Concerns among Central Texas Residents during COVID-19 Pandemic

Published: May 21, 2021

I'm extremely concerned about my parent's exposure level to COVID because their jobs required them to return back to work (chemical plant and elementary school teacher) and I'm concerned that if we get COVID, we'll be the percentage of people who are not healthy enough to survive it because we are overweight and I occasionally smoke cigarettes every few days (my husband smokes every day) .  

Such concerns were cited repeatedly in a survey conducted by researchers at the University of Texas Health Science Center (UTHealth) School of Public Health in Austin. Between June and July 2020, the first COVID survey was sent to participants via email or text. Respondents who completed the first COVID survey were contacted again during December 2020 to January 2021 to complete the second COVID survey. Last question of both surveys asked respondents to “Please share your greatest concern at this time, or any other thoughts you would like to let us know”. A total of 275 out of 367 individuals (75%) responded to that question in survey 1 and 60% (n=304) of respondents completed that question in survey 2. 

Participants (based on the COVID survey1 data) are predominantly female (83%), Hispanic (57%), with the mean age of 43 years. Over half of the participants have at least one child in the household (62%), 22% of respondents live alone, and 49% reported annual household income (in 2019) of $45,000 or less.  

Figure 1 shows the concerns of COVID 1 and COVID 2 survey respondents.  

The top five concerns for COVID survey 1 (shown in blue) were: 

  1. COVID-19 (44.7%) 
  2. Health (13.8%) & Employment (13.8%) 
  3. Financial (12%) 
  4. Going Back to Normality (9.8%) & Social Interaction (9.8%) 
  5. Childcare (4.7%) & Education (4.7%) 

The top five concerns for COVID survey 2 (shown in orange) were: 

  1. COVID-19 (41.2%) 
  2. Health (19.8%) 
  3. Going Back to Normality (13.7%) 
  4. Financial (13.2%) 
  5. Employment (12.1%) 

graph 1


[Murals on boarded up bars in downtown Austin, Texas, at the start of the COVID pandemic (Tom Pennington/Getty Images)]

COVID-19 was the most cited concern 3 months (June/July 2020) and 9 months (December 2020-January 2021) into the pandemic. To further understand the concerns related to COVID-19, we categorized COVID-19 into subcategories (see Figure 2). The two primary concerns most reported by the cohort in both surveys were getting sick and family safety. These concerns reflected the fact that there was a high number of confirmed cases in Central Texas as well as a high number of daily new cases even 9 months into the pandemic. Lack of collective action was a consistently reported concern by respondents, citing the lack of mask-wearing or incorrect mask-wearing, social distancing, and mass gatherings. Not surprisingly, the vaccine was discussed more by participants in the second survey than the first survey. Early in December 2020, two COVID-19 vaccines, Pfizer-BioNTech and Moderna, were issued Emergency Use Authorization by the Food and Drug Administration, followed by the first batch of distribution in Texas for front-line healthcare workers and residents of long-term care facilities. Later that month vaccine registration opened for people 65 years and older, and for people 16 years and older with a health condition that increases risk of severe COVID-19 illness. However, at that time, the timeline of vaccine distribution to everyone remained unknown. Participants wondered when the vaccine would be available to all, and the uncertainty/hesitancy for getting the vaccine and worry about potential side-effects were brought up in some responses.  

graph 2

Health was the second highest cited concern in both surveys. To obtain a better understanding for health-related concerns, we explored the proportion of responses in the following three aspects: 1) mental health, 2) physical health, and 3) access to healthcare. Mental health was the most reported concern in both surveys (survey 1: 6.9%; survey 2: 8.2%), followed by physical health (survey 1: 3.6%; survey 2: 4.9%), and access to healthcare (survey 1: 1.5%; survey 2: 2.2%). Our results suggest that the pandemic itself and its enormous impact on every aspects of our lives has affected health physically and mentally. Financial assistance could relieve some immediate concerns, while support for coping with stress and anxiety would be beneficial to maintain long-term health. Financial and employment concerns among the cohort reflected the impact of pandemic on all walks of life. Longing for normality and missing in-person social interaction indicated the tiredness of the pandemic circumstance. Apart from the concerns mentioned above, our respondents have raised concerns for vulnerable populations, such as children and elderly. Those without a personal vehicle, unable to drive and dependent on public transportation were concerned about the safety and availability of public transportation. 

We are all reshaping our daily life, getting used to wearing masks outside household, practicing social distancing, and interacting with people virtually most of the time. One participant wrote that “We are all in this together and it sucks and yet spending time with my loved one and having time to cook more has been the positive part of all this.  I've learned to bake sourdough bread and taken online cooking classes.  I've also baked more cookies and cakes (rarely before, and don't eat bread or gluten before) but I started swimming and I think I get more sleep (bc no commute!). My weight has stayed the same so I'm feeling good about it mostly.” Despite the difficulty, struggle, pressure and frustration, people are taking care of each other and trying to stay positive for the future. For a list of resources and COVID-19 related work compiled by the Michael and Susan Dell Center for Healthy Living, please visit:

Written by: Yuzi Zhang, Doctoral student at the UTHealth School of Public Health in Austin