Introduction: To slow the spread of COVID-19 in the United States, businesses shutdown in Spring 2020 . Research has indicated the impact on frontlines workers, yet little is known about the impact on those who were not working outside the home or switched to working remotely .

Purpose: The purpose of this report is to identify the financial and healthcare issues and mental health impact of the COVID-19 shutdown on Appalachians by worker categories .

Methods: An online survey was administered from May 8 - June 6 , 2020 to a convenience sample of previous research participants and shared through social media networks, i.e., snowball sampling . Questions investigated mental health, financial and healthcare issues, and employment status . Survey responses were summarized by percentages overall and by working categories .

Results: Of the 751 participants, 276 (42 %) resided in Appalachia . After removing 17 who lost their job due to COVID-19 , 59 (23 %) indicated not working outside the home prior to COVID-19, whereas 111 (43 %) and 89 (34 %) switched to working remotely and continued working outside the home during the shutdown . Respondents were predominately Caucasian and female . Nearly a quarter of participants had lost or reduced income due to the shutdown . Approximately half missed or postponed healthcare appointments . Mental health impacts were similar across the groups, with half of the respondents reporting anxiety due to COVID-19 . Implications: Further research is needed to explore health outcomes associated with missed healthcare appointments during the shutdown . Mental health support may be needed equally by those isolated at home and frontline workers.