Powerless and Pressured: Mental Health Vulnerabilities in the Context of Prolonged Blackouts in Cuba

Background: Stable access to electricity is increasingly recognized as a social determinant of health due to its essential role in daily functioning, safety, and access to services. In Cuba, prolonged and recurrent power outages have become a persistent aspect of daily life and may function as chronic stressors with important mental health consequences. Objective: This study examined the association between prolonged power outages, blackout-related functional disruption, and symptoms of depression, anxiety, and stress among adults living in Cuba. Methods: A cross-sectional online survey was conducted between July and November 2025 with 415 Cuban adults. Mental health symptoms were assessed using the Depression, Anxiety, and Stress Scale–21. Blackout exposure was measured using a Power Outage Severity Index, and functional disruption was assessed with an Outage Functional Impact Index. Hierarchical multiple linear regression analyses were performed to evaluate independent and incremental associations beyond sociodemographic factors. Results: Extremely severe levels of depression, anxiety, and stress predominated across the sample. Both blackout severity and functional impact were positively associated with all mental health outcomes. Functional impact emerged as the strongest predictor, explaining substantial additional variance in stress, anxiety, and depression beyond demographic variables and blackout severity. When functional impact was included, associations between outage severity and stress and anxiety were attenuated, remaining significant only for depression. Younger age was associated with higher stress and depression. Conclusions: Prolonged power outages in Cuba are associated with adverse mental health outcomes, particularly when daily functioning is disrupted, highlighting energy instability as a critical public health concern.