally, the results aligned consistently with prior studies concerning gender and age group disparities. Furthermore, employing a two-level multinomial logistic regression model unearthed two novel insights. First, individuals receiving a COVID-19 vaccination at a pop-up clinic demonstrated an increased likelihood of experiencing anxiety or moderate symptoms of anxiety and depression, emphasizing the influence of service location. Second, a noteworthy relationship between commute duration and mental health outcomes emerged, underscoring the pivotal role of travel time during times of crisis. The implications of the findings were discussed.

Available for download on Saturday, December 27, 2025