Changes in positive mental health before and after the COVID-19 pandemic and its associated sociodemographic characteristics and COVID-19-related stressors.

We aimed to examine the dynamic changes in positive mental health (PMH) over a period of 12 years between 2012 and 2024, and explore their relationships with sociodemographic characteristics, with additional exploratory analyses of COVID-19-related stressors with PMH in 2024. A total of 894 participants from an established longitudinal cohort with complete PMH before and after the outbreak of the pandemic were analyzed. Generalized linear mixed models and multivariate logistic regression were used to investigate the associations of changes in PMH with sociodemographic characteristics and COVID-19-related stressors. Flourishing PMH decreased from 57.9-62.8% to 49.1-52.4% before and after the pandemic. Changes in flourishing PMH were associated with age, marital status, occupation, and the interactions between age and occupation and age and marital status (P < 0.05). Furthermore, flourishing PMH in 2024 was also associated with employment stressors during the pandemic (P < 0.05). These findings demonstrate changes in flourishing PMH before and after the pandemic, and the inequality in PMH across these identified social determinants. This study suggests the need for comprehensive community mental health strategies that integrate individual, social, and contextual factors to cope with public emergencies like the COVID-19 pandemic.