Inequalities in mental and social wellbeing during the COVID-19 pandemic: prospective longitudinal observational study of five UK cohorts

  1. Darío Moreno-Agostino
  2. Helen L. Fisher
  3. Stephani L. Hatch
  4. Craig Morgan
  5. George B. Ploubidis
  6. Jayati Das-Munshi

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Abstract

Background

Research suggests that there have been inequalities in the impact of the COVID-19 pandemic and related non-pharmaceutical interventions on population mental health. We explored these inequalities during the first year of the pandemic using nationally representative cohorts from the UK.

Methods

We analysed data from 26,772 participants from five longitudinal cohorts representing generations born between 1946 and 2000, collected in May 2020, September-October 2020, and February-March 2021 across all five cohorts. We used a multilevel growth curve modelling approach to explore sociodemographic and socioeconomic differences in levels of anxiety and depressive symptomatology, loneliness, and life satisfaction over time.

Results

Younger generations had worse levels of mental and social wellbeing throughout the first year of the pandemic. Whereas these generational inequalities narrowed between the first and last observation periods for life satisfaction (−0.33 [95% CI: −0.51, −0.15]), they became larger for anxiety (0.22 [0.10, 0.33]). Pre-existing generational inequalities in depression and loneliness did not change, but initial depression levels of the youngest cohort were worse than expected if the generational inequalities had not accelerated. Women and those experiencing financial difficulties had worse initial mental and social wellbeing levels than men and those financially living comfortably, respectively, and these gaps did not substantially differ between the first and last observation periods. Inequalities by additional factors are reported.

Conclusions

By March 2021, mental and social wellbeing inequalities persisted in the UK adult population. Pre-existing generational inequalities may have been exacerbated with the pandemic onset. Policies aimed at protecting vulnerable groups are needed.

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  1. ScreenIT

    SciScore for 10.1101/2022.02.07.22270588: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: The COVID-19 Survey was approved by the National Health Service (NHS) Research Ethics Committee, and all participants provided informed consent.
    Consent: The COVID-19 Survey was approved by the National Health Service (NHS) Research Ethics Committee, and all participants provided informed consent.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: Thank you for sharing your data.

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    However, this study has several limitations. First, the tools used to assess anxiety and depressive symptomatology included only core symptoms, thus providing a relevant but relatively limited picture of that symptomatology. Extended assessment tools such as the GAD-7 or the PHQ-9 could not be included due to logistic limitations and to avoid increasing respondent burden. Second, although our study covers an extended period up to March 2021, the reduced number of repeated assessments limits the granularity of the identified trajectories. Therefore, we acknowledge that there may be additional dynamics taking place between the time-points covered in this study.16 Third, although the inclusion of multiple interaction terms allowed the trajectories to vary in both their initial levels and growth parameters by the subgrouping variables under study, this resulted in a substantial reduction of power to assess these differences. Future research may use alternative analytical approaches that allow accounting for multiple intersecting social identities (e.g., ethnicity, gender, sexual orientation) tied to social power developed for their use from an intersectional approach.35–37 It is also important to note that the use of self-reported information to characterise the mental and social wellbeing of participants may have led to the underestimation of emotional difficulties in cases where reporting such experiences may be potentially stigmatised, such as among men.2 Finally, although the...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

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  2. Version published to 10.1101/2022.02.07.22270588 on medRxiv