Health Starting Points: Continuity and Change in Physical and Mental Health before and during the Pandemic.

The pandemic has created multiple changes in the lives of Americans with growing and widespread concerns about the implications for the nation's health and well-being. Most empirical examinations of the physical and mental health implications of the pandemic have rested on aggregate comparisons of pre-pandemic and pandemic indicators of health. We contribute to this body of work by considering continuity and change in health and well-being over time. We draw on respondents in a population-based sample with repeated health measures of physical health, depressive symptoms, and anxiety collected prior to the pandemic and subsequently during the pandemic. Using Sankey figures we illustrate their health pathways and as a result highlight the importance of a longitudinal lens on assessments of health. We find the health-starting-points are critical to understanding distribution and levels of physical and emotional health issues during the pandemic.