Beyond COVID-19: Changes in Mental Health, Hopelessness, and Subjective Social Status Among College Students in Rural Settings

Background Subjective social status (SSS) and hopelessness are linked to anxiety and depression, yet research among undergraduates – particularly considering the COVID-19 pandemic – is limited. This study examined associations among SSS, hopelessness, depression, and anxiety during and after the pandemic.Methods Cross-sectional surveys were conducted at a Southeastern U.S. university in 2021 (N = 1,602) and 2024 (N = 972). Measures included anxiety (GAD-7), depression (PHQ-9), SSS (MacArthur Scale), and hopelessness (Brief-H-Neg). Higher scores indicated greater distress, social status, or hopelessness. Linear regression models assessed associations.Results In 2021, 82.3% reported moderate to severe depression and 63.0% anxiety. By 2024, depression rose slightly (83.0%) and anxiety increased to 70.3%. Mean depression scores increased (p